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Anxiety Disorders in mothers and their children
- Imran Mushtaq, Marla Minn-Din Acting Consultant Child and Adolescent Psychiatrist (9 April 2008)
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Authors' reply
- Andrea Schreier, Hans-Ulrich Wittchen, Michael Höfler, Roselind Lieb (17 April 2008)
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Imran Mushtaq, Associate Specialist-Child & Adolescent Psychiatrist Specialist-CAHMS, Eaglestone Centre, Standing Way,Molton Keynes MK6 5AZ, Marla Minn-Din Acting Consultant Child and Adolescent Psychiatrist
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imranmushtaq{at}doctors.org.uk Imran Mushtaq, et al.
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The study of Schreier et al1 is interesting as they have found that the risk of anxiety disorders in children is increased when mothers have specific anxiety disorders such as social phobia and generalized anxiety disorder. They also claim that their findings confirm and extend the previous findings of Bijl et al2. However, Bijl et al did not demonstrate that parental anxiety symptoms were significantly related to psychiatric disorders in the children, including anxiety disorders. In addition, anxiety disorders in the children were not related to most parental psychiatric symptoms. Moreover their patients were older (adult children) than those in Schreier et al study and we are not certain whether it is possible to compare these two different study populations. References 1. Schreier A, Wittchen HU, Höfler M, and Lieb R. Anxiety disorders in mothers and their children: prospective longitudinal community study. British Journal of Psychiatry 2008;192:308-309. 2. Bijl RV, Cuijpers P, Smit F. Psychiatric disorders in adult children of parents with a history of psychopathology. Soc Psychiatry Psychiatr Epidemiol, 2002 ; 37:7-12. Authors: Imran Mushtaq Associate Specialist-Child & Adolescent Psychiatrist Specialist-CAHMS, Eaglestone Centre, Standing Way,Molton Keynes MK6 5AZ Marla Minn-Din Acting Consultant Child and Adolescent Psychiatrist Child, Adolescent and Family Services, 8 Notre Dame Mews Northampton NN1 2BG Declaration of Interest: None |
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Andrea Schreier Max Planck Institute of Psychiatry, Munich, Germany, Hans-Ulrich Wittchen, Michael Höfler, Roselind Lieb
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schreier{at}mpipsykl.mpg.de Andrea Schreier, et al.
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As Mushtaq and Minn-Din point out quite correctly in their eletter referring to our paper Schreier et al1, Bijl et al2 did not find associations between prevalence rates of any psychiatric disorder (including anxiety disorders) in children and anxiety-related symptoms in parents. However, one must be aware of several methodological differences to our investigation: the results cited by Mushtaq and Minn-Din are based on 12-months prevalence rates and multivariate logistic regression analysis additionally controlling for childhood adversities and sociodemographic characteristics. We would like to clarify, that the results of the Bijl et al paper that are much more comparable to our study and that we are actually referring to are those based on life-time prevalence rates of psychiatric disorders in children without controlling for childhood adversities and reported separately for the various offspring disorders. Here Bijl et al clearly report associations between anxiety in parents and children. In addition, it is true that the adult children in the Bijl et al study were considerably older (18-65 years) than the offspring in the Schreier et al study (17-21 years at follow-up). We would like to add, that there are other substantial ways in which the studies differ, e.g. assessment via direct interviews1 versus family-history information.2 Nevertheless, we do not see why our claim that we confirm and extend the Bijl et al study should be problematic, especially when taking into account the low median for age at onset of anxiety disorders.3 We would also like to point out that both the Bijl et al and Schreier et al studies are community-based so that the use of the term “patients” by Mushtaq and Minn-Din is slightly misleading. 1. Schreier A, Wittchen HU, Höfler M, Lieb R. Anxiety disorders in mothers and their children: prospective longitudinal community study. Br J Psychiatry 2008; 192:308-309. 2. Bijl RV, Cuijpers P, Smit F. Psychiatric disorders in adult children of parents with a history of psychopathology. Soc Psychiatry Psychiatr Epidemiol 2002; 37:7-12. 3. Andrade L, Caraveo-Anduage JJ, Berglund P, et al. Cross-national comparisons of the prevalences and correlates of mental disorders. Bull World Health Organ 2000; 78:413-426 Andrea Schreier, Hans-Ulrich Wittchen, Michael Höfler, Roselind Lieb Declaration of Interest: None |
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