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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: Alcohol abuse
101 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| 1369.00 | Read | Suspect alcohol abuse - denied | symptom | res76: Alcohol abuse | |||
| 136R.00 | Read | Binge drinker | symptom | res76: Alcohol abuse | |||
| 136S.00 | Read | Hazardous alcohol use | diagnostic | res76: Alcohol abuse | |||
| 136T.00 | Read | Harmful alcohol use | diagnostic | res76: Alcohol abuse | |||
| 136W.00 | Read | Alcohol misuse | diagnostic | res76: Alcohol abuse | |||
| 13Y8.00 | Read | Alcoholics anonymous | diagnostic | res76: Alcohol abuse | |||
| 1462.00 | Read | H/O: alcoholism | diagnostic | res76: Alcohol abuse | |||
| 1B1c.00 | Read | Alcohol induced hallucinations | diagnostic | res76: Alcohol abuse | |||
| 2577.11 | Read | O/E - alcoholic breath | symptom | res76: Alcohol abuse | |||
| 66e..00 | Read | Alcohol disorder monitoring | diagnostic | res76: Alcohol abuse | |||
| 66e0.00 | Read | Alcohol abuse monitoring | diagnostic | res76: Alcohol abuse | |||
| 7P22100 | Read | Delivery of rehabilitation for alcohol addiction | diagnostic | res76: Alcohol abuse | |||
| 8BA8.00 | Read | Alcohol detoxification | diagnostic | res76: Alcohol abuse | |||
| 8G32.00 | Read | Aversion therapy - alcoholism | diagnostic | res76: Alcohol abuse | |||
| 8H7p.00 | Read | Referral to community alcohol team | diagnostic | res76: Alcohol abuse | |||
| 8HHe.00 | Read | Referral to community drug and alcohol team | diagnostic | res76: Alcohol abuse | |||
| 8HkG.00 | Read | Referral to specialist alcohol treatment service | diagnostic | res76: Alcohol abuse | |||
| 8IEA.00 | Read | Referral to community alcohol team declined | diagnostic | res76: Alcohol abuse | |||
| 8W2..00 | Read | Refer to MH services deferred until alcohol misuse resolved | diagnostic | res76: Alcohol abuse | |||
| C150500 | Read | Alcohol-induced pseudo-Cushing's syndrome | diagnostic | res76: Alcohol abuse | |||
| E01..00 | Read | Alcoholic psychoses | diagnostic | res76: Alcohol abuse | |||
| E010.00 | Read | Alcohol withdrawal delirium | diagnostic | res76: Alcohol abuse | |||
| E011.00 | Read | Alcohol amnestic syndrome | diagnostic | res76: Alcohol abuse | |||
| E011000 | Read | Korsakov's alcoholic psychosis | diagnostic | res76: Alcohol abuse | |||
| E011100 | Read | Korsakov's alcoholic psychosis with peripheral neuritis | diagnostic | res76: Alcohol abuse | |||
| E011200 | Read | Wernicke-Korsakov syndrome | diagnostic | res76: Alcohol abuse | |||
| E011z00 | Read | Alcohol amnestic syndrome NOS | diagnostic | res76: Alcohol abuse | |||
| E012.00 | Read | Other alcoholic dementia | diagnostic | res76: Alcohol abuse | |||
| E012000 | Read | Chronic alcoholic brain syndrome | diagnostic | res76: Alcohol abuse | |||
| E012.11 | Read | Alcoholic dementia NOS | diagnostic | res76: Alcohol abuse | |||
| E013.00 | Read | Alcohol withdrawal hallucinosis | diagnostic | res76: Alcohol abuse | |||
| E014.00 | Read | Pathological alcohol intoxication | diagnostic | res76: Alcohol abuse | |||
| E015.00 | Read | Alcoholic paranoia | diagnostic | res76: Alcohol abuse | |||
| E01y.00 | Read | Other alcoholic psychosis | diagnostic | res76: Alcohol abuse | |||
| E01y000 | Read | Alcohol withdrawal syndrome | diagnostic | res76: Alcohol abuse | |||
| E01z.00 | Read | Alcoholic psychosis NOS | diagnostic | res76: Alcohol abuse | |||
| E23..00 | Read | Alcohol dependence syndrome | diagnostic | res76: Alcohol abuse | |||
| E230.00 | Read | Acute alcoholic intoxication in alcoholism | diagnostic | res76: Alcohol abuse | |||
| E230000 | Read | Acute alcoholic intoxication, unspecified, in alcoholism | diagnostic | res76: Alcohol abuse | |||
| E230100 | Read | Continuous acute alcoholic intoxication in alcoholism | diagnostic | res76: Alcohol abuse | |||
| E230.11 | Read | Alcohol dependence with acute alcoholic intoxication | diagnostic | res76: Alcohol abuse | |||
| E230200 | Read | Episodic acute alcoholic intoxication in alcoholism | diagnostic | res76: Alcohol abuse | |||
| E230300 | Read | Acute alcoholic intoxication in remission, in alcoholism | diagnostic | res76: Alcohol abuse | |||
| E230z00 | Read | Acute alcoholic intoxication in alcoholism NOS | diagnostic | res76: Alcohol abuse | |||
| E231.00 | Read | Chronic alcoholism | diagnostic | res76: Alcohol abuse | |||
| E231000 | Read | Unspecified chronic alcoholism | diagnostic | res76: Alcohol abuse | |||
| E23..11 | Read | Alcoholism | diagnostic | res76: Alcohol abuse | |||
| E231100 | Read | Continuous chronic alcoholism | diagnostic | res76: Alcohol abuse | |||
| E231200 | Read | Episodic chronic alcoholism | diagnostic | res76: Alcohol abuse | |||
| E231300 | Read | Chronic alcoholism in remission | diagnostic | res76: Alcohol abuse | |||
| E231z00 | Read | Chronic alcoholism NOS | diagnostic | res76: Alcohol abuse | |||
| E23z.00 | Read | Alcohol dependence syndrome NOS | diagnostic | res76: Alcohol abuse | |||
| E250.00 | Read | Nondependent alcohol abuse | diagnostic | res76: Alcohol abuse | |||
| E250000 | Read | Nondependent alcohol abuse, unspecified | diagnostic | res76: Alcohol abuse | |||
| E250100 | Read | Nondependent alcohol abuse, continuous | diagnostic | res76: Alcohol abuse | |||
| E250200 | Read | Nondependent alcohol abuse, episodic | diagnostic | res76: Alcohol abuse | |||
| E250300 | Read | Nondependent alcohol abuse in remission | diagnostic | res76: Alcohol abuse | |||
| E250z00 | Read | Nondependent alcohol abuse NOS | diagnostic | res76: Alcohol abuse | |||
| Eu10.00 | Read | [X]Mental and behavioural disorders due to use of alcohol | diagnostic | res76: Alcohol abuse | |||
| Eu10100 | Read | [X]Mental and behav dis due to use of alcohol: harmful use | diagnostic | res76: Alcohol abuse | |||
| Eu10200 | Read | [X]Mental and behav dis due to use alcohol: dependence syndr | diagnostic | res76: Alcohol abuse | |||
| Eu10211 | Read | [X]Alcohol addiction | diagnostic | res76: Alcohol abuse | |||
| Eu10212 | Read | [X]Chronic alcoholism | diagnostic | res76: Alcohol abuse | |||
| Eu10300 | Read | [X]Mental and behav dis due to use alcohol: withdrawal state | diagnostic | res76: Alcohol abuse | |||
| Eu10400 | Read | [X]Men & behav dis due alcohl: withdrawl state with delirium | diagnostic | res76: Alcohol abuse | |||
| Eu10411 | Read | [X]Delirium tremens, alcohol induced | diagnostic | res76: Alcohol abuse | |||
| Eu10500 | Read | [X]Mental & behav dis due to use alcohol: psychotic disorder | diagnostic | res76: Alcohol abuse | |||
| Eu10511 | Read | [X]Alcoholic hallucinosis | diagnostic | res76: Alcohol abuse | |||
| Eu10512 | Read | [X]Alcoholic jealousy | diagnostic | res76: Alcohol abuse | |||
| Eu10513 | Read | [X]Alcoholic paranoia | diagnostic | res76: Alcohol abuse | |||
| Eu10514 | Read | [X]Alcoholic psychosis NOS | diagnostic | res76: Alcohol abuse | |||
| Eu10600 | Read | [X]Mental and behav dis due to use alcohol: amnesic syndrome | diagnostic | res76: Alcohol abuse | |||
| Eu10611 | Read | [X]Korsakov's psychosis, alcohol induced | diagnostic | res76: Alcohol abuse | |||
| Eu10700 | Read | [X]Men & behav dis due alcoh: resid & late-onset psychot dis | diagnostic | res76: Alcohol abuse | |||
| Eu10711 | Read | [X]Alcoholic dementia NOS | diagnostic | res76: Alcohol abuse | |||
| Eu10712 | Read | [X]Chronic alcoholic brain syndrome | diagnostic | res76: Alcohol abuse | |||
| Eu10800 | Read | [X]Alcohol withdrawal-induced seizure | diagnostic | res76: Alcohol abuse | |||
| Eu10y00 | Read | [X]Men & behav dis due to use alcohol: oth men & behav dis | diagnostic | res76: Alcohol abuse | |||
| Eu10z00 | Read | [X]Ment & behav dis due use alcohol: unsp ment & behav dis | diagnostic | res76: Alcohol abuse | |||
| F11x000 | Read | Cerebral degeneration due to alcoholism | diagnostic | res76: Alcohol abuse | |||
| F11x011 | Read | Alcoholic encephalopathy | diagnostic | res76: Alcohol abuse | |||
| F144000 | Read | Cerebellar ataxia due to alcoholism | diagnostic | res76: Alcohol abuse | |||
| F25B.00 | Read | Alcohol-induced epilepsy | diagnostic | res76: Alcohol abuse | |||
| F375.00 | Read | Alcoholic polyneuropathy | diagnostic | res76: Alcohol abuse | |||
| F394100 | Read | Alcoholic myopathy | diagnostic | res76: Alcohol abuse | |||
| G555.00 | Read | Alcoholic cardiomyopathy | diagnostic | res76: Alcohol abuse | |||
| G852300 | Read | Oesophageal varices in alcoholic cirrhosis of the liver | diagnostic | res76: Alcohol abuse | |||
| J153.00 | Read | Alcoholic gastritis | diagnostic | res76: Alcohol abuse | |||
| J610.00 | Read | Alcoholic fatty liver | diagnostic | res76: Alcohol abuse | |||
| J611.00 | Read | Acute alcoholic hepatitis | diagnostic | res76: Alcohol abuse | |||
| J612.00 | Read | Alcoholic cirrhosis of liver | diagnostic | res76: Alcohol abuse | |||
| J612000 | Read | Alcoholic fibrosis and sclerosis of liver | diagnostic | res76: Alcohol abuse | |||
| J613.00 | Read | Alcoholic liver damage unspecified | diagnostic | res76: Alcohol abuse | |||
| J613000 | Read | Alcoholic hepatic failure | diagnostic | res76: Alcohol abuse | |||
| J617.00 | Read | Alcoholic hepatitis | diagnostic | res76: Alcohol abuse | |||
| J617000 | Read | Chronic alcoholic hepatitis | diagnostic | res76: Alcohol abuse | |||
| J671000 | Read | Alcohol-induced chronic pancreatitis | diagnostic | res76: Alcohol abuse | |||
| Z191.00 | Read | Alcohol detoxification | diagnostic | res76: Alcohol abuse | |||
| Z4B1.00 | Read | Alcoholism counselling | diagnostic | res76: Alcohol abuse | |||
| ZV11300 | Read | [V]Personal history of alcoholism | diagnostic | res76: Alcohol abuse | |||
| ZV6D600 | Read | [V]Alcohol abuse counselling and surveillance | diagnostic | res76: Alcohol abuse |
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