From pre-pregnancy to early school age: maternal mental health and child ADHD in Germany and the UK

Background

Up to 8% of children have attention deficit/hyperactivity disorder (ADHD). They are more likely to live with mothers in poor mental health, yet little is known about how these interdependencies unfold over time and whether they vary by socioeconomic and institutional context.

Methods

We examine bidirectional associations between maternal mental health and child ADHD risk. Using longitudinal data from the German Socioeconomic Panel (SOEP) and the UK Household Longitudinal Study (UKHLS), we analyse how maternal mental health (SF-12 Mental Component Summary) from pre-pregnancy through early childhood is associated with first-born children’s high ADHD risk (top decile of the Strengths and Difficulties Questionnaire Hyperactivity/Inattention Subscale) at school entry (ages 5–6), and how children’s high ADHD risk relates to maternal mental health during the early school years. We further assess moderation by family income.

Results

Poor maternal mental health before pregnancy was associated with children’s high ADHD risk in the UK, whereas in Germany associations emerged during pregnancy. Poor maternal mental health in early childhood was linked to children’s high ADHD risk at school entry, particularly among lower-income mothers in Germany. Children’s high ADHD risk was associated with declining maternal mental health from before pregnancy to ages 6–8, with socioeconomic patterning differing across countries.

Conclusions

Mothers’ and children’s mental health appear linked over time, with the association between maternal mental health and child ADHD risk extending from the period around pregnancy through the child’s early school years. Differences in societal contexts may contribute to variation in these associations.

Key messages

• Child ADHD risk is bidirectionally linked with maternal mental health, and these associations vary by resources and context.

• Links between maternal mental health and child ADHD risk are present already before birth and persist into the early school years, highlighting the importance of early family-level support.