Parental depression is among the most consistent risk factors for childhood anxiety and disruptive behavior disorders and for major depression, with more than a two- to three-fold increased risk in offspring of depressed parents compared with controls.

Achieving remission of depression within three months of treatment reduces the likelihood that a mother's depression will influence her children to develop mood disorders, disruptive behavior patterns or other psychiatric problems, according to a study published in JAMA. The children of mothers who remain depressed are more likely to have these types of problems.

Lead author Myrna M. Weissman, PhD, of Columbia University Medical Center and the New York State Psychiatric Institute, New York, presented the findings of the study Tuesday at a JAMA media briefing on women’s health in New York.

Most Common Risk Factor for Childhood Anxiety

Parental depression is among the most consistent risk factors for childhood anxiety and disruptive behavior disorders and for major depression, with more than a two- to three-fold increased risk in offspring of depressed parents compared with controls. These offspring problems often begin before puberty, continue into adolescence and adulthood, and can be transmitted to the next generation.

The long-term affects include impaired social and occupational functioning and increased risk of medical problems. Although early onset major depression is highly familial and has a strong genetic component, such environmental factors as disrupted parent-child attachment and poor parent-child bonding may affect the impact of parental depression on children's symptoms.

Dr. Weissman and colleagues examined whether effective treatment of a mother's depression with medication is associated with reduction of psychopathological symptoms and disorders in their children.

The study included 151 mother-child pairs in eight primary care and 11 psychiatric outpatient clinics who were part of the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial, which was conducted between December 2001 and April 2004. The mothers in the trial were treated with medication for depression. The children, aged 7 to 17 years, were assessed by a team of evaluators not involved in maternal treatment and unaware of maternal outcomes.

Vigorous Treatment for Mothers

The researchers found that after three months of medication treatment there was an overall 11 percent decrease in rates of diagnoses (from 35 percent to 24 percent) in children of mothers in remission vs. an 8 percent increase (from 35 percent to 43 percent) in children of mothers with continuing depression.

Among the offspring who had psychiatric diagnoses at baseline and whose mother's depression remitted, 33 percent of the children's own diagnoses had remitted, whereas only 12 percent of the children of women whose depression remained lost their diagnosis. Of the children who had no psychiatric disorder at baseline, all remained free of psychiatric disorders at the three-month follow-up if the maternal depression remitted, whereas 17 percent of children of mothers who remained depressed had an onset or relapse over this period

"To our knowledge, this is the first published study to document prospectively the relation between remission of a mother's depression and her child's clinical state. These findings are intriguing because they suggest that an environmental influence (i.e., the impact of maternal depression remission) had a measurable impact on the child’s psychopathology," the authors write.

"Our studies suggest that a reduction in stress associated with maternal remission may reverse the long-standing symptoms in children who are likely to be genetically vulnerable, although we have not genotyped the children in the study," they add.

"From a clinical vantage point, our findings suggest that vigorous treatment of depressed mothers to achieve remission is associated with positive outcomes in their children as well, whereas failure to treat depressed mothers may increase the burden of illness in their children. At a time when there are many questions about the appropriate and safe treatment of psychiatric disorders in children, these findings suggest that it is important to provide vigorous treatment to mothers if they are depressed," the researchers conclude.