Offspring of Mothers with Perinatal Depression at Risk for Psychosis in Adolescence

The children of mothers who experience depression during the perinatal period are more likely to report psychotic experiences at 18 years of age, according to the results of a study published in The Lancet Psychiatry.

Ramya Srinivasan BMBCh, of the division of psychiatry, Faculty of Brain Sciences, University College London, United Kingdom, and colleagues used data from the Avon Longitudinal Study of Parents and Children (ALSPAC). This prospective birth cohort recruited 14,541 pregnant women with estimated delivery dates between April 1, 1991 and December 31, 1992.  The study measured perinatal depression using the Edinburgh Postnatal Depression Scale (EPDS) and offspring psychotic experiences at 18 years using the Psychosis-Like Symptom Interview (PLIKSi).

Offspring of mothers who had complete data on maternal perinatal depression measures, outcomes, and confounding variables were included in the main analysis. The investigators used logistic regression to explore the relationship between maternal perinatal depression and offspring psychotic experiences at age 18 years.

Data on maternal depression during pregnancy and the postnatal period were available for 3067 adolescents who had completed the PLIKSi. Of these adolescents, 334 (8%) met the criteria for depression, and 71 (2%) met the criteria for depression and having experienced a suspected or definite psychotic experience.

Maternal antenatal depressive symptoms were correlated with offspring psychotic experiences at age 18 years (adjusted odds ratio, 1.26; P = .0074), with the odds ratio for a 5-point increase in EPDS score being 1.17 (P =.0065). Furthermore, maternal antenatal depression was linked to offspring depression at 18 years (odds ratio for 5-point increase in EPDS score, 1.18; P =.016).

“We found evidence that the offspring of mothers with higher perinatal depressive symptoms scores were more likely to report psychotic experiences than the offspring of mothers with lower depressive scores,” the researchers noted.

Limitations of the study included genetic confounding, although adjusting for maternal and paternal family history of psychosis had no effect on the study findings. The study was unable to examine the differential effects of antenatal and postnatal depression on outcome. Depression during pregnancy could exert a biologic effect on the developing fetus, whereas postnatal depression could affect parenting.

The investigators suggested that these findings underscore the importance of identifying and treating maternal mental health problems during pregnancy and in the postnatal period.

Reference

Srinivasan R, Pearson RM, Johnson S, Lewis G, Lewis G. Maternal perinatal depressive symptoms and offspring psychotic experiences at 18 years of age: a longitudinal study. Lancet Psychiatry. 2020;7:431-440.