Understanding the Genetic and Environmental Factors of Mental Illness in Children: A Review of 211 Studies

2023-12-15 04:20:00

Children of people with mental illnesses have a higher risk of suffering from the same and different disorders. This is due to a combination of genetic and environmental factors that favor the appearance of these ailments and that are more common in some families than in others. Now, a review of 211 studies published in the scientific journal World Psychiatry, has tried to estimate this increased risk using data that includes three million children with at least one affected parent and 20 million more people without diagnoses in the family as a control.

On average, the authors estimate that about one in two children of people with anxiety, bipolar disorder or depression will suffer from their parent’s condition or another. More than a third of children of parents with an addiction and one in six with psychosis will also have a mental disorder. Regarding the increased risk of suffering from the same disorder as her father, the fact that the parent has attention deficit multiplies by eight the chances that her child will suffer from it. In the case of bipolar disorder, it multiplies the probabilities by five, and in the case of addictions, depression or anxiety by two. When the combined risks are looked at, children of parents with psychosis multiply the risk of suffering from that illness by 5.8 and the risk of suffering from another illness by 2.6. The two figures are similar for bipolar disorder. The results presented in this review of studies are in line with previous studies made with twins. These genetically identical individuals share up to 77% of psychosis, 76% of bipolar disorder, 40% of anxiety, and 34% of depression.

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In a press conference organized by the SMC Spain, Joaquim Raduà, psychiatrist of the Hospital Clinic-IDIBAPS and co-author of the study, has pointed out the value of this work to “identify a subgroup of the population in relatives of people at higher risk to apply specific preventive treatments.” The study warns that this search for symptoms among the children of those affected by these ailments is not applied routinely and is something that should change. “This prevention should be transdiagnostic,” added Raduà, taking into account that both genetic and environmental factors seem to favor the appearance of various disorders.

Although it is not possible to know whether specific prevention measures have prevented the development of a disorder in a specific person, population studies indicate that they are effective, but they need to be individualized. It has been observed that interventions applied at school, in general, to prevent depressive or anxiety symptoms, are not effective and may even cause harm to some people. For this reason, it is important, according to the authors, to identify people at highest risk to start interventions early.

Among the measures proposed, many of them have to do with avoiding factors that increase the risk of a disease being triggered, such as the consumption of cannabis or other substances, poor metabolic health and obesity, which can be prevented by doing exercise and having an adequate diet. Some factors such as exposure to traumatic events or extreme poverty or social isolation also favor the appearance of disorders.

Alberto Ortiz Lobo, psychiatrist at the La Paz University Hospital, in statements to SMC Spain, has been critical of the study’s conclusions. “The results reveal that 55% of the offspring of parents diagnosed with any mental disorder will develop some type of mental disorder throughout their lives, with a confidence interval of no less than between 7% and 95%. ”, he points out. In his opinion, these imprecise figures do not allow “any genetic advice to be considered, as the authors seem to suggest, since the association between diagnoses of mental disorders and biological inheritance has not been demonstrated.” For Ortiz Lobo, it is more relevant to act on social determinants such as child abuse, low educational levels or poverty.

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