Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 185 Cambridge Street, Boston, MA, 02114, USA.
Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, 1493 Cambridge St, Cambridge, MA, 02139, USA.
J Abnorm Child Psychol. 2018 May;46(4):825-837. doi: 10.1007/s10802-017-0323-4.
Child depression is an impairing condition for which psychotherapies have shown modest effects. Parental depression is a risk factor for development of child depression and might also be negatively associated with child depression treatment outcomes. To explore this possibility, we analyzed data from a study in which children were treated for depression after parental depressive symptoms had been assessed at baseline. Among children treated for depression in a randomized controlled trial, we identified 31 who had child- and parent-report pre- and post-treatment data on child symptoms and parent-report of pre-treatment parental depressive symptoms. Children were aged 8-13, 77% boys, and 52% Caucasian, 13% African-American, 6% Latino, and 29% multi-racial. Analyses focused on differences in trajectories of change (across weekly measurements), and post-treatment symptoms among children whose parents did (n = 12) versus did not (n = 19) have elevated depressive symptoms at baseline. Growth curve analyses showed markedly different trajectories of change for the two groups, by both child-report (p = 0.03) and parent-report (p = 0.03) measures: children of parents with less severe depression showed steep symptom declines, but children of parents with more severe depression showed flat trajectories with little change in symptoms over time. ANCOVAs showed lower post-treatment child symptoms for children of parents with less severe depression versus parents with more severe depression (p = 0.05 by child report, p = 0.01 by parent report). Parental depressive symptoms predict child symptom trajectories and poorer child treatment response, and may need to be addressed in treatment.
儿童抑郁症是一种会造成损害的疾病，心理疗法已证明对此有一定疗效。父母的抑郁症是儿童抑郁症发病的一个风险因素，也可能与儿童抑郁症的治疗效果呈负相关。为了探索这种可能性，我们分析了一项研究的数据，该研究在评估基线时父母的抑郁症状后，让儿童接受抑郁症治疗。在一项随机对照试验中接受抑郁症治疗的儿童中，我们确定了 31 名儿童，他们在治疗前和治疗后都有儿童和家长报告的儿童症状以及家长报告的治疗前父母抑郁症状的数据。这些儿童年龄在 8-13 岁之间，77%为男孩，52%为白种人，13%为非裔美国人，6%为拉丁裔，29%为多种族裔。分析集中在（每周测量）变化轨迹的差异和治疗后症状上，比较基线时父母抑郁症状升高的儿童（n=12）和父母抑郁症状不升高的儿童（n=19）。增长曲线分析显示，两组儿童的变化轨迹明显不同，儿童报告（p=0.03）和家长报告（p=0.03）均如此：父母抑郁程度较轻的儿童症状急剧下降，但父母抑郁程度较重的儿童症状随时间推移几乎没有变化，呈平坦轨迹。方差分析显示，父母抑郁程度较轻的儿童治疗后儿童症状较父母抑郁程度较重的儿童低（儿童报告，p=0.05；家长报告，p=0.01）。父母的抑郁症状预测了儿童的症状轨迹和较差的儿童治疗反应，在治疗中可能需要加以解决。
