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OBJECTIVE: To examine the risk of anxiety disorders in offspring of parents with mood disorders METHOD: We conducted a systematic review and meta-analysis. We searched four electronic databases- Medline, Embase, PsycINFO and Web of Science (core collection) to identify cross-sectional and cohort studies that examined the association between parental mood disorders (including bipolar disorder and unipolar depression) and risk of anxiety disorders in offspring. Pooled risk ratios (RRs) of overall and specific anxiety disorders were synthesised using a random effects model. Subgroup analyses and meta-regression were performed to identify moderation factors. RESULTS: 35 studies were included in the final analysis. Our results showed higher risks of all types of anxiety disorders in the offspring of parents with mood disorders (any anxiety disorder, RR= 1.82, 95% CI= 1.47-2.26), except for agoraphobia (RR= 1.08, 0.56-2.08), and with an especially elevated risk of panic disorder (RR= 3.07, 2.19-4.32). Subgroup analysis demonstrated no significant difference between the risks of anxiety disorders across the offspring of parents with bipolar disorder as opposed to unipolar depression. The absence of anxiety disorders in control parents, younger offspring age and specific parent/offspring sex were associated with higher RRs for some anxiety disorders in offspring of parents with mood disorders. CONCLUSION: Our findings suggest a robust relationship between parental mood disorders and offspring anxiety disorders and highlight the potential value of prevention and early intervention for anxiety disorders in this context.

Original publication




Journal article


J Am Acad Child Adolesc Psychiatry

Publication Date



affective, bipolar, depressive, high-risk, parental