Exposure to maternal depressive symptoms in childhood and adolescent suicide-related thoughts and attempts: mediation by child psychiatric symptoms

Abstract

Aims The nature of the association between child psychiatric symptoms and adolescent suicide-related thoughts (SRT) and attempts (SA) remains unclear. Our objective was to assess whether child psychiatric symptoms from 6 to 10 years of age mediate the association between exposure to maternal depressive symptoms in childhood and offspring SRT and SA in adolescence. Methods A population-based cohort study was constructed by linking all eight cycles from the National Longitudinal Survey of Children and Youth (NLSCY), a nationally representative Canadian panel survey conducted from 1994 to 2009. Self-reported maternal depressive symptoms were measured when offspring were between 0 and 5 years. Maternal-reported child psychiatric symptoms and psychiatric comorbid symptoms were measured from 6 to 10 years, and offspring self-reported SRT and SA were measured between 11 and 19 years. Indirect effects, the effect proportion mediated and their corresponding bootstrapped 95% confidence intervals (CI) were estimated. Results Hyperactivity and inattention significantly mediated the association between maternal depressive symptoms in childhood and risk of both SRT and SA from 11 to 19 years, where approximately 60% (SRT 95% CI 23–94%; SA 95% CI 27–95%) of this association was explained by hyperactivity and inattention. Psychiatric comorbid symptoms also significantly mediated this relationship and accounted for 50% (95% CI 18–81%) of this association with SA. Conclusions Targeting hyperactivity and inattention, and co-occurring psychiatric symptoms in offspring of depressed mothers could reduce risk of SRT, eventual SA and halt progression towards suicide. However, further understanding of comorbid psychiatric symptoms in childhood that most strongly predict adolescent SA is needed.

Accidental injury, self‐injury, and assault among children of women with schizophrenia: a population‐based cohort study

“…Children of women with schizophrenia are at higher risk of developing mental disorders themselves, a key risk for self‐injury 45 . Suicidal thoughts in children of mothers with other types of mental illness are at least partly mediated by the child's psychiatric symptoms 46,47 . In our study, the differentially elevated risk of self‐injury started to become apparent in school‐age children and adolescents, when mental disorders begin to emerge, supporting this hypothesis.…”

“…45 Suicidal thoughts in children of mothers with other types of mental illness are at least partly mediated by the child's psychiatric symptoms. 46,47 In our study, the differentially elevated risk of self-injury started to become apparent in schoolage children and adolescents, when mental disorders begin to emerge, supporting this hypothesis. This suggests that children of women with schizophrenia should be monitored not only for emerging mental health conditions, but also thoughts of suicide or deliberate self-injury, and probably earlier than in the teen years.…”

The mediating role of adolescents’ loneliness and social withdrawal in the association between maternal depressive symptoms and suicidality in adolescence: A 20-year population-based study

“…Risk factors for suicide among youth include in-utero and perinatal adverse conditions, child abuse or neglect, family problems, stressful life events, social isolation, academic pressure, bullying, youth's psychiatric disorders, previous self-harm, and suicide in friends or family (Hawton, 2009; Orri et al, 2019; Rodway et al, 2016). Due to genetic and environmental reasons, exposure to parental psychopathology has been identified as a risk factor for youths’ suicide-related thoughts (suicidal ideation) and behaviors (Goodday, Bondy, Brown, Sutradhar, & Rhodes, 2020).…”

“…Identifying environmental, child-related pathways via which exposure to maternal depression leads to suicidality (i.e., ideation and/or attempt) can inform preventive interventions targeting these putative mechanisms. Previous longitudinal studies have shown that children's mental health problems are a pathway through which exposure to maternal depression can increase the risk of youth suicidality (Goodday et al, 2020; Hammerton, Zammit, et al, 2015). However, little is known about other potential mechanisms through which the association between exposure to maternal depression and children's suicidality occurs.…”