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Pathways to Suicide-Related Behavior in Offspring of Mothers With Depression: The Role of Offspring Psychopathology - 19/04/15

Doi : 10.1016/j.jaac.2015.02.006 
Gemma Hammerton, BSc a, , Stanley Zammit, PhD a, b, Liam Mahedy, PhD a, Rebecca M. Pearson, PhD b, Ruth Sellers, PhD a, Anita Thapar, FRCPsych, PhD a, Stephan Collishaw, PhD a
a Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK 
b Centre for Academic Mental Health, University of Bristol, Bristol, UK 

Correspondence to Gemma Hammerton, Child and Adolescent Psychiatry Section, Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, MRC Centre for Neuropsychiatric Genetics and Genomics, Hadyn Ellis Building, Maindy Road, Cardiff, CF24 4HQ, UK

Abstract

Objective

Offspring of mothers with depression are a high-risk group for the development of suicide-related behavior. These offspring are therefore a priority for preventive interventions; however, pathways contributing to risk, including specific aspects of offspring psychopathology, remain unclear. The aim of this study was to examine whether offspring symptoms of major depressive disorder (MDD), generalized anxiety disorder (GAD), disruptive behavior disorder (DBD), attention-deficit/hyperactivity disorder (ADHD), and alcohol abuse independently mediate the association between maternal depression and offspring suicide-related behavior.

Method

Data were used from a population-based birth cohort, the Avon Longitudinal Study of Parents and Children (ALSPAC). Three distinct classes of depression symptoms across the mothers’ first 11 years of their child’s life were identified (minimal, moderate, chronic-severe). Offspring psychopathology was assessed at age 15 years and suicide-related behavior at age 16 years. Data were analyzed using structural equation modeling.

Results

There was evidence for increased risk of suicidal ideation in offspring of mothers with chronic-severe depression symptoms in comparison to offspring of mothers with minimal symptoms (odds ratio = 3.04, 95% CI = 2.19, 4.21). This association was independently mediated by offspring MDD, GAD, and DBD symptoms. The same mechanisms were found for offspring of mothers with moderate depression symptoms over time. Results were similar for offspring suicide attempt except for additional evidence of an indirect effect through offspring ADHD symptoms.

Conclusion

Findings highlight that suicide prevention efforts in offspring of mothers with depression should not only be targeted at offspring with MDD; it is also important to consider offspring with other forms of psychopathology.

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Key Words : suicide-related behavior, ALSPAC, maternal depression, psychopathology


Plan


 Clinical guidance is available at the end of this article.
 The UK Medical Research Council (MRC) and the Wellcome Trust (grant ref: 092731) and the University of Bristol provide core support for the Avon Longitudinal Study of Parents and Children (ALSPAC). This work has been supported by a PhD stipend from the Neuroscience and Mental Health Interdisciplinary Research Group (NNH-IRG) at Cardiff University. Dr. Collishaw is supported by the Waterloo Foundation. Dr. Pearson is supported by an Elizabeth Blackwell Institute Postdoctoral Fellowship funded by the Wellcome Trust Institutional Award (097822/Z/11/ZR). The funders had no further role in the study design, collection, analysis and interpretation of data, writing of the report, or in the decision to submit the paper for publication.
 Disclosure: Prof. Zammit has received research support from the UK MRC. Dr. Mahedy has received research support from the Economic and Social Research Council (ESRC). Dr. Sellers has received research support from the UK MRC. Prof. Thapar has received research support from the UK MRC. Dr. Collishaw has received research support from the ESRC and the UK MRC. Dr. Pearson and Ms. Hammerton report no biomedical financial interests or potential conflicts of interest.


© 2015  American Academy of Child and Adolescent Psychiatry. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 54 - N° 5

P. 385-393 - mai 2015 Retour au numéro
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