The impact of maternal depressive symptoms on health-related quality of life in children with epilepsy: a prospective study of family environment as mediators and moderators.
OBJECTIVE
To examine the impact of maternal depressive symptoms (DS) on health-related quality of life (HRQL) in children with new-onset epilepsy and to identify family factors that moderate and mediate this relationship during the first 24 months after epilepsy diagnosis.


METHODS
A sample of 339 mother-child dyads recruited from pediatric neurologists across Canada in the Health-related Quality of Life in Children with Epilepsy Study. Mothers' and neurologists' reports were collected at four times during the 24-month follow-up. Mothers' DS were measured using the Center for Epidemiological Studies Depression Scale (CES-D) and children's HRQL using the Quality of Life in Childhood Epilepsy (QOLCE). Data were modeled using individual growth curve modeling.


RESULTS
Maternal DS were observed to have a negative impact on QOLCE scores at 24 months (β = -0.47, p < 0.0001) and the rate of change in QOLCE scores during follow-up (β = -0.04, p = 0.0250). This relationship was moderated by family resources (β = 0.25, p = 0.0243), and the magnitude of moderation varied over time (β = 0.09, p = 0.0212). Family functioning and demands partially mediated the impact of maternal DS on child HRQL (β = -0.07, p = 0.0007; β = -0.12, p = 0.0006).


CONCLUSIONS
Maternal DS negatively impact child HRQL in new-onset epilepsy during the first 24 months after diagnosis. This relationship is moderated by family resources and mediated by family functioning and demands. By adopting family centered approaches, health care professionals may be able to intervene at the maternal or family level to promote more positive outcomes in children.
Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ontario, Canada. mark.ferro@schulich.uwo.ca
Mark A
MA
Ferro
William R
WR
Avison
M Karen
MK
Campbell
Kathy N
KN
Speechley
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003863:Depression / Q000523:psychology*; D004827:Epilepsy / Q000523:psychology*; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D017533:Marital Status; D009035:Mothers; D018802:Patient-Centered Care; D011247:Pregnancy; D011446:Prospective Studies; D011788:Quality of Life; D012931:Social Environment; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
D000927:Anticonvulsants