title: Incidence of Mood or Anxiety Disorders in Children of Parents with Multiple Sclerosis.
abstract: Although parental multiple sclerosis (MS) may put children at increased risk for mental health disorders such as anxiety and depression, the incidence and determinants of such disorders have not been examined.
  
  
  
  We carried out a retrospective cohort study in British Columbia, Canada, among children of parents with MS and age-matched children of unaffected parents. Cox regression was used to estimate the association between parental MS and mood or anxiety disorders in children.
  
  
  
  The study included 1028 children of MS parents, 4010 children of unaffected parents, and 25 464 child-years of follow-up (median follow-up of 4 years). Mental health morbidity was more common among MS parents vs. unaffected parents (50.4% vs. 33.1%) and among MS-affected mothers vs. unaffected mothers (54.6% vs. 38.0%, P < 0.001). The incidence of child mood or anxiety disorders was 8.3 and 6.3 per 1000 child-years among children of parents with and without MS respectively. Sex of the MS-affected parent modified the relationship between parental MS and mood or anxiety disorders in children (P = 0.04). Compared with children of unaffected mothers, children of mothers affected by MS had higher rates of mood or anxiety disorders (HR 1.7, 95% CI 1.1, 2.4), whereas children of MS-affected fathers did not (HR 0.5, 95% CI 0.2, 1.7). Adjustment for mental health morbidity in mothers diminished the association between maternal MS and child mood or anxiety disorders.
  
  
  
  Maternal MS is associated with a higher rate of mood or anxiety disorders in children and this association appeared to be mediated by maternal mental health morbidity.
authors.affiliation: School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.|Department of Obstetrics and Gynaecology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Neda
authors.initials: N
authors.lastname: Razaz
authors.affiliation: Centre for Brain Health and Department of Medicine (Division of Neurology), Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.|Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.
authors.forename: Helen
authors.initials: H
authors.lastname: Tremlett
authors.affiliation: Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, University of California, San Francisco, CA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Boyce
authors.affiliation: School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Martin
authors.initials: M
authors.lastname: Guhn
authors.affiliation: Departments of Internal Medicine and Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
authors.forename: Ruth Ann
authors.initials: RA
authors.lastname: Marrie
authors.affiliation: School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.|Department of Obstetrics and Gynaecology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
authors.forename: K S
authors.initials: KS
authors.lastname: Joseph
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000209:etiology*; D001955:British Columbia / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D016241:Child of Impaired Parents / Q000523:psychology*; D002675:Child, Preschool; D003866:Depressive Disorder / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D009103:Multiple Sclerosis / Q000453:epidemiology*; D010290:Parents; D012189:Retrospective Studies; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology
keywords: Child psychiatry; Cohort studies; Maternal Depression; Multiple sclerosis; Pediatric depression; Population-based studies; administrative databases