• Vol. 48 No. 2, 55–62
  • 15 February 2019

Assessing for Mood and Anxiety Disorders in Parents of Clinically-Referred Children: Laying the Foundation for a Family-Based Approach to Mental Health in Singapore



Family history of psychopathology is a risk factor for mood and anxiety disorders in children, but little is known about rates of parental psychopathology among treatment-seeking youth with affective disorders in the Asia Pacific region. This study examined patterns of emotional and behavioural problems in parents of clinically-referred youth in Singapore. We hypothesised that parents would have higher rates of affective disorders compared to the Singapore national prevalence rate of 12%. Materials and Methods: In this cross-sectional study, 47 families were recruited from affective disorders and community-based psychiatry programmes run by a tertiary child psychiatry clinic. All children had a confirmed primary clinical diagnosis of depression or an anxiety disorder. Parents completed the Mini International Neuropsychiatric Interview (MINI) to assess for lifetime mood and anxiety disorders. They also completed the Adult Self Report (ASR) and Adult Behavior Checklist (ABCL) to assess current internalising and externalising symptoms. Results: Consistent with our hypothesis, 38.5% of mothers and 10.5% of fathers reported a lifetime mood or anxiety disorder. Nearly 1/3 of mothers had clinical/subclinical scores on current internalising and externalising problems. A similar pattern was found for internalising problems among fathers, with a slightly lower rate of clinical/subclinical externalising problems. Conclusion: Our findings are consistent with previous overseas studies showing elevated rates of affective disorders among parents—particularly mothers—of children seeking outpatient psychiatric care. Routine screening in this population may help to close the current treatment gap for adults with mood and anxiety disorders.

Parental psychopathology is a documented risk factor for mood disorders in children1,2 and it may be due to a combination of genetic vulnerabilities and psychosocial factors such as parenting style and attachment. While there is evidence for the heritability of mood and anxiety disorders, parental psychopathology can also profoundly affect the environment in which the child is raised.

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