Children of depressed mothers 1 year after the initiation of maternal treatment: findings from the STAR*D-Child Study.
OBJECTIVE
Maternal depression is a consistent and well-replicated risk factor for child psychopathology. The authors examined the changes in psychiatric symptoms and global functioning in children of depressed women 1 year following the initiation of treatment for maternal major depressive disorder.


METHODS
Participants were 1) 151 women with maternal major depression who were enrolled in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study and 2) their eligible offspring who, along with the mother, participated in the child STAR*D (STAR*D-Child) study (mother-child pairs: N=151). The STAR*D study was a multisite study designed to determine the comparative effectiveness and acceptability of various treatment options for adult outpatients with nonpsychotic major depressive disorder. The STAR*D-Child study examined children of depressed women at baseline and involved periodic follow-ups for 1 year after the initiation of treatment for maternal major depressive disorder to ascertain the following data: 1) whether changes in children's psychiatric symptoms were associated with changes in the severity of maternal depression and 2) whether outcomes differed among the offspring of women who did and did not remit (mother-child pairs with follow-up data: N=123). Children's psychiatric symptoms in the STAR*D-Child study were assessed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL), and maternal depression severity in the STAR*D study was assessed by an independent clinician, using the 17-item Hamilton Depression Rating Scale (HAM-D).


RESULTS
During the year following the initiation of treatment, maternal depression severity and children's psychiatric symptoms continued to decrease over time. Decreases in the number of children's psychiatric symptoms were significantly associated with decreases in maternal depression severity. When children's outcomes were examined separately, a statistically significant decrease in symptoms was evident in the offspring of women who remitted early (i.e., within the first 3 months after the initiation of treatment for maternal depression) or late (i.e., over the 1-year follow-up interval) but not in the offspring of nonremitting women.


CONCLUSIONS
Continued efforts to treat maternal depression until remission is achieved are associated with decreased psychiatric symptoms and improved functioning in the offspring.
Pilowsky
Daniel J
DJ
New York State Psychiatric Institute, Columbia University, Unit 24, 1051 Riverside Dr., New York, NY 10032, USA.
Wickramaratne
Priya
P
Talati
Ardesheer
A
Tang
Min
M
Hughes
Carroll W
CW
Garber
Judy
J
Malloy
Erin
E
King
Cheryl
C
Cerda
Gabrielle
G
Sood
A Bela
AB
Alpert
Jonathan E
JE
Trivedi
Madhukar H
MH
Fava
Maurizio
M
Rush
A John
AJ
Wisniewski
Stephen
S
Weissman
Myrna M
MM
D000293:Adolescent; D000328:Adult; D002648:Child; D016241:Child of Impaired Parents / Q000523:psychology* / Q000706:statistics & numerical data*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome