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Poor mental health common, not definite in offspring of parents with depression

Adolescent mental health issues are common, but not inevitable, among offspring of parents with severe or recurrent depression.

“Depression is common, familial, often recurrent, and one of the world’s leading causes of disability burden. Offspring of parents with depression are at three to four times higher risk of developing a wide range of mental health disorders than are offspring of nondepressed parents, with adverse health, educational and social outcomes, including increased risk of suicide,” Stephan Collishaw, DPhil, of Cardiff University School of Medicine, United Kingdom, and colleagues wrote.

To identify protective factors that predict good mental health among adolescents with a parent with depression, researchers conducted a prospective longitudinal study of offspring of parents with recurrent major depressive disorder. Parents, coparents and offspring were assessed three times across 4 years in a community setting. Adolescents were aged 9 to 17 years at baseline. Full data were available for 262 families.

Twenty percent of the adolescent cohort exhibited sustained good mental health.

Index parent positive expressed emotion (P = .001), coparent support (P < .0001), good quality social relationships (P = .001) self-efficacy (P = .03) and frequent exercise (P = .01) were associated with sustained good mental health.

Frequent exercise predicted “better than expected” mood-related mental health (P = .0004), but not behavioral mental health, whereas index parents’ expression of positive emotions predicted “better than expected” behavioral mental health (P = .01) but not mood-related mental health.

Multiple protective factors were required for adolescents to be free of mental health problems.

“This study highlights the combined role protective factors might have for adolescents at risk of depression as the offspring did better with increasing protective factors present,” Mina Fazel, DM, MRCPsych, of University of Oxford, United Kingdom, wrote in an accompanying editorial. “The children at highest risk of developing depression include those whose parents have a mental illness; those for whom early social, economic, and emotional deprivation has been present; or those who suffer from another chronic illness or disability. New models are therefore needed to deliver not only reactive but proactive and integrated mental health services (be that in primary care or general hospital settings); in child and family-friendly spaces, including schools and local religious and voluntary organizations; and within existing mental health provision.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.