Psychology Department, Macquarie University, Sydney, Australia.
J Affect Disord. 2009 Dec;119(1-3):116-23. doi: 10.1016/j.jad.2009.03.001. Epub 2009 Apr 1.
This prospective study explores the ongoing impact of early and subsequent maternal depression on offspring behaviour in the early school years.
Seventy five mothers recruited into a longitudinal study were assessed for symptoms of depression when their children were 4, 12 and 15 months, 4 years and later when the children were 6-8 years of age. Mothers, fathers, and school teachers were asked to report on children's internalising and externalising behaviour problems.
Exposure to maternal depression during the first postpartum year was related to mother reports of child internalising and externalising problems in the early school years. Although depression in the first year predicted later internalising problems, effects for externalising behaviour problems were mediated by concurrent depression. Relations between concurrent maternal depression and externalising problems were confirmed by teacher ratings. Interestingly, the severity of symptoms at four months was significantly correlated with behaviour problems seven years later.
Attrition over successive study contacts and therefore limited statistical power is acknowledged. Findings may be a conservative estimate of associations between maternal depression and later child behaviour problems. Also, the high prevalence of depressive symptomatology in the population from which the sample was drawn may limit the generalisability of results.
Findings confirm the importance of early identification and treatment for mothers with postnatal depression, given the likelihood of ongoing depression and relations with later child behaviour problems. From a practical point, severity of early symptoms may be a reliable index of those mothers and children at greatest risk.
本前瞻性研究探讨了母亲在产后早期和随后的抑郁对子女在早期学龄期行为的持续影响。
75 名母亲参与了一项纵向研究,在孩子 4、12 和 15 个月、4 岁以及孩子 6-8 岁时评估其抑郁症状。母亲、父亲和学校教师被要求报告孩子的内化和外化行为问题。
产后第一年暴露于母亲抑郁与母亲在早期学龄期报告的孩子内化和外化问题有关。尽管第一年的抑郁预测了后来的内化问题,但对外化行为问题的影响则由同时发生的抑郁所介导。教师评定也证实了母亲同时发生的抑郁与外化问题之间的关系。有趣的是,四个月时的症状严重程度与七年后的行为问题显著相关。
连续研究接触中的流失以及因此有限的统计能力是公认的。研究结果可能是母亲抑郁与后来儿童行为问题之间关联的保守估计。此外,从研究样本所在的人群中,抑郁症状的高患病率可能限制了结果的普遍性。
这些发现证实了对产后抑郁母亲进行早期识别和治疗的重要性,因为持续存在的抑郁与后来的儿童行为问题有关。从实际角度来看,早期症状的严重程度可能是那些母亲和孩子风险最大的可靠指标。