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儿童精神病理学随父母抑郁症状改善的变化:一项系统综述

Change in child psychopathology with improvement in parental depression: a systematic review.

作者信息

Gunlicks Meredith L, Weissman Myrna M

机构信息

Both of the authors are with the Department of Psychiatry, Columbia University College of Physicians and Surgeons..

Both of the authors are with the Department of Psychiatry, Columbia University College of Physicians and Surgeons.

出版信息

J Am Acad Child Adolesc Psychiatry. 2008 Apr;47(4):379-389. doi: 10.1097/CHI.0b013e3181640805.

Abstract

OBJECTIVE

To systematically review current research evidence of associations between improvement in parents' depression and their children's psychopathology.

METHOD

Relevant studies were identified using PsycINFO (1806-2007) and Medline (1950-2007). The search terms used were "depression," "postpartum depression," "treatment," "mothers," "fathers," "parents," "offspring," "mother child relations," and "father child relations." The reference sections of identified articles were also examined for additional relevant articles. Open and controlled clinical trials and observational studies of depressed parents that also included psychological and behavioral assessments of offspring 18 years of age or younger were included in the review.

RESULTS

Ten studies meeting broad criteria for inclusion were reviewed. These studies varied considerably in sample, treatment, assessment, and analysis. Based on the few studies, there is some evidence of associations between successful treatment of parents' depression and improvement in children's symptoms and functioning, but treatment of postpartum depression may not be sufficient for improving cognitive development, attachment, and temperament in infants and toddlers.

CONCLUSIONS

Due to the public health implications of the findings, further study of the effects of improvement in parental depression on child psychopathology is warranted. These studies need to examine the precise relation between parental and child symptoms, the differential effect of parents' treatment with psychotherapy versus medication, the effect of fathers' as well as mothers' symptomatic improvement on children, and mediators and moderators of the relation between parental improvement and child psychopathology.

摘要

目的

系统回顾关于父母抑郁症状改善与其子女精神病理学之间关联的现有研究证据。

方法

通过心理学文摘数据库(1806 - 2007年)和医学文献数据库(1950 - 2007年)检索相关研究。使用的检索词为“抑郁”“产后抑郁”“治疗”“母亲”“父亲”“父母”“后代”“母婴关系”及“父子关系”。还查阅了已识别文章的参考文献部分以寻找其他相关文章。纳入综述的研究包括对抑郁父母进行的开放和对照临床试验以及观察性研究,这些研究还包括对18岁及以下子女的心理和行为评估。

结果

对十项符合宽泛纳入标准的研究进行了综述。这些研究在样本、治疗、评估和分析方面差异很大。基于这些少量研究,有一些证据表明成功治疗父母的抑郁与改善子女症状及功能之间存在关联,但产后抑郁的治疗可能不足以改善婴幼儿的认知发展、依恋关系和气质。

结论

鉴于这些研究结果对公共卫生的影响,有必要进一步研究父母抑郁症状改善对儿童精神病理学的影响。这些研究需要考察父母症状与子女症状之间的确切关系、父母接受心理治疗与药物治疗的不同效果、父亲和母亲症状改善对子女的影响,以及父母症状改善与儿童精神病理学之间关系的调节因素和中介因素。

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