University of Groningen
Breaking the cycle?
Havinga, Petra
DOI:10.33612/diss.112725525
IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check the document version below.
Document Version
Publisher's PDF, also known as Version of record
Publication date: 2020
Link to publication in University of Groningen/UMCG research database
Citation for published version (APA):
Havinga, P. (2020). Breaking the cycle? intergenerational transmission of depression/anxiety and opportunities for intervention. Rijksuniversiteit Groningen. https://doi.org/10.33612/diss.112725525
Copyright
Other than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons).
Take-down policy
If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.
Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum.
3
Paternal and maternal depression and
offspring risk; additive effects or worse?
Havinga PJ, Boschloo L, Hartman CA, Schoevers RA. Paternal and maternal depression and offspring risk: Additive effects or worse? Lancet Psychiatry. 2018;5(2):107-108.
To the editor. We read the Article by Gemma Lewis and colleagues1 with great interest, as they convincingly showed in two large population-based cohorts that depressive symptoms in fathers, just like depressive symptoms in mothers, predicted depressive symptoms in adolescent offspring. The impact of paternal depressive symptoms was independent of the impact of maternal depressive symptoms, which stresses the importance of both parents’ mental health for offspring mental health (see also the thoughtful comment by Underwood and Waldie2).
These findings are in line with our recent study in a high-risk sample of offspring of parents in treatment for depressive or anxiety disorders.3 First, we showed that the risk for offspring mood/anxiety disorders did not differ according to whether the affected parent was the mother or the father. Second, having two affected parents significantly increased offspring risk compared to having one affected parent, with a hazard ratio as high as 1•5. Lewis and colleagues’ findings1 also suggest that children are at greater risk when both parents are depressed. This increased risk might be caused by simply adding up the risk associated with depression in the father and depression in the mother assuming that each exposure stands on its own; growing up in a family with two depressed parents could reflect a larger genetic vulnerability transmitted to the child, an increased exposure to environmental influences, or both. However, another possibility is that the effects of paternal depressive symptoms on offspring risk are conditional on maternal depressive symptoms, or vice versa. For example, in families with one affected parent, the second parent might buffer the potential negative effects associated with the other parents’ depression, such as being less responsive to a child’s needs.4 Therefore, it might be that the risk associated with both parents being depressed is even greater than simply the additive effect, as there is no second parent who can take on this compensatory role. We would like to encourage Lewis and colleagues1 to consider this potential interaction effect. Unlike in our sample, the two large population-based samples used in their study included information on depressive symptom severity in parents, ranging from absent to very high, thus providing the opportunity and statistical power to explore this question. In our study, the estimated risk of offspring becoming depressed or anxious was 38% at 20 years, and 65% at 35 years. Both parents being depressed might be an additional indicator to identify subgroups of adolescents with a substantial risk of future depression who could benefit from preventive interventions.
43 43
3
REFERENCES
1. Lewis G, Neary M, Polek E, Flouri E, Lewis G. The association between paternal and adolescent depressive symptoms: Evidence from two population-based cohorts. Lancet Psychiatry. 2017;4(12):920-926.
2. Underwood L, Waldie K. The effect of paternal depression on depressive symptoms in adolescent offspring. Lancet Psychiatry. 2017;4(12):889-890.
3. Havinga PJ, Boschloo L, Bloemen AJ, et al. Doomed for disorder? High incidence of mood and anxiety disorders in offspring of depressed and anxious patients: A prospective cohort study. J Clin Psychiatry. 2017;78(1):e8-e17.
4. England MJ, Sim LJ, eds. Depression in parents, parenting, and children: Opportunities to improve identifica-tion, treatment, and prevention. Washington (DC): National Academies Press; 2009. NBK215117 [bookacces-sion].
