WebMD Medical News
Laura J. Martin, MD
March 15, 2011 -- Children who live with depressed moms are at high risk for depression, but successful treatment of the mother greatly improves the prospects for her child, a study shows.
The study followed 80 depressed mothers and their children over time. It showed that depression symptoms, behavioral problems, and other signs of distress among children tended to correspond with the mothers’ response to treatment.
The women and children were participants in a large trial conducted by the National Institute of Mental Health (NIMH) designed to assess the impact of trying different treatment approaches when initial treatments fail.
“Treatment of depression is trial and error, but many patients give up very early and decide they can’t be helped,” Columbia University professor of epidemiology and psychiatry Myrna M. Weissman, PhD, tells WebMD. “This study showed that improvement is possible even after several unsuccessful tries, and that successful treatment of the parent has a long-lasting impact on the child.”
The study did not included fathers, but Weissman says the findings can probably be extrapolated to depressed dads.
About a third of the children enrolled in the larger NIMH study had a current psychiatric disorder and half had a history of such disorders when their mothers started treatment.
Children were assessed at study entry for psychiatric symptoms as well as behavioral problems and functional issues. They were followed, along with their mothers, throughout the two-year study.
The mothers all had major depression when they entered the study with no history of bipolar disorder or schizophrenia. All were initially treated with the antidepressantCelexa, followed by other drug treatments, behavioral therapy, or a combination of behavioral therapy and drugs if depression symptoms did not improve.
When the mothers responded to treatment within three months, their children were most likely to experience improvements in overall psychosocial functioning both at home and at school for at least a year after maternal remission.
Long-term improvements were also seen in children whose mothers took up to a year to respond to treatments. But the children of mothers who remained depressed over the two-year study showed no improvement in symptoms and an increase in disruptive behaviors.
“Remission of mothers’ depression, regardless of its timing, appears to be related to decreases in problem behaviors and symptoms in their children over the year after remission,” the researchers write in the March 15 issue of the American Journal of Psychiatry.
About 12% of women experience depression in a given year, with about twice as many low-income women reporting symptoms of depression.
In one study of mothers whose children were enrolled in Head Start programs, more than half (52%) reported depressive symptoms. Another study, which screened young mothers at selected community pediatric health centers for depression, found a depression rate of 40%.
Adolescent and child psychiatrist R. Scott Benson, MD, says the newly published findings illustrate the importance of sticking with treatment and trying different approaches when initial depression treatments fail.
“Parents who are depressed need to keep trying to find a treatment that works for them for their own sake and the sake of their children,” he tells WebMD.
Benson, who practices in Pensacola, Fla., says if a treatment is not working in about six weeks, it is time to try something else -- either a different drug or drug combination, behavioral therapy, or a combination of the two.
“Most people can find a treatment that works for them, and they don’t have to suffer for years,” he says.
SOURCES:Wickramaratne, P. American Journal of Psychiatry, published online March 15, 2011.Myrna M. Weissman, PhD, professor of epidemiology and psychiatry, Columbia University and New York State Psychiatric Institute, New York City.R. Scott Benson, MD, adolescent and child psychiatrist, Creekside Psychiatric Center, Pensacola, Fla.News release, American Psychiatric Association.Department of Health and Human Services: “Depression in Head Start Families.”Kahn, R.S. Pediatrics, vol 103: pp 576-581.
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