Hewitt Jackson M A, McArthur Brae Anne, Neville Ross D, Park Joanne L, Tough Suzanne, Madigan Sheri
Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.
JAMA Pediatr. 2025 Aug 25. doi: 10.1001/jamapediatrics.2025.2822.
Research has consistently shown links between parent and child depression. The prevailing assumption is that parent depression precedes the onset, persistence, and even exacerbation of child depression. However, it is plausible, albeit infrequently tested, that child depression triggers subsequent parent depression. Clarifying the direction and developmental timing of these associations is critical for designing and advocating for family-centered approaches to pediatric care.
To estimate the longitudinal bidirectional associations between maternal and child depression from middle childhood through emerging adolescence during a period that coincided with the COVID-19 pandemic, and to assess whether these associations are moderated by key sociodemographic factors.
DESIGN, SETTING, AND PARTICIPANTS: This study used data from the All Our Families (Calgary, Alberta, Canada) cohort across multiple waves during and beyond the COVID-19 pandemic when children were aged 10.3 (May 20 to July 15, 2020), 10.9 (March 4 to April 30, 2021), 11.6 (November 22, 2021 to January 17, 2022), and 12.8 (January 16 to July 7, 2024) years. Data were analyzed between March 1 and August 31, 2024, using random-intercept cross-lagged panel models.
Maternal and child report of depressive symptoms.
The Behavior Assessment System for Children for child depression and the Center for Epidemiologic Studies Depression Scale-10 for maternal depression.
The sample included 1801 mother-child dyads (52% boys, 48% girls). Mothers were a mean (SD) 41.6 (4.4) years old at study entry and most had completed postsecondary education (80%), had an annual income more than CAD $100 000 (75%), and were married or in common-law relationships (71.4%). Consistent cross-sectional correlations were observed, reflecting stable between-participant associations for maternal depression and child depression throughout the study period. Within-participant increases in child depression scores at ages 10.3 and 10.9 years were associated with subsequent increases in maternal depression scores at child ages 10.9 (standardized coefficient 0.12; 95% CI, 0.02-0.22) and 11.6 (0.17; 95% CI, 0.07-0.26) years; however, this was not present for maternal depression. These patterns of associations were moderated by household income (difference test for χ212 = 23.0; P = .03) and within-participant increases in child depression were consistently associated with subsequent increases in maternal depression for the higher income group.
Contrary to prevailing assumptions, these findings suggest that children's depression over time may have contributed to worsening maternal depression, rather than the other way around. While these results should be replicated in nonpandemic contexts to confirm their generalizability, they highlight the need for family-centered approaches to mental health care.
研究一直表明父母抑郁与子女抑郁之间存在关联。普遍的假设是父母抑郁先于子女抑郁的发作、持续，甚至加重。然而，虽然很少进行检验，但儿童抑郁引发随后的父母抑郁也是有可能的。明确这些关联的方向和发展时间对于设计和倡导以家庭为中心的儿科护理方法至关重要。
评估在与新冠疫情同时期从中童年到青少年早期母婴抑郁之间的纵向双向关联，并评估这些关联是否受到关键社会人口学因素的调节。
设计、背景和参与者：本研究使用了来自“我们所有家庭”（加拿大艾伯塔省卡尔加里）队列在新冠疫情期间及之后多轮的数据，当时儿童年龄分别为10.3岁（2020年5月20日至7月15日）、10.9岁（2021年3月4日至4月30日）、11.6岁（2021年11月22日至2022年1月17日）和12.8岁（2024年1月16日至7月7日）。在2024年3月1日至8月31日期间使用随机截距交叉滞后面板模型对数据进行分析。
母亲和儿童报告的抑郁症状。
用于评估儿童抑郁的儿童行为评估系统，以及用于评估母亲抑郁的流行病学研究中心抑郁量表 - 10。
样本包括1801对母婴（52%为男孩，48%为女孩）。研究开始时母亲的平均（标准差）年龄为41.6（4.4）岁，大多数人完成了高等教育（80%），年收入超过10万加元（75%），并且已婚或处于同居关系（71.4%）。观察到一致的横断面相关性，反映了在整个研究期间母亲抑郁和儿童抑郁在参与者之间的稳定关联。在10.3岁和10.9岁时儿童抑郁得分的参与者内增加与随后在儿童10.9岁（标准化系数0.12；95%置信区间，0.02 - 0.22）和11.6岁（0.17；95%置信区间，0.07 - 0.26）时母亲抑郁得分的增加相关；然而，母亲抑郁不存在这种情况。这些关联模式受到家庭收入的调节（χ²12的差异检验 = 23.0；P = 0.03），并且在高收入组中，儿童抑郁的参与者内增加始终与随后母亲抑郁的增加相关。
与普遍假设相反，这些发现表明随着时间推移儿童的抑郁可能导致母亲抑郁恶化，而不是相反。虽然这些结果应在非疫情背景下重复以确认其普遍性，但它们突出了以家庭为中心的心理健康护理方法的必要性。
