Abstract
Objectives
Based on the investigation of 144 families (144 patients affected by Multiple Sclerosis (MS), 109 partners, and 192 children) examined in three different European child and adolescent psychiatric University centres by means of questionnaires, we evaluated the prevalence of psychological symptoms in the offspring and associated risk factors such as duration and severity of the disease as well as depression of the ill and the healthy parent.
Results
Indicate that the severe disease of MS is associated with depression of the ill and healthy parent. Ill parents, especially ill mothers, as well as depressed ill, or depressed healthy parents evaluate their children’s mental health problems with a higher prevalence within the internalizing spectrum. Healthy parents report normal psychological adjustment of their children. If two parents present a depressive state, the prevalence of relevant psychological internalizing symptoms is twice or three times as high as the age norms.
Conclusion
Children in families with a parent affected by MS and associated depression of the parental couple are at high risk of mental health problems, especially internalizing disorders. In focusing on the mental health of children one must also be aware of the potential opportunities to address the parents’ own psychological needs.
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References
Achenbach T (1991a) Manual for the child behaviour checklist and 1991 profile. University of Vermont, Department of Psychiatry, Burlington
Achenbach T (1991b) Manual of the youth self report and 1991 profile. University of Vermont, Department of Psychiatry, Burlington
Aikens JE, Fischer JS, Namey M, Rudick RA (1997) A replicated prospective investigation of life stress, coping, and depressive symptoms in multiple sclerosis. J Behav Med 20(5):433–445
Anderson CA, Hammen CL (1993) Psychosocial outcomes of children of unipolar depressed, bipolar, medically ill and normal women: a longitudinal study. J Consult Clin Psychol 61(3):448–454
Armsden G, Lewis FM (1993) The child“s adaptation to parental medical illness: Theory and clinical implications. Patient Education and Counseling 22(3):153–165
Arnett PA, Higginson CI, Voss WD, Randolph JJ, Grandey AA (2002) Relationship between coping, cognitive dysfunction and depression in multiple sclerosis. Clin Neuropsychol 16(3):341–355
Aronson KJ (1997) Quality of life among persons with multiple sclerosis and their caregivers. Neurology 48:74–80
Beardslee WR, Salt P, Portefield K, et al. (1993) Comparison of preventive interventions for families with parental affective disorder. J Am Acad Adolesc Psychiatry 32:254–263
Beardslee WR, Versage EM, Gladstone TRG (1998) Children of affectively ill parents. A review of the past 10 years. J Am Acad Child Adolesc Psychiatry 37:1134–1141
Beck AT, Steer RA, Garbin MG (1988) Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clin Psychol Rev 8:77–100
Beck AT, Ward C, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:53–63
Brassington JC, Marsh NV (1998): Neuropsychological aspects of multiple sclerosis. Neuropsychol Rev 8(29):43–77
Brennan PA, Hammen C, Andersen MJ, Bor W, Najman JM, Williams GM (2000) Chronicity, severity and timing of maternal depressive symptoms: relationship with child outcomes at age 5. Dev Psychopathol 36:759–766
Brennan PA, Broque RL, Hammen C (2003) Maternal depression, parent–child relationship, and resilient outcomes in adolescence. J Am Acad Child Adolesc Psychiatry 42:1469–1477
Burnfield A (1985) Multiple sklerose: a personal exploration. Souvenir Press Ltd, London
Cheung J, Hocking P (2004) The experience of spousal carers of people with multiple sclerosis. Qual Health Res 14(2):153–166
Chwastiak L, Ehde DM, Gibbons LE, Sullivan M, Bowen JD, Kraft GH (2002) Depression symptoms and severity of illness in multiple sclerosis: epidemiologic study of a large community sample. Am J Psychiatry 159:1862–1868
Davies PT, Windle M (1997) Gender-specific pathways between maternal depressive symptoms, family discord, and adolescent adjustment. Dev Psychol 33:657–668
Döpfner M Schmeck K, Berner W (1994a) Handbuch: Elternfragebogen über das Verhalten von Kindern und Jugendlichen, Forschungsergebnisse zur deutschen Fassung der Child Behaviour Checklist (CBCL), 1.Auflage, KJFD, Arbeitsgruppe Kinder-, Jugend-und familiendiagnostik. Köln
Döpfner M Schmeck K, Lehmkuhl G (1994b) Handbuch: Fragebogen für Jugendliche, Forschungsergebnisse zur deutschen Fassung des Youth Self Report (YSR) der Child Behaviour Checklist (CBCL), 1.Auflage, KJFD, Arbeitsgruppe Kinder-, Jugend-und familiendiagnostik. Köln
Feinstein A, Feinstein K (2001) Depression associated with multiple sclerosis looking beyond diagnosis to symptom expression. J Affect Disord 66:193–198
Feinstein A (2004) The neuropsychiatry of multiple sclerosis. Can J Psychiatry 49(3):157–163
Fergusson DM, Lynskey MT, Horwood LJ (1993) The effect of maternal depression on maternal ratings of child behaviour. J Abnorm Child Psychol 21:245–269
Hakim EA, Bakheit AM, Bryant TM, Roberts MW, McIntosh-Michaelis SA, Spackman AJ, Martin JP, McLellan DL (2000) The social impact of multiple sclerosis: a study of 305 patients and their relatives. Disabil Rehabil 22(6):288–293
Heiney SP, Bryant LH, Walker S, Parrish RS, Provenzano FJ, Kelly KE (1997) Impact of parental anxiety on child emotional adjustment when a parent has cancer. Oncol Nurs Forum 24(4):655–661
Kalb RC (1996) The impact of multiple sclerosis on the family. Int MSJ 3(2):65–69
Knight RG, Devereux RC, Godfrey HPD (1997) Psychosocial consequences of caring for a spouse with multiple sclerosis. J Clin Exp Neuropsychol 19(1):7–19
Kroencke DG, Denney DR, Lynch SG (2001) Depression during exacerbations in multiple sclerosis: the importance of uncertainty. Mult Scler 7:237–242
Landoni MG, Giordano MT, Guidetti GP (2000) Group psychotherapy experiences for people with multiple sclerosis and psychological support for families. J Neurovirol 6 (Suppl 2):S168–S171
Landrø NI, Gulowsen Celius E, Sletvold H (2004) Depressive symptoms account for deficient information processing speed but not for impaired working memory in early phase multiple sclerosis (MS). J Neurol Sci 217:211–216
Leahey M, Wright L (1985) Intervening with families with chronic illness. Fam Syst Med 3(1):60–69
Leinonen JA, Solantaus TS, Punamaki RL (2003) Parental mental health and children’s adjustment: the quality of marital interaction and parenting as mediating factors. J Child Psychol Psychiatry Allied Disciplines 44(2):227–241
Levine HB, Krieger JG (1993) Adjustment of adult children of parents with MS. Institute for Health Policy, Massachusetts
Minden SL, Orav J, Reich P (1987) Depression in multiple sclerosis. Gen Hosp Psychiatry 9:93–97
Minden SL, Schiffer RB (1990) Affective disorders in multiple sclerosis. Review and recommendations for clinical research. Arch Neurol 47(1):98–104
Minden SL (1992) Psychotherapy for people with multiple sclerosis. J Neuropsychiatry Clin Neurosci 4(2):198–213
Minden SL (2000) Mood disorders in multiple sclerosis: diagnosis and treatment. J Neurovirol 6(Suppl 2):S160–S167
Mohr DC, Goodkin DE, Gatto N, Wende JVd (1997) Depression, coping and level of neurological impairment in multiple sclerosis. Mult Scler 3(4):254–258
Najman JM, Williams GM, Nikles J, Spence S, Bor W, O’Callaghan R, Le Broque R, Andersen MJ, Schuttlewood GJ (2001) Bias influencing maternal reports of child behaviour and emotional state. Soc Psychiatry Psychiatr Epidemiol 36:186–194
Noy S, Achiron A, Gabbay U, Barak Y, Rotstein Z, Laor N, Sarova-Pinhas I (1995) A new approach to affective symptoms in relapsing-remitting multiple sclerosis. Compr Psychiatry 36(5):390–395
O’Brien MT (1993) Multiple sclerosis: stressors and coping strategies in spousal caregivers. J Community Nurs 10:123–135
Olfson M, Marcus SC, Druss B, Pincus HA, Weissmann MM (2003) Parental depression, child mental health problems, and health care utilization. Med Care 41(6):716–721
Padrone FJ (1994) Psychotherapeutic issues with family members of persons with physical disabilities. Am J Psychiatry 48(2):195–207
Patten SB, Metz LM, Reimer MA (2000) Biopsychosocial correlates of lifetime major depression in a multiple sclerosis population. Mult Scler 6:115–120
Rolland JS (1999) Parental illness and disability: a family systems framework. J Fam Ther 21:242–266
Romer G, Barkmann C, Schulte-Markwort M, Thomalla G, Riedesser P (2002) Children of somatically ill parents: a methodologic review. Clin Child Psychol Psychiatry 7(1):17–38
Roussos A, Karantanos G, Richardson C, Hartmann C, Karajiannis D, Kypranos S, Lazaratou H, Maihaira O, Tassi M, Zoubou V (1999) Achenbach’s child behaviour checklist and teacher’s report form in a normative sample of greek children. Eur Child Adolesc Psychiatry 8(3):165–172
Roussos A, Francis K, Zoubou V, Kiprianos S, Prokopiou A (2001) The standardization of Achenbach’s youth self-report in Greece in a national sample of high school students. Eur Child Adolesc Psychiatry 10:47–53
Rutter M (1966) Children of sick parents. An environmental and psychiatric study. Oxford University Press, London
Steck B (2000) The psychosocial impact of multiple sclerosis on families and children. Int MS J 7(2):63–70
Steck B (2002) Multiple Sklerose und Familie, Psychosoziale Situation und Krankheitsverarbeitung. Karger Verlag, Basel
Steck B, Amsler F, Dillier AS, Grether A, Kappos L, Bürgin D (2005) Indication for psychotherapy in offspring of a parent affected by a chronic somatic diseas (e.g. multiple sclerosis). Psychopathology 38:38–48
Steck B, Amsler F, Kappos L, Bürgin D (2001) Gender-specific differences in the process of coping in families with a parent affected by a chronic somatic disease (e.g. multiple sclerosis). J Psychopathol 34:236–244
Steele RG, Forehand R, Armistead L (1997) The role of family processes and coping strategies in the relationship between parental chronic illness and childhood internalizing problems.Jof abnorm. Child Psychol 25(2):83–94
Steinhausen H-C, Metzke CW, Kannenberg R (1996) Elternfragebogen über das Verhalten von Kindern und Jugendlichen. Zürich: Psychiatrische Universitäts-Poliklinik für Kind
Steinhausen H-C, Metzke CW, Kannenberg R (1999) Fragebogen für Jugendliche. Zürich: Psychiatrische Universitäts-Poliklinik für Kind
Steinglass P (1992) Multifamily group therapy, multiple sclerosis and the family. Demos Publications, New York pp 83–96
Verhaak PF (1997) Somatic disease and psychological disorder. J Psychosom Res 42(3):261–273
Weissman MM, Feder A, Pilowsky DJ, Olfson M, Fuentes M, Blanco C, Lantigua R, Gameroff MJ, Shea S (2004) Depressed mothers coming to primary care: maternal reports of problems with their children. J Affectice Disord 78:93–100
Wells KB, Stewart A, Hays RD, Burnam MA, Rogers W, Daniels M, Berry S, Greenfield S, Ware J (1989) The functioning and well-being of depressed patients. Results from the medical outcomes study. JAMA 262:914–919
White DM, Catanzaro RN, Buchholz A (1996) Psychological issues among adolescents in families in which a parent has multiple sclerosis. Report to the National Multiple Sclerosis Society, New York
White DM (1998) Treating the family with multiple sclerosis. Phys Med Rehabil Clin N Am 9(3):675–687
Worsham N, Compas B, Sydney E (1997) Children’s coping with parental illness. In: Sandler W (ed) Handbook of children’s coping: linking theory and intervention. New York, pp 195–213
Acknowledgement
This study is part of an international multisite research project, which was supported by a grant from the European Union in its 5th Framework Program. “Quality of Life” (QLGT-2001–02378): “Mental Health Prevention in a Target Group at Risk: Children of Somatically Ill Parents (COSIP)”. The following institutions and Principal Investigators collaborated in this project:
(1) Dept. of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Hamburg-Eppendorf, Germany (Dr. med. Georg Romer);
(2) Dept. of Child and Adolescent Neuropsychiatry, University of Vienna, Austria (Prof. Dr. med. M. Friedrich);
(3) Department of Psychology, University of Aarhus, Denmark (M. Thastum, Ph. D.);
(4) Child Psychiatry Clinic, Turku University Hospital, Finland (Prof. Dr. J. Piha);
(5) Department of Child Psychiatry, Athens University Medical School, Greece (Prof. Dr. J. Tsiantis);
(6) Clinic of Child and Adolescent Psychiatry, University of Medicine and Pharmacy, Bucharest, Romania (Prof. Dr. S. Milea);
(7) Clinic of Child and Adolescent Psychiatry, University of Basel, Switzerland (PD Dr. B. Steck);
(8) Department of Psychological Medicine, Royal Marsden Hospital, Sutton, United Kingdom (M. Watson, Ph. D.).
This study was also supported by the Swiss Multiple Sclerosis Society.
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Steck, B., Amsler, F., Grether, A. et al. Mental health problems in children of somatically ill parents, e.g. multiple sclerosis. Eur Child Adolesc Psychiatry 16, 199–207 (2007). https://doi.org/10.1007/s00787-006-0589-5
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DOI: https://doi.org/10.1007/s00787-006-0589-5