Timing effects across development

A research team led by Kieran O’Donnell, PhD, at Yale School of Medicine (YSM) found that pregnancy is a sensitive period, and exposure to high levels of maternal depression during pregnancy alone is associated with increased risk of psychosis in adult offspring. The findings highlight the importance of adequate mental health support during pregnancy.  

The effects of maternal depression on adult symptoms of depression were detected across childhood, as well as during pregnancy, while paternal effects emerged from mid-childhood. The findings were published online in JAMA Network Open. 

Study design and methods

O’Donnell and his team used a statistical framework borrowed from econometrics to analyze the study data. They analyzed the effects of parental depression, assessed from pregnancy through 21 years of age, on adult mental health outcomes in a 30-year study of more than 5,000 participants.  

“This is one of the most comprehensive studies—if not the most comprehensive—to ask if there are sensitive periods or developmental stages when exposure to parental depression has a particularly strong impact on later mental health,” says O'Donnell, an associate professor at Yale Child Study Center and in the Department of Obstetrics, Gynecology, and Reproductive Sciences at YSM.

Findings and implications for intervention

"Finding that parental mental health was important for long-term mental health outcomes in the next generation was not surprising, and is consistent with previous studies,” says O’Donnell. “What did come as a surprise was the clear difference in the patterns of associations between maternal and paternal depression and each mental health outcome we studied, as well as the distinct timing effects of mother’s versus father’s depression. These findings suggest that multiple and possibly distinct mechanisms underlie the associations between maternal and paternal depression and offspring mental health.” 

One of the study's goals was to investigate key periods of development when parental interventions might be most effective in promoting mental health in the next generation. Study findings suggest that earlier intervention is better, and providing adequate mental health support for parents during pregnancy is important.

“Our findings also highlight the importance of checking in on parents' mental health across childhood,” O’Donnell adds. “Doing so will benefit parents and may also have a positive benefit on the long-term mental health outcomes of their children.” 

Addy Feibel, MD, and Hung Pham, MS, were joint first authors of the published study findings. Feibel is a first-year psychiatry resident at Yale, and Pham is a lead biostatistician in O’Donnell’s research lab at YCSC.