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Research article:
Prevalence of maternal mental illness among children and adolescents in the UK between 2005 and 2017: a national retrospective cohort analysis
Reference:
Kathryn M Abel, Holly Hope, Eleanor Swift, Rosa Parisi, Darren M Ashcroft, Kyriaki Kosidou, Cemre Su Osam, Christina Dalman, Matthias Pierce(2019) Prevalence of maternal mental illness among children and adolescents in the UK between 2005 and 2017: a national retrospective cohort analysis. Lancet Public Health, doi: doi: https://doi.org/10.1016/S2468-2667(19)30059-3
- Link to article
- Abstract
- Background Little information exists about the prevalence of children exposed to maternal mental illness. We aimed to estimate the prevalence of children and adolescents exposed to maternal mental illness in the UK between 2005 and 2017 using primary care data. Methods In this national retrospective cohort study, we included children aged 0–16 years born between Jan 1, 1991, and Dec 31, 2015, who were linked to their mothers and registered on the primary care Clinical Practice Research Datalink (CPRD) between 2005 and 2017. We extracted data on diagnosis, symptoms, and therapy from the CRPD to define the following maternal mental illnesses: depression, anxiety, non-affective psychosis, affective psychosis, eating disorders, personality disorders, alcohol misuse disorder, and substance misuse disorder. We also extracted data on socioeconomic status from the Index of Multiple Deprivation 2010 and data on ethnicity from the Hospital Episode Statistics dataset. The main outcome was prevalence of maternal mental illness. Prevalence was calculated for each 2-year period of childhood (from age 0–<2 to 14–<16 years) using marginal predictions from a logistic regression model. We used survival analysis to estimate the incidence and cumulative risk of children experiencing maternal mental illness by age 16 years. Findings We identified 783 710 children registered in the UK CPRD mother-baby link database, and included 547 747 children (381 685 mothers) in our analysis. Overall prevalence of maternal mental illness was 23·2% (95% CI 23·1–23·4), which increased during childhood (21·9%, 21·7–22·1 among the 0–<2 year age group vs 27·3%, 26·8–27·8 among the 14–<16 year age group). Depression and anxiety were the most prevalent maternal mental illnesses. The proportion of children exposed to maternal mental illness increased from 22·2% (21·9–22·4) between 2005 and 2007 to 25·1% (24·8–25·5) between 2015 and 2017. Geographically, the highest prevalence of maternal mental illness was observed in Northern Ireland (29·8%, 29·0–30·5). In England, prevalence of maternal mental illness was highest among children in the most deprived areas (28·3%, 27·8–28·8). The incidence of maternal mental illness was highest between 0–3 months (26·7 per 100 person years, 26·4–27·1). By age 16 years, the cumulative risk of maternal mental illness was 53·1% (52·8–53·3). Interpretation One in four children aged 0–16 years are exposed to maternal mental illness and the prevalence of diagnosed and treated maternal mental illness is increasing. Policy makers and commissioners should consider this information and channel resources to target individuals in greatest need. Funding The European Research Council and the National Institute for Health Research.
- Author for correspondence
- Holly Hope
- Email for correspondence
- holly.hope@manchester.ac.uk
Code list: res76: Affective psychotic disorders
165 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| 146D.00 | Read | H/O: manic depressive disorder | diagnostic | res76: Affective psychotic disorders | |||
| 1B16.00 | Read | Agitated | symptom | res76: Affective psychotic disorders | |||
| 1B17.00 | Read | Depressed | symptom | res76: Affective psychotic disorders | |||
| 1B17.11 | Read | C/O - feeling depressed | symptom | res76: Affective psychotic disorders | |||
| 1B1E.00 | Read | Hallucinations | symptom | res76: Affective psychotic disorders | |||
| 1B1U.00 | Read | Symptoms of depression | symptom | res76: Affective psychotic disorders | |||
| 1B1U.11 | Read | Depressive symptoms | symptom | res76: Affective psychotic disorders | |||
| 1BQ..00 | Read | Loss of capacity for enjoyment | symptom | res76: Affective psychotic disorders | |||
| 1BT..00 | Read | Depressed mood | symptom | res76: Affective psychotic disorders | |||
| 1BT..11 | Read | Low mood | symptom | res76: Affective psychotic disorders | |||
| 1BU..00 | Read | Loss of hope for the future | symptom | res76: Affective psychotic disorders | |||
| 1BY..00 | Read | Elevated mood | symptom | res76: Affective psychotic disorders | |||
| 1JJ..00 | Read | Suspected depression | symptom | res76: Affective psychotic disorders | |||
| 1S42.00 | Read | Manic mood | diagnostic | res76: Affective psychotic disorders | |||
| 212T.00 | Read | Psychosis, schizophrenia + bipolar affective disord resolved | diagnostic | res76: Affective psychotic disorders | |||
| 212V.00 | Read | Bipolar affective disorder resolved | diagnostic | res76: Affective psychotic disorders | |||
| 2257.00 | Read | O/E - depressed | symptom | res76: Affective psychotic disorders | |||
| 225C.00 | Read | O/E - elated | symptom | res76: Affective psychotic disorders | |||
| E107.00 | Read | Schizo-affective schizophrenia | diagnostic | res76: Affective psychotic disorders | |||
| E107000 | Read | Unspecified schizo-affective schizophrenia | diagnostic | res76: Affective psychotic disorders | |||
| E107100 | Read | Subchronic schizo-affective schizophrenia | diagnostic | res76: Affective psychotic disorders | |||
| E107.11 | Read | Cyclic schizophrenia | diagnostic | res76: Affective psychotic disorders | |||
| E107200 | Read | Chronic schizo-affective schizophrenia | diagnostic | res76: Affective psychotic disorders | |||
| E107300 | Read | Acute exacerbation subchronic schizo-affective schizophrenia | diagnostic | res76: Affective psychotic disorders | |||
| E107400 | Read | Acute exacerbation of chronic schizo-affective schizophrenia | diagnostic | res76: Affective psychotic disorders | |||
| E107500 | Read | Schizo-affective schizophrenia in remission | diagnostic | res76: Affective psychotic disorders | |||
| E107z00 | Read | Schizo-affective schizophrenia NOS | diagnostic | res76: Affective psychotic disorders | |||
| E11..00 | Read | Affective psychoses | diagnostic | res76: Affective psychotic disorders | |||
| E110.00 | Read | Manic disorder, single episode | diagnostic | res76: Affective psychotic disorders | |||
| E110000 | Read | Single manic episode, unspecified | diagnostic | res76: Affective psychotic disorders | |||
| E110100 | Read | Single manic episode, mild | diagnostic | res76: Affective psychotic disorders | |||
| E110.11 | Read | Hypomanic psychoses | diagnostic | res76: Affective psychotic disorders | |||
| E110200 | Read | Single manic episode, moderate | diagnostic | res76: Affective psychotic disorders | |||
| E110300 | Read | Single manic episode, severe without mention of psychosis | diagnostic | res76: Affective psychotic disorders | |||
| E110400 | Read | Single manic episode, severe, with psychosis | diagnostic | res76: Affective psychotic disorders | |||
| E110500 | Read | Single manic episode in partial or unspecified remission | diagnostic | res76: Affective psychotic disorders | |||
| E110600 | Read | Single manic episode in full remission | diagnostic | res76: Affective psychotic disorders | |||
| E110z00 | Read | Manic disorder, single episode NOS | diagnostic | res76: Affective psychotic disorders | |||
| E111.00 | Read | Recurrent manic episodes | diagnostic | res76: Affective psychotic disorders | |||
| E111000 | Read | Recurrent manic episodes, unspecified | diagnostic | res76: Affective psychotic disorders | |||
| E11..11 | Read | Bipolar psychoses | diagnostic | res76: Affective psychotic disorders | |||
| E111100 | Read | Recurrent manic episodes, mild | diagnostic | res76: Affective psychotic disorders | |||
| E11..12 | Read | Depressive psychoses | diagnostic | res76: Affective psychotic disorders | |||
| E111200 | Read | Recurrent manic episodes, moderate | diagnostic | res76: Affective psychotic disorders | |||
| E11..13 | Read | Manic psychoses | diagnostic | res76: Affective psychotic disorders | |||
| E111300 | Read | Recurrent manic episodes, severe without mention psychosis | diagnostic | res76: Affective psychotic disorders | |||
| E111400 | Read | Recurrent manic episodes, severe, with psychosis | diagnostic | res76: Affective psychotic disorders | |||
| E111500 | Read | Recurrent manic episodes, partial or unspecified remission | diagnostic | res76: Affective psychotic disorders | |||
| E111600 | Read | Recurrent manic episodes, in full remission | diagnostic | res76: Affective psychotic disorders | |||
| E111z00 | Read | Recurrent manic episode NOS | diagnostic | res76: Affective psychotic disorders | |||
| E112400 | Read | Single major depressive episode, severe, with psychosis | diagnostic | res76: Affective psychotic disorders | |||
| E113400 | Read | Recurrent major depressive episodes, severe, with psychosis | diagnostic | res76: Affective psychotic disorders | |||
| E114.00 | Read | Bipolar affective disorder, currently manic | diagnostic | res76: Affective psychotic disorders | |||
| E114000 | Read | Bipolar affective disorder, currently manic, unspecified | diagnostic | res76: Affective psychotic disorders | |||
| E114100 | Read | Bipolar affective disorder, currently manic, mild | diagnostic | res76: Affective psychotic disorders | |||
| E114.11 | Read | Manic-depressive - now manic | diagnostic | res76: Affective psychotic disorders | |||
| E114200 | Read | Bipolar affective disorder, currently manic, moderate | diagnostic | res76: Affective psychotic disorders | |||
| E114300 | Read | Bipolar affect disord, currently manic, severe, no psychosis | diagnostic | res76: Affective psychotic disorders | |||
| E114400 | Read | Bipolar affect disord, currently manic,severe with psychosis | diagnostic | res76: Affective psychotic disorders | |||
| E114500 | Read | Bipolar affect disord,currently manic, part/unspec remission | diagnostic | res76: Affective psychotic disorders | |||
| E114600 | Read | Bipolar affective disorder, currently manic, full remission | diagnostic | res76: Affective psychotic disorders | |||
| E114z00 | Read | Bipolar affective disorder, currently manic, NOS | diagnostic | res76: Affective psychotic disorders | |||
| E115.00 | Read | Bipolar affective disorder, currently depressed | diagnostic | res76: Affective psychotic disorders | |||
| E115000 | Read | Bipolar affective disorder, currently depressed, unspecified | diagnostic | res76: Affective psychotic disorders | |||
| E115100 | Read | Bipolar affective disorder, currently depressed, mild | diagnostic | res76: Affective psychotic disorders | |||
| E115.11 | Read | Manic-depressive - now depressed | diagnostic | res76: Affective psychotic disorders | |||
| E115200 | Read | Bipolar affective disorder, currently depressed, moderate | diagnostic | res76: Affective psychotic disorders | |||
| E115300 | Read | Bipolar affect disord, now depressed, severe, no psychosis | diagnostic | res76: Affective psychotic disorders | |||
| E115400 | Read | Bipolar affect disord, now depressed, severe with psychosis | diagnostic | res76: Affective psychotic disorders | |||
| E115500 | Read | Bipolar affect disord, now depressed, part/unspec remission | diagnostic | res76: Affective psychotic disorders | |||
| E115600 | Read | Bipolar affective disorder, now depressed, in full remission | diagnostic | res76: Affective psychotic disorders | |||
| E115z00 | Read | Bipolar affective disorder, currently depressed, NOS | diagnostic | res76: Affective psychotic disorders | |||
| E116.00 | Read | Mixed bipolar affective disorder | diagnostic | res76: Affective psychotic disorders | |||
| E116000 | Read | Mixed bipolar affective disorder, unspecified | diagnostic | res76: Affective psychotic disorders | |||
| E116100 | Read | Mixed bipolar affective disorder, mild | diagnostic | res76: Affective psychotic disorders | |||
| E116200 | Read | Mixed bipolar affective disorder, moderate | diagnostic | res76: Affective psychotic disorders | |||
| E116300 | Read | Mixed bipolar affective disorder, severe, without psychosis | diagnostic | res76: Affective psychotic disorders | |||
| E116400 | Read | Mixed bipolar affective disorder, severe, with psychosis | diagnostic | res76: Affective psychotic disorders | |||
| E116500 | Read | Mixed bipolar affective disorder, partial/unspec remission | diagnostic | res76: Affective psychotic disorders | |||
| E116600 | Read | Mixed bipolar affective disorder, in full remission | diagnostic | res76: Affective psychotic disorders | |||
| E116z00 | Read | Mixed bipolar affective disorder, NOS | diagnostic | res76: Affective psychotic disorders | |||
| E117.00 | Read | Unspecified bipolar affective disorder | diagnostic | res76: Affective psychotic disorders | |||
| E117000 | Read | Unspecified bipolar affective disorder, unspecified | diagnostic | res76: Affective psychotic disorders | |||
| E117100 | Read | Unspecified bipolar affective disorder, mild | diagnostic | res76: Affective psychotic disorders | |||
| E117200 | Read | Unspecified bipolar affective disorder, moderate | diagnostic | res76: Affective psychotic disorders | |||
| E117300 | Read | Unspecified bipolar affective disorder, severe, no psychosis | diagnostic | res76: Affective psychotic disorders | |||
| E117400 | Read | Unspecified bipolar affective disorder,severe with psychosis | diagnostic | res76: Affective psychotic disorders | |||
| E117500 | Read | Unspecified bipolar affect disord, partial/unspec remission | diagnostic | res76: Affective psychotic disorders | |||
| E117600 | Read | Unspecified bipolar affective disorder, in full remission | diagnostic | res76: Affective psychotic disorders | |||
| E117z00 | Read | Unspecified bipolar affective disorder, NOS | diagnostic | res76: Affective psychotic disorders | |||
| E11y.00 | Read | Other and unspecified manic-depressive psychoses | diagnostic | res76: Affective psychotic disorders | |||
| E11y000 | Read | Unspecified manic-depressive psychoses | diagnostic | res76: Affective psychotic disorders | |||
| E11y100 | Read | Atypical manic disorder | diagnostic | res76: Affective psychotic disorders | |||
| E11y300 | Read | Other mixed manic-depressive psychoses | diagnostic | res76: Affective psychotic disorders | |||
| E11yz00 | Read | Other and unspecified manic-depressive psychoses NOS | diagnostic | res76: Affective psychotic disorders | |||
| E11z.00 | Read | Other and unspecified affective psychoses | diagnostic | res76: Affective psychotic disorders | |||
| E11z000 | Read | Unspecified affective psychoses NOS | diagnostic | res76: Affective psychotic disorders | |||
| E11zz00 | Read | Other affective psychosis NOS | diagnostic | res76: Affective psychotic disorders | |||
| E130.00 | Read | Reactive depressive psychosis | diagnostic | res76: Affective psychotic disorders | |||
| Eu0z.12 | Read | [X]Symptomatic psychosis NOS | symptom | res76: Affective psychotic disorders | |||
| Eu20400 | Read | [X]Post-schizophrenic depression | diagnostic | res76: Affective psychotic disorders | |||
| Eu25.00 | Read | [X]Schizoaffective disorders | diagnostic | res76: Affective psychotic disorders | |||
| Eu25000 | Read | [X]Schizoaffective disorder, manic type | diagnostic | res76: Affective psychotic disorders | |||
| Eu25011 | Read | [X]Schizoaffective psychosis, manic type | diagnostic | res76: Affective psychotic disorders | |||
| Eu25100 | Read | [X]Schizoaffective disorder, depressive type | diagnostic | res76: Affective psychotic disorders | |||
| Eu25111 | Read | [X]Schizoaffective psychosis, depressive type | diagnostic | res76: Affective psychotic disorders | |||
| Eu25200 | Read | [X]Schizoaffective disorder, mixed type | diagnostic | res76: Affective psychotic disorders | |||
| Eu25211 | Read | [X]Cyclic schizophrenia | diagnostic | res76: Affective psychotic disorders | |||
| Eu25212 | Read | [X]Mixed schizophrenic and affective psychosis | diagnostic | res76: Affective psychotic disorders | |||
| Eu25y00 | Read | [X]Other schizoaffective disorders | diagnostic | res76: Affective psychotic disorders | |||
| Eu25z00 | Read | [X]Schizoaffective disorder, unspecified | diagnostic | res76: Affective psychotic disorders | |||
| Eu25z11 | Read | [X]Schizoaffective psychosis NOS | diagnostic | res76: Affective psychotic disorders | |||
| Eu30.00 | Read | [X]Manic episode | diagnostic | res76: Affective psychotic disorders | |||
| Eu30000 | Read | [X]Hypomania | diagnostic | res76: Affective psychotic disorders | |||
| Eu30100 | Read | [X]Mania without psychotic symptoms | diagnostic | res76: Affective psychotic disorders | |||
| Eu30.11 | Read | [X]Bipolar disorder, single manic episode | diagnostic | res76: Affective psychotic disorders | |||
| Eu30200 | Read | [X]Mania with psychotic symptoms | diagnostic | res76: Affective psychotic disorders | |||
| Eu30211 | Read | [X]Mania with mood-congruent psychotic symptoms | diagnostic | res76: Affective psychotic disorders | |||
| Eu30212 | Read | [X]Mania with mood-incongruent psychotic symptoms | diagnostic | res76: Affective psychotic disorders | |||
| Eu30y00 | Read | [X]Other manic episodes | diagnostic | res76: Affective psychotic disorders | |||
| Eu30z00 | Read | [X]Manic episode, unspecified | diagnostic | res76: Affective psychotic disorders | |||
| Eu30z11 | Read | [X]Mania NOS | diagnostic | res76: Affective psychotic disorders | |||
| Eu31.00 | Read | [X]Bipolar affective disorder | diagnostic | res76: Affective psychotic disorders | |||
| Eu31000 | Read | [X]Bipolar affective disorder, current episode hypomanic | diagnostic | res76: Affective psychotic disorders | |||
| Eu31100 | Read | [X]Bipolar affect disorder cur epi manic wout psychotic symp | diagnostic | res76: Affective psychotic disorders | |||
| Eu31.11 | Read | [X]Manic-depressive illness | diagnostic | res76: Affective psychotic disorders | |||
| Eu31.12 | Read | [X]Manic-depressive psychosis | diagnostic | res76: Affective psychotic disorders | |||
| Eu31.13 | Read | [X]Manic-depressive reaction | diagnostic | res76: Affective psychotic disorders | |||
| Eu31200 | Read | [X]Bipolar affect disorder cur epi manic with psychotic symp | diagnostic | res76: Affective psychotic disorders | |||
| Eu31300 | Read | [X]Bipolar affect disorder cur epi mild or moderate depressn | diagnostic | res76: Affective psychotic disorders | |||
| Eu31400 | Read | [X]Bipol aff disord, curr epis sev depress, no psychot symp | diagnostic | res76: Affective psychotic disorders | |||
| Eu31500 | Read | [X]Bipolar affect dis cur epi severe depres with psyc symp | diagnostic | res76: Affective psychotic disorders | |||
| Eu31600 | Read | [X]Bipolar affective disorder, current episode mixed | diagnostic | res76: Affective psychotic disorders | |||
| Eu31700 | Read | [X]Bipolar affective disorder, currently in remission | diagnostic | res76: Affective psychotic disorders | |||
| Eu31800 | Read | [X]Bipolar affective disorder type I | diagnostic | res76: Affective psychotic disorders | |||
| Eu31900 | Read | [X]Bipolar affective disorder type II | diagnostic | res76: Affective psychotic disorders | |||
| Eu31911 | Read | [X]Bipolar II disorder | diagnostic | res76: Affective psychotic disorders | |||
| Eu31y00 | Read | [X]Other bipolar affective disorders | diagnostic | res76: Affective psychotic disorders | |||
| Eu31y11 | Read | [X]Bipolar II disorder | diagnostic | res76: Affective psychotic disorders | |||
| Eu31y12 | Read | [X]Recurrent manic episodes | diagnostic | res76: Affective psychotic disorders | |||
| Eu31z00 | Read | [X]Bipolar affective disorder, unspecified | diagnostic | res76: Affective psychotic disorders | |||
| Eu32300 | Read | [X]Severe depressive episode with psychotic symptoms | diagnostic | res76: Affective psychotic disorders | |||
| Eu32311 | Read | [X]Single episode of major depression and psychotic symptoms | diagnostic | res76: Affective psychotic disorders | |||
| Eu32312 | Read | [X]Single episode of psychogenic depressive psychosis | diagnostic | res76: Affective psychotic disorders | |||
| Eu32313 | Read | [X]Single episode of psychotic depression | diagnostic | res76: Affective psychotic disorders | |||
| Eu32314 | Read | [X]Single episode of reactive depressive psychosis | diagnostic | res76: Affective psychotic disorders | |||
| Eu32800 | Read | [X]Major depression, severe with psychotic symptoms | diagnostic | res76: Affective psychotic disorders | |||
| Eu32900 | Read | [X]Single major depr ep, severe with psych, psych in remiss | diagnostic | res76: Affective psychotic disorders | |||
| Eu32A00 | Read | [X]Recurr major depr ep, severe with psych, psych in remiss | diagnostic | res76: Affective psychotic disorders | |||
| Eu33213 | Read | [X]Manic-depress psychosis,depressd,no psychotic symptoms | diagnostic | res76: Affective psychotic disorders | |||
| Eu33300 | Read | [X]Recurrent depress disorder cur epi severe with psyc symp | diagnostic | res76: Affective psychotic disorders | |||
| Eu33311 | Read | [X]Endogenous depression with psychotic symptoms | diagnostic | res76: Affective psychotic disorders | |||
| Eu33312 | Read | [X]Manic-depress psychosis,depressed type+psychotic symptoms | diagnostic | res76: Affective psychotic disorders | |||
| Eu33313 | Read | [X]Recurr severe episodes/major depression+psychotic symptom | diagnostic | res76: Affective psychotic disorders | |||
| Eu33314 | Read | [X]Recurr severe episodes/psychogenic depressive psychosis | diagnostic | res76: Affective psychotic disorders | |||
| Eu33315 | Read | [X]Recurrent severe episodes of psychotic depression | diagnostic | res76: Affective psychotic disorders | |||
| Eu33316 | Read | [X]Recurrent severe episodes/reactive depressive psychosis | diagnostic | res76: Affective psychotic disorders | |||
| Eu3z.11 | Read | [X]Affective psychosis NOS | diagnostic | res76: Affective psychotic disorders | |||
| F481K00 | Read | Visual hallucinations | symptom | res76: Affective psychotic disorders | |||
| R001.00 | Read | [D]Hallucinations | symptom | res76: Affective psychotic disorders | |||
| R001000 | Read | [D]Hallucinations, auditory | symptom | res76: Affective psychotic disorders | |||
| R001400 | Read | [D]Visual hallucinations | symptom | res76: Affective psychotic disorders | |||
| R001z00 | Read | [D]Hallucinations NOS | symptom | res76: Affective psychotic disorders | |||
| ZV11111 | Read | [V]Personal history of manic-depressive psychosis | diagnostic | res76: Affective psychotic disorders | |||
| ZV11112 | Read | [V]Personal history of manic-depressive psychosis | diagnostic | res76: Affective psychotic disorders |
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