Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Gryphon Scientific, Takoma Park, MD, USA.
Prev Sci. 2024 May;25(Suppl 2):272-290. doi: 10.1007/s11121-022-01383-3. Epub 2022 May 31.
Poor parental mental health and stress have been associated with children's mental disorders, including attention-deficit/hyperactivity disorder (ADHD), through social, genetic, and neurobiological pathways. To determine the strength of the associations between parental mental health and child ADHD, we conducted a set of meta-analyses to examine the association of parent mental health indicators (e.g., parental depression, antidepressant usage, antisocial personality disorder, and stress and anxiety) with subsequent ADHD outcomes in children. Eligible ADHD outcomes included diagnosis or symptoms. Fifty-eight articles published from 1980 to 2019 were included. We calculated pooled effect sizes, accounting for each study's conditional variance, separately for test statistics based on ADHD as a dichotomous (e.g., diagnosis or clinical cutoffs) or continuous measurement (e.g., symptoms of ADHD subtypes of inattentiveness and hyperactivity/impulsivity). Parental stress and parental depression were significantly associated with increased risk for ADHD overall and both symptoms and diagnosis. Specifically, maternal stress and anxiety, maternal prenatal stress, maternal depression, maternal post-partum depression, and paternal depression were positively associated with ADHD. In addition, parental depression was associated with symptoms of ADHD inattentive and hyperactive/impulsive subtypes. Parental antisocial personality disorder was also positively associated with ADHD overall and specifically ADHD diagnosis. Prenatal antidepressant usage was associated with ADHD when measured dichotomously only. These findings raise the possibility that prevention strategies promoting parental mental health and addressing parental stress could have the potential for positive long-term impacts on child health, well-being, and behavioral outcomes.
父母的心理健康状况不佳和压力与儿童的精神障碍有关，包括注意力缺陷/多动障碍（ADHD），其涉及社会、遗传和神经生物学途径。为了确定父母心理健康状况与儿童 ADHD 之间的关联强度，我们进行了一系列荟萃分析，以检查父母心理健康状况指标（例如，父母抑郁、使用抗抑郁药、反社会人格障碍以及压力和焦虑）与儿童随后发生 ADHD 结果之间的关联。符合条件的 ADHD 结果包括诊断或症状。纳入了 1980 年至 2019 年发表的 58 篇文章。我们计算了汇总效应大小，分别考虑了基于 ADHD 的测试统计数据的条件方差，这些数据是二分类的（例如，诊断或临床标准）或连续测量的（例如，注意力不集中和多动/冲动亚型的 ADHD 症状）。父母的压力和抑郁与 ADHD 总体以及症状和诊断的风险增加显著相关。具体而言，母亲的压力和焦虑、母亲产前压力、母亲产后抑郁以及父亲的抑郁与 ADHD 呈正相关。此外，父母抑郁与 ADHD 注意力不集中和多动/冲动亚型的症状有关。父母的反社会人格障碍也与 ADHD 总体以及 ADHD 诊断呈正相关。仅在二分类测量时，产前抗抑郁药的使用与 ADHD 相关。这些发现表明，促进父母心理健康和解决父母压力的预防策略可能对儿童的健康、幸福和行为结果产生积极的长期影响。
