MD/PhD Program, 3710McMaster University, Hamilton, Ontario, Canada.
Arts & Science Undergraduate Program, 3710McMaster University, Hamilton, Ontario, Canada.
Can J Psychiatry. 2021 Jun;66(6):517-536. doi: 10.1177/0706743720966447. Epub 2020 Oct 16.
Parental psychopathology is a significant risk factor for mental health challenges in offspring, but the nature and magnitude of this link in Indigenous Peoples is not well understood. This systematic review examined the emotional and behavioral functioning of the offspring of Indigenous parents with mental health challenges.
We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and Web of Science from their inceptions until April 2020. Studies were included if they included assessments of emotional, behavioral, or other psychological outcomes in the offspring of Indigenous parents with a mental health challenge.
The 14 studies eligible for review were focused on parental substance misuse ( = 8), maternal internalizing (i.e., depression, anxiety) issues ( = 5), and poor overall parental mental health ( = 4). In 11 studies, parental substance misuse, depression, and/or overall mental health challenges were associated with 2 to 4 times the odds of offspring externalizing and internalizing behaviors as compared to offspring of Indigenous parents without mental health challenges.
The findings suggest higher risks of mental health challenges among offspring of Indigenous parents with psychiatric difficulties than among Indigenous children of parents without similar difficulties. Knowledge of these phenomena would be improved by the use of larger, more representative samples, culturally appropriate measures, and the engagement of Indigenous communities. Future studies should be focused on both risk and resilience mechanisms so that cycles of transmission can be interrupted and resources aimed at detection, prevention, and treatment optimally allocated.
父母的精神病理学是子女心理健康挑战的一个重要风险因素,但在原住民中,这种联系的性质和程度还没有得到很好的理解。本系统评价研究了有心理健康挑战的原住民父母的子女的情绪和行为功能。
我们从各数据库的起始时间到 2020 年 4 月检索了 MEDLINE、EMBASE、PsycINFO、CINAHL 和 Web of Science。如果研究包括对有心理健康挑战的原住民父母的子女进行情绪、行为或其他心理结果评估,则将其纳入研究。
有 14 项研究符合审查条件,这些研究主要关注父母的物质滥用(8 项)、母亲的内化问题(即抑郁、焦虑)(5 项)和整体父母心理健康状况较差(4 项)。在 11 项研究中,与没有心理健康挑战的原住民父母的子女相比,父母的物质滥用、抑郁和/或整体心理健康挑战与子女出现外化和内化行为的几率增加了 2 至 4 倍。
研究结果表明,与没有类似困难的原住民父母的子女相比,有精神疾病的原住民父母的子女出现心理健康挑战的风险更高。使用更大、更具代表性的样本、文化上适当的措施以及原住民社区的参与,将有助于更好地了解这些现象。未来的研究应侧重于风险和恢复力机制,以便中断传播周期,并优化针对检测、预防和治疗的资源分配。