Offspring outcomes when a parent experiences one or more major psychiatric disorder(s): a clinical review

Abstract

We sought evidence on quantifiable offspring outcomes, including problems, needs and strengths, associated with their experience of major parental psychiatric disorder(s), focusing on schizophrenia, affective illnesses and personality disorder(s). We were motivated by the absence of any systematic exploration of the needs of offspring of parents in secure hospitals. Seven electronic databases were searched to identify systematic reviews of studies quantifying offspring outcomes when a parent, or parent surrogate, has major psychiatric disorder(s). Our search (updated in February 2018) identified seven high-quality reviews, which incorporated 291 unique papers, published in 1974–2017. The weight of evidence is of increased risk of poor offspring outcomes, including psychiatric disorder and/or behavioural, emotional, cognitive or social difficulties. No review explored child strengths. Potential moderators and mediators examined included aspects of parental disorder (eg, severity), parent and child gender and age, parenting behaviours, and family functioning. This clinical review is the first review of systematic reviews to focus on quantifiable offspring problems, needs or strengths when a parent has major psychiatric disorder(s). It narratively synthesises findings, emphasising the increased risk of offspring problems, while highlighting limits to what is known, especially the extent to which any increased risk of childhood problems endures and the extent to which aspects of parental disorder moderate offspring outcomes. The absence of the reviews’ consideration of child strengths and protective factors limits opportunity to enhance offspring resilience.

Adult mental health service engagement with patients who are parents: Evidence from 15 English mental health trusts

“…At any given moment, an estimated one in six adults in England will meet the criteria for a psychiatric disorder and up to half of these adults will also be parents (Maybery & Reupert, 2018; Mcmanus, Bebbington, Jenkins, & Brugha, 2014), which corresponds to one in four children experiencing maternal mental illness (Abel, Hope, Swift, et al., 2019). While many parents who struggle with their mental health provide excellent, nurturing care, there is also a clear relationship between parental mental health difficulties and impaired child outcomes, across a wide range of domains including educational attainment, social connectedness, and physical and mental health (Argent, Kalebic, Rice, & Taylor, 2020; O’Donnell et al., 2015; Pierce et al., 2020; Sidebotham & Heron, 2006). In particular, a parent’s mental ill health is associated with increased risk of their child developing a mental disorder (Santvoort et al., 2015).…”

Development of an intervention to support parents receiving treatment in psychiatric inpatient hospital using participatory design methods

“…There is limited research into the impact of parental hospitalisation for psychiatric needs of parents on child outcomes but there is evidence that it is associated with poorer school outcomes and housing instability ( 2 , 3 ). Research into the impact of parental serious mental illness (SMI, with which most hospitalised parents are diagnosed) suggests that children of parents with SMI are at high risk of negative mental and physical health outcomes including developing mental health problems of their own ( 4 , 5 ). Parents with serious mental health difficulties are more likely to be raising children in the context of economic challenges and lone parenthood ( 6 ).…”

Association of maternal and paternal personality disorders with risk of mental disorders in children: A nationwide, register‐based cohort study of 1,406,965 children

“…Children of parents with a mental disorder are at increased risk of developing a mental disorder 1–6 ; however, knowledge of the association of parental personality disorder with mental disorder in offspring is limited. Personality disorders are characterised by pervasive difficulties in interpersonal relationships across contexts, including family, workplace, friendships and parent–child relationships 7–11 .…”