SAN FRANCISCO – Children of mothers with chronic depression are almost four times as likely to have multiple behavior problems at the age of 3 years as are children of mothers without depression, according to a poster presentation by Dr. Diane L. Langkamp at the annual meeting of the Pediatric Academic Societies.
In addition, both maternal smoking and the lack of health insurance for the child significantly increased the odds of multiple child-behavior problems, wrote Dr. Langkamp and her coinvestigators from the Ohio State University in Columbus.
The investigators of the current study analyzed the results of the 1988 National Maternal and Infant Health Survey–a nationally representative, weighted sample of 9,953 children who were born in the United States that year–and also analyzed a 1991 follow-up to that survey with the same mothers.
When the mothers were first interviewed, their children's ages averaged 17 months; at the follow-up the children's ages averaged 35 months.
At each interview, the original investigators administered the Center for Epidemiologic Studies Depression Scale (CES-D). Scores greater than 15 on that scale are associated with substantial symptoms of clinical depression.
Among the women surveyed, those whose scores were greater than 15 during both interviews were judged to have chronic depression for the purposes of the study. They were compared with women whose scores were 15 or less during both interviews.
At the 1991 follow-up, mothers were asked about the degree or frequency of several types of child behavior or emotional state, such as exhibiting behaviors that were difficult for the mother to manage, the frequency of temper tantrums, and fearfulness.
After adjusting for the mother's smoking status, the child's health insurance status, and maternal race, the odds of multiple behavior problems for children of mothers with chronic depression were 3.69 times higher compared with the children of mothers who did not have depression, Dr. Langkamp and her associates reported.
Maternal smoking increased the odds of behavior problems by 48%, and the lack of health insurance for the child increased the odds of behavior problems by another 50%.
There was also a significant interaction between race and the child's having chronic illness: The odds of behavior problems were higher for African American and Hispanic children with chronic illnesses but not for white children, the investigators said.
Additionally, the investigators found that if the child's birth father lived in the home, significant protection was provided against the effects of the mother's chronic depression on the child's behavior, they noted.
The odds of not having multiple behavior problems were four times higher for children of chronically depressed mothers living with the child's birth father compared with children of mothers not living with the child's birth father, Dr. Langkamp and her associates wrote.
On the other hand, having another adult–such as a grandparent–living in the home provided no protection against child behavior problems in the presence of maternal chronic depression.
Interventions aimed at reducing maternal smoking in the treatment of depression in mothers of young children may have a positive effect on the behavior of those children, concluded the investigators at the meeting, which was sponsored by the American Pediatric Society, Society for Pediatric Research, Ambulatory Pediatric Association, and American Academy of Pediatrics.