title: Family environment and pediatric major depressive disorder.
abstract: BACKGROUND
  The risks for depression broadly include biological and environmental factors. Furthermore, having a family member suffering from major depression is also likely to have consequences for the family environment. Further research aimed at understanding the effects of having a child with major depression on family interaction patterns is warranted.
  
  
  METHODS
  We studied 31 families with an 8- to 17-year-old child (mean age +/- SD = 12.9 +/- 2.7 years) who met the DSM-IV criteria for major depressive disorder (MDD) and 34 families with no mentally ill children (mean age +/- SD = 12.6 +/- 2.9 years) or parents. Children and their parents were assessed with the K-SADS-PL (Kiddie Schedule for Affective Disorders and Schizophrenia--Present and Lifetime Version) interview. Parents completed the Moos Family Environment Scale (FES) to assess their perceptions of current family functioning. Data were analyzed using the nonparametric Wilcoxon-Mann-Whitney test.
  
  
  RESULTS
  Families of MDD children showed significantly different patterns of family functioning on FES subscales representing relationships and personal growth dimensions. The families with MDD children showed higher levels of conflict (p < 0.001) and lower levels of cohesion (p < 0.001), expressiveness (p = 0.003) and active-recreational orientation (p = 0.02) compared to the families without mentally ill children.
  
  
  CONCLUSIONS
  Families with MDD children show a lower degree of commitment, provide less support to one another, provide less encouragement to express feelings and have more conflicts compared to families with no mentally ill children or parents. Interventions aimed at improving family dynamics may be beneficial to MDD children and their families.
authors.affiliation: Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, Tex., USA.
authors.forename: Kelin M
authors.initials: KM
authors.lastname: Ogburn
authors.forename: Marsal
authors.initials: M
authors.lastname: Sanches
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Williamson
authors.forename: Sheila C
authors.initials: SC
authors.lastname: Caetano
authors.forename: Rene L
authors.initials: RL
authors.lastname: Olvera
authors.forename: Steven
authors.initials: S
authors.lastname: Pliszka
authors.forename: John P
authors.initials: JP
authors.lastname: Hatch
authors.forename: Jair C
authors.initials: JC
authors.lastname: Soares
mesh_terms: D000293:Adolescent; D002648:Child; D003865:Major Depressive Disorder / Q000523:psychology*; D005195:Family Relations; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D016487:Parenting; D012307:Risk Factors; D012931:Social Environment; D018709:Statistics, Nonparametric