Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Hadyn Ellis Building, Maindy Road, Cardiff, CF24 4HQ, UK.
Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil.
Syst Rev. 2022 Sep 5;11(1):190. doi: 10.1186/s13643-022-02056-6.
Parental depression is associated with a range of mental health conditions and other difficulties in the offspring. Nevertheless, some offspring exposed to parental depression do not develop mental health problems, indicating the presence of protective factors that may buffer parental depression-related risk effects. However, evidence of protective factors that might explain good sustained mental health in offspring of depressed parents is limited and systematic synthesis of these factors is still needed. Therefore, as far as we are aware, this will be the first systematic review that will identify parent, family, child, social, and lifestyle factors associated with mental health resilience in offspring of depressed parents, examine evidence for sex-, developmental stage-, and outcome-specific factors and define mental health resilience in the parental depression context.
This protocol has been developed according to the PRISMA-P guidelines. Electronic searches will be performed for articles published up to 2022 in PsycINFO, Embase, MEDLINE, Web of Science Core Collection, and Cochrane Library. Two reviewers will independently screen titles/abstracts and full-texts against eligibility criteria, extract the data, and assess the overall quality of evidence. Both observational and RCT studies will be eligible for inclusion if they report offspring mental health resilience/outcome and depressive symptoms or depressive disorder in at least one of the parents/caregivers. Risk of bias will be assessed using The Joanna Briggs Institute (JBI) critical appraisal checklists and The Revised Cochrane risk of bias tool for randomised trials (RoB 2). It is expected that studies will be heterogeneous; therefore, meta-analysis will not be attempted. Studies will be systematically retrieved and collated using numerical, graphical, tabular, and narrative summaries and grouped by their design, scope, or overall quality. Further sub-group analyses will be performed to examine sex-, developmental stage-, and outcome-specific protective factors.
The proposed systematic review will be the first to summarise and critically assess quality and strength of evidence of protective factors associated with mental health resilience in offspring of depressed parents. Directions and effect sizes of the protective factors will be discussed as well as differences between the studies, their limitations, and research gaps and future directions. Strengths and limitations of the proposed systematic review will be also discussed. The proposed systematic review findings are expected to help better understand mental health resilience and identify targets for evidence-based prevention and intervention strategies for those in need.
A previous version of this systematic review protocol has been registered in the International Prospective Register of Systematic Reviews (PROSPERO) database ( www.crd.york.ac.uk/PROSPERO , CRD42021229955).
父母的抑郁与子女的一系列心理健康问题和其他困难有关。然而，一些暴露于父母抑郁中的子女并没有发展出心理健康问题，这表明存在保护因素，可能缓冲父母抑郁相关风险的影响。然而，能够解释抑郁父母的子女保持良好持续心理健康的保护因素的证据有限，仍然需要对这些因素进行系统综合。因此，据我们所知，这将是第一项系统综述，旨在确定与抑郁父母的子女心理健康复原力相关的父母、家庭、儿童、社会和生活方式因素，检查性别、发育阶段和结果特异性因素的证据，并定义父母抑郁背景下的心理健康复原力。
本方案根据 PRISMA-P 指南制定。将在 PsycINFO、Embase、MEDLINE、Web of Science 核心合集和 Cochrane 图书馆中对截至 2022 年发表的文章进行电子检索。两名评审员将独立筛选标题/摘要和全文，以符合入选标准，提取数据，并评估整体证据质量。如果至少有一位父母/照顾者报告了子女的心理健康复原力/结果和抑郁症状或抑郁障碍，则将观察性研究和 RCT 研究都纳入。使用 Joanna Briggs 研究所（JBI）的批判性评价检查表和针对随机试验的修订 Cochrane 偏倚风险工具（RoB 2）来评估偏倚风险。预计研究将具有异质性；因此，不会尝试进行荟萃分析。研究将使用数值、图形、表格和叙述性摘要进行系统检索和整理，并按设计、范围或整体质量分组。还将进行进一步的亚组分析，以检查性别、发育阶段和结果特异性保护因素。
拟议的系统综述将是第一个总结和批判性评估与抑郁父母的子女心理健康复原力相关的保护因素的质量和证据强度。还将讨论保护因素的方向和效果大小，以及研究之间的差异、它们的局限性以及研究差距和未来方向。还将讨论拟议的系统综述的优缺点。预计该系统综述的结果将有助于更好地理解心理健康复原力，并为有需要的人确定基于证据的预防和干预策略的目标。
该系统综述的一个先前版本已在国际前瞻性系统评价登记册（PROSPERO）数据库（www.crd.york.ac.uk/PROSPERO，CRD42021229955）中注册。
