ogy, have also been investigated as adjunctive therapies for depression. The evidence is inconclusive, and further research is needed.

IMPACT OF TREATMENT OF DEPRESSED PARENTS AND THEIR CHILDREN

While the benefits and risks of antidepressants for adult depression have been widely studied, very few investigations have examined the use of antidepressants, interpersonal psychotherapy, or cognitive-behavioral therapy by parents and its role in the prevention of adverse outcomes in their children. The treatment of parents’ depression to remission and to prevent relapse reduces or removes exposure to this risk factor for their children. Chapter 7 reviews preventive interventions and programs that investigate the role of treatment of a parent’s depression in the prevention of adverse outcomes for children as well as approaches that target intermediate mechanisms (i.e., parenting, social support). In general, successful treatment of a parent’s depression has been associated with improvement in children’s symptoms of emotional and behavioral problems, academic and global functioning, and parent-children interactions, but it may not be sufficient for improving some other aspects of their cognitive development and functioning (Gunlicks and Weissman, 2008). The systematic review by Gunlicks and Weissman (2008) found no studies of the effects on children of treating depressed fathers.

INTERVENTIONS

Depression is best viewed as a chronic illness, with most patients suffering multiple episodes over the course of a lifetime. Thus, the treatments used acutely to relieve depressive symptoms are best viewed as tools, whereas interventions may be analogous to comprehensive approaches to delivering treatments and preventing relapse. In response, researchers have answered this challenge by applying structured and comprehensive treatment strategies inspired by Wagner’s chronic illness model. Most of these interventions are consistent with this model to the extent that they feature (1) frequent, scheduled follow-up, (2) efficient information systems, (3) decision support trees, and (4) emphasis on self-management. By individualizing the management of a patient’s depression in this stepped care approach, researchers have been able to demonstrate very positive outcomes, but the preponderance of these studies have been conducted in primary care settings.

As with the previous section on treatments, the body of literature on interventions for parents, specifically, is quite thin. It is also site specific. Thus, we have provided a brief summary of interventions in the general depressed population (which has been studied almost exclusively in primary



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement