Abstract
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Background:
Although depression can affect anyone at any time, the first year after the
birth of a child appears to be a time when both parents are more likely to
experience depression. Research has mainly focussed on maternal perinatal or
early depression which has an estimated incidence of 10-15%. Less is known
about early paternal depression or early comorbid depression, where both
parents experience depression. Methods: I conduct a systematic review on the
prevalence of early comorbid parental depression and associated childhood
outcomes. Next, I explore adolescent depression recording in UK primary care,
and trends over time. Finally, I use structural equation modelling to provide
a quantitative analysis of the association between early comorbid parental
depression and adolescent outcomes, focussing on the effects of recurrent
parental depression and internalizing behaviours in childhood. I examine
depression and its intergenerational transmission using data from a large UK
primary care database, The Health Improvement Network (THIN). Results:
Prevalence of early comorbid depression in parents ranged from 0 to 20%.
However, it was not feasible to perform a meta-analysis due to measurement
variation and study quality. I identified only two studies assessing child
outcomes. Diagnoses of adolescent depression and antidepressant prescribing
have increased in recent years despite a temporary drop in 2002-2005. Symptom
recording increased steadily between 1995-2009. I did not find evidence for
an association between early comorbid parental depression and adolescent
depression (OR: 2.02, 95% CI: 0.42-9.67). Early maternal depression does
increase the risk of adolescent depression. The effect is mainly indirect, mediated
by recurrent parental depression (OR: 1.54, 95% CI: 1.26-1.87), as opposed to
direct (OR: 1.06, 95% CI: 0.69-1.63). Childhood internalizing behaviour might
be an early indicator of depression risk. Conclusion: Early parental
depression increases the risk of adolescent depression, but the effect is
strongly mediated by recurrent parental depression.
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