Kids Of Parents With Mental Issues At Greater Risk; Therapy Helps

Two new studies suggest that talking to therapists can break this cycle, reducing the risk of mental health problems in children and teens.

Both studies released this week focused on "cognitive behavior therapy," in which patients learn coping techniques, how to avoid situations that might make them depressed or anxious and other strategies for positive thinking.

A study in today's Journal of the American Medical Association focused on high-risk teens of depressed parents. All 316 of the teens already had suffered from depression in the past or had some symptoms of depression when the study began. Half were randomly assigned to attend eight weekly group sessions with other teens.

After nine months, 21% of teens who attended group therapy experienced an episode of depression, compared to 33% of teens who received their usual medical care, but didn't get therapy, the study shows.

Children of depressed adults may feel adrift because their parents aren't able to give them the support and encouragement they need, says Bryan King, director of child and adolescent psychiatry at Seattle Children's Hospital, who wasn't involved in the study.

And in addition to a genetic predisposition to depression, children may inherit their parent's negative attitudes.

"The children may be experiencing the negative thinking that their parents are wrestling with," King says. "The world at large is being viewed through the dark lenses of depression: everything is bad, everything is hopeless, there is no future."

Depressed kids are more likely to have trouble in school or with relationships and are at increased risk for suicide or substance abuse, the study shows.

Cognitive behavior therapy also aims to keep kids engaged in things that can make them happy, such as school, sports or social outings, King says. "They try to preempt this vicious spiral where if you feel bad, you pull back, you stop going to the football game or the movie or dance," King says. "Then, you get fewer opportunities for pleasure, which adds to your overall feelings of sadness and lack of worth."

The new study's results may have been modest, King says, because these teens were already dealing with symptoms of depression. He says this kind of therapy could have more success if used to treat high-risk kids who aren't yet depressed.

That was the focus of a small study from Johns Hopkins Children's Center, in which researchers tried to help children who weren't yet having anxiety disorders. All 40 of the kids, ages 7 to 12, had parents with anxiety disorders.

Researchers offered half of youngsters and their parents an eight-week course of "cognitive behavioral therapy. In these hour-long sessions, parents learned how to recognize things they were doing that might make their children anxious - such as being overprotective or worrying out loud. Children also learned coping skills, according to the study, in the June issue of the Journal of Consulting and Clinical Psychology, released Monday.

After a year, none of the children in therapy had developed an anxiety disorder. But doctors diagnosed anxiety disorders in 30% of children in the comparison group, who were placed on a waiting list but didn't receive therapy during the clinical trial, says lead author Golda Ginsburg, a child psychologist.

Ginsburg says she is already planning a larger study with 100 children.

Although few insurers pay for cognitive behavioral therapy, Ginsburg says she hopes her study will provide evidence that it's worth the investment.