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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: Depression

131 codes in list

Code Coding system Description Entity type List name
1465.00 Read H/O: depression diagnostic res76: Depression
1B17.00 Read Depressed symptom res76: Depression
1B17.11 Read C/O - feeling depressed symptom res76: Depression
1B17.12 Read C/O - feeling unhappy symptom res76: Depression
1B1I111 Read C/O weepiness symptom res76: Depression
1B1U.00 Read Symptoms of depression symptom res76: Depression
1B1U.11 Read Depressive symptoms symptom res76: Depression
1BO..00 Read Mood swings symptom res76: Depression
1BQ..00 Read Loss of capacity for enjoyment symptom res76: Depression
1BT..00 Read Depressed mood symptom res76: Depression
1BT..11 Read Low mood symptom res76: Depression
1BU..00 Read Loss of hope for the future symptom res76: Depression
1JJ..00 Read Suspected depression symptom res76: Depression
212S.00 Read Depression resolved diagnostic res76: Depression
2257.00 Read O/E - depressed symptom res76: Depression
62T1.00 Read Puerperal depression diagnostic res76: Depression
8BK0.00 Read Depression management programme diagnostic res76: Depression
8HHq.00 Read Referral for guided self-help for depression diagnostic res76: Depression
9H90.00 Read Depression annual review diagnostic res76: Depression
9H91.00 Read Depression medication review diagnostic res76: Depression
9H92.00 Read Depression interim review diagnostic res76: Depression
9HA0.00 Read On depression register diagnostic res76: Depression
9HA1.00 Read Removed from depression register diagnostic res76: Depression
9kQ..00 Read On full dose long term treatment depression - enh serv admin diagnostic res76: Depression
E03y300 Read Unspecified puerperal psychosis diagnostic res76: Depression
E11..12 Read Depressive psychoses diagnostic res76: Depression
E112.00 Read Single major depressive episode diagnostic res76: Depression
E112000 Read Single major depressive episode, unspecified diagnostic res76: Depression
E112100 Read Single major depressive episode, mild diagnostic res76: Depression
E112.11 Read Agitated depression diagnostic res76: Depression
E112.12 Read Endogenous depression first episode diagnostic res76: Depression
E112.13 Read Endogenous depression first episode diagnostic res76: Depression
E112.14 Read Endogenous depression diagnostic res76: Depression
E112200 Read Single major depressive episode, moderate diagnostic res76: Depression
E112300 Read Single major depressive episode, severe, without psychosis diagnostic res76: Depression
E112500 Read Single major depressive episode, partial or unspec remission diagnostic res76: Depression
E112600 Read Single major depressive episode, in full remission diagnostic res76: Depression
E112z00 Read Single major depressive episode NOS diagnostic res76: Depression
E113.00 Read Recurrent major depressive episode diagnostic res76: Depression
E113000 Read Recurrent major depressive episodes, unspecified diagnostic res76: Depression
E113100 Read Recurrent major depressive episodes, mild diagnostic res76: Depression
E113.11 Read Endogenous depression - recurrent diagnostic res76: Depression
E113200 Read Recurrent major depressive episodes, moderate diagnostic res76: Depression
E113300 Read Recurrent major depressive episodes, severe, no psychosis diagnostic res76: Depression
E113500 Read Recurrent major depressive episodes,partial/unspec remission diagnostic res76: Depression
E113600 Read Recurrent major depressive episodes, in full remission diagnostic res76: Depression
E113700 Read Recurrent depression diagnostic res76: Depression
E113z00 Read Recurrent major depressive episode NOS diagnostic res76: Depression
E118.00 Read Seasonal affective disorder diagnostic res76: Depression
E11y200 Read Atypical depressive disorder diagnostic res76: Depression
E11z100 Read Rebound mood swings symptom res76: Depression
E11z200 Read Masked depression diagnostic res76: Depression
E135.00 Read Agitated depression diagnostic res76: Depression
E204.00 Read Neurotic depression reactive type diagnostic res76: Depression
E204.11 Read Postnatal depression diagnostic res76: Depression
E211200 Read Depressive personality disorder diagnostic res76: Depression
E290.00 Read Brief depressive reaction diagnostic res76: Depression
E290z00 Read Brief depressive reaction NOS diagnostic res76: Depression
E291.00 Read Prolonged depressive reaction diagnostic res76: Depression
E2B..00 Read Depressive disorder NEC diagnostic res76: Depression
E2B0.00 Read Postviral depression diagnostic res76: Depression
E2B1.00 Read Chronic depression diagnostic res76: Depression
Eu15500 Read [X]Mental/behav dis oth stims inc caffeine: psychotic dis diagnostic res76: Depression
Eu3..00 Read [X]Mood - affective disorders diagnostic res76: Depression
Eu32.00 Read [X]Depressive episode diagnostic res76: Depression
Eu32000 Read [X]Mild depressive episode diagnostic res76: Depression
Eu32100 Read [X]Moderate depressive episode diagnostic res76: Depression
Eu32.11 Read [X]Single episode of depressive reaction diagnostic res76: Depression
Eu32.12 Read [X]Single episode of psychogenic depression diagnostic res76: Depression
Eu32.13 Read [X]Single episode of reactive depression diagnostic res76: Depression
Eu32200 Read [X]Severe depressive episode without psychotic symptoms diagnostic res76: Depression
Eu32211 Read [X]Single episode agitated depressn w'out psychotic symptoms diagnostic res76: Depression
Eu32212 Read [X]Single episode major depression w'out psychotic symptoms diagnostic res76: Depression
Eu32213 Read [X]Single episode vital depression w'out psychotic symptoms diagnostic res76: Depression
Eu32400 Read [X]Mild depression diagnostic res76: Depression
Eu32500 Read [X]Major depression, mild diagnostic res76: Depression
Eu32600 Read [X]Major depression, moderately severe diagnostic res76: Depression
Eu32700 Read [X]Major depression, severe without psychotic symptoms diagnostic res76: Depression
Eu32B00 Read [X]Antenatal depression diagnostic res76: Depression
Eu32y00 Read [X]Other depressive episodes diagnostic res76: Depression
Eu32y11 Read [X]Atypical depression diagnostic res76: Depression
Eu32y12 Read [X]Single episode of masked depression NOS diagnostic res76: Depression
Eu32z00 Read [X]Depressive episode, unspecified diagnostic res76: Depression
Eu32z11 Read [X]Depression NOS diagnostic res76: Depression
Eu32z12 Read [X]Depressive disorder NOS diagnostic res76: Depression
Eu32z13 Read [X]Prolonged single episode of reactive depression diagnostic res76: Depression
Eu32z14 Read [X] Reactive depression NOS diagnostic res76: Depression
Eu33.00 Read [X]Recurrent depressive disorder diagnostic res76: Depression
Eu33000 Read [X]Recurrent depressive disorder, current episode mild diagnostic res76: Depression
Eu33100 Read [X]Recurrent depressive disorder, current episode moderate diagnostic res76: Depression
Eu33.11 Read [X]Recurrent episodes of depressive reaction diagnostic res76: Depression
Eu33.12 Read [X]Recurrent episodes of psychogenic depression diagnostic res76: Depression
Eu33.13 Read [X]Recurrent episodes of reactive depression diagnostic res76: Depression
Eu33.14 Read [X]Seasonal depressive disorder diagnostic res76: Depression
Eu33.15 Read [X]SAD - Seasonal affective disorder diagnostic res76: Depression
Eu33200 Read [X]Recurr depress disorder cur epi severe without psyc sympt diagnostic res76: Depression
Eu33211 Read [X]Endogenous depression without psychotic symptoms diagnostic res76: Depression
Eu33212 Read [X]Major depression, recurrent without psychotic symptoms diagnostic res76: Depression
Eu33214 Read [X]Vital depression, recurrent without psychotic symptoms diagnostic res76: Depression
Eu33400 Read [X]Recurrent depressive disorder, currently in remission diagnostic res76: Depression
Eu33y00 Read [X]Other recurrent depressive disorders diagnostic res76: Depression
Eu33z00 Read [X]Recurrent depressive disorder, unspecified diagnostic res76: Depression
Eu33z11 Read [X]Monopolar depression NOS diagnostic res76: Depression
Eu34.00 Read [X]Persistent mood affective disorders diagnostic res76: Depression
Eu34000 Read [X]Cyclothymia diagnostic res76: Depression
Eu34012 Read [X]Cycloid personality diagnostic res76: Depression
Eu34100 Read [X]Dysthymia diagnostic res76: Depression
Eu34111 Read [X]Depressive neurosis diagnostic res76: Depression
Eu34113 Read [X]Neurotic depression diagnostic res76: Depression
Eu34114 Read [X]Persistant anxiety depression diagnostic res76: Depression
Eu34y00 Read [X]Other persistent mood affective disorders diagnostic res76: Depression
Eu34z00 Read [X]Persistent mood affective disorder, unspecified diagnostic res76: Depression
Eu3y.00 Read [X]Other mood affective disorders diagnostic res76: Depression
Eu3y000 Read [X]Other single mood affective disorders diagnostic res76: Depression
Eu3y011 Read [X]Mixed affective episode diagnostic res76: Depression
Eu3y100 Read [X]Other recurrent mood affective disorders diagnostic res76: Depression
Eu3y111 Read [X]Recurrent brief depressive episodes diagnostic res76: Depression
Eu3yy00 Read [X]Other specified mood affective disorders diagnostic res76: Depression
Eu3z.00 Read [X]Unspecified mood affective disorder diagnostic res76: Depression
Eu53.00 Read [X]Mental and behav disorders assoc with the puerperium NEC diagnostic res76: Depression
Eu53000 Read [X]Mild mental/behav disorder assoc with the puerperium NEC diagnostic res76: Depression
Eu53011 Read [X]Postnatal depression NOS diagnostic res76: Depression
Eu53012 Read [X]Postpartum depression NOS diagnostic res76: Depression
Eu53100 Read [X]Severe mental and behav disorder assoc wth puerperium NEC diagnostic res76: Depression
Eu53111 Read [X]Puerperal psychosis NOS diagnostic res76: Depression
Eu53z00 Read [X]Puerperal mental disorder, unspecified diagnostic res76: Depression
Eu92000 Read [X]Depressive conduct disorder diagnostic res76: Depression
L184.00 Read Mental disorders in pregnancy, childbirth and the puerperium diagnostic res76: Depression
L184200 Read Mental disorder in the puerperium - baby delivered diagnostic res76: Depression
L184300 Read Mental disorder during pregnancy - baby not yet delivered diagnostic res76: Depression
L184400 Read Mental disorder in puerperium - baby previously delivered diagnostic res76: Depression

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