title: Trajectories of maternal depressive symptoms predict child problem behaviour: the Generation R study.
abstract: BACKGROUND
  It is unclear how the course of maternal depressive symptoms affects child development. We modelled trajectories of maternal depressive symptoms from mid-pregnancy to 3 years after childbirth to better determine their associations with child problem behaviour.
  
  
  METHODS
  Mother-child dyads (n = 4167) participated in a population-based prospective cohort in The Netherlands. Depressive symptoms were assessed with the Brief Symptom Inventory during pregnancy and at 2, 6 and 36 months postnatally. When children were 3 years old, problem behaviour was assessed with the Child Behaviour Checklist completed by each parent. A group-based modelling technique was used to model trajectories of maternal depressive symptoms and to examine their association with child problem behaviour. The added value of trajectory modelling was determined with successive linear regressions.
  
  
  RESULTS
  We identified four trajectories of maternal depressive symptoms; 'no' (34%), 'low' (54%), 'moderate' (11%) and 'high' (1.5%). Child problem behaviour varied as a function of maternal trajectory membership. Whether rated by mother or father, children of mothers assigned to higher trajectories had significantly more problem behaviours than children of mothers assigned to lower trajectories. The model including trajectories had additive predictive value over a model relying only on a summed repeated measure of severity and a predefined chronicity variable.
  
  
  CONCLUSIONS
  Depending on their course, maternal depressive symptoms have different effects on child problem behaviour. More information is gained by studying trajectories of symptoms, than only predefined measures of severity and chronicity. Moreover, trajectories can help identifying clinically depressed mothers who are possible candidates for early interventions.
authors.affiliation: The Generation R Study Group, Erasmus MC-University Medical Centre, Rotterdam, The Netherlands.
authors.forename: R A M
authors.initials: RA
authors.lastname: Cents
authors.forename: S
authors.initials: S
authors.lastname: Diamantopoulou
authors.forename: J J
authors.initials: JJ
authors.lastname: Hudziak
authors.forename: V W V
authors.initials: VW
authors.lastname: Jaddoe
authors.forename: A
authors.initials: A
authors.lastname: Hofman
authors.forename: F C
authors.initials: FC
authors.lastname: Verhulst
authors.forename: M P
authors.initials: MP
authors.lastname: Lambregtse-van den Berg
authors.forename: H
authors.initials: H
authors.lastname: Tiemeier
mesh_terms: D000328:Adult; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D002675:Child, Preschool; D003863:Depression / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008960:Models, Psychological; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D009426:Netherlands / Q000453:epidemiology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index