title: Changes in children's behavior and costs for service use associated with parents' response to treatment for dysthymia.
abstract: OBJECTIVE
  This study examined differences in children's behavior and expenditures for health and social services used when their parents with dysthymia did or did not respond to antidepressant therapy.
  
  
  METHODS
  Children ages 4 to 16 years of consenting parents enrolled in a treatment trial for dysthymia who did and did not respond to treatment were compared at baseline and 24 months. The responder was a parent with at least a 40% reduction in his or her baseline depressive symptoms using the Montgomery Asberg Depression Rating Scale. Children's behavior was measured using the Child Behavior Checklist, and expenditures for health and social services use was measured in Canadian dollars using the Health and Social Service Utilization Questionnaire.
  
  
  RESULTS
  Children of parents with dysthymia who responded to treatment had significantly greater reductions in emotional symptoms at 2-year follow-up than children of nonresponders, along with an economically important (not statistically significant) reduction in expenditures for health and social services use.
  
  
  CONCLUSIONS
  Reductions in parental symptoms of dysthymia may be associated with reductions in childhood behavioral problems and in expenditures for the child's use of services.
authors.affiliation: Dr. Byrne is with the University of Ontario Institute of Technology, Faculty of Health Sciences, Oshawa, and McMaster University's Faculty of Health Sciences System-Linked Research Unit on Health and Social Service Utilization, Hamilton; Drs. Browne and Roberts are with McMaster University's System-Linked Research Unit on Health and Social Service Utilization and the Department of Clinical Epidemiology and Biostatistics; Drs. Mills and Bell are with the Caroline Medical Group, Burlington; Dr. Gafni is with McMaster University's Faculty of Health Sciences Department of Clinical Epidemiology and Biostatistics, Centre for Health Economics and Policy Analysis, and System-Linked Research Unit on Health and Social Service Utilization; Ms. Jamieson and Ms. Webb are with McMaster University's System-Linked Research Unit on Health and Social Service Utilization, Hamilton.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Byrne
authors.affiliation: Dr. Byrne is with the University of Ontario Institute of Technology, Faculty of Health Sciences, Oshawa, and McMaster University's Faculty of Health Sciences System-Linked Research Unit on Health and Social Service Utilization, Hamilton; Drs. Browne and Roberts are with McMaster University's System-Linked Research Unit on Health and Social Service Utilization and the Department of Clinical Epidemiology and Biostatistics; Drs. Mills and Bell are with the Caroline Medical Group, Burlington; Dr. Gafni is with McMaster University's Faculty of Health Sciences Department of Clinical Epidemiology and Biostatistics, Centre for Health Economics and Policy Analysis, and System-Linked Research Unit on Health and Social Service Utilization; Ms. Jamieson and Ms. Webb are with McMaster University's System-Linked Research Unit on Health and Social Service Utilization, Hamilton. Electronic address: gina.browne@mcmaster.ca.
authors.forename: Gina
authors.initials: G
authors.lastname: Browne
authors.affiliation: Dr. Byrne is with the University of Ontario Institute of Technology, Faculty of Health Sciences, Oshawa, and McMaster University's Faculty of Health Sciences System-Linked Research Unit on Health and Social Service Utilization, Hamilton; Drs. Browne and Roberts are with McMaster University's System-Linked Research Unit on Health and Social Service Utilization and the Department of Clinical Epidemiology and Biostatistics; Drs. Mills and Bell are with the Caroline Medical Group, Burlington; Dr. Gafni is with McMaster University's Faculty of Health Sciences Department of Clinical Epidemiology and Biostatistics, Centre for Health Economics and Policy Analysis, and System-Linked Research Unit on Health and Social Service Utilization; Ms. Jamieson and Ms. Webb are with McMaster University's System-Linked Research Unit on Health and Social Service Utilization, Hamilton.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Roberts
authors.affiliation: Dr. Byrne is with the University of Ontario Institute of Technology, Faculty of Health Sciences, Oshawa, and McMaster University's Faculty of Health Sciences System-Linked Research Unit on Health and Social Service Utilization, Hamilton; Drs. Browne and Roberts are with McMaster University's System-Linked Research Unit on Health and Social Service Utilization and the Department of Clinical Epidemiology and Biostatistics; Drs. Mills and Bell are with the Caroline Medical Group, Burlington; Dr. Gafni is with McMaster University's Faculty of Health Sciences Department of Clinical Epidemiology and Biostatistics, Centre for Health Economics and Policy Analysis, and System-Linked Research Unit on Health and Social Service Utilization; Ms. Jamieson and Ms. Webb are with McMaster University's System-Linked Research Unit on Health and Social Service Utilization, Hamilton.
authors.forename: Michael
authors.initials: M
authors.lastname: Mills
authors.affiliation: Dr. Byrne is with the University of Ontario Institute of Technology, Faculty of Health Sciences, Oshawa, and McMaster University's Faculty of Health Sciences System-Linked Research Unit on Health and Social Service Utilization, Hamilton; Drs. Browne and Roberts are with McMaster University's System-Linked Research Unit on Health and Social Service Utilization and the Department of Clinical Epidemiology and Biostatistics; Drs. Mills and Bell are with the Caroline Medical Group, Burlington; Dr. Gafni is with McMaster University's Faculty of Health Sciences Department of Clinical Epidemiology and Biostatistics, Centre for Health Economics and Policy Analysis, and System-Linked Research Unit on Health and Social Service Utilization; Ms. Jamieson and Ms. Webb are with McMaster University's System-Linked Research Unit on Health and Social Service Utilization, Hamilton.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bell
authors.affiliation: Dr. Byrne is with the University of Ontario Institute of Technology, Faculty of Health Sciences, Oshawa, and McMaster University's Faculty of Health Sciences System-Linked Research Unit on Health and Social Service Utilization, Hamilton; Drs. Browne and Roberts are with McMaster University's System-Linked Research Unit on Health and Social Service Utilization and the Department of Clinical Epidemiology and Biostatistics; Drs. Mills and Bell are with the Caroline Medical Group, Burlington; Dr. Gafni is with McMaster University's Faculty of Health Sciences Department of Clinical Epidemiology and Biostatistics, Centre for Health Economics and Policy Analysis, and System-Linked Research Unit on Health and Social Service Utilization; Ms. Jamieson and Ms. Webb are with McMaster University's System-Linked Research Unit on Health and Social Service Utilization, Hamilton.
authors.forename: Amiram
authors.initials: A
authors.lastname: Gafni
authors.affiliation: Dr. Byrne is with the University of Ontario Institute of Technology, Faculty of Health Sciences, Oshawa, and McMaster University's Faculty of Health Sciences System-Linked Research Unit on Health and Social Service Utilization, Hamilton; Drs. Browne and Roberts are with McMaster University's System-Linked Research Unit on Health and Social Service Utilization and the Department of Clinical Epidemiology and Biostatistics; Drs. Mills and Bell are with the Caroline Medical Group, Burlington; Dr. Gafni is with McMaster University's Faculty of Health Sciences Department of Clinical Epidemiology and Biostatistics, Centre for Health Economics and Policy Analysis, and System-Linked Research Unit on Health and Social Service Utilization; Ms. Jamieson and Ms. Webb are with McMaster University's System-Linked Research Unit on Health and Social Service Utilization, Hamilton.
authors.forename: Ellen
authors.initials: E
authors.lastname: Jamieson
authors.affiliation: Dr. Byrne is with the University of Ontario Institute of Technology, Faculty of Health Sciences, Oshawa, and McMaster University's Faculty of Health Sciences System-Linked Research Unit on Health and Social Service Utilization, Hamilton; Drs. Browne and Roberts are with McMaster University's System-Linked Research Unit on Health and Social Service Utilization and the Department of Clinical Epidemiology and Biostatistics; Drs. Mills and Bell are with the Caroline Medical Group, Burlington; Dr. Gafni is with McMaster University's Faculty of Health Sciences Department of Clinical Epidemiology and Biostatistics, Centre for Health Economics and Policy Analysis, and System-Linked Research Unit on Health and Social Service Utilization; Ms. Jamieson and Ms. Webb are with McMaster University's System-Linked Research Unit on Health and Social Service Utilization, Hamilton.
authors.forename: Michelle
authors.initials: M
authors.lastname: Webb
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D002648:Child; D002653:Child Behavior Disorders / Q000191:economics / Q000453:epidemiology*; D002662:Child Health Services / Q000191:economics*; D016241:Child of Impaired Parents / Q000523:psychology*; D002675:Child, Preschool; D019263:Dysthymic Disorder / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D005102:Health Expenditures; D006801:Humans; D016015:Logistic Models; D008297:Male; D009864:Ontario / Q000453:epidemiology; D012947:Social Work / Q000191:economics*