School-age offspring of mothers with major depression consistently have elevated rates of depression (1–7), and we and others have found that the remission of maternal depression is associated with a reduction in their offspring’s psychiatric symptoms (8–11). Because these studies were observational and the mothers’ treatment was not randomly assigned, we could not conclude that the improvement in the child’s symptoms was due to the mother’s treatment. A 9-month randomized controlled study of 47 depressed mothers receiving either interpersonal psychotherapy or treatment as usual, and their 6- to 18-year-old children (12), found that symptom improvement in mothers receiving interpersonal psychotherapy was statistically significant at 12 weeks,and the treatment effects on children were significant at 9 months. Two other randomized controlled trials testing the effects of maternal treatment on children included much younger children(ages 2–4 and 4–11)and found that there were no statistically significant treatment effects on children(13,14).
In this study, we independently assessed children of depressed mothers participating in a 12-week double-blind randomized clinical trial testing the effects of escitalopram, bupropion, or the combination of the two (15). We hypothesized that mothers receiving the combination treatment would have an earlier onset and a higher rate of remission than those receiving either of the monotherapies and that the results would be reflected in their children.