Timing of parental depression on risk of child depression and poor educational outcomes: a population based routine data cohort study from Born in Wales, UK

AbstractBackgroundMaternal depression is a risk factor for depression in children, though the influence of paternal depression has been less well examined. We examined the association between maternal and paternal depression, and the timing of their depression (before or after the child’s birth) and outcomes for the child including incidence of child depression and poor educational attainment.MethodsA linked routine data cohort study linking General Practitioner(GP), hospital and education records of young people (aged 0 to 30 years) in Wales. Parental and child diagnosis of depression was identified from GP data. Regression analysis examined the association of maternal and paternal depression with time to diagnosis of depression in the child and odds of attaining educational milestones.OutcomesIn adjusted models, the relative risk of offspring developing depression was 1.22 if the mother had depression before the child was born, 1.55 if the mother had depression after the child was born and 1.73 if she had depression both before and after the child was born (chronic depression), compared to those were there was no maternal depression history. For achieving milestones at end of primary school, odds were 0.92, 0.88 and 0.79 respectively. Association of depression in the child was similar if the male living in the household had depression with risk ratios of 1.24 (before), 1.43 (after) and 1.27 (before and after) for child diagnosed depression and 0.85, 0.79 and 0.74 for achieving age 11 milestones.InterpretationChildren who live with a parent who has depression are more likely to develop depression and not achieve educational milestones, compared to children who live with a parent who has a history of depression (but no active depression in child’s lifetime) and compared to those with no depression. This finding suggests that working closely with families where depression (particularly chronic depression) is present in either parent and treating parental depression to remission is likely to have long-term benefits for children’s mental health and educational attainment.FundingThis study had no specific funding. The infrastructure to enable the study was funded by Health Care Research Wales (https://healthandcareresearchwales.org/) which funded; the National Centre for Population Health and Wellbeing Research (https://ncphwr.org.uk/) enabling the involvement of SB, CT, MAR, TK, the National Centre for Mental Health Wales (https://www.ncmh.info/), which supported the involvement of FR, and the Secure Anonymised Information Linkage Database (https://saildatabank.com/)

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Timing of parental depression on risk of child depression and poor educational outcomes: A population based routine data cohort study from Born in Wales, UK

PLoS ONE ◽

10.1371/journal.pone.0258966 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0258966

Author(s):

Sinead Brophy ◽

Charlotte Todd ◽

Muhammad A. Rahman ◽

Natasha Kennedy ◽

Frances Rice

Keyword(s):

Cohort Study ◽

Educational Attainment ◽

Maternal Depression ◽

Routine Data ◽

Parental Depression ◽

Population Based ◽

Chronic Depression ◽

Child Depression ◽

Paternal Depression ◽

Before And After

Background Maternal depression is a risk factor for depression in children, though the influence of paternal depression has been less well examined. We examined the association between maternal and paternal depression, and the timing of their depression (before or after the child’s birth) and outcomes for the child including incidence of child depression and poor educational attainment. Methods A linked routine data cohort study linking General Practitioner(GP), hospital and education records of young people (aged 0 to 30 years) in Wales. Parental and child diagnosis of depression was identified from GP data. Regression analysis examined the association of maternal and paternal depression with time to diagnosis of depression in the child and odds of attaining educational milestones. Outcomes In adjusted models, the relative risk of offspring developing depression was 1.22 if the mother had depression before the child was born, 1.55 if the mother had depression after the child was born and 1.73 if she had depression both before and after the child was born (chronic depression), compared to those were there was no maternal depression history. For achieving milestones at end of primary school, odds were 0.92, 0.88 and 0.79 respectively. Association of depression in the child was similar if the male living in the household had depression with risk ratios of 1.24 (before), 1.43 (after) and 1.27 (before and after) for child diagnosed depression and 0.85, 0.79 and 0.74 for achieving age 11 milestones. Interpretation Children who live with a parent who has depression are more likely to develop depression and not achieve educational milestones, compared to children who live with a parent who has a history of depression (but no active depression in child’s lifetime) and compared to those with no depression. This finding suggests that working closely with families where depression (particularly chronic depression) is present in either parent and treating parental depression to remission is likely to have long-term benefits for children’s mental health and educational attainment.

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Impact of The Daily Mile on children’s physical and mental health, and educational attainment in primary schools: iMprOVE cohort study protocol

BMJ Open ◽

10.1136/bmjopen-2020-045879 ◽

2021 ◽

Vol 11 (5) ◽

pp. e045879

Author(s):

Bina Ram ◽

Anna Chalkley ◽

Esther van Sluijs ◽

Rachel Phillips ◽

Tishya Venkatraman ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Cohort Study ◽

Educational Attainment ◽

Primary School ◽

Primary Schools ◽

Intervention Group ◽

Control Group ◽

Physical And Mental Health ◽

School Year

IntroductionSchool-based active mile initiatives such as The Daily Mile (TDM) are widely promoted to address shortfalls in meeting physical activity recommendations. The iMprOVE Study aims to examine the impact of TDM on children’s physical and mental health and educational attainment throughout primary school.Methods and analysisiMprOVE is a longitudinal quasi-experimental cohort study. We will send a survey to all state-funded primary schools in Greater London to identify participation in TDM. The survey responses will be used for non-random allocation to either the intervention group (Daily Mile schools) or to the control group (non-Daily Mile schools). We aim to recruit 3533 year 1 children (aged 5–6 years) from 77 primary schools and follow them up annually until the end of their primary school years. Data collection taking place at baseline (children in school year 1) and each primary school year thereafter includes device-based measures of moderate-to-vigorous physical activity (MVPA) and questionnaires to measure mental health (Strengths and Difficulties Questionnaire) and educational attainment (ratings from ‘below expected’ to ‘above expected levels’). The primary outcome is the mean change in MVPA minutes from baseline to year 6 during the school day among the intervention group compared with controls. We will use multilevel linear regression models adjusting for sociodemographic data and participation in TDM. The study is powered to detect a 10% (5.5 min) difference between the intervention and control group which would be considered clinically significant.Ethics and disseminationEthics has been approved from Imperial College Research Ethics Committee, reference 20IC6127. Key findings will be disseminated to the public through research networks, social, print and media broadcasts, community engagement opportunities and schools. We will work with policy-makers for direct application and impact of our findings.

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Predictors of persistent maternal depression trajectories in early childhood: results from the EDEN mother–child cohort study in France

Psychological Medicine ◽

10.1017/s003329171500015x ◽

2015 ◽

Vol 45 (9) ◽

pp. 1999-2012 ◽

Cited By ~ 27

Author(s):

J. van der Waerden ◽

C. Galéra ◽

M.-J. Saurel-Cubizolles ◽

A.-L. Sutter-Dallay ◽

M. Melchior ◽

...

Keyword(s):

Mental Health ◽

Risk Factors ◽

Cohort Study ◽

Depressive Symptoms ◽

Maternal Depression ◽

Mental Health Problems ◽

Birth Cohort Study ◽

Preschool Period ◽

Persistent Depression ◽

Associated Risk Factors

BackgroundMaternal depression in the pre- and postpartum period may set women on a course of chronic depressive symptoms. Little is known about predictors of persistently elevated depressive symptoms in mothers from pregnancy onwards. The aims of this study are to determine maternal depression trajectories from pregnancy to the child's fifth birthday and identify associated risk factors.MethodMothers (N = 1807) from the EDEN mother–child birth cohort study based in France (2003–2011) were followed from 24–28 weeks of pregnancy to their child's fifth birthday. Maternal depression trajectories were determined with a semi-parametric group-based modelling strategy. Sociodemographic, psychosocial and psychiatric predictors were explored for their association with trajectory class membership.ResultsFive trajectories of maternal symptoms of depression from pregnancy onwards were identified: no symptoms (60.2%); persistent intermediate-level depressive symptoms (25.2%); persistent high depressive symptoms (5.0%); high symptoms in pregnancy only (4.7%); high symptoms in the child's preschool period only (4.9%).Socio-demographic predictorsassociated with persistent depression were non-French origin;psychosocial predictorswere childhood adversities, life events during pregnancy and work overinvestment;psychiatric predictorswere previous mental health problems, psychological help, and high anxiety during pregnancy.ConclusionsPersistent depression in mothers of young children is associated to several risk factors present prior to or during pregnancy, notably anxiety. These characteristics precede depression trajectories and offer a possible entry point to enhance mother's mental health and reduce its burden on children.

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The ELAStiC (Electronic Longitudinal Alcohol Study in Communities) project

International Journal for Population Data Science ◽

10.23889/ijpds.v1i1.284 ◽

2017 ◽

Vol 1 (1) ◽

Author(s):

Ashley Akbari ◽

Ronan Lyons ◽

Damon Berridge ◽

John Gallacher ◽

John MacLeod ◽

...

Keyword(s):

Mental Health ◽

Cohort Study ◽

Alcohol Consumption ◽

Longitudinal Data ◽

Routine Data ◽

Household Composition ◽

Police Data ◽

The Uk ◽

Alcohol Related Harm ◽

Related Harm

ABSTRACT ObjectivesThe ELAStiC (Electronic Longitudinal Alcohol Study in Communities) project was established to determine factors that predict pathways into alcohol misuse and the life-course effects of alcohol use and misuse on health and well-being. This is achieved through accessing existing longitudinal data that are key sources of evidence for social and health policy, developing statistical methods and modelling techniques from a diverse range of disciplines, working with stakeholders in both policy, practice and the third sector to bring relevance to the work, and to bring together a diverse team of experts to collaborate and facilitate learning across diverse fields. ApproachThe project will link data that include cohort studies such as; UK Biobank, ALSPAC (Avon Longitudinal Study of Parents and Children), Millennium Cohort Study, British Household Panel Survey, Understanding Society, E_CATALyST (Caerphilly Health and Social Needs Electronic Cohort Study) and WECC (Wales Electronic Cohort for Children). These data will be linked with routine data from primary and secondary healthcare in England, Scotland and Wales. Additional data from education and police data source will also be linked as part of the project. The main work packages for the project are: Methodological InnovationsMethodological developments in mechanisms for correcting bias in reporting alcohol consumption and for combining routine data with cohort data; the application of Markov models for examining the extent to which past behaviour influences future behaviour, and econometric hedonic pricing methods for providing insights into the costs of alcohol-related harm. Pathways into HarmDo family structure, household composition, youngsters’ previous ill-health and educational attainment predict their use of alcohol and what socio-economic factors and household transitions contribute to hazardous alcohol consumption in adults? Secondary HarmsWhat is the effect on children’s health and educational achievement of living in households in which one or more adults has experienced alcohol-related harm? Mental Health & Well-BeingWhat is the relationship between alcohol consumption, hospital admission and mental health in adults and children? ResultsThe results of the data linkage between the multiple cohorts and health, education and police data will be reported. The challenges of linking cohort and other data types from different nations will be discussed. ConclusionsOur project will aim to provide evidence that informs the UK Government’s commitment to “radically reshape the approach to alcohol and reduce the number of people drinking to excess”, by working with existing longitudinal data collected in the UK to inform policy and practice.

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Stillbirth rates, service outcomes and costs of implementing NHS England’s Saving Babies’ Lives care bundle in maternity units in England: A cohort study

PLoS ONE ◽

10.1371/journal.pone.0250150 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0250150

Author(s):

Kate Widdows ◽

Stephen A. Roberts ◽

Elizabeth M. Camacho ◽

Alexander E. P. Heazell

Keyword(s):

Cohort Study ◽

Health Care Professionals ◽

Care Bundle ◽

Adjusted Relative Risk ◽

Stillbirth Rate ◽

Process Measures ◽

Link Type ◽

Process Outcomes ◽

Before And After ◽

Implementation Period

Objective To assess implementation of the Saving Babies Lives (SBL) Care Bundle, a collection of practice recommendations in four key areas, to reduce stillbirth in England. Design A retrospective cohort study of 463,630 births in 19 NHS Trusts in England using routinely collected electronic data supplemented with case note audit (n = 1,658), and surveys of service users (n = 2,085) and health care professionals (n = 1,064). The primary outcome was stillbirth rate. Outcome rates two years before and after the nominal SBL implementation date were derived as a measure of change over the implementation period. Data were collected on secondary outcomes and process outcomes which reflected implementation of the SBL care bundle. Results The total stillbirth rate, declined from 4.2 to 3.4 per 1,000 births between the two time points (adjusted Relative Risk (aRR) 0.80, 95% Confidence Interval (95% CI) 0.70 to 0.91, P<0.001). There was a contemporaneous increase in induction of labour (aRR 1.20 (95%CI 1.18–1.21), p<0.001) and emergency Caesarean section (aRR 1.10 (95%CI 1.07–1.12), p<0.001). The number of ultrasound scans performed (aRR 1.25 (95%CI 1.21–1.28), p<0.001) and the proportion of small for gestational age infants detected (aRR 1.59 (95%CI 1.32–1.92), p<0.001) also increased. Organisations reporting higher levels of implementation had improvements in process measures in all elements of the care bundle. An economic analysis estimated the cost of implementing the care bundle at ~£140 per birth. However, neither the costs nor changes in outcomes could be definitively attributed to implementation of the SBL care bundle. Conclusions Implementation of the SBL care bundle increased over time in the majority of sites. Implementation was associated with improvements in process outcomes. The reduction in stillbirth rates in participating sites exceeded that reported nationally in the same timeframe. The intervention should be refined to identify women who are most likely to benefit and minimise unwarranted intervention. Trial registration The study was registered on (NCT03231007); www.clinicaltrials.gov.

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Changes in prescription of antidepressants and disability pension due to back pain, compared with other musculoskeletal and other somatic diagnoses: a cohort study in Sweden

BMJ Open ◽

10.1136/bmjopen-2019-029836 ◽

2019 ◽

Vol 9 (9) ◽

pp. e029836

Author(s):

Annina Ropponen ◽

Syed Ghulam Rahman ◽

Pia Svedberg ◽

Magnus Helgesson ◽

Thomas Ernst Dorner ◽

...

Keyword(s):

Mental Health ◽

Cohort Study ◽

Back Pain ◽

Repeated Measures ◽

Disability Pension ◽

Population Based ◽

Swedish Population ◽

Antidepressant Prescription ◽

Before And After

ObjectivesThe aim was to investigate differences in the prescription of antidepressants during the transition to disability pension (DP) comparing DP due to back pain with DP due to other musculoskeletal and DP due to other somatic diagnoses.DesignA population-based cohort study with follow-up 3 years before and after the event. Estimated prevalence and adjusted ORs with 95% CIs for antidepressant prescription were computed for the 7-year window (ie, t-3 to t+3) around the DP by generalised estimating equations for repeated measures.Setting and participantsThis Swedish population-based nationwide study with registry data included individuals aged 18–64 years, with DP due to back pain (n=2011), DP due to other musculoskeletal (n=3548) or DP due to other somatic diagnoses (n=11 809).Primary outcome measuresPrescription of antidepressants.ResultsBefore DP, the prevalence of prescription of antidepressants was stable in DP due to back pain, but increased for the other DP groups. Similarly, the likelihood of prescription increased only marginally before DP due to back pain (ORs from 0.86 at t-3 to 1.10 at t-1), but clearly in DP due to musculoskeletal (from 0.42 to 1.15) and somatic diagnoses (from 0.29 to 0.98). Both prevalence measures and risks remained at the elevated levels after DP.ConclusionsPathways to DP due to musculoskeletal and somatic diagnoses seem to be partly driven by adverse mental health, which remains at a higher level after DP. The increasing prescription of antidepressants prior to DP suggests that special attention should be paid to mental health for prevention of DP. The period after DP needs attention to avoid deterioration of mental health.

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Validation of the Transition Readiness and Appropriateness Measure (TRAM) for the Managing the Link and Strengthening Transition from Child to Adult Mental Healthcare in Europe (MILESTONE) study

BMJ Open ◽

10.1136/bmjopen-2019-033324 ◽

2020 ◽

Vol 10 (6) ◽

pp. e033324 ◽

Cited By ~ 2

Author(s):

Paramala Santosh ◽

Jatinder Singh ◽

Laura Adams ◽

Mathilde Mastroianni ◽

Natalie Heaney ◽

...

Keyword(s):

Mental Health ◽

Cohort Study ◽

Mental Health Services ◽

Young People ◽

Health Services ◽

Randomised Trial ◽

Cluster Randomised Trial ◽

Transition Readiness ◽

Link Type ◽

Cluster Randomised

ObjectiveYoung people moving from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS) are faced with significant challenges. To improve this state of affairs, there needs to be a recognition of the problem and initiatives and an urgent requirement for appropriate tools for measuring readiness and outcomes at the transfer boundary (16–18 years of age in Europe). The objective of this study was to develop and validate the Transition Readiness and Appropriateness Measure (TRAM) for assessing a young person’s readiness for transition, and their outcomes at the transfer boundary.DesignMILESTONE prospective study.SettingEight European Union (EU) countries participating in the EU-funded MILESTONE study.ParticipantsThe first phase (MILESTONE validation study) involved 100 adolescents (pre-transition), young adults (post-transition), parents/carers and both CAMHS and AMHS clinicians. The second phase (MILESTONE cohort study and nested cluster randomised trial) involved over 1000 young people.ResultsThe development of the TRAM began with a literature review on transitioning and a review of important items regarding transition by a panel of 34 mental health experts. A list of 64 items of potential importance were identified, which together comprised the TRAM. The psychometric properties of the different versions of the TRAM were evaluated and showed that the TRAM had good reliability for all versions and low-to-moderate correlations when compared with other established instruments and a well-defined factor structure. The main results of the cohort study with the nested cluster randomised trial are not reported.ConclusionThe TRAM is a reliable instrument for assessing transition readiness and appropriateness. It highlighted the barriers to a successful transition and informed clinicians, identifying areas which clinicians on both sides of the transfer boundary can work on to ease the transition for the young person.Trial registration numberISRCTN83240263 (Registered 23 July 2015), NCT03013595 (Registered 6 January 2017); Pre-results.

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Early-life maternal attachment and risky health behaviours in adolescence: findings from the United Kingdom Millennium Cohort Study

BMC Public Health ◽

10.1186/s12889-021-12141-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Beatrice D. Reyes ◽

Dougal S. Hargreaves ◽

Hanna Creese

Keyword(s):

Mental Health ◽

Cohort Study ◽

United Kingdom ◽

Maternal Depression ◽

Early Life ◽

Social Inequalities ◽

Maternal Attachment ◽

Millennium Cohort Study ◽

The United Kingdom ◽

Risky Behaviours

Abstract Background Early uptake of multiple risky behaviours during adolescence, such as substance use, antisocial and sexual behaviours, can lead to poor health outcomes without timely interventions. This study investigated how early-life maternal attachment, or emotional bonds between mothers and infants, influenced later risky behaviours in adolescence alongside other potential explanatory pathways using the United Kingdom Millennium Cohort Study. Methods Total maternal attachment scores measured at 9 months using the Condon (1998) Maternal Postnatal Attachment Scale compared higher and lower attachment, where mothers in the lowest 10th percentile represented lower attachment. Multiple risky behaviours, defined as two or more risky behaviours (including smoking cigarettes, vaping, alcohol consumption, illegal drug use, antisocial behaviour, criminal engagement, unsafe sex, and gambling), were scored from 0 to 8 at age 17. Five multivariate logistic regression models examined associations between maternal attachment and multiple risky behaviours among Millennium Cohort Study members (n = 7796). Mediation analysis sequentially adjusted for blocks of explanatory mechanisms, including low attachment mechanisms (multiple births, infant prematurity, sex, breastfeeding, unplanned pregnancy and maternal age at birth), maternal depression, and social inequalities (single-parent status, socioeconomic circumstance by maternal education and household income) at 9 months and poor adolescent mental health at 14 years. Results Children of mothers with lower maternal attachment at 9 months had 23% increased odds of multiple risky behaviours at 17 years (OR: 1.23, 95% CI: 1.00–1.50) in the unadjusted baseline model. All five explanatory blocks attenuated baseline odds. Low attachment mechanisms attenuated 13%, social inequalities 17%, and poor mental health 17%. Maternal depression attenuated the highest proportion (26%) after fully adjusting for all factors (30%). Conclusions Lower maternal attachment in early life predicted increased adolescent multiple risky behaviours. Almost a third of the excess risk was attributable to child, maternal and socioeconomic factors, with over a quarter explained by maternal depression. Recognising the influence of early-life risk factors on adolescent health could innovate current policies and interventions addressing multiple risky behaviour uptake affecting health inequalities across the life course.

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Clinical and socio-demographic characteristics associated with involuntary admissions in Switzerland between 2008 and 2016: An observational cohort study before and after implementation of the new legislation

European Psychiatry ◽

10.1016/j.eurpsy.2019.04.004 ◽

2019 ◽

Vol 59 ◽

pp. 70-76 ◽

Cited By ~ 2

Author(s):

Florian Hotzy ◽

Michael P. Hengartner ◽

Paul Hoff ◽

Matthias Jaeger ◽

Anastasia Theodoridou

Keyword(s):

Cohort Study ◽

Psychiatric Treatment ◽

Routine Data ◽

Demographic Characteristics ◽

Observational Cohort Study ◽

University Hospital ◽

Organizational Level ◽

Increased Risk ◽

Before And After ◽

Observational Cohort

AbstractBackground:Involuntary admission (IA) for psychiatric treatment has a history of controversial discussions. We aimed to describe characteristics of a cohort of involuntarily compared to voluntarily admitted patients regarding clinical and socio-demographic characteristics before and after implementation of the new legislation.Methods:In this observational cohort study, routine data of 15’125 patients who were admitted to the University Hospital of Psychiatry Zurich between 2008 and 2016 were analyzed using a series of generalized estimating equations.Results:At least one IA occurred in 4’560 patients (30.1%). Of the 31’508 admissions 8’843 (28.1%) were involuntary. In the final multivariable model, being a tourist (OR = 3.5) or an asylum seeker (OR = 2.3), having a schizophrenic disorder (OR = 2.1), or a bipolar disorder (OR = 1.8) contributed most to our model. Male gender, higher age, prescription of neuroleptics (all OR < 2.0) as well as having a depressive disorder, prescription of psychotherapy, prescription of antidepressants and admission after implementation of the new legislation (all OR > 0.6) were also weakly associated with IA.Conclusions:Besides schizophrenic or bipolar disorders, a small group of patients had an increased risk for IA due to non-clinical parameters (i.e. tourists and asylum seekers). Knowledge about risk factors should be used for the development of multi-level strategies to prevent frequent (involuntary) hospitalizations in patients at risk. On the organizational level, we could show that the new legislation decreased the risk for IA, and therefore may have succeeded in strengthening patient autonomy.

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