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Maternal Postnatal Depression and the Development of Depression in Offspring Up to 16 Years of Age

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Objective

The aim of this study was to determine the developmental risk pathway to depression by 16 years in offspring of postnatally depressed mothers.

Method

This was a prospective longitudinal study of offspring of postnatally depressed and nondepressed mothers; child and family assessments were made from infancy to 16 years. A total of 702 mothers were screened, and probable cases interviewed. In all, 58 depressed mothers (95% of identified cases) and 42 nondepressed controls were recruited. A total of 93% were assessed through to 16-year follow-up. The main study outcome was offspring lifetime clinical depression (major depression episode and dysthymia) by 16 years, assessed via interview at 8, 13, and 16 years. It was analysed in relation to postnatal depression, repeated measures of child vulnerability (insecure infant attachment and lower childhood resilience), and family adversity.

Results

Children of index mothers were more likely than controls to experience depression by 16 years (41.5% versus 12.5%; odds ratio = 4.99; 95% confidence interval = 1.68–14.70). Lower childhood resilience predicted adolescent depression, and insecure infant attachment influenced adolescent depression via lower resilience (model R2 = 31%). Family adversity added further to offspring risk (expanded model R2 = 43%).

Conclusions

Offspring of postnatally depressed mothers are at increased risk for depression by 16 years of age. This may be partially explained by within child vulnerability established in infancy and the early years, and by exposure to family adversity. Routine screening for postnatal depression, and parenting support for postnatally depressed mothers, might reduce offspring developmental risks for clinical depression in childhood and adolescence.

Section snippets

Participants

Mothers (and children) were recruited at 2 months postpartum, and assessments conducted at 18 months, and 5, 8, 13 and 16 years. Initially, a community sample of mothers on postnatal wards of the Cambridge (UK) maternity hospital (N = 702) was screened with the Edinburgh Postnatal Depression Scale21 at 6 weeks postpartum. The response rate was 97%. Mothers were primiparous, aged 18 to 42 years, were cohabiting or married, and had healthy, full-term infants. The Standardized Psychiatric Interview

Results

Mean offspring age was 16.06 years (SD = 0.18 years; range, 15.75–17.00 years). There were minimal differences between index and control groups regarding socioeconomic status (I, II, and III nonmanual35: 61.5% for control versus 67.9% for PND), child gender (male 50% for control vs 47.2% for PND), and current family status (child resident with both biological parents, 87.5% for control versus 73.6% for PND).

Discussion

We report the occurrence of clinical depression in a community sample of adolescents within a prospective longitudinal study that uniquely included direct investigation of interpersonal psychology (mother–infant attachment) and indices of low resilience under social stress. Furthermore, we examined the role of ongoing family adversity to establish the extent to which it added to child risk, and accounted for any association between maternal PND and child disorder.

In line with other studies,11,

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  • Cited by (0)

    The study was supported by grants from the Medical Research Council (G9324094) and the Tedworth Charitable Trust (TED76).

    Disclosure: Drs. Murray, Arteche, Fearon, Halligan, Goodyer, and Cooper report no biomedical financial interests or potential conflicts of interest.

    This article is discussed in an editorial by Dr. David Reiss on page 431.

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