The relationship of life stressors and maternal depression to pediatric asthma morbidity in a subspecialty practice.
OBJECTIVE
To examine the relationships among demographic characteristics, caregiver life stressors, and depressive symptoms of mothers and their children's asthma morbidity.


METHODS
Three pediatric asthma subspecialty programs, 2 in the inner city and 1 in the suburbs.


METHODS
Cross-sectional census sample of caregivers of children with asthma: interviews mostly with mothers (N = 123) regarding their children's asthma symptoms and health care utilization. Information collected on demographics and caregivers' own recent life stressors and depressive symptoms.


METHODS
Caregivers of children ages 18 months to 12 years with asthma at their subspecialty visit.


METHODS
Structured interviews: a survey instrument prepared for this study and standardized instruments for depression (Center for Epidemiologic Studies--Depression) and life stressors (Crisis in Family Systems).


RESULTS
A total of 32% of respondents' children had high asthma morbidity, 28% intermediate, and 40% low. Caregiver life stressors and depression and the children's sex showed the strongest relationships to asthma morbidity in a model that also included race, residence, and Medicaid status. Children were more likely to have high morbidity if they had caregivers with more depressive symptoms and negative life stressors and if they were female.


CONCLUSIONS
Respondents experienced many life stressors and symptoms of depression while managing their children's illness. Caregivers' lives may affect their children's asthma morbidity, offering empirical evidence for the potential value of targeted case management for children in subspecialty care.
Shalowitz
M U
MU
Department of Pediatrics, Northwestern University Medical School, Chicago, IL 60201, USA. m-shalowitz@northwestern.edu
Berry
C A
CA
Quinn
K A
KA
Wolf
R L
RL
D000704:Analysis of Variance; D001249:Asthma / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D016002:Discriminant Analysis; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009035:Mothers / Q000523:psychology*; D015999:Multivariate Analysis; D012307:Risk Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000523:psychology*