Children of depressed mothers 1 year after the initiation of maternal treatment: Findings from the STAR*D-Child study
Children of depressed mothers 1 year after the initiation of maternal treatment: Findings from the STAR*D-Child study
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DOI：
10.1176/appi.ajp.2008.07081286
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发表时间：
2008-09-01
影响因子：
17.7
通讯作者：
Weissman, Myrna M.
中科院分区：
文献类型：
--
作者：
Pilowsky, Daniel J.;Wickramaratne, Priya;Weissman, Myrna M.
目的：母亲抑郁症是儿童精神病理学的一个一致且重复性良好的危险因素。作者检查了抑郁妇女的孩子在开始治疗孕产妇重度抑郁症一年后精神症状和整体功能的变化。方法：参与者为 1) 151 名患有孕产妇重度抑郁症的妇女，她们参加了缓解抑郁的序贯治疗替代方案 (STAR*D) 研究；2) 她们的符合条件的后代，与母亲一起参加了儿童 STAR*D (STAR*D-Child) 研究（母子对： N=151）。 STAR*D 研究是一项多中心研究，旨在确定非精神病性重度抑郁症成人门诊患者各种治疗方案的比较有效性和可接受性。 STAR*D-Child 研究在基线时检查了抑郁妇女的孩子，并在开始治疗孕产妇重度抑郁症后 1 年内定期随访，以确定以下数据：1）儿童精神症状的变化是否与孕产妇抑郁症严重程度的变化相关；2）缓解和未缓解的妇女的后代的结果是否不同（具有随访数据的母子对：N = 123）。 STAR*D-Child 研究中的儿童精神症状使用《学龄儿童情感障碍和精神分裂症表》（K-SADS-PL）进行评估，STAR*D 研究中的母亲抑郁严重程度由独立临床医生使用 17 项汉密尔顿抑郁评定量表（HAM-D）进行评估。 结果：在开始治疗后的一年内，母亲抑郁严重程度和抑郁程度随着时间的推移，儿童的精神症状持续减轻。儿童精神症状数量的减少与母亲抑郁严重程度的降低显着相关。当单独检查儿童的结局时，早期缓解（即开始母亲抑郁症治疗后的前 3 个月内）或晚期缓解（即超过 1 年随访间隔）的妇女的后代症状明显有统计学意义的减轻，但未缓解的妇女的后代则没有。结论：持续努力治疗母亲抑郁症直至缓解与后代精神症状的减少和功能的改善有关。
Objective: Maternal depression is a consistent and well-replicated risk factor for child psychopathology. The authors examined the changes in psychiatric symptoms and global functioning in children of depressed women 1 year following the initiation of treatment for maternal major depressive disorder.Method: Participants were 1) 151 women with maternal major depression who were enrolled in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study and 2) their eligible offspring who, along with the mother, participated in the child STAR*D (STAR*D-Child) study (mother-child pairs: N=151). The STAR*D study was a multisite study designed to determine the comparative effectiveness and acceptability of various treatment options for adult outpatients with nonpsychotic major depressive disorder. The STAR*D-Child study examined children of depressed women at baseline and involved periodic follow-ups for 1 year after the initiation of treatment for maternal major depressive disorder to ascertain the following data: 1) whether changes in children's psychiatric symptoms were associated with changes in the severity of maternal depression and 2) whether outcomes differed among the offspring of women who did and did not remit (mother-child pairs with follow-up data: N=123). Children's psychiatric symptoms in the STAR*D-Child study were assessed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL), and maternal depression severity in the STAR*D study was assessed by an independent clinician, using the 17-item Hamilton Depression Rating Scale (HAM-D).Results: During the year following the initiation of treatment, maternal depression severity and children's psychiatric symptoms continued to decrease over time. Decreases in the number of children's psychiatric symptoms were significantly associated with decreases in maternal depression severity. When children's outcomes were examined separately, a statistically significant decrease in symptoms was evident in the offspring of women who remitted early (i.e., within the first 3 months after the initiation of treatment for maternal depression) or late (i.e., over the 1-year follow-up interval) but not in the offspring of nonremitting women.Conclusions: Continued efforts to treat maternal depression until remission is achieved are associated with decreased psychiatric symptoms and improved functioning in the offspring.