Journal of the American Academy of Child & Adolescent Psychiatry
Volume 51, Issue 1 , Pages 8-17.e8, January 2012

Effect of Preventive Interventions in Mentally Ill Parents on the Mental Health of the Offspring: Systematic Review and Meta-Analysis

  • Eliane Siegenthaler, M.D.

      Affiliations

    • University Psychiatry Hospital, Bern, Switzerland
    • Corresponding Author InformationCorrespondence to Eliane Siegenthaler, M.D., Consultant in Child and Adolescent Psychiatry, University Child and Adolescent Psychiatric Services, University Psychiatry Hospital, University of Bern, 3010 Bern, Switzerland
  • ,
  • Thomas Munder, M.Sc.

      Affiliations

    • Institute of Social and Preventive Medicine (ISPM), University of Bern
  • ,
  • Matthias Egger, M.D.

      Affiliations

    • Institute of Social and Preventive Medicine (ISPM), University of Bern
    • University of Bristol, United Kingdom

Accepted 28 October 2011. published online 05 December 2011.

Objective

Mental illness in parents affects the mental health of their children. A systematic review and a meta-analysis of the effectiveness of interventions to prevent mental disorders or psychological symptoms in the offspring were performed.

Method

The Cochrane, MEDLINE, EMBASE, and PsycINFO databases were searched for randomized controlled trials of interventions in parents with mental disorders. Outcomes in the child included incident mental disorders of the same nature and internalizing (negative emotions, depressive symptoms, anxiety) or externalizing (hyperactivity, aggressiveness, behavioral problems) symptoms. Relative risks and standardized mean differences in symptom scores were combined in random-effects meta-analysis.

Results

Thirteen trials including 1,490 children were analyzed. Interventions included cognitive, behavioral, or psychoeducational components. Seven trials assessed the incidence of mental disorders and seven trials assessed symptoms. In total 161 new diagnoses of mental illness were recorded, with interventions decreasing the risk by 40% (combined relative risk 0.60, 95% CI 0.45–0.79). Symptom scores were lower in the intervention groups: standardized mean differences were −0.22 (95% CI −0.37 to −0.08) for internalizing symptoms (p = .003) and −0.16 (95% confidence interval −0.36 to 0.04) for externalizing symptoms (p = .12).

Conclusions

Interventions to prevent mental disorders and psychological symptoms in the offspring of parents with mental disorders appear to be effective.

Key Words:  preventive intervention , mentally ill parents , internalizing and externalizing symptoms , randomized controlled trials , meta-analysis

 

 Supplemental material cited in this article is available online.

 Disclosure: Drs. Siegenthaler and Egger and Mr. Munder report no biomedical financial interests or potential conflicts of interest.

PII: S0890-8567(11)00993-2

doi:10.1016/j.jaac.2011.10.018

Journal of the American Academy of Child & Adolescent Psychiatry
Volume 51, Issue 1 , Pages 8-17.e8, January 2012