Depression in mothers of children presenting for emergency and primary care: impact on mothers' perceptions of caring for their children.
BACKGROUND
Maternal mental health conditions may influence how mothers utilize emergency health care for their children. However, little is known about the prevalence of depression among mothers of children presenting for emergency health care and how maternal depression affects a mother's perception of how difficult it is to care for her children.


OBJECTIVE
To screen for maternal depression and to examine whether mothers with depressive symptoms perceive that these symptoms interfere with their roles in caring for their children.


METHODS
Cross-sectional survey.


METHODS
An urban, tertiary-care, children's hospital.


METHODS
Mothers bringing their children, aged 6 months to 18 years, to an emergency department for low-acuity illness (n = 243) or to a pediatric primary care clinic (n = 249) for well-child care.


METHODS
Positive screening tests for depression using the Prime MD Patient Health Questionnaire.


RESULTS
The prevalence of positive screening tests for depression was similar in both emergency and primary care settings, with 18% of mothers having either major (9%) or subthreshold (9%) depression and 5% percent having suicidal ideation. Seventy-six percent of mothers with a positive screen for major depression and 17% of those with a negative screen for depression reported that their mental health symptoms made it difficult to care for their children. Mothers with a positive screen for depression reported poorer health status for themselves (P =.014) but not for their children (P =.37).


CONCLUSIONS
Screening questionnaires in both primary care and emergency care settings with sociodemographically similar groups of mothers produced similar rates of depression. The high rates of depressive symptoms and of mothers' reports that these symptoms cause them difficulty in caring for their children indicate that resources to screen for and address depressive symptoms in mothers should receive higher priority in pediatric health care settings.
Grupp-Phelan
Jacqueline
J
Divisions of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45213, USA. grupj0@CCHMC.org
Whitaker
Robert C
RC
Naish
Aimee B
AB
D000293:Adolescent; D000328:Adult; D002648:Child; D002654:Child Care / Q000523:psychology*; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008403:Mass Screening / Q000706:statistics & numerical data; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D009820:Ohio / Q000453:epidemiology; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data; D020377:Self Efficacy; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires