Parental depression worsens school performance

From JAMA Psychiatry, “Associations of Parental Depression With Child School Performance at Age 16 Years in Sweden“:

IMPORTANCE Depression is a common cause of morbidity and disability worldwide. Parental depression is associated with early-life child neurodevelopmental, behavioral, emotional, mental, and social problems. More studies are needed to explore the link between parental depression and long-term child outcomes.

OBJECTIVE To examine the associations of parental depression with child school performance at the end of compulsory education (approximately age 16 years).

DESIGN, SETTING, AND PARTICIPANTS Parental depression diagnoses (based on the International Classification of Diseases, Eighth Revision [ICD-8], International Classification of Diseases, Ninth Revision [ICD-9], and the International Statistical Classification of Diseases, 10th Revision [ICD-10]) in inpatient records from 1969 onward, outpatient records beginning in 2001, and school grades at the end of compulsory education were collected for all children born from 1984 to 1994 in Sweden. The final analytic sample size was 1 124 162 biological children. We examined the associations of parental depression during different periods (before birth, after birth, and during child ages 1-5, 6-10, and 11-16 years, as well as any time before the child’s final year of compulsory schooling) with the final school grades. Linear regression models adjusted for various child and parent characteristics. The dates of the analysis were January to November 2015.

MAIN OUTCOME AND MEASURE Decile of school grades at the end of compulsory education (range, 1-10, with 1 being the lowest and 10 being the highest).

I’ve written about depression many times before. Besides its devastating consequences to people who, themselves, are depressed, it also impairs their children. Prior work has shown that parental depression is associated with many detrimental consequences in early childhood, from a behavioral, social, and emotional standpoint. Long-term outcomes are less well understood.

This study sought to investigate the relationship between parental depression and school performance at 16 years of age in Sweden. Researchers examined a cohort of more than 1.1 million children born between 1984 and 1994. They gathered data from medical records from 1969 onward to see if their parents had a diagnosis of depression.

The main outcome of interest was the decile of school grades (1-10) at the end of compulsory education. They controlled for many things, like child characteristics including sex, birth year, birth order, and whether the child was part of a multiple birth. They accounted for pregnancy characteristics including maternal  and paternal age, and maternal smoking during pregnancy. Family characteristics controlled for included parental education, disposable family income, parental region of birth, and parental alcohol abuse.

Both maternal and paternal depression at any time before the final compulsory school year were associated with worse school performance. Even after adjusting for all covariates, depression was associated with a reduction of almost half a decile. The effect was greater for girls than for boys.

There are limitations, of course. Depression that was never diagnosed would be missed. This is an epidemiological study, so causation is not assured, and other unmeasured confounding could be important.

We also don’t know whether the lower school performance is because children were affected by their parents’ depression, or because they, themselves, have problems because of genetic or familial predispositions.

Regardless, this study shows that parental depression is linked to long-term effects on children. Even depression when kids are young appears to be associated with worse school performance many years later. There are so many reasons to diagnose and treat depression, in both adults and children. This just might be one more.


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