Missed opportunities: mental disorder in children of parents with depression.
BACKGROUND
Emerging evidence suggests that early intervention and prevention programmes for mental health problems in the offspring of parents with depression are important. Such programmes are difficult to implement if children with psychiatric disorder are not identified  and are not accessing services, even if their parents are known to primary care.


OBJECTIVE
To investigate service use in children of parents who have recurrent depression, and factors that influence such contact.


METHODS
A total of 333 families  were recruited, mainly through primary health care, in which at least one parent had received treatment for recurrent depression and had a child aged 9-17 years.


METHODS
Psychiatric assessments of parents and children were completed using research diagnostic interviews.  The service-use interview recorded current (in the 3 months prior to interview) and lifetime contact with health, educational, and social services due to concerns about the child's emotions or behaviour.


RESULTS
Only 37% of children who met criteria for psychiatric  disorder were in contact with any service at the time of interview. A third, who were suicidal or self-harming and had a psychiatric disorder at that time, were not in contact with any service. Lack of parental worry predicted lower service use, with higher rates in children with comorbidity  and suicidality.


CONCLUSIONS
Most children with a psychiatric disorder in this high-risk sample were not in contact with services. Improving ease of access to services, increasing parental and professional awareness that mental health problems can cluster in families, and  improving links between adult and child services may help early detection and intervention strategies for the offspring of parents with depression.
Child and Adolescent Psychiatry Section, Institute of PsychologicalMedicine and Clinical Neurosciences, School ofMedicine, Cardiff University, MRC centre for Neuropsychiatric Genetics and Gemonics, Neuroscience and Mental Health Research Institute, Cardiff. potterr@cf.ac.uk
Robert
R
Potter
Becky
B
Mars
Olga
O
Eyre
Sophie
S
Legge
Tamsin
T
Ford
Ruth
R
Sellers
Nicholas
N
Craddock
Frances
F
Rice
Stephan
S
Collishaw
Anita
A
Thapar
Ajay K
AK
Thapar
D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis*; D002648:Child; D016241:Child of Impaired Parents / Q000523:psychology*; D003866:Depressive Disorder; D001068:Feeding and Eating Disorders / Q000175:diagnosis*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D012008:Recurrence; D011795:Surveys and Questionnaires; D055815:Young Adult