Evaluation of a Family-Based Intervention Program for Children of Mentally Ill Parents: Study Protocol for a Randomized Controlled Multicenter Trial

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Abstract

Background: Children of mentally ill parents have a three to seven times higher risk of developing mental disorders compared to the general population. For this high-risk group, specialized prevention and intervention programs have already been developed. However, there has been insufficient sytematic evaluation to date. Moreover, effectiveness and the cost-effectiveness data of the respective programs until today is very scarce and at the same time constitutes the pre-condition for the program's implementation into regular health care.

Methods: The study consists of a two-group randomized controlled multicenter trial conducted at seven study sites throughout Germany and Switzerland. Participants are families with mentally ill parents and their children aged from 3 to 19 years. The intervention comprises 6 to 8 semi-structured sessions over a period of about 6 months. Topics discussed in the intervention include parental mental illness, coping, family relations and social support. Families in the control condition will receive treatment as usual. The children's mental health, assessed using the K-SADS-PL by blinded external raters will constitute the primary efficacy outcome. Further outcomes will be assessed from the parents' as well as from the children's perspectives. Participants are investigated at baseline, 6, 12, and 18 months after baseline assessment. In addition to the assessment of various psychosocial outcomes, a comprehensive health-economic evaluation will be performed.

Discussion: This paper describes the evaluation of a family-based intervention program for children of mentally ill parents (CHIMPs) in the regular health care system in Germany and Switzerland. A methodically sophisticated study design has been developed to reflect the complexity of the actual health care situation. This trial will contribute to the regular health care for the high-risk group of children of mentally ill parents.

Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT02308462; German Clinical Trials Register: DRKS00006806.

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Most cited references 74

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Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene.

Avshalom Caspi, Karen Sugden, Terrie E Moffitt … (2003)

In a prospective-longitudinal study of a representative birth cohort, we tested why stressful experiences lead to depression in some people but not in others. A functional polymorphism in the promoter region of the serotonin transporter (5-HT T) gene was found to moderate the influence of stressful life events on depression. Individuals with one or two copies of the short allele of the 5-HT T promoter polymorphism exhibited more depressive symptoms, diagnosable depression, and suicidality in relation to stressful life events than individuals homozygous for the long allele. This epidemiological study thus provides evidence of a gene-by-environment interaction, in which an individual's response to environmental insults is moderated by his or her genetic makeup.

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A children's global assessment scale (CGAS).

David Shaffer (1983)

We evaluated the Children's Global Assessment Scale (CGAS), an adaptation of the Global Assessment Scale for adults. Our findings indicate that the CGAS can be a useful measure of overall severity of disturbance. It was found to be reliable between raters and across time. Moreover, it demonstrated both discriminant and concurrent validity. Given these favorable psychometric properties and its relative simplicity, the CGAS is recommended to both clinicians and researchers as a complement to syndrome-specific scales.

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Negative life events, social support and gender difference in depression: a multinational community survey with data from the ODIN study.

Odd Dalgard, Christopher Dowrick, Ville Lehtinen … (2006)

To explore if differences in negative life events, vulnerability and social support may explain the gender difference in depression. Cross-sectional, multinational, community survey from five European countries (n = 8,787). Depression is measured by Beck Depression Inventory, whereas negative life events and social support are measured by various questionnaires. Women report slightly more negative life events than men do, mainly related to the social network, but more social support in general and in connection with reported life events. This trend is the same in all participating countries except Spain, where there is no gender difference in the reported support. In general, women are not more vulnerable to negative life events than men are. However, women with no social support, who are exposed to life events, are more vulnerable than men without support. The higher rate of depression in women is not explained by gender differences in negative life events, social support or vulnerability.

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Author and article information

Contributors

Silke Wiegand-Grefe: URI : http://loop.frontiersin.org/people/1176680/overview

Mareike Busmann: URI : http://loop.frontiersin.org/people/653128/overview

Reinhold Kilian: URI : http://loop.frontiersin.org/people/116288/overview

Martin Lambert: URI : http://loop.frontiersin.org/people/823889/overview

Kai von Klitzing: URI : http://loop.frontiersin.org/people/397816/overview

Kurt Albermann: URI : http://loop.frontiersin.org/people/1176653/overview

Karl Wegscheider: URI : http://loop.frontiersin.org/people/551806/overview

Angela Plass-Christl: URI : http://loop.frontiersin.org/people/977825/overview

Journal

Journal ID (nlm-ta): Front Psychiatry

Journal ID (iso-abbrev): Front Psychiatry

Journal ID (publisher-id): Front. Psychiatry

Title: Frontiers in Psychiatry

Publisher: Frontiers Media S.A.

ISSN (Electronic): 1664-0640

Publication date (Electronic): 20 January 2021

Publication date Collection: 2020

Volume: 11

Electronic Location Identifier: 561790

Affiliations

[1] ¹Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf , Hamburg, Germany

[2] ²Section of Health Economics and Health Services Research, Department of Psychiatry and Psychotherapy II, Ulm University , Günzburg, Germany

[3] ³Department of General Psychiatry, Landschaftsverband Westfalen-Lippe (LWL) Hospital Gütersloh , Gütersloh, Germany

[4] ⁴Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf , Hamburg, Germany

[5] ⁵Department of General Psychiatry and Psychotherapy, LWL Hospital Paderborn , Paderborn, Germany

[6] ⁶Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University of Leipzig , Leipzig, Germany

[7] ⁷Centre of Social Paediatrics, Cantonal Hospital Winterthur , Winterthur, Switzerland

[8] ⁸Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Charité Universitätsmedizin Berlin , Berlin, Germany

[9] ⁹Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf , Hamburg, Germany

[10] ¹⁰Department Child and Adolescent Psychiatry, Evangelical Hospital Hamburg Alsterdorf , Hamburg, Germany

Author notes

Edited by: Andrea Raballo, University of Perugia, Italy

Reviewed by: Samantha Cartwright-Hatton, University of Sussex, United Kingdom; Alice Masillo, Azienda Sanitaria Locale Roma 3, Italy

*Correspondence: Silke Wiegand-Grefe s.wiegand-grefe@ 123456uke.de

Angela Plass-Christl angela.plass-christl@ 123456eka.alsterdorf.de

This article was submitted to Child and Adolescent Psychiatry, a section of the journal Frontiers in Psychiatry

Article

DOI: 10.3389/fpsyt.2020.561790

PMC ID: 7854699

PubMed ID: 33551858

SO-VID: 33dd4987-360b-4f07-a224-f094fdf8c337

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

History

Date received : 13 May 2020

Date accepted : 18 December 2020

Page count

Figures: 1, Tables: 2, Equations: 0, References: 74, Pages: 13, Words: 10365

Funding

Funded by: Bundesministerium für Bildung und Forschung 10.13039/501100002347

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Evaluation of a Family-Based Intervention Program for Children of Mentally Ill Parents: Study Protocol for a Randomized Controlled Multicenter Trial

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Most cited references 74

Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene.

A children's global assessment scale (CGAS).

Negative life events, social support and gender difference in depression: a multinational community survey with data from the ODIN study.

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