Korhonen Marie, Luoma Ilona, Salmelin Raili, Tamminen Tuula
Marie Korhonen, M.D., School of Medicine, University of Tampere , Tampere , Finland .
Nord J Psychiatry. 2014 Jul;68(5):323-32. doi: 10.3109/08039488.2013.838804. Epub 2013 Sep 27.
The negative effect of maternal depressive symptoms on child wellbeing has been quite extensively studied. There is, however, debate as to whether it is the timing, the recurrence or the chronicity of maternal depressive symptoms that puts the child's wellbeing at risk.
This study explores the associations between the timing, recurrence and the patterns of maternal depressive symptoms and adolescent psychosocial functioning.
One hundred and ninety-one mothers and 192 adolescents were followed up from the mother's pregnancy to the child's adolescence. Maternal depressive symptoms were screened with the Edinburgh Postnatal Depression Scale prenatally, postnatally, in early and middle childhood, and at adolescence. The adolescents' outcomes were screened using Child Behavior Checklists and Youth Self Reports.
The results indicate that the initial exposure to maternal depressive symptoms at pregnancy is associated with more externalizing problems in adolescence, 2 months postnatally with more internalizing problems, in early childhood with poorer social competence and concurrently with more externalizing problems. Combined analyses indicate that recurrent maternal depressive symptoms best explain adolescents' internalizing problems and the chronic pattern of maternal depressive symptoms externalizing problems. The chronic and intermittent patterns of maternal depressive symptoms best explained adolescents' poorer social competence.
Recurrent or chronic maternal depressive symptoms rather than the timing predict adolescents' psychosocial problems better. The timing, however, may explain the different kinds of problems in adolescence depending on the developmental task at the time of the exposure. The findings should be noted when treating both mothers and children in psychiatric clinics and other health services.
母亲抑郁症状对儿童幸福的负面影响已得到相当广泛的研究。然而,关于是母亲抑郁症状的发生时间、复发情况还是慢性程度会使儿童幸福面临风险,仍存在争议。
本研究探讨母亲抑郁症状的发生时间、复发情况及模式与青少年心理社会功能之间的关联。
对191名母亲和192名青少年从母亲孕期至孩子青春期进行随访。在产前、产后、儿童早期和中期以及青春期,使用爱丁堡产后抑郁量表筛查母亲的抑郁症状。使用儿童行为清单和青少年自评报告筛查青少年的结果。
结果表明,孕期初次暴露于母亲抑郁症状与青少年更多的外化问题相关,产后2个月与更多的内化问题相关,儿童早期与较差的社会能力相关,同时与更多的外化问题相关。综合分析表明,母亲抑郁症状的复发最能解释青少年的内化问题,而母亲抑郁症状的慢性模式则最能解释外化问题。母亲抑郁症状的慢性和间歇性模式最能解释青少年较差的社会能力。
母亲抑郁症状的复发或慢性程度比发生时间更能预测青少年的心理社会问题。然而,发生时间可能会根据暴露时的发育任务解释青少年不同类型的问题。在精神科诊所和其他医疗服务机构对母亲和儿童进行治疗时,应注意这些发现。