Parental depression associated with worse school performance by children

Having parents diagnosed with depression during a child's life was associated with worse school performance at age 16 in a new study of children born in Sweden, according to an article published online by JAMA Psychiatry.

Depression is a leading cause of morbidity and disability worldwide with adverse consequences for those affected by depression and their families. Poor school performance is a powerful predictor of future health outcomes and subsequent occupation and income. Therefore, it is relevant to examine student performance for the effect of parental depression.

Brian K. Lee, Ph.D., M.H.S., of the Drexel University School of Public Health, Philadelphia, and coauthors looked at associations of parental depression with child school performance at the end of compulsory education in Sweden at about age 16.

The authors used parental depression diagnoses from inpatient and outpatient records and school grades for all children born from 1984 to 1994 in Sweden. The final analytic sample had more than 1.1 million children and authors examined the associations of parental depression during different time periods including from before a child's birth and any time before the child's final year of compulsory schooling. In the national sample, 33,906 mothers (3 percent) and 23,724 fathers (2.1 percent) had depression before the final year of a child's compulsory education.

The authors report worse school performance was associated with maternal and paternal depression at any time before the final compulsory school year, but the association decreased when adjusting for other factors. In general, both maternal and paternal depression in all periods of a child's life were associated with worse school performance, although paternal depression during the postnatal period did not reach statistical significance. Maternal depression was associated with a larger negative effect on school performance for girls compared with boys, according to the results.

The authors note study limitations that include the underdiagnosis of depression and that authors could not identify if the children were living with birth parents during the duration of the study.

"Our results suggest that diagnoses of parental depression may have a far-reaching effect on child development. Because parental depression may be more amendable to improvement compared with other influences, such as socioeconomic status, it is worth verifying the present results in independent cohorts. If the associations observed are causal, the results strengthen the case even further for intervention and support among children of affected parents," the study concludes.

(JAMA Psychiatry. Published online February 3, 2016. doi:10.1001/jamapsychiatry.2015.2917.

Editor's Note: The work was funded by a grant from the Swedish Research Council. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Editorial: Children of Depressed Parents - A Public Health Opportunity

"The study by Shen et al concludes that 'diagnoses of parental depression may have a far-reaching effect on child development.' We extend that conclusion to state that effective treatment of the diagnosed parents may also have far-reaching effects. The Mental Health Parity and Addiction Equity Act of 2008 and the Patient Protection and Affordable Care Act of 2010 promised to significantly expand access to high-quality intervention for mental health and substance use disorders for the American people. Until the promise of a more personalized understanding of a common disease, such as depression, becomes reality, access to treatments that are vigorous, substantiated and evidence-based is a public health opportunity for improving the lives of both depressed parents and their children," writes Myrna M. Weissman, Ph.D., of Columbia University, New York.