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Parental psychiatric disorder: effects on children

Published online by Cambridge University Press:  09 July 2009

Michael Rutter*
Affiliation:
Department of Child and Adolescent Psychiatry, Institute of Psychiatry, London
David Quinton
Affiliation:
Department of Child and Adolescent Psychiatry, Institute of Psychiatry, London
*
1 Address for correspondence: Professor Michael Rutter, Department of Child and Adolescent Psychiatry, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF.

Synopsis

A 4-year prospective study was undertaken of the families of 137 newly referred English speaking psychiatric patients with children at home aged under 15 years. The group comprised a representative sample of such patients living in one inner London borough. Teacher questionnaires were obtained yearly for all children of school age in the families, and for age-, sex- and classroom-matched controls. Detailed standardized interviews were undertaken yearly with parent-patients and with their spouses. A comparison was also made with a control group of families in the general population with 10-year-old children. Patients' families differed in terms of a higher rate of psychiatric disorder in spouses and a much higher level of family discord. Both parental mental disorder and marital discord tended to persist over the 4-year period, but persistence of both was much more marked when the parent had a personality disorder. The children of psychiatric patients had an increased rate of persistent emotional/behavioural disturbance, which tended to involve disorders of conduct. The psychiatric risk to the children was greatest in the case of personality disorders associated with high levels of exposure to hostile behaviour. Boys showing temperamental risk features were most vulnerable to the ill-effects associated with parental mental disorder.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1984

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References

Beardslee, W. R. (1984). Adaptation in children at risk: children of parents with major depressive disorder. In Depression in Children: Developmental Perspectives (ed. Rutter, M., Izard, C. E. and Read, P.). Guilford Press: New York (in the press).Google Scholar
Billings, A. G. & Moos, R. H. (1983). Comparisons of children of depressed and non-depressed parents: a social-environmental perspective. Journal of Abnormal Child Psychology 11, 463486.CrossRefGoogle Scholar
Birtchnell, J. & Kennard, J. (1983 a). Does marital maladjustment lead to mental health? Social Psychiatry 18, 7988.CrossRefGoogle Scholar
Birtchnell, J. & Kennard, J. (1983 b). Marriage and mental illness. British Journal of Psychiatry 142, 193198.CrossRefGoogle ScholarPubMed
Bohman, M., Sigvardsson, S. & Cloninger, R. (1981). Maternal inheritance of alcohol abuse: cross-fostering analysis of adopted women. Archives of General Psychiatry 38, 965969.CrossRefGoogle ScholarPubMed
Bothwell, S. & Weissman, M. M. (1977). Social impairments four years after an acute depressive episode. American Journal of Orthopsychiatry 47, 231237.CrossRefGoogle ScholarPubMed
Brown, G. W. & Harris, T. (1978). Social Origins of Depression. Tavistock: London.Google ScholarPubMed
Brown, G. W. & Rutter, M. (1966). The measurement of family activities and relationships: a methodological study. Human Relations 19, 241263.CrossRefGoogle Scholar
Brown, G., Chadwick, O., Shaffer, D., Rutter, M. & Traub, M. (1981). A prospective study of children with head injuries: III. Psychiatric sequelae. Psychological Medicine 11, 6378.CrossRefGoogle ScholarPubMed
Buck, C. & Laughton, K. (1959). Family patterns of illness: the effect of psychoneurosis in the parent upon illness in the child. Acta Psychiatrica et Neurologica Scandinavica 34, 165175.CrossRefGoogle ScholarPubMed
Cloninger, C. R., Bohman, M. & Sigvardsson, S. (1981). Inheritance of alcohol abuse: cross fostering analysis of adopted men. Archives of General Psychiatry 38, 861868.CrossRefGoogle ScholarPubMed
Cohler, B. J., Grunebaum, H. U., Weiss, J. L., Gamer, E. & Gallant, D. H. (1977). Disturbance of attention among schizophrenic depressed and well mothers and their young children. Journal of Child Psychology and Psychiatry 18, 115135.CrossRefGoogle ScholarPubMed
Cox, A. D. & Mills, M. (1983). Paper given to British Psychological Society, Developmental Section. Annual Conference,Oxford.Google Scholar
Crowe, R. R. (1983). Antisocial personality disorders. In The Child At Psychiatric Risk (ed. Tarter, R. E.), pp. 214227. Oxford University Press: Oxford.Google Scholar
Cytryn, L., McKnew, D. W., Zahn-Waxler, C. & Gershon, E. S. (1984). Developmental issues in risk research: the offspring of affectively ill parents. In Depression in Children: Developmental Perspectives (ed. Rutter, M., Izard, C. E. and Read, P.). Guilford Press: New York (in the press).Google Scholar
Dunn, J. (1980). Individual differences in temperament. In Scientific Foundations of Developmental Psychiatry (ed. Rutter, M.), pp. 101109. Heinemann Medical: London.Google Scholar
Dunn, J. & Kendrick, C. (1982). Siblings: Love, Envy and Understanding. Harvard University Press: Cambridge, Mass.CrossRefGoogle Scholar
Emery, R. E. (1982). Interparental conflict and the children of discord and divorce. Psychological Bulletin 92, 310330.CrossRefGoogle ScholarPubMed
Emery, R. E., Weintraub, S. & Neale, J. M. (1982). Effects of marital discord on the school behavior of children of schizophrenic, affective disorders and normal parents. Journal of Abnormal Child Psychology 10, 215228.CrossRefGoogle ScholarPubMed
Fisher, L., Kokes, R. F., Harder, D. W. & Jones, J. E. (1980). Child competence and psychiatric risk. VI. Summary and integration of findings. Journal of Nervous and Mental Disease 168, 353355.CrossRefGoogle ScholarPubMed
Folstein, S. E., Franz, M. L., Jensen, B. A., Chase, G. A. & Folstein, M. F. (1983). Conduct disorder and affective disorder among the offspring of patients with Huntington's disease. Psychological Medicine 13, 4552CrossRefGoogle ScholarPubMed
Garmezy, N. (1983). Stressors of childhood. In Stress, Coping and Development in Children (ed. Garmezy, N. and Rutter, M.), pp. 4384. McGraw-Hill: New York.Google Scholar
Garmezy, N., Masten, A. S. & Tellegen, A. (1984). The study of stress and competence in children: a building block for developmental psychopathology. Child Development 55, 97111.CrossRefGoogle Scholar
Gershon, E. S. (1984). The Origins of Depression: Current Concepts and Approaches. Springer Verlag: New York (in the press). (Berlin: Dahlem Konferenzen, 1982.)Google Scholar
Gottesman, I. I. & Shields, J. (1976). A critical review of recent adoption, twin, and family studies of schizophrenia: behavioural genetics perspective. Schizophrenia Bulletin 2, 360400.CrossRefGoogle Scholar
Graham, P. & Rutter, M. (1968). The reliability and validity of the psychiatric assessment of the child: II. Interview with the parent. British Journal of Psychiatry 114, 581592.CrossRefGoogle ScholarPubMed
Graham, P., Rutter, M. & George, S. (1973). Temperamental characteristics as predictors of behavior disorders in children. American Journal of Orthopsychiatry 43, 328339.CrossRefGoogle ScholarPubMed
Hare, E. H. & Shaw, G. K. (1965). A study in family health: II. A comparison of the health of fathers, mothers and children. British Journal of Psychiatry 111, 467471.CrossRefGoogle Scholar
Hobbs, P. (1982). The relative timing of psychiatric disorder in parents and children. British Journal of Psychiatry 140, 3743.CrossRefGoogle ScholarPubMed
Huxley, P. J., Goldberg, D. P., Maguire, G. P. & Kincey, V. A. (1979). The prediction of the course of minor psychiatric disorders. British Journal of Psychiatry 135, 535543.CrossRefGoogle ScholarPubMed
Janet, P. (1925). Psychological Healing, Vol. 1 (transl. Paul, E. and Paul, C.), pp. 426427. Allen & Unwin: London.Google Scholar
Kagan, J. (1980). Perspectives on continuity. In Constancy and Change in Human Development (ed. Brim, O. G. Jr and Kagan, J.), pp. 2674. Harvard University Press: Cambridge, Mass.Google Scholar
Kellner, R. (1963). Family III Health: An Investigation in General Practice. Tavistock: London.Google Scholar
Lewis, A. (1974). Psychopathic personality: a most elusive category. Psychological Medicine 4, 133140.CrossRefGoogle ScholarPubMed
McNeil, T. F. & Kaij, L. (1984). Offspring of women and nonorganic psychoses: progress report, February 1980. In Children At Risk for Schizophrenia: A Longitudinal Perspective (ed. Watt, N., Anthony, E. J., Wynne, L. C. and Rolf, J.). Cambridge University Press: Cambridge (in the press).Google Scholar
Merikangas, K. R. & Spiker, D. G. (1982). Assortative mating among in-patients with primary affective disorder. Psychological Medicine 12, 753764.CrossRefGoogle ScholarPubMed
Mills, M., Puckering, C., Pound, A. & Cox, A. D. (1984). What is it about depressed mothers that influences their children's functioning? In Recent Research in Developmental Psychopathology (ed. Stevenson, J.). Journal of Child Psychology and Psychiatry Monograph Supplement No. 4. Pergamon: Oxford (in the press).Google Scholar
Parker, G. & Hadzi-Pavlovic, D. (1984). Modification of levels of depression in mother-bereaved women by parental and marital relationships. Psychological Medicine 14, 125136.CrossRefGoogle ScholarPubMed
Pearce, J. (1978). The recognition of depressive disorder in children. Journal of the Royal Society of Medicine 71, 494500.CrossRefGoogle ScholarPubMed
Porter, R. & Collins, G. M. (eds.) (1982). Temperamental Differences in Infants and Young Children. Ciba Foundation Symposium 89. Pitman: London.Google Scholar
Pound, A., Cox, A. D., Puckering, C. & Mills, M. (1984). The impact of maternal depression on young children. In Recent Research in Developmental Psychopathology (ed. Stevenson, J.). Journal of Child Psychology and Psychiatry Monograph Supplement No. 4. Pergamon: Oxford (in the press).Google Scholar
Quinton, D., Rutter, M. & Rowlands, O. (1976). An evaluation of an interview assessment of marriage. Psychological Medicine 6, 577586.CrossRefGoogle ScholarPubMed
Quinton, D., Rutter, M. & Liddle, C. (1984). Institutional rearing, parenting difficulties and marital support. Psychological Medicine 14, 107124.CrossRefGoogle ScholarPubMed
Rice, E. P., Ekdahl, M. C. & Miller, L. (1971). Children of Mentally III Parents: Problems in Child Care. Behavioral Publications: New York.Google Scholar
Richardson, S. A., Dorhenwend, B. S. & Klein, D. (1965). Interviewing: Its Forms and Functions. Basic Books: New York.Google Scholar
Richman, N., Stevenson, J. & Graham, P. J. (1982). Preschool to School: a Behavioural Study. Academic Press: London.Google Scholar
Rodnick, E. H. & Goldstein, M. J. (1974). Premorbid adjustment and the recovery of mothering function in acute schizophrenic women. Journal of Abnormal Psychology 83, 623628.CrossRefGoogle ScholarPubMed
Rolf, J. E. & Garmezy, N. (1974). The school performance of children vulnerable to behaviour pathology. In Life History Research in Psychopathology, Vol. 3 (ed. Ricks, D. F., Thomas, A. and Roff, M.). University of Minnesota Press: Minneapolis.Google Scholar
Rutter, M. (1966). Children of Sick Parents: An Environmental and Psychiatric Study. Institute of Psychiatry Maudsley Monographs No. 16. Oxford University Press: London.Google Scholar
Rutter, M. (1967). A children's behaviour questionnaire for completion by teachers: preliminary findings. Journal of Child Psychology and Psychiatry 8, 111.CrossRefGoogle ScholarPubMed
Rutter, M. (1970). Sex differences in children's response to family stress. In The Child in His Family (ed. Anthony, E. J. and Koupernik, C.), pp. 165196. Wiley: New York.Google Scholar
Rutter, M. (1971). Parent-child separation: psychological effects on the children. Journal of Child Psychology and Psychiatry 12, 233260.CrossRefGoogle ScholarPubMed
Rutter, M. (1977 a). Prospective studies to investigate behavioral change. In The Origins and Course of Psychopathology (ed. Strauss, J. S., Babigian, H. M. and Roff, M.), pp. 223247. Plenum: New York.CrossRefGoogle Scholar
Rutter, M. (1977 b). Individual differences. In Child Psychiatry: Modern Approaches (ed. Rutter, M. and Hersov, L.), pp. 321. Blackwell Scientific: Oxford.Google Scholar
Rutter, M. (1978). Family, area and school influences in the genesis of conduct disorders. In Aggression and Antisocial Behaviour in Childhood and Adolescence (ed. Hersov, L. A., Berger, M. and Shaffer, D.), pp. 95113. Journal of Child Psychology and Psychiatry Monograph Supplement No. 1. Pergamon: Oxford.Google Scholar
Rutter, M. (1981). The city and the child. American Journal of Orthopsychiatry 51, 610625.CrossRefGoogle ScholarPubMed
Rutter, M. (1982). Epidemiological–longitudinal approaches to the study of development. In The Concept of Development (ed. Collins, W. A.), pp. 105144. Minnesota Symposia on Child Psychology, Vol. 15. Erlbaum: Hillsdale, NJ.Google Scholar
Rutter, M. (1983). Statistical and personal interactions: facets and perspectives. In Human Development: An Interactional Perspective (ed. Magnusson, D. and Allen, V.), pp. 295319. Academic Press: New York.Google Scholar
Rutter, M. (1984 a). Psychopathology and development: links between childhood and adult life. In Child Psychiatry: Modern Approaches (2nd edn) (ed. Rutter, M. and Hersov, L.). Blackwell Scientific: Oxford (in the press).Google Scholar
Rutter, M. (1984 b). Continuities and discontinuities in socio-emotional development: empirical and conceptual perspectives. In Continuities and Discontinuities in Development (ed. Emde, R. and Harmon, R.). Plenum: New York (in the press).CrossRefGoogle Scholar
Rutter, M. & Brown, G. W. (1966). The reliability and validity of measures of family life and relationships in families containing a psychiatric patient. Social Psychiatry 1, 3853.CrossRefGoogle Scholar
Rutter, M. & Garmezy, N. (1983). Developmental psychopathology. In Socialization, Personality, and Social Development, Vol. 4, Handbook of Child Psychology (ed. Hetherington, E. M.), pp. 775911. Wiley: New York.Google Scholar
Rutter, M. & Giller, H. (1983). Juvenile Delinquency: Trends and Perspectives. Penguin: Harmondsworth.Google Scholar
Rutter, M. & Quinton, D. (1977). Psychiatric disorder in ecological factors and concepts of causation. In Ecological Factors in Human Development (ed. McGurk, H.), pp. 173187. North-Holland: Amsterdam.Google Scholar
Rutter, M. & Quinton, D. (1981). Longitudinal studies of institutional children and children of mentally ill parents (United Kingdom). In Prospective Longitudinal Research: An Empirical Basis for the Primary Prevention of Psychosocial Disorders (ed. Mednick, S. A. and Baert, A. E.), pp. 297305. Oxford University Press: Oxford.Google Scholar
Rutter, M., Birch, H. G., Thomas, A. & Chess, S. (1964). Temperamental characteristics in infancy and the later development of behavioural disorders. British Journal of Psychiatry 110, 651661.CrossRefGoogle ScholarPubMed
Rutter, M., Tizard, J. & Whitmore, K. (eds.) (1970). Education, Health and Behaviour. Longmans: London. (Reprinted Krieger: New York, 1981.)Google Scholar
Rutter, M., Cox, A., Tupling, C., Berger, M. & Yule, W. (1975 a). Attainment and adjustment in two geographical areas. I. The prevalence of psychiatric disorder. British Journal of Psychiatry 126, 493509.CrossRefGoogle Scholar
Rutter, M., Yule, B., Quinton, D., Rowlands, O., Yule, W. & Berger, M. (1975 b). Attainment and adjustment in two geographical areas. III. Some factors accounting for area differences. British Journal of Psychiatry 126, 520533.CrossRefGoogle ScholarPubMed
Rutter, M., Graham, P., Chadwick, O. & Yule, W. (1976). Adolescent turmoil: fact or fiction? Journal of Child Psychology and Psychiatry 17, 3556.CrossRefGoogle ScholarPubMed
Rutter, M., Quinton, D. & Liddle, C. (1983). Parenting in two generations: looking backwards and looking forwards. In Families at Risk (ed. Madge, N.), pp. 6098. Heinemann Educational: London.Google Scholar
Sameroff, A. J., Barocas, R. & Safer, R. (1984). Rochester Longitudinal Study progress report. In Children At Risk for Schizophrenia: A Longitudinal Perspective (ed. Watt, N., Anthony, E. J., Wynne, L. C. and Rolf, J.). Cambridge University Press: Cambridge (in the press).Google Scholar
Shepherd, M. & Sartorius, N. (1974). Personality disorder and the International Classification of Diseases. British Journal of Psychiatry 135, 163167.Google Scholar
Shepherd, M., Oppenheim, B. & Mitchell, S. (1971). Childhood Behaviour and Mental Health. University of London Press: London.Google Scholar
Stewart, M. & De Blois, S. (1983). Father-son resemblances in aggressive and antisocial behaviour. British Journal of Psychiatry 142, 7884; 143, 310–311.CrossRefGoogle ScholarPubMed
Thomas, A., Chess, S. & Birch, H. G. (1968). Temperament and Behavior Disorders in Children. University Press: New York.Google Scholar
Torgersen, S. (1983). Genetics of neurosis: the effects of sampling variation upon the twin concordance ratio. British Journal of Psychiatry 142, 126132.CrossRefGoogle ScholarPubMed
Tyrer, P. & Alexander, J. (1979). Classification of personality disorder. British Journal of Psychiatry 135, 163167.CrossRefGoogle ScholarPubMed
Tyrer, P., Alexander, M. S., Cicchetti, D., Cohen, M. S. & Remington, M. (1979). Reliability of a schedule for rating personality disorders. British Journal of Psychiatry 135, 168174.CrossRefGoogle ScholarPubMed
Tyrer, P., Casey, P. & Gall, J. (1983). Relationship between neurosis and personality disorder. British Journal of Psychiatry 142, 404408.CrossRefGoogle ScholarPubMed
Watt, N. K., Anthony, E. J., Wynne, L. C. & Rolf, E. (eds.) (1984). Children At Risk for Schizophrenia: A Longitudinal Perspective. Cambridge University Press: Cambridge (in the press).Google Scholar
Weintraub, S. & Neale, J. M. (1984). The Stony Brook High-Risk Project. In Children At Risk for Schizophrenia: A Longitudinal Perspective (ed. Watt, N., Anthony, E. J., Wynne, L. C. and Rolf, J.). Cambridge University Press: Cambridge (in the press).Google Scholar
Weintraub, S., Prinz, R. J. & Neale, J. M. (1978). Peer evaluations of the competence of children vulnerable to psychopathology. Journal of Abnormal Child Psychology 6, 461474.CrossRefGoogle ScholarPubMed
Weissman, M. M. & Paykel, E. S. (1974). The Depressed Woman: a Study of Social Relationships. University of Chicago Press: Chicago.Google Scholar
Weissman, M. M., Paykel, E. S. & Klerman, G. L. (1972). The depressed woman as a mother. Social Psychiatry 7, 98108.CrossRefGoogle Scholar
Weissman, M. M., Prusoff, B. A. & Klerman, G. L. (1978). Personality and the prediction of long term outcome of depression. American Journal of Psychiatry 135, 797800.Google ScholarPubMed
Weissman, M. M., Prusoff, B. A., Gammon, G. D., Merikangas, K. R., Leckman, J. F. & Kidd, K. F. (1984). Psychopathology in the children (ages 6–18) of depressed and normal women. Journal of the American Academy of Child Psychiatry 23, 7884.CrossRefGoogle Scholar
Wing, J. K. & Hailey, A. M. (1972). Evaluating a Community Psychiatric Service: The Camberwell Register 1964–1971. Oxford University Press: London.Google Scholar
Wing, J. K., Birley, J. L. T., Cooper, J. E., Graham, P. & Isaacs, A. D. (1967). Reliability of a procedure for measuring and classifying ‘Present Psychiatric State’. British Journal of Psychiatry 113, 499515.CrossRefGoogle ScholarPubMed
Winters, K. C., Stone, A. A., Weintraub, S. & Neale, J. M. (1981). Cognitive and attentional deficits in children vulnerable to psychopathology. Journal of Abnormal Child Psychology 9, 435454.CrossRefGoogle ScholarPubMed
Worland, J., Janes, C. L. & Anthony, E. J. (1984). St Louis Risk Research Project: experimental studies. In Children At Risk for Schizophrenia: A Longitudinal Perspective (ed. Watt, N., Anthony, E. J., Wynne, L. C. and Rolf, J.). Cambridge University Press: Cambridge (in the press).Google Scholar