According to World Health Organisation (WHO) statistics, prevalence of disabling mental illnesses among children and adolescents attending urban health centers ranges between 20-30% and 13-18% in rural areas. Out of these 3-4% are suffering from serious mental illnesses and require treatment [1]. Millions of children and adolescents are exposed to parental mental health problems at any given time [2].

Studies have noted that offspring of mentally ill parents have higher rates of psychiatric diagnoses in childhood and are more likely to show developmental delays, lower academic competence, and difficulty with social relationships [3]. In addition, these offspring are more likely to have mental health problems in adolescence and adulthood [4]. Childhood is the developmental period in which most children are not only living with parents, but are also almost completely dependent on parents for their emotional and physical needs.

1. To evaluate the frequency and nature of psychiatric morbidities in parents of children attending the child guidance clinic.
2. To study the association between the psychiatric morbidity in children with their parental psychiatric morbidity.

Study design: Cross-sectional study.

Study period: 1/7/2014 to 30/6/2015

Study setting: Child Guidance Clinic (CGC), Department of Psychiatry, Government Medical College, Kottayam, Kerala.

Inclusion criteria for children

1. Children with a definite diagnosis of psychiatric illness as per the diagnostic criteria for research (DCR-10).
2. Children with age less than 12 years.
3. Children of parents giving consent

Exclusion criteria for children

1. Adopted children
2. Children who are physically unfit for evaluation.
3. Parents inaccessible.

Among the 200 fathers 122 had psychiatric morbidity of which most common was harmful use of alcohol in 60 fathers (30%) followed by alcohol dependence syndrome in 38 fathers (19%). 8 fathers had co morbid psychiatric disorder along with alcohol use disorder of which mood disorder was commonest. Out of the 200 mothers 50 (25%) had psychiatric morbidity of which depressive disorders n=22(11%) was the most common followed by anxiety disorder n=18 (9%).

Significant associations were found between 1) conduct disorders in children with fathers’ alcohol dependence and bipolar affective disorder and mothers’ depressive disorder 2) ADHD (F90.0) in children with fathers’ alcohol harmful use 3)Hyperkinetic conduct disorder(ADHD+CD) in children with fathers’ alcohol dependence and bipolar affective disorder and mothers’ depression 4) Pervasive developmental disorder in children with fathers’ alcohol dependence 5) Mental retardation in children with fathers’ alcohol dependence and psychosis .

Table-1: showing various psychiatric diagnosis of children attending child guidance clinic

*Others included 2 children with non-organic sleep disorders, 3 children with post encephalitic sequelae and 2 children with non-organic enuresis

Table-2: Psychiatric morbidity among fathers of children attending child guidance clinic

The criteria for diagnosing disorders were according to the Diagnostic Criteria for Research (DCR 10) accompanying the ICD 10. But some of the names of the diagnoses have been used interchangeably with DSM-5 since most of the studies on childhood disorders were based on DSM.

Table-5: Association between paternal and child psychiatric illness (except ADHD)

Table-6: Association between maternal and child psychiatric illness (except ADHD)

Test used was Pearson chi square test, df =1, p value significant level <0.05(*fischer’s exact test value).

In our study total of 122 fathers and 50 mothers had psychiatric morbidity which constitute 43 % of parents of either sex. This is in correspondence with the study done in Philipps University Marburg Germany which showed 48.3 % of parents of either sex had psychiatric morbidity [8]. Most common psychiatric morbidity among fathers was harmful use of alcohol(30%) followed by alcohol dependence syndrome in 38 fathers (19%). This is in accordance with the study by Philipps University Marburg Germany which showed 20.7 % of substance dependence among parents of children with psychiatric disorders.Among the mothers depressive disorder n=22(11%) was the most common psychiatric morbidity followed by anxiety disorder n=18 (9%) [8]. As per a study from a south Indian rural population prevalence of depressive disorder was 14.82% and anxiety was 4% [9]. Significant association was found between, ADHD in children with fathers’ alcohol harmful use (p=0.041).A study done in US found that there is significant association between ADHD in children and fathers’ substance use disorder. In this study 29% of children with ADHD had their fathers having substance use disorder [10]. In this study there was significant association between ADHD with conduct disorder (CD) in children and fathers’ alcohol dependence (p= 0.011) and bipolar affective disorder (p=0.005) and mothers’ depression (p=0.008). The US study also found similar association with 31.5% of children with ADHD and conduct disorder had their fathers having substance use disorder and 43.3% of mothers having mood disorder [10]. Mental retardation in children was significantly associated with fathers’ alcohol dependence (p=0.007) and psychosis (p=0.020).An Indian study on parents of children with mental retardation found significant association between mental retardation in children and dysthymia ,anxiety disorder and depression in parents.Substance use disorder is highly co-morbid with all these conditions [11].

Psychiatric illnesses in parents represent a risk for children in the family. These children have a higher risk for developing behavioral problems than other children.