Violence Between Parents During Childhood Tied to Later Depression

Exposure to parental intimate partner violence (IPV) or maternal depression during childhood was linked to an increased risk of depression at age 18, according to a longitudinal cohort study.

Among over 5,000 children, exposure to both IPV between parents and depression in mothers was associated with a 68% higher risk of depression at age 18 (adjusted risk ratio [aRR] 1.68, 95% CI 1.34-2.10), reported Rebecca E. Lacey, PhD, of University College London, and co-authors.

Exposure to IPV only was associated with a 24% higher risk (aRR 1.24, 95% CI 0.97-1.59), and exposure to maternal depression only was associated with a 35% higher risk (aRR 1.35, 95% CI 1.11-1.64), they noted in JAMA Network Open.

These findings are important because maternal depression and parental IPV "are highly prevalent and are often detected at primary care visits," with more than 40% of the study population having experienced one or both of these, Lacey and team wrote. "Preventing these exposures from happening or reducing their impact on child's depression may help to improve population mental health."

"All clinical contacts, including general practitioner appointments or emergency department visits, present an opportunity to ask about potential mental health problems among children, which may help to identify vulnerable children early," they noted. "Likewise, organizations tackling IPV can work closely with primary care and mental health services, as advocated by the World Health Organization."

However, Lacey and team pointed out that "it is important to emphasize that most children from households experiencing IPV or depression will not develop mental health problems."

In fact, at the individual level, the area under the receiver operating characteristic curve was 0.58 (95% CI 0.55-0.60) for depression according to the Short Mood and Feelings Questionnaire and 0.59 (95% CI 0.55-0.62) according to the Clinical Interview Schedule-Revised, which indicated a 58% to 59% probability that a random participant with depression at 18 had been exposed to IPV and/or maternal depression compared with a random participant without depression.

Therefore, "the ability to estimate whether an individual develops depression in adolescence on the basis of only on the information from maternally reported parental IPV or depression is poor," the authors concluded.

For this study, Lacey and colleagues used data from the Avon Longitudinal Study of Parents and Children, a U.K. population-based birth cohort, which recruited pregnant mothers with estimated due dates in 1991 and 1992. Data were collected to 2009. The study included 5,029 children, 56.9% of whom were girls.

IPV was self-reported by mothers and assessed on eight occasions when the child was 1 to 11 years old. Maternal depression was assessed using the Edinburgh Postnatal Depression Scale or by self-reported use of antidepressants by the mother over eight occasions when the child was 2 to 12 years old.

Lacey and colleagues cautioned that "care needs to be taken not to treat this information in a deterministic fashion, assuming that the child will eventually develop depression," as "this could potentially result in stigmatization of children from vulnerable households and misallocation of resources."

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