title: Relative impact of maternal depression and associated risk factors on offspring psychopathology.
abstract: BACKGROUND
  In general, mothers with depression experience more environmental and family risk factors, and lead riskier lifestyles, than mothers who are not depressed.
  
  
  OBJECTIVE
  To test whether the exposure of a child to risk factors associated with mental health adds to the prediction of child psychopathology beyond exposure to maternal depression.
  
  
  METHODS
  In 7429 mother-offspring pairs participating in the Avon Longitudinal Study of Parents and Children in the UK, maternal depression was assessed when the children were aged 1.5 years; multiple risk factor exposures were examined between birth and 2 years of age; and DSM-IV-based externalising and internalising diagnoses were evaluated when the children were 7.5 years of age.
  
  
  RESULTS
  Children of clinically depressed mothers were exposed to more risk factors associated with maternal mental health. Maternal depression increased diagnoses of externalising and internalising disorders, but a substantial portion of these associations was explained by increased risk factor exposure (41% for externalising and 37% for internalising disorders). At the same time, these risk exposures significantly increased the odds of both externalising and internalising diagnoses, over and above the influence of maternal depression.
  
  
  CONCLUSIONS
  Children of clinically depressed mothers are exposed to both maternal psychopathology and risks that are associated with maternal mental health. These results may explain why treating mothers with depression shows beneficial effects for children, but does not completely neutralise the increased risk of psychopathology and impairment.
authors.affiliation: Department of Psychological Science, Birkbeck, University of London, Malet Street; London WC1E 7AX, UK. t.barker@bbk.ac.uk
authors.forename: Edward D
authors.initials: ED
authors.lastname: Barker
authors.forename: William
authors.initials: W
authors.lastname: Copeland
authors.forename: Barbara
authors.initials: B
authors.lastname: Maughan
authors.forename: Sara R
authors.initials: SR
authors.lastname: Jaffee
authors.forename: Rudolf
authors.initials: R
authors.lastname: Uher
mesh_terms: D001007:Anxiety / Q000453:epidemiology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000453:epidemiology*; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology; D016241:Child of Impaired Parents / Q000523:psychology / Q000706:statistics & numerical data*; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004739:England / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007223:Infant; D007389:Internal-External Control; D008297:Male; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D011247:Pregnancy; D011569:Psychiatric Status Rating Scales; D012931:Social Environment; D012944:Social Support; D012959:Socioeconomic Factors; D055815:Young Adult