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Do preventive interventions for children of mentally ill parents work? Results of a systematic review and meta-analysis

Thanhäuser, Martinaa; Lemmer, Gunnarb; de Girolamo, Giovannic; Christiansen, Hannaa

Current Opinion in Psychiatry: July 2017 - Volume 30 - Issue 4 - p 283–299
doi: 10.1097/YCO.0000000000000342
PROVISION OF SERVICES TO PEOPLE WITH MENTAL ILLNESS: Edited by Giovanni de Girolamo and Thomas Becker

Purpose of review The transgenerational transmission of mental disorders is one of the most significant causes of psychiatric morbidity. Several risk factors for children of parents with mental illness (COPMI) have been identified in numerous studies and meta-analyses.

Recent findings Many interventions have been developed for this high-risk group, but data about their efficacy are heterogeneous.

Summary The current meta-analysis reports on 96 articles including 50 independent samples from randomized controlled trials quantifying effects of preventive interventions for COPMI. Random effect models resulted in small, though significant Effect Sizes (ES) for programs enhancing the mother-infant interaction (ES = 0.26) as well as mothers’ (ES = 0.33) and children's (ES = 0.31) behavior that proved to be stable over the 12-month follow-up, except for infants’ behavior. Interventions for children/adolescents resulted in significant small effects for global psychopathology (ES = 0.13), as well as internalizing symptoms (ES = 0.17), and increased significantly over time, with externalizing symptoms reaching significance in the follow-up assessments as well (ES = 0.17). Interventions addressing parents and children jointly produced overall larger effects. Higher study quality was associated with smaller effects. There is a dearth of high quality studies that effectively reduce the high risk of COPMI for the development of mental disorders.

aDepartment of Psychology, Clinical Child and Adolescent Psychology

bDepartment of Psychology, Psychological Methods and Social Psychology, Philipps University Marburg, Marburg, Germany

cSt. John of God Clinical Research Centre, Brescia, Italy

Correspondence to Dr Hanna Christiansen, Department of Psychology, Clinical Child and Adolescent Psychology, Philipps University Marburg, Gutenbergstr. 18, D-35037 Marburg, Germany. Tel: +49 6421 282 3706; e-mail: christih@staff.uni-marburg.de

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