title: Explaining risk for suicidal ideation in adolescent offspring of mothers with depression.
abstract: BACKGROUND
  It is well-established that offspring of depressed mothers are at increased risk for suicidal ideation. However, pathways involved in the transmission of risk for suicidal ideation from depressed mothers to offspring are poorly understood. The aim of this study was to examine the contribution of potential mediators of this association, including maternal suicide attempt, offspring psychiatric disorder and the parent-child relationship.
  
  
  METHODS
  Data were utilized from a population-based birth cohort (ALSPAC). Three distinct classes of maternal depression symptoms across the first 11 years of the child's life had already been identified (minimal, moderate, chronic-severe). Offspring suicidal ideation was assessed at age 16 years. Data were analysed using structural equation modelling.
  
  
  RESULTS
  There was evidence for increased risk of suicidal ideation in offspring of mothers with chronic-severe depression symptoms compared to offspring of mothers with minimal symptoms (odds ratio 3.04, 95% confidence interval 2.19-4.21). The majority of this association was explained through maternal suicide attempt and offspring psychiatric disorder. There was also evidence for an independent indirect effect via the parent-child relationship in middle childhood. There was no longer evidence of a direct effect of maternal depression on offspring suicidal ideation after accounting for all three mediators. The pattern of results was similar when examining mechanisms for maternal moderate depression symptoms.
  
  
  CONCLUSIONS
  Findings highlight that suicide prevention efforts in offspring of depressed mothers should be particularly targeted at both offspring with a psychiatric disorder and offspring whose mothers have made a suicide attempt. Interventions aimed at improving the parent-child relationship may also be beneficial.
authors: Institute of Psychological Medicine and Clinical Neurosciences,Cardiff University,Cardiff,UK.
authors: G
authors: G
authors: Hammerton
authors: Institute of Psychological Medicine and Clinical Neurosciences,Cardiff University,Cardiff,UK.
authors: S
authors: S
authors: Zammit
authors: Institute of Psychological Medicine and Clinical Neurosciences,Cardiff University,Cardiff,UK.
authors: A
authors: A
authors: Thapar
authors: Institute of Psychological Medicine and Clinical Neurosciences,Cardiff University,Cardiff,UK.
authors: S
authors: S
authors: Collishaw
mesh_terms: D000293:Adolescent; D016241:Child of Impaired Parents / Q000523:psychology*; D015331:Cohort Studies; D003863:Depression; D003866:Depressive Disorder; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008137:Longitudinal Studies; D001523:Mental Disorders / Q000523:psychology; D009035:Mothers; D016017:Odds Ratio; D010287:Parent-Child Relations; D012306:Risk; D012720:Severity of Illness Index; D059020:Suicidal Ideation; D013406:Suicide, Attempted; D006113:United Kingdom
keywords: Adolescence; maternal depression; mechanisms; parent-child relationship; suicidal ideation