Depression in Mothers of Children Presenting for Emergency and Primary Care: Impact on Mothers' Perceptions of Caring for Their Children

Abstract

Maternal mental health conditions may influence how mothers utilize emergency health care for their children. However, little is known about the prevalence of depression among mothers of children presenting for emergency health care and how maternal depression affects a mother's perception of how difficult it is to care for her children. To screen for maternal depression and to examine whether mothers with depressive symptoms perceive that these symptoms interfere with their roles in caring for their children. Cross-sectional survey. An urban, tertiary-care, children's hospital. Mothers bringing their children, aged 6 months to 18 years, to an emergency department for low-acuity illness (n = 243) or to a pediatric primary care clinic (n = 249) for well-child care. Positive screening tests for depression using the Prime MD Patient Health Questionnaire. The prevalence of positive screening tests for depression was similar in both emergency and primary care settings, with 18% of mothers having either major (9%) or subthreshold (9%) depression and 5% percent having suicidal ideation. Seventy-six percent of mothers with a positive screen for major depression and 17% of those with a negative screen for depression reported that their mental health symptoms made it difficult to care for their children. Mothers with a positive screen for depression reported poorer health status for themselves (P =.014) but not for their children (P =.37). Screening questionnaires in both primary care and emergency care settings with sociodemographically similar groups of mothers produced similar rates of depression. The high rates of depressive symptoms and of mothers' reports that these symptoms cause them difficulty in caring for their children indicate that resources to screen for and address depressive symptoms in mothers should receive higher priority in pediatric health care settings.