Identifying people most likely to develop a mental disorder would allow preventive measures to be taken to counteract this risk or early therapy to be instituted. An investigation led by the Clínic-IDIBAPS together with Dalhousie University (Canada) and King’s College London (United Kingdom) in which data from 3.2 million children of parents with mental disorders who had participated have been analyzed In 211 previous studies, it has been determined that they are more at risk of suffering from the same disorder as their parents, but also more likely to suffer from any other type of mental pathology.
This is the largest meta-analysis carried out to date on the subject and defines the specific risk that the child of a person with a mental disorder has of developing a mental health problem. For example, in children of parents with psychosis, the risk of suffering from psychosis is multiplied by 5.8, but the risk of suffering from another disorder is multiplied by 2.6. Something similar happens with children of parents with bipolar disorder, since they have five times the risk of developing this disease and twice the risk of having any other mental illness.
“This study provides mental health professionals with descriptive tables where they can see the average risk that children of people with a certain mental disorder have of developing different mental health disorders. This information can be very useful in deciding what preventive interventions to recommend, such as what type of psychotherapy, physical exercise, etc.; Furthermore, it shows us the need to systematically explore the mental health of the patients’ children,” declared Joaquim Raduà, co-author of the study and head of the research group on Imaging of disorders related to mood and anxiety. (IMARD) of IDIBAPS, researcher at CIBERSAM and associate professor at the University of Barcelona.
55% of children of parents with mental disorders will develop one
The results of the meta-analysis have been published in the journal World Psychiatry and reveal, for example, that if parents suffer from depressive disorders, the risk of their offspring suffering from them is also multiplied by 2.3; if they suffer from psychosis, by two; bipolar disorder, by 2.1; anxiety disorders, for two; disorders due to toxic substance use, by 2.4; attention deficit and hyperactivity disorders, for two; disruptive disorders, by 1.8; obsessive compulsive disorder, by 3.2; eating disorders, by 3.9, and any other type of mental disorder, by 1.9.
“We must keep in mind that up to 55% of children of parents with mental disorders will develop one throughout their lives, which is why it is so important to carry out a complete synthesis of the risks that will help us improve prevention techniques,” adds Lydia Fortea, researcher in the IMARD group of IDIBAPS and co-author of the study.
The individual studies that have been carried out until now have mainly focused on depressive, bipolar or psychotic disorders, but in this large meta-analysis other conditions such as attention deficit hyperactivity disorder, anxiety, substance use disorders have been grouped together and included. , eating disorders, obsessive-compulsive disorder, or borderline personality disorder.
“Individual risk can be substantially different, since it also depends on other factors such as cannabis use, lack of physical exercise, poor metabolic health, or obesity”
“Analyzing this broad spectrum of diseases has allowed us to interrelate them and not focus only on the parents’ illness, thus filling the gap that existed in the literature. Furthermore, it tells us that preventive interventions should not be focused on a single diagnosis, but rather should be transdiagnostic,” says María Ortuño, researcher in the Multimodal Neuroimaging group in recent-onset and high-risk psychosis at IDIBAPS and co-author of the study.
“It is important to note that this study investigates the average risk of all children of parents with mental disorders, but the individual risk can be substantially different, since it also depends on other factors such as cannabis use, lack of physical exercise, poor metabolic health, or obesity. That is why we recommend that children of parents with mental disorders especially avoid these risk factors,” concludes Joaquim Raduà.
Avoid social factors associated with mental disorders
In the opinion of Javier Costas, lead researcher of the Psychiatric Genetics group at the Health Research Institute of Santiago de Compostela (IDIS) and member of the Research Network in Primary Care of Addictions (RIAPAd), who has not participated in the work: “ The appearance of a mental disorder must be considered from a biopsychosocial model, that is, both genetic and environmental factors play an important role. These factors are more common in some families than in others. Therefore, if a person has a parent who suffers from a mental disorder, they themselves will be more likely to develop that disorder than the general population. This issue has great clinical relevance, both in the identification of subgroups of people at high risk of suffering from a psychiatric disorder for targeted prevention, and in genetic counseling. In this case, it allows the interested family member to be informed about the probability that they will have the disorder in the future, if preventive measures are not taken,” as stated to SMC Spain.
More critical is Alberto Ortiz Lobo, Doctor of Medicine and psychiatrist at the Carlos III Day Hospital – Hospital Universitario La Paz (Madrid), who also did not participate in the study, and who has pointed out its limitations in statements to the same medium: “The Epidemiological studies in psychiatry are very controversial. There are no objective measures, laboratory tests, imaging tests, genetic tests, or any biomarker that discriminates the diagnosis of a mental disorder. With these in mind, an article published in The Lancet Psychiatry on July 30, 2023 has stated that half of the population will develop at least one mental disorder throughout their lives of the thirteen they analyzed.”
“The study that has just been published in World Psychiatry is along the same lines of inflation of diagnoses and imprecision in their determination. The results reveal that 55% of the offspring of parents diagnosed with any mental disorder will develop some type of mental disorder throughout their lives, with a confidence interval of no less than between 7% and 95%. When they estimate the absolute risks by diagnosis, the same vagueness is maintained: the offspring of parents diagnosed with psychosis will be diagnosed with any mental disorder throughout their lives in 17%, with a confidence interval between 1% and 82%.”
“These imprecise figures also do not allow us to consider any genetic advice as the authors seem to suggest, since the association between diagnoses of mental disorders and biological inheritance has not been demonstrated, and the environment is crucial in the appearance of psychological suffering. The primary prevention in mental health proposed by the WHO is to establish policies that act on the social determinants that are associated with serious mental disorders such as child abuse (whether due to neglect, physical, sexual or psychological abuse, parental loss, bullying). colleagues…), low educational levels, violence, wars, discrimination, substandard housing, etc.
Source: Clínic-IDIBAPS
