Mental and pediatric disorders among children 0–6 years of parents with severe mental illness

Abstract

Objective Parental severe mental illness (SMI) increases the lifetime risk of mental and pediatric disorders in the offspring but little is known about specific disorders during early childhood. The primary aim was to investigate the incidence of mental and pediatric disorders among children 0–6 years old exposed to parental SMI, and secondarily to investigate the distribution of disorders on specific child age. Methods A nationwide, register‐based cohort study of 1,477,185 children born in Denmark between 1994.01.01 and 2016.12.31. Incidence rate ratios were calculated using Poisson regression analysis for any and specific mental and pediatric disorders. Results IRR for any psychiatric disorder was elevated by a factor 2–5 among SMI offspring. Maternal schizophrenia resulted in the highest IRR = 5.23 (4.80–5.69) of any child psychiatric disorder. The risk of anxiety/OCD and attachment disorder among offspring exposed to parental, and in particular maternal, SMI was markedly raised with IRRs for anxiety/OCD between 7.59 and 17.02 and attachment disorders between 6.26 and 15.40. IRRs of mental disorders were highest at age 0–1 year and declined with age. IRR for any pediatric disorder was also elevated with IRRs between 1.01 and 1.28. Disorders of the digestive system and ill‐defined symptoms were associated with the highest IRRs. Maternal (vs. paternal) SMI was associated with higher IRRs. IRRs declined slightly with child age. Conclusion Children exposed to parental SMI are at increased risk of mental and pediatric disorders during early childhood, particularly anxiety/OCD and attachment disorders. If associations are estimates of a modifiable causal relationship, our results indicate a need for early intervention to promote mental and pediatric health among SMI offspring.

Children of parents with different severities of mental health conditions have higher risk of somatic morbidity: a Danish nationwide register-based cohort study

“…The direction of a higher risk of somatic morbidity across a broad range of disease categories in children with severe parental mental health conditions found in this explorative study is consistent with two other Danish nationwide studies [ 24 , 25 ]. Although these children generally had the highest risk of being diagnosed, they merely concern a small proportion of the total study population.…”

“…To our knowledge, merely two studies have examined the risk of somatic morbidity across several disease categories in the offspring of parents with mental health conditions. Both studies found a higher risk in most of the categories for the examined age-groups (0–6 years [ 24 ] and 0–30 years [ 25 ]). However, these studies only focused on severe parental mental health conditions such as schizophrenia and bipolar disorder [ 24 , 25 ].…”

“…Both studies found a higher risk in most of the categories for the examined age-groups (0–6 years [ 24 ] and 0–30 years [ 25 ]). However, these studies only focused on severe parental mental health conditions such as schizophrenia and bipolar disorder [ 24 , 25 ]. Since only very few (2.2%) of the children with parental mental health conditions in Denmark have parents with a severe mental health condition [ 1 ], there is no knowledge concerning physical health in the majority of children with parental mental health conditions.…”

Attachment representations in 7‐year‐old children at familial high risk of schizophrenia or bipolar disorder: Associations with mental disorders and daily functioning

“…This could indicate that parents with schizophrenia or bipolar disorder are just as able to establish secure attachment with their children as parents without these illnesses. Although lack of an effect of parental psychosis or bipolar disorder per se is in keeping with some of the previous sparse evidence (Doucette et al ., 2013; Sameroff et al ., 1982), this contrasts with findings that children of parents with severe mental illness have an increased risk of diagnosed attachment disorders (Davidsen et al ., 2021). Another possible explanation could be that attachment measured beyond infancy is not solely an expression of the relationships with the primary caregivers, as the child's social world is expanding and other interpersonal relationships become sources of influence on attachment representations.…”

A family perspective on parental psychosis: An interpretative phenomenological analysis study

“…Although the majority of children living with parental mental illness have parents who experience affective symptoms or anxiety (Abel, Hope, Swift, et al, 2019), a significant proportion of children live with parents who experience psychosis, and they are at a higher risk for emotional and behavioural difficulties (Davidsen et al, 2021). Furthermore, psychosis is a highly burdensome episodic illness, which can lead to inpatient stays, and it is, therefore, important to investigate the specific needs of children affected by parental psychosis.…”