The physical health of children of mothers experiencing mental illness in a UK primary care cohort

• Main Author: Osam, Nejla Cemre Su
• Format: Dissertation
• Language: English
• Published: University of Manchester 2021
• Subjects: CPRD; Maternal Mental Illness; Psychiatric Epidemiology

Background: In the UK, the prevalence of children living with Mothers with Mental Illness (MMI) is increasing and improving the lives of these children is an urgent concern. Although we know that children with MMI experience multiple challenges including congenital anomalies and neurodevelopmental problems, less is known about how and when mother's mental illness affects their child's physical health outcomes. Aims: The main aim of this thesis is to better understand how MMI (depression, anxiety, psychotic disorders, substance and alcohol misuse disorders, personality and eating disorders) affects some of the common and rare physical health outcomes including preventative healthcare use as vaccination uptake along with childhood obesity, atopic disorders and childhood cancer in their children. Methods: To address the aim of this thesis, cohorts were extracted from the Clinical Practice Research Datalink (CPRD-GOLD) which is the largest anonymous primary healthcare data source in the world and linked to external data sources namely Hospital Episode Statistics (HES) and Index of Multiple Deprivation (IMD). The effects of MMI on childhood vaccination uptake were quantified using logistic regression models. The risk of other physical health outcomes which are atopic disorders and childhood cancers among children with MMI were investigated using Cox proportional hazard models. Results: Maternal mental illness was found to have a considerable effect on childhood physical health outcome and the risk of outcome varied on the type of maternal mental illness to which the child is exposed. Children exposed to maternal addiction disorders were the most vulnerable group as they have the highest risk of missing vaccinations and risk of developing cancer in childhood. In terms of atopic disorders, children exposed to maternal depression and anxiety were at highest risk compared to children exposed to other types of MMI. It was also observed that children with MMI were more likely to be from most deprived areas and had mothers who actively smoke, which are highly associated with mental illness and physical health outcomes. Conclusion: Findings of this thesis indicate that in the UK, children living with maternal mental illness are at risk of missing necessary vaccinations and developing various physical illnesses including atopic disorders and childhood cancers. The public health interventions and policies could benefit from acknowledging the effects of MMI on children's health which may play an important role in reducing the health inequalities that are associated with this group by developing better resource allocation and service provision.