Abstract
BACKGROUND: Maternal depression is a risk factor for depression in children, though the influence of paternal depression has been less well examined. We examined the association between maternal and paternal depression, and the timing of their depression (before or after the child's birth) and outcomes for the child including incidence of child depression and poor educational attainment. METHODS: A linked routine data cohort study linking General Practitioner(GP), hospital and education records of young people (aged 0 to 30 years) in Wales. Parental and child diagnosis of depression was identified from GP data. Regression analysis examined the association of maternal and paternal depression with time to diagnosis of depression in the child and odds of attaining educational milestones. OUTCOMES: In adjusted models, the relative risk of offspring developing depression was 1.22 if the mother had depression before the child was born, 1.55 if the mother had depression after the child was born and 1.73 if she had depression both before and after the child was born (chronic depression), compared to those were there was no maternal depression history. For achieving milestones at end of primary school, odds were 0.92, 0.88 and 0.79 respectively. Association of depression in the child was similar if the male living in the household had depression with risk ratios of 1.24 (before), 1.43 (after) and 1.27 (before and after) for child diagnosed depression and 0.85, 0.79 and 0.74 for achieving age 11 milestones. INTERPRETATION: Children who live with a parent who has depression are more likely to develop depression and not achieve educational milestones, compared to children who live with a parent who has a history of depression (but no active depression in child's lifetime) and compared to those with no depression. This finding suggests that working closely with families where depression (particularly chronic depression) is present in either parent and treating parental depression to remission is likely to have long-term benefits for children's mental health and educational attainment.