Tuesday, April 28, 2020

Nurturing Home Environment May Protect Against Depression, AJP Study Suggests

The environment in which a child is raised may influence his or her risk of developing depression later in life, reports a study appearing today in AJP in Advance. The findings suggest that efforts to improve rearing environments for children at known risk for depression may help to reduce this risk.

“[N]umerous studies have shown that growing up with depressed parents can have a range of adverse psychiatric effects,” wrote Kenneth S. Kendler, M.D., of Virginia Commonwealth University School of Medicine and colleagues. “We sought to further clarify the role of the rearing environment in risk for major depression by utilizing a powerful natural experiment in which matched offspring of a high-risk biological parent were reared in different family environments.”

Kendler and colleagues used linked data from multiple Swedish nationwide registries and health care data to compare depression outcomes in children who shared at least one parent with major depression and were raised either by their biological parents or adoptive parents.

The full sibling database included 666 adopted individuals who had 1,254 full siblings who were raised by the biological parent(s), and the half sibling database included 2,596 adopted individuals who had 5,511 half siblings who were raised by the biological parent. The researchers tracked the full and half siblings from age 15 to the time of first registration for major depression, death, emigration, or end of follow-up (December 31, 2015).

The researchers found that compared with home-reared full and half siblings, children who had been adopted had a 23% and 19% decreased risk of major depression. “This protective rearing effect was not influenced by the relative educational status of the biological and adoptive parents. However, in both full and half sibships, the protective effect of adoption disappeared when an adoptive parent or stepsibling had major depression or the adoptive home was disrupted by parental death or divorce,” Kendler and colleagues wrote.

“The results demonstrate the strong impact of the rearing environment on risk for major depression and support the importance of intervention efforts to improve the rearing environment in high-risk families,” Myrna M. Weissman, Ph.D., of Vagelos College of Physicians and Surgeons and Mailman School of Public Health at Columbia University and the New York State Psychiatric Institute, wrote in an accompanying editorial. Still, she noted, a limitation of the study acknowledged by Kendler and colleagues was that the study relied on indirect measures of the quality of the rearing environment in the home-reared or adoptive families.

Weissman wrote, “I would be curious about Sweden’s criteria and approach to determining that the adoptive home is able to provide a ‘high-quality and stable rearing environment.’ High education and economic security, while measurable, are only part of the story. Information on a stable nurturing rearing environment and how to measure it would be useful for several domains.”

(Image: iStock/PeopleImages)

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