Depressed mothers coming to primary care: Maternal reports of problems with their children

Myrna M. Weissman, Adriana Feder, Daniel J. Pilowsky, Mark Olfson, Milton Fuentes, Carlos Blanco, Rafael Lantigua, Marc J. Gameroff, Steven Shea

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

Background: Studies of depressed mothers have generally been conducted in psychiatric settings with non-minority, middle-class women. Primary care has an increasing role in early detection and treatment, especially for the poor who have less access to specialized mental health services. Data on the relationship between maternal depression and problems in the offspring in a primary care context could help physicians to more effectively identify children in need of psychiatric help. Methods: All mothers aged 25 to 55 from a systematic sample of consecutive adults (response rate, 80%) in an urban general medicine practice were screened using the PRIME-MD Patient Health Questionnaire (PHQ). Mothers who screened positive for major depression (n=85); other psychiatric disorders, but not major depression (n=67); or no psychiatric disorders (n=191) were compared on their children's history of emotional problems, unmet need for mental health treatment, parent-child discord, maternal functional status and mental health treatment. Results: Compared to non-psychiatric controls, depressed mothers reported a three-times greater risk of serious emotional problems in their children (95% confidence interval [CI], 1.7-6.1); a four-times greater risk of having their children's problems left untreated (95% CI, 2.3-8.2), and a 10-times greater risk of having poor mother-child relations within the past month (95% CI, 3.9-29.4). Depressed mothers reported more functional disability, more psychiatric treatment and more problems in their offspring than mothers with non-depressive psychiatric disorders. Although a majority of mothers (regardless of psychiatric status) believed that counseling (96%) or medication (84%) should be offered to those with serious emotional problems, only about half (49%) of the depressed mothers had received mental health treatment in the past month. Limitations: Children were not assessed directly. Conclusions: The children of low-income depressed women at a general medicine practice were reported to have a greatly increased risk for emotional problems. Many mothers had not received treatment for their own emotional problems. By enquiring about the emotional health of children of adult primary care patients, primary care providers have an opportunity to promote early detection and to facilitate appropriate treatment for both the mothers and their children.

Original languageEnglish
Pages (from-to)93-100
Number of pages8
JournalJournal of Affective Disorders
Volume78
Issue number2
DOIs
StatePublished - 1 Jan 2004

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Primary Health Care
Mothers
Psychiatry
Mental Health
Confidence Intervals
Depression
General Practice
Therapeutics
Medicine
Mother-Child Relations
Mental Health Services
Counseling
Patient Care
Physicians
Health

Keywords

  • Depressive disorder
  • Mental health
  • Needs assessment

Cite this

Weissman, Myrna M. ; Feder, Adriana ; Pilowsky, Daniel J. ; Olfson, Mark ; Fuentes, Milton ; Blanco, Carlos ; Lantigua, Rafael ; Gameroff, Marc J. ; Shea, Steven. / Depressed mothers coming to primary care : Maternal reports of problems with their children. In: Journal of Affective Disorders. 2004 ; Vol. 78, No. 2. pp. 93-100.
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title = "Depressed mothers coming to primary care: Maternal reports of problems with their children",
abstract = "Background: Studies of depressed mothers have generally been conducted in psychiatric settings with non-minority, middle-class women. Primary care has an increasing role in early detection and treatment, especially for the poor who have less access to specialized mental health services. Data on the relationship between maternal depression and problems in the offspring in a primary care context could help physicians to more effectively identify children in need of psychiatric help. Methods: All mothers aged 25 to 55 from a systematic sample of consecutive adults (response rate, 80{\%}) in an urban general medicine practice were screened using the PRIME-MD Patient Health Questionnaire (PHQ). Mothers who screened positive for major depression (n=85); other psychiatric disorders, but not major depression (n=67); or no psychiatric disorders (n=191) were compared on their children's history of emotional problems, unmet need for mental health treatment, parent-child discord, maternal functional status and mental health treatment. Results: Compared to non-psychiatric controls, depressed mothers reported a three-times greater risk of serious emotional problems in their children (95{\%} confidence interval [CI], 1.7-6.1); a four-times greater risk of having their children's problems left untreated (95{\%} CI, 2.3-8.2), and a 10-times greater risk of having poor mother-child relations within the past month (95{\%} CI, 3.9-29.4). Depressed mothers reported more functional disability, more psychiatric treatment and more problems in their offspring than mothers with non-depressive psychiatric disorders. Although a majority of mothers (regardless of psychiatric status) believed that counseling (96{\%}) or medication (84{\%}) should be offered to those with serious emotional problems, only about half (49{\%}) of the depressed mothers had received mental health treatment in the past month. Limitations: Children were not assessed directly. Conclusions: The children of low-income depressed women at a general medicine practice were reported to have a greatly increased risk for emotional problems. Many mothers had not received treatment for their own emotional problems. By enquiring about the emotional health of children of adult primary care patients, primary care providers have an opportunity to promote early detection and to facilitate appropriate treatment for both the mothers and their children.",
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Weissman, MM, Feder, A, Pilowsky, DJ, Olfson, M, Fuentes, M, Blanco, C, Lantigua, R, Gameroff, MJ & Shea, S 2004, 'Depressed mothers coming to primary care: Maternal reports of problems with their children', Journal of Affective Disorders, vol. 78, no. 2, pp. 93-100. https://doi.org/10.1016/S0165-0327(02)00301-4

Depressed mothers coming to primary care : Maternal reports of problems with their children. / Weissman, Myrna M.; Feder, Adriana; Pilowsky, Daniel J.; Olfson, Mark; Fuentes, Milton; Blanco, Carlos; Lantigua, Rafael; Gameroff, Marc J.; Shea, Steven.

In: Journal of Affective Disorders, Vol. 78, No. 2, 01.01.2004, p. 93-100.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Depressed mothers coming to primary care

T2 - Maternal reports of problems with their children

AU - Weissman, Myrna M.

AU - Feder, Adriana

AU - Pilowsky, Daniel J.

AU - Olfson, Mark

AU - Fuentes, Milton

AU - Blanco, Carlos

AU - Lantigua, Rafael

AU - Gameroff, Marc J.

AU - Shea, Steven

PY - 2004/1/1

Y1 - 2004/1/1

N2 - Background: Studies of depressed mothers have generally been conducted in psychiatric settings with non-minority, middle-class women. Primary care has an increasing role in early detection and treatment, especially for the poor who have less access to specialized mental health services. Data on the relationship between maternal depression and problems in the offspring in a primary care context could help physicians to more effectively identify children in need of psychiatric help. Methods: All mothers aged 25 to 55 from a systematic sample of consecutive adults (response rate, 80%) in an urban general medicine practice were screened using the PRIME-MD Patient Health Questionnaire (PHQ). Mothers who screened positive for major depression (n=85); other psychiatric disorders, but not major depression (n=67); or no psychiatric disorders (n=191) were compared on their children's history of emotional problems, unmet need for mental health treatment, parent-child discord, maternal functional status and mental health treatment. Results: Compared to non-psychiatric controls, depressed mothers reported a three-times greater risk of serious emotional problems in their children (95% confidence interval [CI], 1.7-6.1); a four-times greater risk of having their children's problems left untreated (95% CI, 2.3-8.2), and a 10-times greater risk of having poor mother-child relations within the past month (95% CI, 3.9-29.4). Depressed mothers reported more functional disability, more psychiatric treatment and more problems in their offspring than mothers with non-depressive psychiatric disorders. Although a majority of mothers (regardless of psychiatric status) believed that counseling (96%) or medication (84%) should be offered to those with serious emotional problems, only about half (49%) of the depressed mothers had received mental health treatment in the past month. Limitations: Children were not assessed directly. Conclusions: The children of low-income depressed women at a general medicine practice were reported to have a greatly increased risk for emotional problems. Many mothers had not received treatment for their own emotional problems. By enquiring about the emotional health of children of adult primary care patients, primary care providers have an opportunity to promote early detection and to facilitate appropriate treatment for both the mothers and their children.

AB - Background: Studies of depressed mothers have generally been conducted in psychiatric settings with non-minority, middle-class women. Primary care has an increasing role in early detection and treatment, especially for the poor who have less access to specialized mental health services. Data on the relationship between maternal depression and problems in the offspring in a primary care context could help physicians to more effectively identify children in need of psychiatric help. Methods: All mothers aged 25 to 55 from a systematic sample of consecutive adults (response rate, 80%) in an urban general medicine practice were screened using the PRIME-MD Patient Health Questionnaire (PHQ). Mothers who screened positive for major depression (n=85); other psychiatric disorders, but not major depression (n=67); or no psychiatric disorders (n=191) were compared on their children's history of emotional problems, unmet need for mental health treatment, parent-child discord, maternal functional status and mental health treatment. Results: Compared to non-psychiatric controls, depressed mothers reported a three-times greater risk of serious emotional problems in their children (95% confidence interval [CI], 1.7-6.1); a four-times greater risk of having their children's problems left untreated (95% CI, 2.3-8.2), and a 10-times greater risk of having poor mother-child relations within the past month (95% CI, 3.9-29.4). Depressed mothers reported more functional disability, more psychiatric treatment and more problems in their offspring than mothers with non-depressive psychiatric disorders. Although a majority of mothers (regardless of psychiatric status) believed that counseling (96%) or medication (84%) should be offered to those with serious emotional problems, only about half (49%) of the depressed mothers had received mental health treatment in the past month. Limitations: Children were not assessed directly. Conclusions: The children of low-income depressed women at a general medicine practice were reported to have a greatly increased risk for emotional problems. Many mothers had not received treatment for their own emotional problems. By enquiring about the emotional health of children of adult primary care patients, primary care providers have an opportunity to promote early detection and to facilitate appropriate treatment for both the mothers and their children.

KW - Depressive disorder

KW - Mental health

KW - Needs assessment

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