The transmission of psychiatric illness from parent to child is a phenomenon that should not be underestimated.
Lisanne van Houtum
Postdoctoral researcher Erasmus MC
If one of the parents has a mental illness or addiction, there is a significant chance that their children will also develop mental health problems. In the Netherlands, no fewer than 900,000 children and adolescents are growing up with this familial risk. How do people with mental illness who want to have children deal with this? And what can the healthcare sector do to help them?
''The transmission of psychiatric illness from parent to child is a phenomenon that should not be underestimated,'' says Lisanne van Houtum, postdoctoral researcher at Erasmus MC. ''If one of your parents suffers from bipolar disorder or depression, for example, you as a child have a sixty to seventy percent chance of also developing a mental illness at some point in your life. That is about twice as much as children of mentally healthy parents. The cause is partly hereditary, but we believe that upbringing and the environment in which the child grows up play at least as big a role.''
Interviews with patients
''There is already a lot of scientific literature on heredity, mostly based on clinical research,'' Van Houtum continues. "In the study Running in the family? Risk for and resilience against mental illness in (future) children, which is supported by the Erasmus University Rotterdam Fund, we talk to the people themselves. We ask ten people who suffer from what is known as SMI [Severe Mental Illness] what risks they see for their children or future children. We focus on people with bipolar disorder, schizophrenia or severe depression requiring hospitalisation, both men and women. After all, fathers can also pass on a disease genetically and they play an important role in raising children. We also hope to talk to people who are already pregnant or have a young child."
It is well known that people with a psychiatric disorder who want to have children can be very anxious. They are often afraid of becoming a bad father or mother. Van Houtum: ''We ask questions such as: how can a parent reduce the risk of their child developing a mental illness? Do you think this is purely hereditary, or can you protect your child through parenting? And do you see yourself, your partner and your child as resilient? We also want to know whether they are open to biological research, for example into their child's brain development. In this way, we hope to gain a good understanding of the care and advice they would appreciate. This could include monitoring the development of their young child or a six-monthly consultation. Strangely enough, it is quite unique for us to involve patients themselves in thinking about possible support options."
Gap in care
Where nature (heredity) is difficult to influence, nurture (upbringing) is certainly much more so. Lisanne van Houtum: ''We are approaching the research with an open mind and hope to gain valuable new insights. We will share these with colleagues via an infographic, a scientific paper and a presentation at a conference. The ultimate goal is, of course, to help families who want to have children or who have young children as much as possible. This is a gap in healthcare. At Erasmus MC, we have set up the KOPP centre of expertise in collaboration with Obstetrics, which stands for Centre for Children of Parents with Psychiatric Problems. Unfortunately, we have noticed that prospective parents are not routinely asked about psychiatric disorders. I hope that I can contribute to more attention and support for these vulnerable families and to reducing the stigma surrounding mental health issues."