Columbia University, New York State Psychiatric Institute, NY 10032, USA.
Am J Psychiatry. 2011 Jun;168(6):593-602. doi: 10.1176/appi.ajp.2010.10010032. Epub 2011 Mar 15.
Maternal major depressive disorder is an established risk factor for child psychopathology. The authors previously reported that 1 year after initiation of treatment for maternal depression, children of mothers whose depression remitted had significantly improved functioning and psychiatric symptoms. This study extends these findings by examining changes in psychiatric symptoms, behavioral problems, and functioning among children of depressed mothers during the first year after the mothers' remission from depression.
Children were assessed at baseline and at 3-month intervals with the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version, the Child Behavior Checklist, and the Children's Global Assessment Scale for 1 year after their mothers' remission or for 2 years if the mothers did not remit. The authors compared children of early remitters (0-3 months; N=36), late remitters (3-12 months; N=28), and nonremitters (N=16).
During the postremission year, children of early-remitting mothers showed significant improvement on all outcomes. Externalizing behavioral problems decreased in children of early- and late-remitting mothers but increased in children of nonremitting mothers. Psychiatric symptoms decreased significantly only in children of mothers who remitted, and functioning improved only in children of early-remitting mothers.
Remission of mothers' depression, regardless of its timing, appears to be related to decreases in problem behaviors and symptoms in their children over the year after remission. The favorable effect of mothers' remission on children's functioning was observed only in children of early-remitting mothers.
产妇重度抑郁症是儿童精神病理学的既定风险因素。作者先前报告称,在开始治疗产妇抑郁症后 1 年,其抑郁症缓解的母亲的孩子的功能和精神症状有明显改善。本研究通过检查抑郁母亲缓解后第一年期间儿童的精神症状、行为问题和功能变化,扩展了这些发现。
在基线时和每隔 3 个月时,使用儿童心境障碍和精神分裂症谱系障碍现患和终身检查(Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version)、儿童行为检查表(Child Behavior Checklist)和儿童总体评估量表(Children's Global Assessment Scale)对儿童进行评估,评估时间为母亲缓解后 1 年或母亲未缓解则为 2 年。作者比较了早期缓解者(0-3 个月;N=36)、晚期缓解者(3-12 个月;N=28)和未缓解者(N=16)的儿童。
在缓解后的一年中,早期缓解母亲的孩子在所有结果上均显示出显著改善。早期和晚期缓解母亲的孩子的外化行为问题减少,但未缓解母亲的孩子的行为问题增加。只有缓解母亲的孩子的精神症状显著减少,只有早期缓解母亲的孩子的功能改善。
无论其时间如何,母亲的抑郁缓解似乎与缓解后一年中孩子的问题行为和症状减少有关。仅在早期缓解母亲的孩子中观察到母亲缓解对孩子功能的有利影响。