Parental depressive symptoms and children's school attendance and emergency department use: a nationally representative study.
We sought to assess the association between parental depressive symptoms and school attendance and emergency department (ED) use among children with and without chronic health conditions. Secondary analysis of the 1997-2004 National Health Interview Survey, a nationally representative survey. Parental depressive symptoms were measured by three questions assessing sadness, hopelessness, or worthlessness in the past month. Children with and without asthma or attention-deficit/hyperactivity disorder (ADHD) were identified, and their school attendance and ED visits were reported by adult household respondents. Children with information on parental depressive symptoms, health conditions, and services use were eligible. We incorporated weights available in the survey for each eligible child to reflect the complex sampling design. 104,930 eligible children were identified. The point prevalence of parental depressive symptoms was low (1.8 %, 95 % CI 1.7-2.0), but greater among children with asthma (2.7 %, 95 % CI 2.4-3.0) and ADHD (3.8 %, 95 % CI 3.2-4.4) than among other children (1.6 %, 95 % CI 1.5-1.7). After adjustment for potential confounders, children whose parents reported depressive symptoms most or all of the time were more likely to report an ED visit (adjusted incident rate ratio [IRR] 1.18, 95 % CI 1.06-1.32) or school absence (adjusted IRR 1.36, 95 % CI 1.14-1.63) than children whose parents did not. The effect of parental depressive symptoms was not modified by child health conditions. Parental depressive symptoms were adversely associated with school attendance and ED use in children. These results suggest the importance of measuring depressive symptoms among adult caregivers of children.
PolicyLab: Center to Bridge Research, Practice, and Policy, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. Guevara@email.chop.edu
James P
JP
Guevara
David
D
Mandell
Shooshan
S
Danagoulian
Jacqueline
J
Reyner
Susmita
S
Pati
D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000453:epidemiology; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology; D002648:Child; D016241:Child of Impaired Parents / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D010290:Parents / Q000523:psychology*; D015995:Prevalence; D012307:Risk Factors; D012574:Schools; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology