Effects of parental mental illness on children's physical health: systematic review and meta-analysis

Matthias Pierce; Holly F Hope; Adekeye Kolade; Judith Gellatly; Cemre Su Osam; Reena Perchard; Kyriaki Kosidou; Christina Dalman; Vera Morgan; Patricia Di Prinzio; Kathryn M Abel

doi:10.1192/bjp.2019.216

Effects of parental mental illness on children's physical health: systematic review and meta-analysis

Matthias Pierce, Holly F Hope, Adekeye Kolade, Judith Gellatly, Cemre Su Osam, Reena Perchard, Kyriaki Kosidou, Christina Dalman, Vera Morgan, Patricia Di Prinzio, Kathryn M Abel

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Abstract

BACKGROUND: Children of parents with mental disorder face multiple challenges.

AIMS: To summarise evidence about parental mental disorder and child physical health.

METHOD: We searched seven databases for cohort or case-control studies quantifying associations between parental mental disorders (substance use, psychotic, mood, anxiety, obsessive-compulsive, post-traumatic stress and eating) and offspring physical health. Studies were excluded if: they reported perinatal outcomes only (<28 days) or outcomes after age 18; they measured outcome prior to exposure; or the sample was drawn from diseased children. A meta-analysis was conducted. The protocol was registered on the PROSPERO database (CRD42017072620).

RESULTS: Searches revealed 15 945 non-duplicated studies. Forty-one studies met our inclusion criteria: ten investigated accidents/injuries; eight asthma; three other atopic diseases; ten overweight/obesity; ten studied other illnesses (eight from low-and middle-income countries (LMICs)). Half of the studies investigated maternal perinatal mental health, 17% investigated paternal mental disorder and 87% examined maternal depression. Meta-analysis revealed significantly higher rates of injuries (OR = 1.15, 95% CI 1.04-1.26), asthma (OR = 1.26, 95% CI 1.12-1.41) and outcomes recorded in LMICs (malnutrition: OR = 2.55, 95% CI 1.74-3.73; diarrhoea: OR = 2.16, 95% CI 1.65-2.84). Evidence was inconclusive for obesity and other atopic disorders.

CONCLUSIONS: Children of parents with mental disorder have health disadvantages; however, the evidence base is limited to risks for offspring following postnatal depression in mothers and there is little focus on fathers in the literature. Understanding the physical health risks of these vulnerable children is vital to improving lives. Future work should focus on discovering mechanisms linking physical and mental health across generations.

DECLARATION OF INTEREST: None.

Original language	English
Pages (from-to)	354-363
Number of pages	10
Journal	The British journal of psychiatry : the journal of mental science
Volume	217
Issue number	1
Early online date	15 Oct 2019
DOIs	https://doi.org/10.1192/bjp.2019.216
Publication status	Published - 2019

Keywords

Child Health/statistics & numerical data
Child of Impaired Parents/statistics & numerical data
Family Health/statistics & numerical data
Humans
Mental Disorders/epidemiology
Mental Health/statistics & numerical data
Mothers/psychology
Parents/psychology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1192/bjp.2019.216

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Pierce, M., Hope, H. F., Kolade, A., Gellatly, J., Osam, C. S., Perchard, R., Kosidou, K., Dalman, C., Morgan, V., Di Prinzio, P., & Abel, K. M. (2019). Effects of parental mental illness on children's physical health: systematic review and meta-analysis. The British journal of psychiatry : the journal of mental science, 217(1), 354-363. https://doi.org/10.1192/bjp.2019.216

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title = "Effects of parental mental illness on children's physical health: systematic review and meta-analysis",

abstract = "BACKGROUND: Children of parents with mental disorder face multiple challenges.AIMS: To summarise evidence about parental mental disorder and child physical health.METHOD: We searched seven databases for cohort or case-control studies quantifying associations between parental mental disorders (substance use, psychotic, mood, anxiety, obsessive-compulsive, post-traumatic stress and eating) and offspring physical health. Studies were excluded if: they reported perinatal outcomes only (<28 days) or outcomes after age 18; they measured outcome prior to exposure; or the sample was drawn from diseased children. A meta-analysis was conducted. The protocol was registered on the PROSPERO database (CRD42017072620).RESULTS: Searches revealed 15 945 non-duplicated studies. Forty-one studies met our inclusion criteria: ten investigated accidents/injuries; eight asthma; three other atopic diseases; ten overweight/obesity; ten studied other illnesses (eight from low-and middle-income countries (LMICs)). Half of the studies investigated maternal perinatal mental health, 17% investigated paternal mental disorder and 87% examined maternal depression. Meta-analysis revealed significantly higher rates of injuries (OR = 1.15, 95% CI 1.04-1.26), asthma (OR = 1.26, 95% CI 1.12-1.41) and outcomes recorded in LMICs (malnutrition: OR = 2.55, 95% CI 1.74-3.73; diarrhoea: OR = 2.16, 95% CI 1.65-2.84). Evidence was inconclusive for obesity and other atopic disorders.CONCLUSIONS: Children of parents with mental disorder have health disadvantages; however, the evidence base is limited to risks for offspring following postnatal depression in mothers and there is little focus on fathers in the literature. Understanding the physical health risks of these vulnerable children is vital to improving lives. Future work should focus on discovering mechanisms linking physical and mental health across generations.DECLARATION OF INTEREST: None.",

keywords = "Child Health/statistics & numerical data, Child of Impaired Parents/statistics & numerical data, Family Health/statistics & numerical data, Humans, Mental Disorders/epidemiology, Mental Health/statistics & numerical data, Mothers/psychology, Parents/psychology",

author = "Matthias Pierce and Hope, {Holly F} and Adekeye Kolade and Judith Gellatly and Osam, {Cemre Su} and Reena Perchard and Kyriaki Kosidou and Christina Dalman and Vera Morgan and {Di Prinzio}, Patricia and Abel, {Kathryn M}",

year = "2019",

doi = "10.1192/bjp.2019.216",

language = "English",

volume = "217",

pages = "354--363",

journal = "The British journal of psychiatry : the journal of mental science",

issn = "0007-1250",

publisher = "Cambridge University Press",

number = "1",

}

Pierce, M , Hope, HF, Kolade, A, Gellatly, J, Osam, CS, Perchard, R, Kosidou, K, Dalman, C, Morgan, V, Di Prinzio, P & Abel, KM 2019, 'Effects of parental mental illness on children's physical health: systematic review and meta-analysis', The British journal of psychiatry : the journal of mental science, vol. 217, no. 1, pp. 354-363. https://doi.org/10.1192/bjp.2019.216

TY - JOUR

T1 - Effects of parental mental illness on children's physical health

T2 - systematic review and meta-analysis

AU - Pierce, Matthias

AU - Hope, Holly F

AU - Kolade, Adekeye

AU - Gellatly, Judith

AU - Osam, Cemre Su

AU - Perchard, Reena

AU - Kosidou, Kyriaki

AU - Dalman, Christina

AU - Morgan, Vera

AU - Di Prinzio, Patricia

AU - Abel, Kathryn M

PY - 2019

Y1 - 2019

N2 - BACKGROUND: Children of parents with mental disorder face multiple challenges.AIMS: To summarise evidence about parental mental disorder and child physical health.METHOD: We searched seven databases for cohort or case-control studies quantifying associations between parental mental disorders (substance use, psychotic, mood, anxiety, obsessive-compulsive, post-traumatic stress and eating) and offspring physical health. Studies were excluded if: they reported perinatal outcomes only (<28 days) or outcomes after age 18; they measured outcome prior to exposure; or the sample was drawn from diseased children. A meta-analysis was conducted. The protocol was registered on the PROSPERO database (CRD42017072620).RESULTS: Searches revealed 15 945 non-duplicated studies. Forty-one studies met our inclusion criteria: ten investigated accidents/injuries; eight asthma; three other atopic diseases; ten overweight/obesity; ten studied other illnesses (eight from low-and middle-income countries (LMICs)). Half of the studies investigated maternal perinatal mental health, 17% investigated paternal mental disorder and 87% examined maternal depression. Meta-analysis revealed significantly higher rates of injuries (OR = 1.15, 95% CI 1.04-1.26), asthma (OR = 1.26, 95% CI 1.12-1.41) and outcomes recorded in LMICs (malnutrition: OR = 2.55, 95% CI 1.74-3.73; diarrhoea: OR = 2.16, 95% CI 1.65-2.84). Evidence was inconclusive for obesity and other atopic disorders.CONCLUSIONS: Children of parents with mental disorder have health disadvantages; however, the evidence base is limited to risks for offspring following postnatal depression in mothers and there is little focus on fathers in the literature. Understanding the physical health risks of these vulnerable children is vital to improving lives. Future work should focus on discovering mechanisms linking physical and mental health across generations.DECLARATION OF INTEREST: None.

AB - BACKGROUND: Children of parents with mental disorder face multiple challenges.AIMS: To summarise evidence about parental mental disorder and child physical health.METHOD: We searched seven databases for cohort or case-control studies quantifying associations between parental mental disorders (substance use, psychotic, mood, anxiety, obsessive-compulsive, post-traumatic stress and eating) and offspring physical health. Studies were excluded if: they reported perinatal outcomes only (<28 days) or outcomes after age 18; they measured outcome prior to exposure; or the sample was drawn from diseased children. A meta-analysis was conducted. The protocol was registered on the PROSPERO database (CRD42017072620).RESULTS: Searches revealed 15 945 non-duplicated studies. Forty-one studies met our inclusion criteria: ten investigated accidents/injuries; eight asthma; three other atopic diseases; ten overweight/obesity; ten studied other illnesses (eight from low-and middle-income countries (LMICs)). Half of the studies investigated maternal perinatal mental health, 17% investigated paternal mental disorder and 87% examined maternal depression. Meta-analysis revealed significantly higher rates of injuries (OR = 1.15, 95% CI 1.04-1.26), asthma (OR = 1.26, 95% CI 1.12-1.41) and outcomes recorded in LMICs (malnutrition: OR = 2.55, 95% CI 1.74-3.73; diarrhoea: OR = 2.16, 95% CI 1.65-2.84). Evidence was inconclusive for obesity and other atopic disorders.CONCLUSIONS: Children of parents with mental disorder have health disadvantages; however, the evidence base is limited to risks for offspring following postnatal depression in mothers and there is little focus on fathers in the literature. Understanding the physical health risks of these vulnerable children is vital to improving lives. Future work should focus on discovering mechanisms linking physical and mental health across generations.DECLARATION OF INTEREST: None.

KW - Child Health/statistics & numerical data

KW - Child of Impaired Parents/statistics & numerical data

KW - Family Health/statistics & numerical data

KW - Humans

KW - Mental Disorders/epidemiology

KW - Mental Health/statistics & numerical data

KW - Mothers/psychology

KW - Parents/psychology

U2 - 10.1192/bjp.2019.216

DO - 10.1192/bjp.2019.216

M3 - Article

C2 - 31610824

SN - 0007-1250

VL - 217

SP - 354

EP - 363

JO - The British journal of psychiatry : the journal of mental science

JF - The British journal of psychiatry : the journal of mental science

IS - 1

ER -

Effects of parental mental illness on children's physical health: systematic review and meta-analysis

Abstract

Keywords

UN SDGs

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