Changes in children's behavior and costs for service use associated with parents' response to treatment for dysthymia.
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.
Byrne
Carolyn
C
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.
Browne
Gina
G
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.
Roberts
Jacqueline
J
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.
Mills
Michael
M
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.
Bell
Barbara
B
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.
Gafni
Amiram
A
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.
Jamieson
Ellen
E
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.
Webb
Michelle
M
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.
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*