Brief Psychotherapy for Maternal Depression: Impact on Mothers and Children

Abstract

Objective Two-generation studies demonstrate that treating maternal depression benefits school-age children. Although mothers prefer psychotherapy to medication, little is known about how psychotherapy for maternal depression affects offspring, especially in very high-risk families wherein both mothers and children concurrently meet syndromal criteria for psychiatric disorders. This trial evaluated effects of two brief psychotherapies for maternal depression on very high-risk families. Method Mothers with major depressive disorder were randomly assigned to nine sessions of either brief interpersonal psychotherapy for mothers (IPT-MOMS; n=85) or brief supportive psychotherapy (BSP; n=83). Independent assessors evaluated mothers and their children, ages 7-18, diagnosed with at least one internalizing disorder, every three months over one year. Results Symptoms and functioning of mothers and children improved significantly over time, with no between-group differences. However, children of mothers assigned to BSP had more outpatient mental health visits and were more likely to receive antidepressant medication. Mothers reported greater satisfaction with IPT-MOMS than BSP. Improvement in mothers’ depressive symptoms was associated with improvement in child functioning in time-lagged fashion, with children improving 3-6 months after mothers improved. Antidepressant medication use and number of mental health visits received by children did not affect outcomes. Conclusion IPT-MOMS and BSP demonstrated comparable beneficial effects on maternal depression. Children's functioning improved following maternal improvement, independent of youth's treatment. Children of mothers randomized to IPT-MOMS, compared to BSP, achieved comparable outcomes despite less follow-up treatment. Observation of lagged association between maternal improvement and change in child functioning should influence treatment planning for families.

Prospective assessment of social network quality among depressed mothers treated with brief psychotherapy: The Social Network Quality (SNQ) scales

“…A Treatment × Time interaction did not significantly predict any of the SNI and SNQ scales. The main treatment outcome study also did not find a significant Treatment × Time interaction for primary outcomes [23]. …”

“…Interventions were administered as nine individual psychotherapy sessions provided to mothers over a 12-week period. Full study details are provided elsewhere [23]. Participants completed follow-up self-report measures 3, 6, 9, and 12 months after baseline assessment.…”

“…We tested the utility of the SNQ scales in a sample of depressed mothers of psychiatrically-ill offspring [23], a group for whom both structural and qualitative components of social relationships are likely important determinants of functioning. In terms of criterion validity, we hypothesized that the SNQ scales would show strong concurrent relationships with conceptually proximal measures of social network structure (i.e., SNI) and global measures of perceived social support (ISEL) and interpersonal difficulties (IIP).…”

Which psychiatric symptoms of the mother are related with preschool child’s emotional and behavioral problems?

“…It has been reported that psychotherapy to mothers has been beneficial for the functionality of children at 7-18 years (22). In a follow-up study, it was shown that the child's internalizing behavior problems supported the positive parenting, which in turn contributed to the decrease of the internalizing symptoms, whereas the externalizing behavior problems hampered the positive parenting (23).…”

Annual Research Review: Defining and treating pediatric treatment‐resistant depression

“…It remains unclear whether this association is fully attributable to confounding by indication – insomnia itself is a predictor of poor antidepressant response (Emslie et al, ), or whether trazodone itself is associated with poor antidepressant response. Social or familial factors that are associated with poor treatment responses include early adversity or current trauma (Nanni, Uher, & Danese, ; Shamseddeen et al, ), family conflict (Rengasamy et al, ), parental depression (Swartz et al, ; Weissman et al, ), being bullied (van Geel, Vedder, & Tanilon, ), and being a member of a sexual or gender minority group (Russell & Fish, ). The presence of one or more of these factors can alert mental health workers to a higher likelihood of case complexity, as well as provide targets for intervention.…”