Markers of Maternal Depressive Symptoms in an Urban Pediatric Clinic

Abstract

To identify markers of maternal depressive symptoms in medical records of children aged 1-6 years. Using a case-control methodology, mothers who were screened for depressive symptoms with the Quick Inventory of Depressive Symptomatology Self-Rated Questionnaire (QIDS-SR) at well-child visits between June 2006 and June 2008 in an inner-city pediatric clinic were grouped into cases with depressive symptoms (QIDS-SR score ≥ 11) and controls with no symptoms (QIDS-SR score ≤ 5). Potential markers for maternal depressive symptoms were collected from the children's medical record and grouped into 3 domains: (1) child health and development (eg, maternal concerns/negative attributions regarding the child's behavior); (2) child health care utilization (eg, missed appointments); and (3) maternal psychosocial factors (eg, single parent). The association between maternal depressive symptoms and each factor was determined using multiple logistic regression to calculate aORs. Maternal depressive symptoms were significantly associated with reports of concerns/negative attributions about the child's behavior (aOR, 2.35; P = .01) and concerns about speech (aOR, 2.40; P = .04) and sleep (aOR, 7.75; P < .001); these were identified at the visit when the depression screening was done. Other associations included history of maternal depression (aOR, 4.94; P = .001) and a previous social work referral (aOR, 1.98; P = .01). Information readily available to pediatricians was associated with maternal depressive symptoms and can serve as clinical markers to help identify at-risk mothers during well-child visits.