Family relationships in childhood and common psychiatric disorders in later life: systematic review of prospective studies

Background Most evidence for associations between childhood adversity and adult mental illness is retrospective. Aims To evaluate prospective evidence of associations between poor parent-child relationships and common psychiatric disorders in later life. Method Systematic review of studies published between 1970 and 2008 including: (a) more than 100 participants, (b) measures of relationships in the home during childhood, (c) at least 10 years between assessment of exposures, and (d) measures of anxiety, depression, suicide, suicidal ideation or post-traumatic stress disorder (PTSD). Analysis was by narrative synthesis. Results Twenty-three papers were identified reporting data from 16 cohorts. Abusive relationships predicted depression, anxiety and PTSD. Maternal emotional unavailability in early life predicted suicide attempts in adolescence. Results of studies investigating less severe relationship problems were Suggestive but not conclusive of causal association, due partly to methodological heterogeneity. Conclusions Given the prevalence and disabling nature of common psychiatric problems, these studies highlight the need to minimise harm associated with dysfunctional parent-child relationships.