Parental psychopathology before and after the child's diagnosis of a mental disorder: a population-based matched cohort study

Background: More research is needed to understand psychopathology among parents of children with mental disorders in the years before and after the child is diagnosed. Here, we estimated the risk of mental disorders and psychotropic medication use in parents of children with versus without mental disorders and the temporal associations between child and parental psychopathology. Methods: We conducted a population-based matched cohort study using Danish register data. The study population included child–parent pairs of all children diagnosed with a mental disorder of interest (attention-deficit/hyperactivity disorder, autism spectrum disorder, intellectual disability, anxiety disorder, mood disorder, eating disorder, substance use disorder, and schizophrenia spectrum disorder) by 18 years of age during the period 1999–2014 and a matched reference population. Each child with a diagnosis was matched to 10 children of the same sex and birth year who had not been diagnosed with the mental disorder of interest. For all parents, we estimated the yearly incidence proportion of parental mental disorders and prescriptions for psychotropic medications 4 years before and after the child's diagnosis. Results: We observed a substantially increased risk of mental disorders and psychotropic medication use among parents of children with a mental disorder, compared to the reference population. On average, parents of children with a diagnosis had twice the odds of mood disorders, anxiety disorders, and prescriptions for anti-depressants and anti-psychotics. The incidence of mood and anxiety disorders peaked in the 1–2 years before and after the child's diagnosis. The incidence of parental prescriptions for psychotropic medications (particularly anti-psychotics) peaked in the year the child was diagnosed and in the 3 years before the child's diagnosis for anti-depressants and sleep medications. Conclusions: This study demonstrates clear temporal associations between child and parental psychopathology, with parental psychopathology peaking in the years immediately before and after the child's diagnosis.