Such early risk constellations as low parental education, elevated drinking in both parents, and elevated mental health symptoms in fathers were associated with significant increases in the risk for subsequent anxiety and/or depression in children, according to study results published in JAMA Pediatrics.

This prospective cohort study comprised 8773 children from Norway who participated in the adolescent survey of the Nord-Trøndelag Health Study (Young-HUNT) age 13 to 19 as well as 6696 2-parent families who participated in the adult HUNT survey in 1995 to 1997 and/or 2006 to 2008. The surveys captured the drinking habits, mental health, and education of parents, and mental health symptoms in children. Investigators then abstracted data on children’s diagnoses or treatment of anxiety and depression from health registries between 2008 and 2016.  Latent profile analysis was performed to classify family risk profiles.

Of the 8773 participating children, 4404 (50.2%) were boys; mean (SD) age at the time of survey participation was 16.1 (1.8). Anxiety and/or depression, as defined by at least 1 registry record, were present in 24.3% of participants. A 5-class latent profile model showed good fit for the data. When compared with no-risk families, the risk profiles most strongly associated with anxiety and depression in children were characterized by (1) the lowest parental education (adjusted relative risk [aRR], 1.13; 95% CI, 1.01-1.25) and (2) elevated drinking in both parents and elevated mental health symptoms in fathers (aRR, 1.52; 95% CI, 1.03-2.22).

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These data underscore the prospective impact of parental drinking and psychiatric symptoms on childhood mental health outcomes. Of note, the risk level associated with each individual characteristic was not high; accumulations of several risks, however, had a significant impact on youth outcomes. Thus, screening for certain family characteristics may be useful for predicting psychiatric outcomes in young patients.


Lund IO, Skurtveit S, Handal M, et al. Association of constellations of parental risk with children’s subsequent anxiety and depression [published online January 7, 2019]. JAMA Pediatrics. doi:10.1001/jamapediatrics.2018.4360