Treating perinatal depression with antidepressants: the influence on emotional availability and child mental disorders.

While there is substantial research in maternal antidepressant treatment and depression and child mental health outcomes very few studies examine the role of remission of depression and whether this improves parenting and child outcomes. This study utilises data from a sample of 246 women from the first trimester of pregnancy until the child reached 4 years of age including 49 women who took antidepressants in pregnancy, 23 women who had untreated depressive disorder and 174 control women. At recruitment the Structured Clinical Interview for DSM (SCID) was administered. The Edinburgh Postnatal Depression Scale (EPDS) twice in pregnancy and at 6 and 12 months postpartum. At 6 months, the parent-infant relationship was measured using the Emotional Availability Scales (EAS). Child mental disorders were measured at 4 years of age with the Preschool Age Psychiatric Assessment (PAPA). Women whose depression was not successfully treated were more likely to have a child with an emotional disorder. Women with higher concurrent EPDS scores and those with lower EAS scores were both more likely to have a child with a behavioural disorder. The quality of the parent-infant relationship was not found to mediate a relationship between antidepressant treatment and either child behavioural or emotional disorders outcomes at 4 years of age. Successful treatment of antenatal depression reduced vulnerability to childhood emotional disorders; however, how this occurs is unclear and it was not found to be through improving parent-infant relationship quality. Independently, the quality of early parent-infant relationship did predict later vulnerability to childhood behavioural disorders.