Importance Depression is a common cause of morbidity and disability worldwide. Parental depression is associated with early-life child neurodevelopmental, behavioral, emotional, mental, and social problems. More studies are needed to explore the link between parental depression and long-term child outcomes. 
 
 Objective To examine the associations of parental depression with child school performance at the end of compulsory education (approximately age 16 years). 
 
 Design, Setting, and Participants Parental depression diagnoses (based on the International Classification of Diseases, Eighth Revision [ICD-8], International Classification of Diseases, Ninth Revision [ICD-9], and the International Statistical Classification of Diseases, 10th Revision [ICD-10]) in inpatient records from 1969 onward, outpatient records beginning in 2001, and school grades at the end of compulsory education were collected for all children born from 1984 to 1994 in Sweden. The final analytic sample size was 1 124 162 biological children. We examined the associations of parental depression during different periods (before birth, after birth, and during child ages 1-5, 6-10, and 11-16 years, as well as any time before the child’s final year of compulsory schooling) with the final school grades. Linear regression models adjusted for various child and parent characteristics. The dates of the analysis were January to November 2015. 
 
 Main Outcome and Measure Decile of school grades at the end of compulsory education (range, 1-10, with 1 being the lowest and 10 being the highest). 
 
 Results The study cohort comprised 1 124 162 children, of whom 48.9% were female. Maternal depression and paternal depression at any time before the final compulsory school year were associated with worse school performance. After covariate adjustment, these associations decreased to −0.45 (95% CI, −0.48 to −0.42) and −0.40 (−0.43 to −0.37) lower deciles, respectively. These effect sizes are similarly as large as the observed difference in school performance between the lowest and highest quintiles of family income but approximately one-third of the observed difference between maternal education of 9 or less vs more than 12 years. Both maternal depression and paternal depression at different periods (before birth, after birth, and during child ages 1-5, 6-10, and 11-16 years) generally were associated with worse school performance. Child sex modified the associations of maternal depression with school performance such that maternal depression had a larger negative influence on child school performance for girls compared with boys. 
 
 Conclusions and Relevance Diagnoses of parental depression throughout a child’s life were associated with worse school performance at age 16 years. Our results suggest that diagnoses of parental depression may have a far-reaching effect on an important aspect of child development, with implications for future life course outcomes. ||||| A Drexel University-led international study of more than 1 million children has found that teens' academic performance can be impacted if their parents ever had depression, even if they were diagnosed before the child was born. 
 
 "I think it's often not realized that mental health issues affect persons beyond [the] immediate patient," said Dr. Brian Lee, an associate professor of epidemiology and biostatistics at Drexel's School of Public Health. "Persons in the family, especially children, who are going to be more vulnerable, are likely to be at risk as well." 
 
 Researchers had access to an enormous data set encompassing more than 1 million children born in Sweden between 1984 and 1994 as well as their parents' mental health records. Sweden was chosen because it has a universal health care system and keeps meticulous records that are available in anonymized form to health researchers. 
 
 "It would be impossible to do a similar study like this in the U.S. without millions of dollars being invested," Lee noted. 
 
 Scientists at Drexel; the Karolinska Institutet in Stockholm, Sweden; and the University of Bristol in England had access to a register of year-end grades for the nation's 16-year-olds, plus records of whether their parents had been diagnosed with depression. Adopted children were not included in the study, since depression is inheritable. 
 
 Parental depression was found to have an even greater effect on grades than coming from a low-income family. Moreover, no matter how old the children were when their parents were diagnosed, it affected their grades at age 16. 
 
 
 
 "One of the interesting things that we did observe was that even if parental depression occurred before the child was born, that was still associated with school performance when the child was 16," said Lee. 
 
 However, these correlations were not always large enough to be statistically significant. 
 
 "In general, paternal depression and maternal depression in all periods were independently associated with worse school performance, although paternal depression during the postnatal period did not attain statistical significance," researchers wrote in the study, which was published in the journal JAMA Psychiatry. 
 
 In particular, researchers saw greater effects when the mother was depressed than when the father was depressed, especially if they had a daughter. For example, a girl's final grades were typically 5.1 points lower on a 1-100 scale if her mother had ever been depressed, while a boy's final grades were 3.4 points lower. 
 
 "Maternal depression in the mother seemed to affect girls more than it did boys, in terms of their school performance, whereas for a father's depression, it had an equivalent effect in both girls and boys," said Lee. 
 
 That finding suggests that the mother-daughter relationship is particularly meaningful to a child's development, or that girls more keenly feel the burden of having a parent with mental illness. 
 
 Lee said that the findings fit well with previous research. The large sample size, plus the fact that researchers saw associations between depression and grades no matter when parents were diagnosed, gives very strong evidence to a theory that rings true: "Parental depression affects the child."
– Having a depressed parent can take a toll on a child in any number of ways, and a comprehensive new study suggests a tangible one: lower school grades. The study led by researchers at Philadelphia's Drexel University found that kids whose mothers were diagnosed with depression had GPAs about 4.5 points lower than their peers at age 16, while kids with depressed fathers were about 4 points behind, reports NPR. The effect was especially pronounced for daughters whose mothers were depressed, notes Philly Voice: Those teen girls scored 5.1 points lower. The study looked at the grades of more than 1 million students in Sweden and cross-referenced them with their parents' mental health records; Sweden was used because records were easier to assess there. "One of the interesting things that we did observe was that even if parental depression occurred before the child was born, that was still associated with school performance when the child was 16," says Drexel researcher Brian Lee. The researchers don't get into the reasons why parental depression might hurt their kids' grades, though an epidemiologist at Columbia University Medical Center notes that a parent in this situation isn't going to make it to an appointment with a teacher, for instance, or have the energy to talk to their kids about problems in general. "Diagnoses of parental depression may have a far-reaching effect on an important aspect of child development, with implications for future life course outcomes," write the researchers in JAMA. (A TV star shut down his fat shamers by telling his own story of depression.)