We now are far more aware that children and adolescents who have parents with mental illness are more likely to experience wide-ranging health disadvantages compared to children and adolescents in the general population. However, current knowledge about the extent of maternal mental illness in the UK, and the associated consequences, is very limited. This study will aim to quantify how many children and adolescents there are who have a mother with a mental illness. We shall also find out whether the numbers have been changing over time because of social changes like the, financial crisis of 2008, or changes in medications for women with serious mental illness that might affect fertility. We shall also find out if these children and adolescents are more or less likely to use health-care services; which kinds of service they use and what are the associated costs; what diseases are driving any excess healthcare use; and whether they are more or less likely to use preventive health care like vaccination during childhood. The study will provide vital statistical information which will help to develop better planning, support and health services for these vulnerable young people.
Having a parent experiencing mental illness increases the risk of infant mortality and developing mental illness during adulthood. However, little is known about the scale of parental mental illness and other risks for this group of vulnerable young people. The fertility rate of women with a mental illness diagnosis will be determined and compared with women who do not have a mental illness. We will then identify a cohort of offspring of mothers with mental illness, using a probabilistic linkage algorithm. Exposed children will enter the cohort from the date of maternal mental illness diagnosis, or from birth if diagnosis within five years prior to birth.
We will use this cohort to estimate the period-prevalence of children with a mother with mental illness. Secular trends will be examined to assess whether this is affected by the widespread introduction of atypical antipsychotic agents and by ecological changes. Healthcare utilisation and associated costs will be compared between exposed and unexposed children. Finally, the association between an offspring with a mother with a mental illness and uptake of vaccination during early childhood will be quantified.
Fertility rate (miscarriages, stillbirths and livebirths per year) comparing mothers with a mental illness with those without.
- Period prevalence of children born to mothers with a mental illness
- Rates of health service utilisation, defined by a consultation in primary care (face to face, telephone, other) and hospital visits (in-patient, outpatient and accident and emergency), associated with offspring with a mother with a mental illness
- Health service costs associated with off spring with a mother with a mental illness
- Vaccine uptake in children (up to age 5) with a mother with a mental illness
- Specific childhood physical health conditions: atopic disorders, infections, obesity, cancer, and accidents and injuries
- Causes of infertility comparing women with mental illness versus those without
- Specific childhood neurodevelopmental conditions: cerebral palsy, epilepsy, autism spectrum disorder, intellectual disability, attention deficit hyperactivity disorder
Kathryn Abel - Chief Investigator - University of Manchester
Matthias Pierce - Corresponding Applicant - University of Manchester
Darren Ashcroft - Collaborator - University of Manchester
Holly Hope - Collaborator - University of Manchester
Richard Emsley - Collaborator - King's College London (KCL)
CPRD Mother-Baby Link;HES Accident and Emergency;HES Admitted Patient Care;HES Outpatient;ONS Death Registration Data;Patient Level Index of Multiple Deprivation;Pregnancy Register