Preventing mood and anxiety disorders in youth: a multi-centre RCT in the high risk offspring of depressed and anxious patients

<p>Abstract</p> <p>Background</p> <p>Anxiety and mood disorders are highly prevalent and pose a huge burden on patients. Their offspring is at increased risk of developing these disorders as well, indicating a clear need for prevention of psychopathology in this group. Given high comorbidity and non-specificity of intergenerational transmission of disorders, prevention programs should target both anxiety and depression. Further, while the indication for preventive interventions is often elevated symptoms, offspring with other high risk profiles may also benefit from resilience-based prevention programs.</p> <p>Method/design</p> <p>The current STERK-study (Screening and Training: Enhancing Resilience in Kids) is a randomized controlled clinical trial combining selected and indicated prevention: it is targeted at both high risk individuals without symptoms and at those with subsyndromal symptoms. Individuals without symptoms meet two of three criteria of the High Risk Index (HRI; female gender, both parents affected, history of a parental suicide (attempt). This index was developed in an earlier study and corresponds with elevated risk in offspring of depressed patients. Children aged 8–17 years (n = 204) with subthreshold symptoms or meeting the criteria on the HRI are randomised to one of two treatment conditions, namely (a) 10 weekly individual child CBT sessions and 2 parent sessions or (b) minimal information. Assessments are held at pre-test, post-test and at 12 and 24 months follow-up. Primary outcome is the time to onset of a mood or anxiety disorder in the offspring. Secondary outcome measures include number of days with depression or anxiety, child and parent symptom levels, quality of life, and cost-effectiveness. Based on models of aetiology of mood and anxiety disorders as well as mechanisms of change during interventions, we selected potential mediators and moderators of treatment outcome, namely coping, parent–child interaction, self-associations, optimism/pessimism, temperament, and emotion processing.</p> <p>Discussion</p> <p>The current intervention trial aims to significantly reduce the risk of intergenerational transmission of mood and anxiety disorders with a short and well targeted intervention that is directed at strengthening the resilience in potentially vulnerable children. We plan to evaluate the effectiveness and cost-effectiveness of such an intervention and to identify mechanisms of change.</p> <p>Trial registration</p> <p>NTR2888</p

Gender differences in the relation between social support, problems in parent-offspring communication, and depression and anxiety

Gender differences in the buffer-effect of social support in the relation between stressful circumstances and the development of depression and anxiety disorders are widely assumed, but few studies address this three-way interaction between gender, stress, and support. Data in the present study came from the baseline assessment of the Adolescents at Risk for Anxiety and Depression (ARIADNE) study in 502 adolescent and young-adult children of 356 parents in the Netherlands with a depression, panic disorder and/or obsessive-compulsive disorder. Results indicate that the daughters benefit more from social support than the sons when problems in parent-offspring communication are high, but that this effect holds only for depression symptoms and particularly in relation to problems in father-offspring communication. Social support does not seem to play a role in the development of anxiety. (c) 2004 Elsevier Ltd. All rights reserved

Mental health among older married couples: the role of gender and family life.

PURPOSE: As shared family context may be an important influence on mental health, and gender differences in mental health, in later life we investigated how gender, family-related variables and gender roles were associated with mental health in older married couples. METHODS: Using data on a sample of 2,511 married couples born between 1923 and 1953 (drawn from the British Household Panel Survey) we analysed differences in the mental health of husbands and wives by fertility history, length of marriage, presence of co-resident children, reported social support, hours of household work, attitudes to gender roles and health of husband and wife. Mental health in 2001 was measured using the General Health Questionnaire (GHQ-12). Multilevel modelling was used to assess effects in husbands and wives and variations between husbands and wives. RESULTS: Results showed that although the mental health of married couples was correlated, wives had poorer mental health than their husbands. The gender difference was smaller in couples who lived with a child aged 16 or more (and had no younger co-resident children) and in couples in which both spouses had experienced early parenthood. The influence of individual and family characteristics on mental health also differed between husbands and wives. For husbands, early fatherhood and co-residence with a child or children aged 16 or more increased the odds of poor mental health. For wives, having had a child when aged 35 or more appeared protective while having traditional gender role attitudes increased the odds of poorer mental health. CONCLUSIONS: The role of family characteristics in the shared marital context has complex associations with mental health, some of which seem gender specific. Although wives express more mental distress, husbands in general show poorer mental health related to family characteristics

General, Specific and Unique Cognitive Factors Involved in Anxiety and Depressive Disorders

Stress-related psychiatric disorders across the life spa