Baruch Ivcher School of Psychology, Interdisciplinary Center, Herzlia, Israel.
The Gonda Multidisciplinary Center, Bar-Ilan University, Ramat Gan, Israel.
Depress Anxiety. 2018 Dec;35(12):1145-1157. doi: 10.1002/da.22818. Epub 2018 Aug 21.
Exposure to maternal depression bears long-term negative consequences for children's well-being. Yet, no study has tested the joint contribution of maternal and child's hypothalamic pituitary axis and immune systems in mediating the effects of maternal depression on child psychopathology.
We followed a birth cohort over-represented for maternal depression from birth to 10 years (N = 125). At 10 years, mother and child's cortisol (CT) and secretory immunoglobulin A (s-IgA), biomarkers of the stress and immune systems, were assayed, mother-child interaction observed, mothers and children underwent psychiatric diagnosis, and children's externalizing and internalizing symptoms reported.
Depressed mothers had higher CT and s-IgA levels and displayed more negative parenting, characterized by negative affect, intrusion, and criticism. Children of depressed mothers exhibited more Axis-I disorders, higher s-IgA levels, and greater social withdrawal. Structural equation modeling charted four paths by which maternal depression impacted child externalizing and internalizing symptoms: (a) increasing maternal CT, which linked with higher child CT and behavior problems; (b) augmenting maternal and child's immune response, which were associated with child symptoms; (c) enhancing negative parenting that predicted child social withdrawal and symptoms; and (d), via a combined endocrine-immune pathway suppressing symptom formation.
Our findings, the first to test stress and immune biomarkers in depressed mothers and their children in relation to social behavior, describe mechanisms of endocrine synchrony in shaping children's stress response and immunity, advocate the need to follow the long-term effects of maternal depression on children's health throughout life, and highlight maternal depression as an important public health concern.
母亲抑郁会对孩子的幸福感产生长期的负面影响。然而，尚无研究检验过母婴下丘脑-垂体轴和免疫系统在介导母亲抑郁对儿童精神病理学影响方面的共同作用。
我们对一个出生队列进行了随访，该队列中母亲抑郁的比例较高，从出生到 10 岁（N=125）。在 10 岁时，检测了母亲和孩子的皮质醇（CT）和分泌型免疫球蛋白 A（s-IgA），这两种生物标志物分别反映了压力和免疫系统的状况，观察了母婴互动，对母亲和孩子进行了精神病学诊断，并报告了孩子的外在和内在症状。
抑郁的母亲 CT 和 s-IgA 水平较高，表现出更多的消极养育方式，特征是消极情绪、侵犯和批评。抑郁母亲的孩子表现出更多的轴 I 障碍、更高的 s-IgA 水平和更大的社交退缩。结构方程模型描绘了母亲抑郁影响儿童外在和内在症状的四条途径：（a）增加母亲 CT，这与孩子 CT 升高和行为问题有关；（b）增强母婴免疫反应，这与孩子症状有关；（c）增强消极养育，这预示着孩子的社交退缩和症状；以及（d）通过抑制症状形成的内分泌-免疫联合途径。
我们的研究结果首次检验了抑郁母亲及其子女的应激和免疫生物标志物与社会行为之间的关系，描述了内分泌同步在塑造儿童应激反应和免疫反应方面的机制，提倡需要终生关注母亲抑郁对儿童健康的长期影响，并强调母亲抑郁是一个重要的公共卫生问题。
