Summarization of an article

COMPLEX MEDICAL-PSYCHIATRIC ISSUES (MB RIBA, SECTION EDITOR)

Update on Mental Health of Infants and Children of Parents Affected With Mental Health Issues

Gisèle Apter1 & Anne Bobin1,2 & Marie-Camille Genet1 & Maya Gratier1,2 & Emmanuel Devouche1,3

# Springer Science+Business Media, LLC 2017

Abstract This paper highlights the most recent publications, in the field of psychiatry, on offspring of patients with psychi- atric illnesses such as schizophrenia and bipolar disorder, and then summarizes what we know about the progeny of adults with mood disorders, the most prevalent of parental disorders. Studies examining personality disorders and contextual fac- tors such as stress and trauma are examined with a focus on the crucial question of development and attachment status in children. Findings converge to reveal that offspring of parents (generally mothers) with most major psychiatric disorders

present a higher risk for all mental disorders, and a wide range of disorders are also found in children, adolescent, and finally adult offspring of mothers with mood and anxiety disorders. Developmental psychopathology and infant and child psychi- atry have focused on early relationship formation through so- cial interaction and attachment patterns as pathways affected by vulnerability or resilience factors. First year of life longi- tudinal studies following mothers and infants has shown that maternal psychopathology is positively correlated with higher risk of attachment issues. It would seem that pathology ap- pears when adaptation to real-life contexts becomes difficult in association with an accumulation of negative individual characteristics and environmental circumstances. We suggest that in order to move forward psychiatry should embrace a developmental cascade model, which posits a cumulative pathway for the emergence of psychopathology in the devel- oping child. We propose that we have sufficient knowledge today to start implementing multilevel approaches to enhance the health and mental health of the next generation.

Keywords Parent mental illness . Offspring mental illness .

Developmental psychopathology . Cumulative risk

Introduction

The health and mental health of infants and children have al- ways attracted less attention than that of adults. And when child and adolescent psychiatry emerged decades after its adult coun- terpart, it rarely included the period of infancy. However, more recently, focus on transgenerational transmission of severe pa- rental trauma and stress to offspring [1] and lifetime health impact of fetal development has promoted expanding research in the field of mental health during the peripartum [2–4]. This has not, however, been matched with as many studies as one

The editors would like to thank Dr. Harrison Levine for taking the time to review this manuscript.

This article is part of the Topical Collection on Complex Medical- Psychiatric Issues

* Gisèle Apter [email protected]

Anne Bobin [email protected]

Marie-Camille Genet [email protected]

Maya Gratier [email protected]

Emmanuel Devouche [email protected]

1 Erasme Hospital, Psychiatry and Psychopathology Research Institute, 143 Avenue Armand Guillebaud, 92160 Antony, France

2 EA 3456 - LABORATOIRE ETHOLOGIE COGNITION DEVELOPPEMENT (LECD), Paris Ouest Nanterre University, 200 avenue de la République, 92001 Nanterre Cedex, France

3 Laboratoire de Psychopathologie et Processus de Santé (EA 4057), Paris Descartes University, 71 avenue Edouard Vaillant, 92774 Boulogne-Billancourt Cedex, France

Curr Psychiatry Rep (2017) 19:72 DOI 10.1007/s11920-017-0820-8

would hope for in infants, children, and social interactions in the field of psychiatry and psychopathology.

So, what do we know today on the mental health of infants and children of affected parents? Do we have better knowl- edge of processes involved in transmission of vulnerability versus resilience? When do these pathways organize, pre and/or postnatally? Can we build on this knowledge to suggest adequate responses and treatment planning? And finally, what paths could be taken to better investigate children and youth mental health prevention and treatment?

We will begin by highlighting the most recent publications, in the field of psychiatry, on offspring of patients with two important psychiatric illnesses, i.e., schizophrenia (SZ) and bipolar disorder (BD), and then go on to summarize what we know about the progeny of adults with mood disorders, the most highly prevalent parental disorder. Personality disor- ders (PD) and contextual factors such as stress and trauma, we argue, should be included in analyzing what we know about offspring’s mental health, thus integrating the crucial question of development and attachment status in children.

We propose that in order to move forward psychiatry should embrace the developmental cascade model, which posits a cu- mulative pathway for the emergence of psychopathology in the developing child. Despite the difficulty of taking into account the complex interactions between multiple factors over time, such a model claims a more pragmatic approach that encom- passes both a public health point of view and a psychopatho- logical one [5–7]. It begs for more integrative research on such essential subjects as the pathways towards a “good enough” mental health for infants, children, and adolescents.

What Do We Know Today About the Mental Health of Infants and Children of Affected Parents?

The number/quantity of studies focusing on perinatal psychi- atry has considerably increased in the last years. It is now finally admitted that psychiatric disorders do not miraculously disappear during pregnancy and the postpartum or that the peripartum period does not magically protect against de novo psychiatric disorders. On the contrary, psychiatric illness is pervasive in the peripartum in connection with various risk factors [8]. Epidemiology of psychiatric disorders during the peripartum is still subject to wide variations even among the most common disorders, i.e., mood disorders and depressive episodes [9]. Therefore, even though there is still a large con- troversy on whether psychiatric disorders during this period are specific or not, it is difficult to ignore their reality and their impact on the fetus, newborn, and infant [10–13].

Research exploring the development of offspring of parents affected with psychiatric disorders can be separated in two cat- egories, those that have a “macro” perspective with longitudinal follow-up of larger samples and those that have a “micro”

perspective, examining social interactions in infancy, toddler- hood, and early childhood in smaller population samples.

In 2015, Malhotra et al. [14] examined the characteristics of 30 families with mothers affected with SZ and compared symp- tomatology for externalizing, internalizing and other (social) problems in their 10-year-old on-average children with a group of 30 same-age control families. The general results were unsur- prisingly that the offspring of SZ mothers did not do as well as those of controls. However, even though this study is pioneering in studying this population in a low/middle income country, it is incomplete. Analyses conducted are simple Pearson’s correla- tions and thus do not take into account potential interactions between the child’s mental health and maternal severity and/or length of illness. Furthermore, children’s symptoms are reported by the parent through the children’s behavior checklist (CBCL) but the accuracy and validity of such reports by parents with severe mental illness or their spouses need to be tested. The authors aware of these risks advocate for a systematic screening of psychological, emotional, and behavioral issues in children of mothers affected with SZ on the Indian subcontinent. In line with this study, last year, Mohajer and Lewis [15•] published a systematic review of 46 papers presenting the result of 18 lon- gitudinal studies. The authors concentrated on research investi- gating children considered at familial high risk, i.e., having one or both parents with SZ. The originality of the review consists in the fact that its main focus was on developmental features through childhood. The reviewed studies suggest that these chil- dren show distinct developmental patterns characterized by higher rates of obstetric complication, neurodevelopmental fea- tures such as motor and cognitive deficits, and distinctive social behavior. Offspring of parents with SZ appear to be at high risk not only for SZ, but also for poor developmental and general mental health outcomes, a conclusion that leads the authors of the systematic review to recommend that: “specific intervention models to support their {offspring} development need to be fur- ther developed and evaluated.” Note that the high incidence of obstetric complication corroborates previous research showing that women with SZ are at higher risk for adverse pregnancy outcomes such as preeclampsia, prematurity, and small for ges- tational age (SGA) [16].

A recent study by Sanchez-Gistau and colleagues [17••] broadens the scope of Mohajer and Lewis’ review [15•] by comparing offspring of parents affected with SZ or BD. They found that children and adolescents presented a much higher risk of being diagnosed with attention deficit-hyperactivity disorder (ADHD) when a parent had a diagnosis of SZ and with depres- sion when a parent was affected by BD. Both groups were compared to unaffected families. This study presents a number of strengths compared to that of Malhotra et al. For example, its control group is well defined with exclusion of first degree fam- ily with history of either BD or SZ. However, among the limi- tations underlined by the authors, the SZ group was character- ized by lower SES and higher male offspring, while children of

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both groups, SZ and BD, had a higher risk of having both parents with an axis 1 disorder. Notwithstanding these differ- ences, adjusted odd ratios persistently showed that children were at higher risk than their control counterparts. It seems important to underline that from a clinical point of view these children are at an even higher risk of severe mental illness (SMI) if they have two parents with a psychiatric condition, low SES, and are boys. This outcome might even be linked to other negative factors that were not the object of the study but are essential, such as length of parental illness (once again not included), severity of illness, or number and duration of separations from parent due to hos- pitalizations. This study confirms the results of a previous meta- analysis showing that offspring of parents with SMI are at high risk for developing a range of psychiatric disorders with one third of them presenting an SMI by early adulthood [18].

Severe mental illness thus seems to take its toll on the next generation. But what about depression and anxiety, often con- sidered less severe conditions? One of the most well-known and methodologically sound longitudinal studies, conducted in the UK, focuses on outcomes from the earliest developmen- tal stages in infancy. For close to 20 years, Lynne Murray and her team have followed a homogenous population of highly educated mothers, some of whom were affected by peripartum depression (PPD). All along, she found higher risk of negative outcome, on externalized and internalized behavioral disorders, on academic performance or on the development of depression in the affected group with a strong male gender effect [19, 20]. Numerous studies have now shown the potential negative im- pact of PPD on infant and child health and mental health (see Goodman et al. [21] for a review). More recently, the heteroge- neity of postpartum depression and its frequent comorbidity with PD and/or anxiety have raised more questions than an- swers on the manner in which they may affect children’s mental health [22]. These studies, nonetheless, continue to underscore the negative impact of maternal mental health issues and com- mon comorbid PD on offspring’s developmental outcomes [23, 24, 25•]. A wide range of disorders are found in children, ado- lescent, and finally adult offspring of mothers with PPD, in- cluding mood and anxiety disorders [26]. This last negative outcome has been repetitively found at different stages in life of offspring, up to transition to adulthood [27].

Do We Have Better Knowledge of Interactive and Behavioral Processes Involved in Transmission of Vulnerability?

We know today that offspring of parents (generally mothers) with most major psychiatric disorders present a higher risk for all mental disorders. However, the manner in which this risk is built up remains an object of debate. It remains to be deter- mined whether different “building blocks” such as genetics, epigenetics, biology, social environment, social context and

interaction, parenting, and education can be teased apart, and whether they add up and/or interact in the unfolding pathways leading from risk into pathology.

A groundbreaking paper has now shown how both maternal depression and cumulative risk factors are involved in height- ening risks of psychiatric disorder in children at age 7 [28]. Barker et al. [28] teased apart both depression per se and mul- tiple environmental risk exposure analyzing the added and sep- arate impact of maternal mood disorder assessed at 18 months postpartum and a cumulative risk index of environmental, fam- ily risk, and maternal lifestyle risk factors. Even though depres- sion and cumulative risk together predicted the highest level of childhood internalizing and externalizing disorders, each addi- tional risk factor increased risk of childhood disorder by over 20%, with just three factors together generating an 80% risk for psychopathology in the child.

More recently, this cumulative model has been extended to include a longitudinal perspective [29••]. Matisevitch et al. [29••] looked at prolonged depression in mothers as a predic- tor of childhood mental health. They followed trajectories of maternal depression from 3 months to 6 years postpartum assessing maternal symptoms five times longitudinally. They showed that it is the chronicity of depression that is most deleterious, the “high chronic” risk group was associated with prediction of the most negative outcome, and the moderately low risk group was associated with higher risk of child disor- der than the low risk trajectory group.

The risk of developmental delay is combined with that of higher levels of psychopathology for children of mothers with postnatal depression. This has been underlined again as a global health concern [30]. The existence of a continuity be- tween symptoms of an antenatal and a postnatal depression raises two important questions. First, to what extent antenatal maternal depression might have a negative impact on the de- veloping fetus? Second, how may this entail implicit neonatal and postnatal characteristics that in turn influence the mother infant relationship from the very beginning? [31] The hypoth- esis of bidirectional effects of maternal psychopathology put forward by Mc Adams et al. [32] indeed suggests that one more factor should be included in the appraisal of impacts of offspring, that is, the quality of parent-child interaction itself. Based on a twin study and an adoption study, Mac Adams et al. [32] suggest that offspring psychopathology could not be “solely attributable to shared genes, and that bidirectional effects may be present in intergenerational associations.” These authors conclude that, because offspring characteristics in turn impact parental reaction to the child, the dyad should be the target of attention, specifically when envisaging treat- ment. This calls for greater attention to dyadic and early inter- active studies in cases of parental psychiatric disorder.

However, though numerous studies have been conducted, based on interactive models and patterns of dyadic interaction, few studies explore interactions per se between affected parents

Curr Psychiatry Rep (2017) 19:72 Page 3 of 7 72

and offspring or focus on outcome measures for these interac- tions. The mutual influence mothers and children have on each other, include models of mutual regulation model and primary intersubjectivity supporting a systems theory approach that looks at social development as a dyadic dynamic flow of matching, mismatching, and repair [33–36]. In the first semester, in case of maternal depression, interactions are dysregulated and the main finding consists in how infant and parent cannot mutually “con- nect.” As early as 3 or 4 months postpartum, interactive patterns organize in rigid configurations too tight for improvisation or too chaotic and loose for regulation [37]. Thus, infants are unable to establish a sense of agency and are at risk for emotional dysreg- ulation. As early as 3 months, when mothers present with PD and specifically borderline personality disorder, these patterns be- come the manner in which the infant interacts with the world. The shape of interactions becomes embedded in the infants’ early emotional development and impacts its capacity to self-regulate and to adapt to minor social stress [38].

Recently, Davidsen et al. [39] reviewed 27 studies with limit- ed evidence on processes of interactive disturbances. Interaction was an outcome measure in only 13 out the 27 studies and some of the studies took place in a mother and baby unit which, in fact, is a therapeutic setting. Most of the studies that were examined did not take into account comorbidity and maternal history of illness, or history and nature of medication. The review confirms that offspring are at very high risk for developmental or clinical adversity, i.e., over 50%, but underscore the lack of research and specifically of longitudinal studies in this domain [39]. However, Axelson et al. [40] pose the question of the validity of such reviews and meta-analyses based on populations with the same diagnosis but with many differences in other respects and suggest that reported results may be totally undermined by confounders such as history of abuse and/or comorbid addictive disorders.

Developmental psychopathology and infant and child psy- chiatry have focused on early relationship formation through social interaction and attachment patterns as pathways leading to vulnerability or resilience [41, 42]. It is now well-known that insecure disorganized attachment status is one of the most potent negative vulnerability factors that exist during child- hood [43, 44]. Furthermore, disorganized attachment has been shown to be linked to dysregulated patterns of interaction during the first year of life [45–48]. First year of life longitu- dinal studies following mothers and infants has shown that maternal psychopathology is positively correlated with higher risk of attachment issues [49•, 50]. At the same time, looking at other predictive factors of childhood psychopathology, such as maternal, maladaptive child rearing practices and substance abuse/personality disorders should be a primary concern [51].

Research in the field of developmental psychopathology has recently pointed to cascade models that include disorga- nized attachment as milestones in the negative trajectories of infants and children [7]. Over the past years, a growing scien- tific literature has shown that enduring, chronic early trauma,

abuse, and neglect entail lifelong negative mental health out- comes [52•]. Moreover, epigenetic animal studies have insisted on the chronic and transgenerational impact of non- optimal maternal and parental care to pups [53–55]. These studies provide fuel for utilizing their evidence to understand negative impact on children of neglectful or distorted parent- ing behaviors [56••].

Can We Build on This Knowledge To Suggest Treatment Planning and Response?

These recent articles including an up-to-date systematic re- view and a meta-analysis show that offspring of parents with SMI are at high risk of major psychiatric disorders both during childhood and adolescence and as young adults [15•]. Despite methodological limitations, there are a growing number of studies underlining on the one hand, the intricate interplay between numerous complex factors, among which parental mental health and other cumulative risk factors, and on the other hand, the effects of chronicity of mental illness on off- spring, with a heightened negative risk for the development of psychopathology at different stages in life [57]. Much confu- sion, however, persists with regard to essential factors and to what might be considered as “noise” that could be deemed unimportant or even negligible. Taking an interest in child- hood involves looking at children’s developmental trajecto- ries, and therefore at situations involving complexity. Yet, precise knowledge of which interferences are most important and when in the course of development their effects may be deleterious is scant.

This single factor approach is showing considerable limits and is now being challenged by such authors as Lee et al. [58]. They suggest that: “psychiatric disorders may be understood to be an array of behavioral traits that have emerged as envi- ronmental adaptation against adverse stressful environments in the evolution of organisms” (p. 5). This dynamic interactive approach is coherent in the light of a cumulative risk perspec- tive. Pathology appears if adaptation becomes too difficult, due to the accumulation of negative individual characteristics and environmental circumstances.

In a Danish population-wide cohort study, Mok et al. [59] showed that having a parent or both parents with a psychiatric disorder is associated with increased violent behavior and self- harm in offspring, underscoring the importance for public health policies to focus on vulnerable populations such as those where parents have a psychiatric disorder.

Poverty and lack of education have always been additional negative factors often found as part of the negative factors among populations studied and as consequences of lifelong mental illness. They are often considered as confounders that need to be extricated as if they were not directly involved in psychopathology. However, more and more data show how

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poverty is implicated both in child and adolescent mental health, with a two- to threefold increase in risk of any psychi- atric disorder for children of low SES families as illustrated by a wide-ranging meta-analysis [60].

These social and economic factors are obviously not within the limits of mental health program intervention. They concern general long-term targeted actions, as em- phasized in a comment by Tobias [61•]. The author suggests that the number one investment from a public health perspective should be in children, in early child- hood development enrichment, and in intensive parent support programs. Recently, Meany [55] underlines that there is a lack of focus on social interactions as the channel through which environment impacts biology through epigenetic expression of potential buffering or vulnerability elements [54, 55]. Meaney [55] insists on the importance of understanding the complexity of hu- man development compared to animal models. His con- tention is that we are still grappling with what elements potentialize vulnerability while others buffer risks dur- ing early development. And most importantly, we have not defined our end outcome model: is it behavior or is it brain and/or biology?

There is a paucity of pragmatic translational research in our field: we should be truly going from bench to bedside, and the “bench” says that the disorder is not explained by a single mechanism within homogeneous populations, that transmis- sion of illness to children is at high risk when chronicity and accumulation of factors collude. Treatment trials should there- fore address these populations and themselves be inclusive, plurifocal, and well-described. This involves what one could call an exquisite mix of cure and care teamwork [62].

Conclusion: What Paths Should We Be Taking?

Most analyses look at separate approaches to address chil- dren’s disorders in terms of factors trying to determine a def- inite, absolute, and recognized approach to both cause and therefore cure. However, in behavioral and complex disorders, we know the models are too simplistic.

Targeting preventive programs to underserved and high cumulative risk families, when psychiatric disorder and other risks are present, could be implemented at a more local level. Longitudinal research needs to be assessed to explore if this approach is effective and cost effective in the developmental long term, i.e., from infancy to adulthood through childhood and adolescence. Specifically addressing third level care for already affected parents and children needs to be well defined and comprehensive when symptoms already exist; they there- fore need to be screened for and addressed. If not, it is the secondary and tertiary complications of illness already

chronically embedded in both parents and children that we will be faced with tomorrow.

Not only does this beg for more research but also for more immediate therapeutic action. We have sufficient knowledge today to start implementing multilevel approaches to enhance the health and mental health of the next generation.

Compliance with Ethical Standards

Conflict of Interest The authors declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

1. Yehuda R, Schmeidler J, Wainberg M, Binder-Brynes K, Duvdevani T. Vulnerability to posttraumatic stress disorder in adult offspring of holocaust survivors. Am J Psychiatry. 1998;155:1163– 71.

2. O’Donnell KJ, Meaney MJ, Fetal origins of mental health: the developmental origins of health and disease hypothesis. Am J Psychiatry. 2016; Nov 14: appiajp201616020138.

3. Lewis AJ, Austin E, Knapp R, Vaiano T, Galbally M. Perinatal maternal mental health, fetal programming and child development. Wallack L, ed. Healthcare 2015;3(4):1212–1227.

4. Faa G, Manchia M, Pintus R, Gerosa C, Marcialis MA, Fanos V. Fetal programming of neuropsychiatric disorders. Birth Defect Res C. 2016;108:207–23.

5. de Jong JTVM, Berckmoes LH, Kohrt BA, Song S, Tol WA, Reis R. A public health approach to address the mental health burden of youth in situations of political violence and humanitarian emergen- cies. Curr Psychiatry Rep. 2015;17:60.

6. Sameroff AJ. Developmental systems and psychopathology. Dev Psychopathol. 2000;12(3):297–312.

7. Masten AS, Cicchetti D. Developmental cascades. Dev Psychopathol. 2010;22(3):491–5.

8. Howard LM, Piot P, Stein A. No health without perinatal mental health. Lancet. 2014;384:1723–4.

9. Howard LM, Molyneaux E, Dennis CL, Rochat T, Stein A, Milgrom J. Non-psychotic mental disorders in the perinatal period. Lancet. 2014;384:1775–88.

10. Putnam KT, Robertson-Blackmore E, Sharkey KM, Payne JL, Bergink V, Munk-Olsen T, et al. Heterogeneity of postpartum de- pression: a latent class analysis. The Lancet Psychiatry. 2015;2(1): 59–67.

11. Jones I, Chandra PS, Dazzan P, Howard LM. Bipolar disorder, affective psychosis, and schizophrenia in pregnancy and the post- partum period. Lancet. 2014;384:1789–99.

12. Stein A, Pearson RM, Goodman SH. Effects of perinatal mental disorders on the fetus and child. Lancet. 2014;384:1800–19.

13. Herrman H. Protecting the mental health of women in the perinatal period. The Lancet Psychiatry. 2015;2(2):116–8.

Curr Psychiatry Rep (2017) 19:72 Page 5 of 7 72

14. Malhotra M, Kumar D, Verma R. Effect of psychosocial environ- ment in children having mother with schizophrenia. Psychiatry Res. 2015;226:418–24.

15.• Mohajer AH, Lewis AJ. Offspring of parents with schizophrenia: a systematic review of developmental features across childhood. Harvard Review of Psychiatry. 2016;24(2):104–17. An exhaustive review of studies investigating developmental features of chil- dren having one or both parents with SZ. The review shows that offspring of parents with SZ are at high risk for poor developmental and general mental health outcomes.

16. Vigod SN, Kurdyak PA, Dennis CL, Gruneir A, Newman A, Seeman MV, et al. Maternal and newborn outcomes among women with schizophrenia: a retrospective population-based cohort study. BJOG. 2014;121(5):566–74.

17.•• Sanchez-Gistau V, Romeroa S, Moreno D, de la Serna E, Baeza I, Sugranyes G, et al. Psychiatric disorders in child and adolescent offspring of patients with schizophrenia and bipolar disorder: a controlled study. Schizophr Res. 2015;168(1–2):197–203. A study comparing offspring of parents affected with SZ or BD to un- affected families that shows that children are at an even higher risk of severe mental illness if they have 2 parents with a psy- chiatric condition and low SES.

18. Rasic D, Hajek T, Alda M, Uher R. Risk of mental illness in off- spring of parents with schizophrenia, bipolar disorder, and major depressive disorder: a meta-analysis of family high-risk studies. Schizophr Bull. 2014;40(1):28–38.

19. Murray L, Arteche A, Fearon P, Halligan S, Croudace T, Cooper P. The effects of maternal postnatal depression and child sex on aca- demic performance at age 16 years: a developmental approach. J Child Psychol Psychiatry. 2010;51(10):1150–9.

20. Murray L, Arteche A, Fearon P, Halligan S, Goodyer I, Cooper P. Maternal postnatal depression and the development of depression in offspring up to 16 years of age. J Am Acad Child Adolesc Psychiatry. 2011;50(5):460–70.

21. Goodman SH, Rouse MH, Connell AM, Broth MR, Hall CM, Heyward D. Maternal depression and child psychopathology: a meta-analytic review. Clin Child Fam Psychol Rev. 2011;14(1):1– 27.

22. Apter G, Devouche E, Gratier M, Valente M, Le Nestour A. What lies behind postnatal depression: is it only a mood disorder? Journal of Personality Disorder. 2012;26(3):357–67.

23. Genet MC. De l’interpersonnel à l’intrapsychique : étude longitudinale et comparative des dysfonctionnements interactifs, de l’attachement puis du devenir narratif et du fonctionnement psychique des enfants de mères présentant un trouble de personnalité borderline/état-limite. Doctoral Dissertation. 2012 Paris Descartes University.

24. Genet MC, Golse B, Devouche E, Apter G. Psychopathologie, attachement et devenir des enfants de mères présentant un trouble de personnalité borderline/état-limite: une revue de la littérature. Psychiatr Enfant. 2014;57(1):259–329.

25.• Prenoveau JM, Craske MG, West V, Giannakakis A, Zioga M, Lehtonen A, et al. Maternal postnatal depression and anxiety and their association with child emotional negativity and behavior prob- lems at two years. Dev Psychol. 2017;53(1):50–62. In this study, included in the Oxford Parent Project, persistent maternal psy- chopathology was found to impact children negatively at two years rather than maternal anxiety alone or less durable ma- ternal experience of depression.

26. Weissman MM, Wickramaratne P, Nomura Y, Warner V, Pilowsky D, Verdeli H. Offspring of depressed parents: 20 years later. Am J Psychiatr. 2006;163(6):1001–8.

27. Gonçalves H, Pearson RM, Horta BL, González-Chica DA, Castilho E, Damiani M, et al. Maternal depression and anxiety predicts the pattern of offspring symptoms during their transition to adulthood. Psychol Med. 2016;46:415–24.

28. Barker ED, Copeland W, Maughan B, Jaffee SR, Uher R. The relative impact of maternal depression and associated risk factors on offspring psychopathology Br J Psychiatry 2012;200(2):124– 129.

29.•• Matijasevich A, Murray J, Cooper PJ, Anselmi L, Barros AJ, Barros FC, et al. Trajectories of maternal depression and offspring psychopathology at 6 years: 2004 Pelotas cohort study. J Affect Disord. 2015;174:424–31. An original longitudinal follow-up of maternal depression over the first six years postpartum show- ing that the more chronic and higher the level of depression, the more the child is at risk for a mental health disorder.

30. Santos IS, Matijasevich A, Barros AJ, Barros FC. Antenatal and postnatal maternal mood symptoms and psychiatric disorders in pre-school children from the 2004 Pelotas Birth Cohort. J Affect Disord. 2014;164:112–7.

31. Vameghi R, Akbari SAA, Sajjadi H, Sajedi F, Alavimajd H. Correlation between mothers’ depression and developmental delay in infants aged 6-18 months. Global Journal of Health Science. 2016;8(5):11.

32. McAdams TA, Rijsdijk FV, Neiderhiser JM, Narusyte J, Shaw DS, Natsuaki MN, et al. The relationship between parental depressive symptoms and offspring psychopathology: evidence from a children-of-twins study and an adoption study. Psychol Med. 2015;45:2583–94.

33. Weinberg MK, Tronick EZ. Beyond the face: an empirical study of infant affective configurations of facial, vocal, gestural, and regula- tory behaviors. Child Dev. 1994;65(5):1503–15.

34. Tronick E, Beeghly M. Infants’ meaning-making and the develop- ment of mental health problems. Am Psychol. 2011;66(2):107–19.

35. Beebe B, Messinger D, Bahrick LE, Margolis A, Buck KA, Chen H. A systems view of mother-infant face-to-face communication. Dev Psychol. 2016;52(4):556–71.

36. Trevarthen C, Aitken KJ. Infant intersubjectivity: research, theory, and clinical applications. J Child Psychol Psychiatry. 2001;42(1):3– 48.

37. Beebe B, Steele M, Jaffe J, Buck KA, Chen H, Cohen P, et al. Maternal anxiety symptoms and mother–infant self- and interactive contingency. Infant Ment Health J. 2011;32(2):174–206.

38. Apter G, Devouche E, Garez V, Valente M, Genet MC, Gratier M, et al. The still face: a greater challenge for infants of borderline mothers. Journal of Personality Disorder. 2016;30:1–14.

39. Davidsen KA, Harder S, MacBeth A, Lundy JM, Gumley A. Mother–infant interaction in schizophrenia: transmitting risk or re- silience? A systematic review of the literature. Soc Psychiatry Psychiatr Epidemiol. 2015;50:1785–98.

40. Axelson D, Goldstein B, Goldstein T, Monk K, Yu H, Hickey MB, et al. Diagnostic precursors to bipolar disorder in offspring of par- ents with bipolar disorder: a longitudinal study. Am J Psychiatry. 2015;172:638–46.

41. Simard V, Moss E, Pascuzzo K. Early maladaptive schemas and child and adult attachment: a 15-year longitudinal study. Psychol Psychother. 2011;84(4):349–66.

42. Madigan S, Moran G, Schuengel C, Pederson DR, Otten R. Unresolved maternal attachment representations, disrupted mater- nal behavior and disorganized attachment in infancy: links to tod- dler behavior problems. J Child Psychol Psychiatry. 2007;48(10): 1042–50.

43. Zeanah CH, Keyes A, Settles L. Attachment relationship experi- ences and childhood psychopathology. Ann N Y Acad Sci. 2003;1008:22–30.

44. Pasco Fearon RM, Belsky J. Infant-mother attachment and the growth of externalizing problems across the primary-school years. J Child Psychol Psychiatry. 2011;52(7):782–91.

45. Beebe B, Jaffe J, Markese S, Buck K, Chen H, Cohen P, et al. The origins of 12-month attachment: a microanalysis of 4-month moth- er-infant interaction. Attach Hum Dev. 2010;12(1–2):3–141.

72 Page 6 of 7 Curr Psychiatry Rep (2017) 19:72

46. Beebe B, Steele M. How does microanalysis of mother-infant com- munication inform maternal sensitivity and infant attachment? Attach Hum Dev. 2013;15(5–6):583–602.

47. Lyons-Ruth K, Bronfman E, Parsons E. Maternal disrupted affec- tive communication, maternal frightened or frightening behavior, and disorganized infant attachment strategies. Monographs of the Society for Research in Child Development 1999;64(3).

48. van Ijzendoorn MH, Schuengel C, Bakermans-Kranenburg MJ. Disorganized attachment in early childhood: meta-analysis of pre- cursors, concomitants, and sequelae. Dev Psychopathol. 1999;11(2):225–49.

49.• Smith-Nielsen J, Tharner A, Steele H, Cordes K, Mehlhase H, Vaever MS. Postpartum depression and infant-mother attachment security at one year: the impact of co-morbid maternal personality disorders. Infant Behav Dev. 2016;44:148–58. Co-morbid mater- nal personality disorders predict insecure attachment while post-partum depression without comorbidity does not, in this longitudinal study.

50. Wan MW, Green J. The impact of maternal psychopathology on child-mother attachment. Arch Womens Ment Health. 2009;12(3): 123–34.

51. Brook DW, Lee JY, Morojele NK, Rosenberg G, Brook JS. Predictors of childhood depressed mood: a two-generational study. J Child Fam Stud. 2015;24(9):2786–94.

52.• Verhulst FC. Early life deprivation: is the damage already done? Lancet. 2017; doi:10.1016/S0140-6736(17)30541-X. A comment supporting the rule of “the earlier the better” for improving the caregiving environment for young children whose basic needs are profoundly violated.

53. Lucion AB, Bortolini MC. Mother-pup interactions: rodents and humans. Front Endocrinol (Lausanne). 2014;5:17.

54. Luby JL, Belden A, Harms MP, Tillman R, Barch DM. Preschool is a sensitive period for the influence of maternal support on the

trajectory of hippocampal development. Proc Natl Acad Sci U S A. 2016;113(20):5742–7.

55. Meaney MJ. Mother nurture and the social definition of neurodevelopment. Proc Natl Acad Sci U S A. 2016;113(22):6094–6.

56.•• Drury SS, Sanchez MM, Gonzalez A. When mothering goes awry: challenges and opportunities for utilizing evidence across rodent, nonhuman primate and human studies to better define the biological consequences of negative early caregiving. Horm Behav. 2016;77: 182–92. A review that highlights the powerful role played by maternal care in regulating the developmental trajectory of the infant and identifies areas of possible translational research across species.

57. Atkinson L, Beitchman J, Gonzalez A, Young A, Wilson B, Escobar M, et al. Cumulative risk, cumulative outcome: a 20-year longitudinal study. PLoS One. 2015;10(6):e0127650.

58. Lee YA, Yamaguchi Y, Goto Y. Neurodevelopmental plasticity in pre-and postnatal environmental interactions: implications for psy- chiatric disorders from an evolutionary perspective. Neural plastic- ity. 2015; doi:10.1155/2015/291476.

59. Mok PL, Pedersen CB, Springate D, Astrup A, Kapur N, Antonsen S, et al. Parental psychiatric disease and risks of attempted suicide and violent criminal offending in offspring: a population-based co- hort study. Jama Psychiatry. 2016;73(10):1015–22.

60. Reiss F. Socioeconomic inequalities and mental health problems in children and adolescents: a systematic review. Soc Sci Med. 2013;90:24–31.

61.•• Tobias M. Social rank: a risk factor whose time has come? Lancet. doi:10.1016/S0140-6736(17)30191-5. A plea for placing social determinants and the health system squarely at the center of sustainable child development.

62. Lauritzen C, Reedtz C. Knowledge transfer in the field of parental mental illness: objectives, effective strategies, indicators of success, and sustainability. Int J Ment Heal Syst. 2015;9(1):6.

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