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Forensic Psychiatry
Offspring outcomes when a parent experiences one or more major psychiatric disorder(s): a clinical review
  1. Sarah Elizabeth Argent,
  2. Natasha Kalebic,
  3. Frances Rice,
  4. Pamela Taylor
  1. Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
  1. Correspondence to Dr Sarah Elizabeth Argent, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff CF24 4HQ, UK; argents{at}


We sought evidence on quantifiable offspring outcomes, including problems, needs and strengths, associated with their experience of major parental psychiatric disorder(s), focusing on schizophrenia, affective illnesses and personality disorder(s). We were motivated by the absence of any systematic exploration of the needs of offspring of parents in secure hospitals. Seven electronic databases were searched to identify systematic reviews of studies quantifying offspring outcomes when a parent, or parent surrogate, has major psychiatric disorder(s). Our search (updated in February 2018) identified seven high-quality reviews, which incorporated 291 unique papers, published in 1974–2017. The weight of evidence is of increased risk of poor offspring outcomes, including psychiatric disorder and/or behavioural, emotional, cognitive or social difficulties. No review explored child strengths. Potential moderators and mediators examined included aspects of parental disorder (eg, severity), parent and child gender and age, parenting behaviours, and family functioning. This clinical review is the first review of systematic reviews to focus on quantifiable offspring problems, needs or strengths when a parent has major psychiatric disorder(s). It narratively synthesises findings, emphasising the increased risk of offspring problems, while highlighting limits to what is known, especially the extent to which any increased risk of childhood problems endures and the extent to which aspects of parental disorder moderate offspring outcomes. The absence of the reviews’ consideration of child strengths and protective factors limits opportunity to enhance offspring resilience.

  • schizophrenia & psychotic disorders
  • depression & mood disorders
  • personality disorders

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  • Contributors SEA and PT conceived the work and the review question. SEA and PT together with NK and FR worked on the design of the review protocol. SEA and NK rated the first 100 titles and where necessary abstracts of results generated by the searches. The remaining titles and where necessary abstracts were rated by SEA. The full texts which were acquired following rating of the search results were rated by both SEA and NK. Where there were any discrepancies, discussion with PT resolved this. SEA completed quality assessment of the reviews which remained after examination of the full texts. Data extraction of the reviews deemed eligible for inclusion was undertaken by both SEA and NK. The results from data extraction were examined by all four authors and discussed extensively. SEA drafted the work and the three other authors each revised it critically. All four authors have given their approval of the final version submitted for publication and have agreed to be accountable for all aspects of the work and ensure that any questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data availability statement Data sharing not applicable as no data sets generated and/or analysed for this study. As this is a clinical review of systematic reviews, there are no data sets except for the systematic reviews themselves, which are referenced.