Abstract
Children of depressed mothers have been shown to express behaviour problems to a greater extent than children of non-depressed mothers. The purpose of this study was to examine the persistence of depressive symptoms in mothers and to evaluate the relative importance of symptoms of postpartum depression (PPD) and concurrent maternal symptoms of depression, on child behaviour at age 12. A birth cohort of 1,707 children and their mothers was followed from 3 months after birth to 12 years after birth. Self-reported symptoms of depression in mothers were assessed at baseline and 12-year follow-up where 893 mothers (52.3 %) and their children participated. The mothers’ reports on the behaviour of their children at age 12 were used. Multivariate analysis was used to assess factors that increased the risk of child behaviour problems. At baseline, 10.4 % scored above the cutoff for symptoms of postpartum depression. At follow up, 18.2 % scored above the cutoff for depressive symptoms. Multivariate analysis showed that ongoing maternal symptoms of depression, as distinct from PPD-symptoms, was the strongest predictor of child behaviour problems at age 12. The gender of the child and socio-demographic factors at baseline were additional factors that affected the risk of behaviour problems in the 12 year old children. Children of mothers who reported symptoms of depression, both postpartum and at follow-up, were at a greater risk of behaviour problems compared to children of women with no depressive symptoms on either occasion. Our findings indicate that recurrent and ongoing maternal depressive symptoms significantly increase the risk of child behaviour problems as reported by mothers, while symptoms of PPD do not seem to result in an increased risk of behaviour problems in 12 year olds. High maternal socio-demographic life stress at childbirth constitutes an important risk factor for later child behaviour problems.
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Munk-Olsen, T., Laursen, T. M., Pedersen, C. B., Mors, O., & Mortensen, P. B. (2006). New parents and mental disorders: a population-based register study. JAMA, 296(21), 2582–2589.
Ascaso Terrén, C., Garcia Esteve, L., Navarro, P., Aguado, J., Ojuel, J., & Tarragona, M. J. (2003). Prevalence of postpartum depression in Spanish mothers: Comparison of estimation by mean of the structured clinical interview for DSM-IV with the Edinburgh Postnatal Depression Scale. Medicina Clínica (Barc), 120(9), 326–329.
Josefsson, A., Berg, G., Nordin, C., & Sydsjö, G. (2001). Prevalence of depressive symptoms in late pregnancy and postpartum. Acta Obstetricia et Gynecologica Scandinavica, 80, 251–255.
Rubertsson, C., Wickberg, B., Gustavsson, P., & Rådestad, I. (2005). Depressive symptoms in early pregnancy, two months and one year postpartum-prevalence and psychosocial risk factors in a national Swedish sample. Archives of Women’s Mental Health, 8, 97–104.
Bloch, M., Daly, R. C., & Rubinow, D. R. (2003). Endocrine factors in the etiology of postpartum depression. Comprehensive Psychiatry, 44(3), 234–246.
Payne, J. L. (2003). The role of estrogen in mood disorders in women. International Review of Psychiatry, 15(3), 280–290.
Halligan, S. L., Murray, L., Martins, C., & Cooper, P. J. (2007). Maternal depression and psychiatric outcomes in adolescent offspring: A 13-year longitudinal study. Journal of Affective Disorders, 97(1–3), 145–154.
Josefsson, A., & Sydsjö, G. (2007). A follow-up study of postpartum depressed women: Recurrent maternal depressive symptoms and child behavior after four years. Archives of Women’s Mental Health, 10(4), 141–145.
Araya, R., Hu, X., Heron, J., Enoch, M. A., Evans, J., Lewis, G., et al. (2009). Effects of stressful life events, maternal depression and 5-HTTLPR genotype on emotional symptoms in pre-adolescent children. American Journal of Medical Genetics Part B, Neuropsychiatric Genetics, 150B(5), 670–682.
Brennan, P. A., Hammen, C., Andersen, M. J., Bor, W., Najman, J. M., & Williams, G. M. (2000). Chronicity, severity, and timing of maternal depressive symptoms: Relationships with child outcomes at age 5. Developmental Psychology, 36(6), 759–766.
Campbell, S. B., Morgan-Lopez, A. A., Cox, M. J., & McLoyd, V. C. (2009). A latent class analysis of maternal depressive symptoms over 12 years and offspring adjustment in adolescence. Journal of Abnormal Psychology, 118(3), 479–493.
Civic, D., & Holt, V. L. (2000). Maternal depressive symptoms and child behavior problems in a nationally representative normal birthweight sample. Maternal and Child Health Journal, 4(4), 215–221.
Fihrer, I., McMahon, C. A., & Taylor, A. J. (2009). The impact of postnatal and concurrent maternal depression on child behaviour during the early school years. Journal of Affective Disorders, 119, 116–123.
Hammen, C., Brennan, P. A., & Shih, J. H. (2004). Family discord and stress predictors of depression and other disorders in adolescent children of depressed and nondepressed women. Journal of the American Academy of Child and Adolescent Psychiatry, 43(8), 994–1002.
Hay, D. F., Pawlby, S., Angold, A., Harold, G. T., & Sharp, D. (2003). Pathways to violence in the children of mothers who were depressed postpartum. Developmental Psychology, 39(6), 1083–1094.
Hay, D. F., Pawlby, S., Waters, C. S., & Sharp, D. (2008). Antepartum and postpartum exposure to maternal depression: Different effects on different adolescent outcomes. Journal of Child Psychology and Psychiatry and Allied Disciplines, 49(10), 1079–1088.
Kim-Cohen, J., Moffitt, T. E., Taylor, A., Pawlby, S. J., & Caspi, A. (2005). Maternal depression and children’s antisocial behavior: Nature and nurture effects. Archives of General Psychiatry, 62(2), 173–181.
Luoma, I., Tamminen, T., Kaukonen, P., Laippala, P., Puura, K., Salmelin, R., et al. (2001). Longitudinal study of maternal depressive symptoms and child well-being. Journal of the American Academy of Child and Adolescent Psychiatry, 40(12), 1367–1374.
Murray, L., Sinclair, D., Cooper, P., Ducournau, P., Turner, P., & Stein, A. (1999). The socioemotional development of 5-year-old children of postnatally depressed mothers. Journal of Child Psychology and Psychiatry, 40(8), 1259–1271.
Goodman, S. H., Rouse, M. H., Conell, A. M., Broth, M. R., Hall, C. M., & Heyward, D. (2011). Maternal depression and child psychopathology: A meta-analytic review. Clinical Child and Family Psychology Review, 14(1), 1–27.
Costello, E. J., Mustillo, S., Erkanli, A., Keeler, G., & Angold, A. (2003). Prevalence and development of psychiatric disorders in childhood and adolescence. Archives of General Psychiatry, 60(8), 837–844.
Angold, A., Erkanli, A., Silberg, J., Eaves, L., & Costello, E. J. (2002). Depression scale scores in 8–17-year-olds: Effects of age and gender. Journal of Child Psychology and Psychiatry, 43(8), 1052–1063.
Barnow, S., Schuckit, M., Smith, T. L., Preuss, U., & Danko, G. (2002). The real relationship between the family density of alcoholism and externalizing symptoms among 146 children. Alcohol and Alcoholism, 37, 383–387.
Preuss, U. W., Schuckit, M. A., Smith, T. L., Barnow, S., & Danko, G. P. (2002). Mood and anxiety symptoms among 140 children from alcoholic and control families. Drug and Alcohol Dependance, 67, 235–242.
Kalff, A. C., Kroes, M., Vles, J. S. H., Hendriksen, J. G. M., Feron, F. J. M., Steyaert, J., et al. (2001). Neighbourhood level and individual level SES effects on child problem behaviour: A multilevel analysis. Journal of Epidemiology and Community Health, 55, 246–250.
Sieh, D. S., Meijer, A. M., Oort, F. J., Visser-Meily, J. M. A., & Van der Leij, D. A. V. (2010). Problem behavior in children of chronically Ill parents: A meta-analysis. Clinical Child and Family Psychology Review, 13, 384–397.
Dekeyser, L., Svedin, C. G., Agnafors, S., & Sydsjö, G. (2011). Self-reported mental health in 12-year-old second-generation immigrant children in Sweden. Nordic Journal of Psychiatry, 65(6), 389–395.
Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. The British Journal of Psychiatry, 150, 782–786.
Berle, J. Ø., Aarre, T. F., Mykletun, A., Dahl, A. A., & Holsten, F. (2003). Screening for postnatal depression. Validation of the Norwegian version of the Edinburgh Postnatal Depression Scale, and assessment of risk factors for postnatal depression. Journal of Affective Disorders, 76(1–3), 151–156.
Nordberg, L., Rydelius, P. A., Nylander, I., Aurelius, G., & Zetterström, R. (1989). Psychomotor and mental development during infancy. Relation to psychosocial conditions and health. Part IV of a longitudinal study of children in a new Stockholm suburb. Acta Paediatrica Scandinavica Supplement, 353, 1–35.
Nettelbladt, P., Hansson, L., Stefansson, C. G., Borgquist, L., & Nordström, G. (1993). Test characteristics of the Hopkins Symptom Check List-25 (HSCL-25) in Sweden, using the Present State Examination (PSE-9) as a caseness criterion. Social Psychiatry and Psychiatric Epidemiology, 28(3), 130–133.
Herva, A., Jokelainen, J., Pouta, A., Veijola, J., Timonen, M., Karvonen, J. T., et al. (2004). Age at menarche and depression at the age of 31 years: Findings from the Northern Finland 1966 Birth Cohort Study. Journal of Psychosomatic Research, 57(4), 359–362.
Strand, B. H., Dalgard, O. S., Tambs, K., & Rognerud, M. (2003). Measuring the mental health status of the Norwegian population: A comparison of the instruments SCL-25, SCL-10, SCL-5 and MHI-5 (SF-36). Nordic Journal of Psychiatry, 57(2), 113–118.
Achenbach, T. M. (1991). Manual for the child behavior checklist/4–18 and 1991 Profile. Burlington, VT: Department of Psychiatry, University of Vermont.
Crijnen, A. A., Achenbach, T. M., & Verhulst, F. C. (1999). Problems reported by parents of children in multiple cultures: The Child Behavior Checklist syndrome constructs. The American Journal of Psychiatry, 156(4), 569–574.
Bohlin, G., & Janols, L. O. (2004). Behavioural problems and psychiatric symptoms in 5–13 year-old Swedish children-a comparison of parent ratings on the FTF (Five to Fifteen) with the ratings on CBCL (Child Behavior Checklist). European Child and Adolescent Psychiatry, 13(Suppl 3), 14–22.
Larsson, B., & Frisk, M. (1999). Social competence and emotional/behaviour problems in 6–16 year-old Swedish school children. European Child and Adolescent Psychiatry, 8(1), 24–33.
Centre for Epidemiology, National Board of Health and Welfare. (2003). The swedish medical birth register. Stockholm, Sweden: A summary of content and quality.
van der Toorn, S. L., Huizink, A. C., Utens, E. M., Verhulst, F. C., Ormel, J., & Ferdinand, R. F. (2010). Maternal depressive symptoms, and not anxiety symptoms, are associated with positive mother-child reporting discrepancies of internalizing problems in children: A report on the TRAILS study. European Child and Adolescent Psychiatry, 19(4), 379–388.
De Los Reyes, A., & Kazdin, A. E. (2005). Informant discrepancies in the assessment of childhood psychopathology: A critical review, theoretical framework, and recommendations for further study. Psychological Bulletin, 131(4), 483–509.
Achenbach, T. M., Howell, C. T., Quay, H. C., & Conners, C. K. (1991). National survey of problems and competencies among four- to sixteen-year-olds: parents’ reports for normative and clinical samples. Monographs of the Society for Research in Child Development, 56(3), 1–131.
Gotlib, I. H., Lewinsohn, P. M., & Seeley, J. R. (1995). Symptoms versus a diagnosis of depression: Differences in psychosocial functioning. Journal of Consulting and Clinical Psychology, 63, 90–100.
The National Board of Health and Welfare. (2010). National guidelines for healthcare and treatment of depression and anxiety conditions 2010—support for organization and management. Edita Västra Aros (In Swedish): Västerås.
Acknowledgment
Thank you to the Swedish Council for Working Life and Social Research for financial support, to Professor emerita Marianne Cederblad for her work with the earlier waves of the study, and to statistician Marie Bladh, MA for statistical advice.
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Agnafors, S., Sydsjö, G., deKeyser, L. et al. Symptoms of Depression Postpartum and 12 years Later-Associations to Child Mental Health at 12 years of Age. Matern Child Health J 17, 405–414 (2013). https://doi.org/10.1007/s10995-012-0985-z
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DOI: https://doi.org/10.1007/s10995-012-0985-z