Grandmothers' mental health is associated with grandchildren's emotional and behavioral development: a three-generation prospective study in Brazil.

BACKGROUND: Maternal mental health is associated with an increased risk of emotional and behavioural problems in children, and the risk is partly explained by the negative impact of maternal depression on caregiving. The role of mental health in other family members, who in many contexts also provide substantial caregiving, has received far less attention. We examined the impact of grandmothers' emotional symptoms, whose role in child care is increasing across the world, on internalizing and externalizing symptoms in grandchildren from a three-generation birth cohort study. METHODS: Prospective data from three generations in two birth cohorts 22 years apart (1982 and 2004) in Pelotas, Brazil, were used (n = 92). Mental health in grandmothers and parents was assessed using the Self-Reported Questionnaire (SRQ-20). Grandchildren were members of the 2004 birth cohort, and behavioural and emotional problems were measured using the Child-Behaviour Checklist (CBCL) at age 4 years. RESULTS: Grandmothers' symptoms were associated with more emotional and behavioural problems in grandchildren after adjustment for confounding factors. The size of the associations between grandmothers' and grandchildren mental health symptoms was comparable to the associations between maternal emotional symptoms and children emotional and behavioural problems. There was no evidence for associations with paternal symptoms. These effects were substantially stronger for maternal compared to paternal grandmothers. CONCLUSIONS: In some contexts, grandmothers' mental health may be as important to grandchild emotional and behavioural development as maternal mental health. Interventions to improve the mental health of grandmothers, as well as parents, may be important to child mental health.

Transition to parenthood and mental health at 30 years: a prospective comparison of mothers and fathers in a large Brazilian birth cohort.

Parenthood represents a major biological, social and environmental life change. Mental health disorders are common in parents and impact both the parent and their offspring. However, the relationship between parenthood and mental health and the direction of these effects are poorly understood. Longitudinal data from the Pelotas 1982 birth cohort, Southern Brazil, on 3701 individuals was used to investigate the association between number of children by age 30 years and mental health disorders using DSM-IV diagnoses at age 30 years, suicidal risk and the change in symptoms using repeated measures (using the SRQ-20) from age 19 to 30 years. Mothers, but not fathers, with higher number of children by age 30 years, were at a substantially increased risk of a wide range of mental health disorders compared to women with no children. There was evidence that motherhood was associated with an increase in symptoms over time rather than higher symptoms at baseline. Younger age at first child was also a risk factor for mental health disorders. Mothers, particularly those with multiple children, are at risk of a wide range of mental health disorders. The mechanisms to explain these risks are yet to be elucidated; however, the risk of mental health disorders was not replicated in fathers, which would be expected if residual confounding explained observed associations. Thus, multiparous mothers represent a high-risk group and should be prioritised for supportive interventions.

Maternal depression and anxiety predicts the pattern of offspring symptoms during their transition to adulthood.

BACKGROUND: Episodes of depression and anxiety (D&A) during the transition from late adolescence to adulthood, particularly when persistent, are predictive of long-term disorders and associated public health burden. Understanding risk factors at this time is important to guide intervention. The current objective was to investigate the associations between maternal symptoms of D&A with offspring symptoms during their transition to adulthood. METHOD: Data from a large population-based birth cohort study, in South Brazil, were used. Prospective associations between maternal D&A and offspring risk of these symptoms during the transition to adulthood (18/19, 24 and 30 years) were estimated. RESULTS: Maternal D&A in adolescence was associated with offspring symptoms across the transition to adulthood, associations were consistently stronger for females than for males. Daughters whose mothers reported D&A were 4.6 times (95% confidence interval 2.71-7.84) as likely to report D&A at all three time-points, than daughters of symptom-free mothers. CONCLUSIONS: Maternal D&A is associated with persistent D&A during the daughter's transition to adulthood. Intervention strategies should consider the mother's mental health.