Introduction

Both parental psychological and physical illness increase the risk of adverse cognitive, emotional, and social child development. Their importance is underlined by considering the prevalence of different illnesses or disorders. For example, depression, the most common condition amongst women of child-bearing age has a prevalence of over 8 per cent.(1) Many parents will also experience either severe illness such as cancer or coronary disease, or a chronic condition such as diabetes. Breast cancer alone affects approximately 1 in 12 women in the United Kingdom, about a third of whom have children of school age.

It is clear that, particularly in the case of mental illness, child problems may persist well after remission of the parental disorder. Nevertheless, it must be emphasized that a significant proportion of children at high risk do not develop problems and demonstrate resilience. (2) Furthermore, many parents manage to rear their children well despite their own illness. This chapter reviews the current state of evidence regarding a range of psychiatric and physical conditions, with a view to extracting overarching themes that can guide clinical practice when faced with a seriously ill parent, in terms of the meaning for the parent and the child. The key question in relation to intervention is: What are the mechanisms whereby childhood disturbance does or does not develop in conjunction with parental illness?

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