Change in child psychopathology with improvement in parental depression: a systematic review.

OBJECTIVE To systematically review current research evidence of associations between improvement in parents' depression and their children's psychopathology. METHOD Relevant studies were identified using PsycINFO (1806-2007) and Medline (1950-2007). The search terms used were "depression," "postpartum depression," "treatment," "mothers," "fathers," "parents," "offspring," "mother child relations," and "father child relations." The reference sections of identified articles were also examined for additional relevant articles. Open and controlled clinical trials and observational studies of depressed parents that also included psychological and behavioral assessments of offspring 18 years of age or younger were included in the review. RESULTS Ten studies meeting broad criteria for inclusion were reviewed. These studies varied considerably in sample, treatment, assessment, and analysis. Based on the few studies, there is some evidence of associations between successful treatment of parents' depression and improvement in children's symptoms and functioning, but treatment of postpartum depression may not be sufficient for improving cognitive development, attachment, and temperament in infants and toddlers. CONCLUSIONS Due to the public health implications of the findings, further study of the effects of improvement in parental depression on child psychopathology is warranted. These studies need to examine the precise relation between parental and child symptoms, the differential effect of parents' treatment with psychotherapy versus medication, the effect of fathers' as well as mothers' symptomatic improvement on children, and mediators and moderators of the relation between parental improvement and child psychopathology.