title: Long-term effects of chronic depressive symptoms among low-income childrearing mothers.
abstract: OBJECTIVE
  Longitudinal studies of maternal depression in the postpartum period have demonstrated that a chronic state of depressive symptoms is not rare. In spite of this, however, the characteristics of chronically depressed mothers have rarely been studied. This study examines the demographic and socioenvironmental characteristics across time of childrearing women with chronic depressive symptoms.
  
  
  METHODS
  A cohort of 476 childrearing lower-income mothers was interviewed from the first trimester of pregnancy through the tenth year postpartum. The Center for Epidemiologic Studies-Depression Scale (CES-D; Radloff, L. (1977) Appl Psychol Meas 1:385-401) was used to define depressive symptomatology. Four groups were defined based on the CES-D scores at 18 months, 3, 6 and 10 years: never-depressed (CES-D < 16), depressed only at one phase (CES-D > or = 16), chronically mildly depressed (CES-D > 16 and < or =24 at three or more phases), and chronically severely depressed (CES-D > or = 25 at three or more times). Demographic and socioenvironmental characteristics of the groups were evaluated across time.
  
  
  RESULTS
  Chronically depressed women compared to never-depressed women were less likely to be married, had less education, had lower family income, and were more likely to use substances. They reported more frequent arguments with close family members or friends, separation/divorce with partners, financial problems, less social support, and more financial strain.
  
  
  CONCLUSIONS
  Women who continue to be depressed across the 10 postpartum years have less optimal outcomes compared to women who are not depressed and those who are only intermittently depressed. Pregnancy and delivery and subsequent pediatric visits are important times to identify women who are depressed.
authors.affiliation: Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Masako
authors.initials: M
authors.lastname: Seto
authors.forename: Marie D
authors.initials: MD
authors.lastname: Cornelius
authors.forename: Lidush
authors.initials: L
authors.lastname: Goldschmidt
authors.forename: Kanehisa
authors.initials: K
authors.lastname: Morimoto
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Day
mesh_terms: D002908:Chronic Disease; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008429:Maternal Welfare / Q000523:psychology*; D010414:Pennsylvania; D011203:Poverty; D013995:Time