Parental Depression and Child Psychopathology: Mechanisms of Risk and Effect of Remission

Depressive disorders are among the most commonly diagnosed psychiatric disorders in adults. Parental major depressive disorder (MDD) is the strongest risk factor for MDD and other psychiatric disorders in children: including depressive, anxiety, and behavioral disorders. Possible mechanisms involved in the transmission of risk include genetic heritability, neuroregulatory mechanisms during development, early-life stress, and psychosocial correlates. The current dissertation examined psychopathology in children of depressed parents with a focus on the psychosocial correlates most commonly examined in this group. The study used a sample of 168 children aged 7-17 with either a mother (N= 82) or father (N= 11) enrolled in a double-blind treatment study combining antidepressants to hasten remission of MDD. Children (including siblings), parents, and co-parents received diagnostic assessments and questionnaires in 6 assessments over 9 months. The first aim was to examine baseline data to determine current and lifetime prevalence rates of psychiatric disorders in children of depressed mothers compared to depressed fathers and to examine previously identified general and specific risk factors in this population. The second aim of this work was to replicate previous research showing that parental remission from depression is associated with improved child outcome. Children of depressed parents had elevated rates of psychopathology, consistent with previous work. Children of depressed mothers had significantly more psychiatric symptoms than children of depressed fathers, although both groups had similar rates of anxiety symptoms. However, the findings with children of depressed fathers were limited by a small sample size. Rates of psychopathology in children of depressed mothers were similar across study sites, despite significant demographic differences. Results also replicated the finding that parental remission from depression is associated with improved child outcome. This study was the first to examine children of remitting parents, compared to non-remitters and relapsers. The key finding among these groups was that children of parents who relapse do not do any better than children of non-remitters. Thus, sustained remission is crucial to outcome. Improvements in parental functioning and the parent-child relationship among remitting parents was found to partially explain children’s improvements.