Change in child psychopathology with improvement in parental depression: a systematic review Gunlicks ML, Weissman MM CRD summary The authors concluded that some consistent evidence existed to suggest that reduction or remission of parental depressive symptoms was related to long-term success, but definitive conclusions about treatments were not possible. The review included variable studies of uncertain quality and was substantially flawed in all parts of the review process. The authors conclusions are unlikely to be reliable. Authors' objectives To evaluate the effect of treating parental depression on child psychopathology outcomes. Searching PsycINFO (1806 to 2007) and MEDLINE (1950 to 2007) were searched to identify relevant published English- language articles for inclusion in the review. Search terms were reported. Reference lists of identified articles were scanned for further relevant material. Study selection Open and controlled clinical trials of treatments for parental depression that included psychological and behavioural assessments of their children aged 18 years and younger were eligible for inclusion in the review. Observational studies that explored the association between improvements in parental depression and child outcomes were included. Studies that did not report treatment-related or naturalistic reductions in parental depression were excluded, as were those that did not include parent and child outcome assessments, where mothers received psycho-pharmacological treatment during pregnancy and studies where treatments targeted parenting skills or parent-child relationships. There was substantial variation in all aspects of inclusion criteria in the included studies. All parents were assessed using Diagnostic and Statistical Manual of mental disorders-based (DSM-based) criteria; most had major depressive disorder. It was not possible to separate findings for mothers and fathers. Child-related outcomes were psychiatric and psychosocial measures that used a mixture of parental report and independent blinded evaluation. Parent outcomes were measured by various tools (all detailed in the paper). The included treatments were individual and group psychotherapy, and medication (unspecified). Studies of treatment for maternal depression were included; it was not clear whether all were studies postpartum. The authors stated neither how the papers were selected for the review nor how many reviewers performed the selection. Assessment of study quality The authors did not state that they assessed validity. Data extraction Data were extracted and reported narratively as changes in child outcomes following parental treatment and response. The authors stated neither how the data were extracted for the review nor how many reviewers performed the data extraction. Methods of synthesis Studies were synthesised narratively. Child outcomes were reported according to whether parents had been treated and in relation to specific responses. Tables of study details were available to examine between-study differences. Results of the review Ten studies were included in the review (n=1,120). Sample sizes ranged from 10 to 260 participants. Database of Abstracts of Reviews of Effects (DARE) Produced by the Centre for Reviews and Dissemination Copyright © 2013 University of York Page: 1 / 3