Parental depression and child conduct problems: evaluation of parental service use and associated costs after attending the Incredible Years Basic Parenting Programme

Judy Hutchings,Joanna M Charles,Rhiannon Tudor Edwards,Lu Zou,Tracey J Bywater

doi:10.1186/1472-6963-13-523

Judy Hutchings, Joanna M Charles + Show 3 more

Open Access

https://doi.org/10.1186/1472-6963-13-523

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Abstract

BackgroundThere is co-morbidity between parental depression and childhood conduct disorder. The Incredible Years (IY) parenting programmes reduce both conduct disorder in children and depression in their parents. Recent U.K. and Ireland trials of the effectiveness and cost-effectiveness of IY parenting programmes have assessed children’s health and social care service use, but little is known about the programme’s impact on parental service use. This paper explores whether an above clinical cut-off score on the Beck Depression Inventory II (BDI II) is associated with high or low parental health and social care service use in high-risk families receiving the IY Basic Programme.MethodsThis is a secondary analysis of a subsample (N = 119) from the first U.K. community-based randomised controlled trial of the 12-week IY Basic Programme (N = 153). Parents with children at risk of developing conduct disorder were randomised to receive the programme or to a waiting-list control group. BDI II total and BDI II clinical depression cut-off scores were compared to frequencies and costs of parents’ service use, at baseline, six, twelve and eighteen months post-baseline for the intervention group and at baseline and six months post-baseline for the control group.ResultsIntervention group parents who scored above the clinical cut-off on the BDI II at baseline used more health and social care services than those who scored below at baseline, six and eighteen months. Significant reductions in service use frequencies were found for the intervention group only.ConclusionParents with higher levels or depression used more health and social care service and parenting programmes have been shown to reduce parental depression and also health and social service use. However, further exploration of depressed parents’ service use and the cost implications for publically funded health and social care services is needed.Trial registrationRegistration of the original RCT of the IY Basic Parenting Programme - Current Controlled Trials ISRCTN46984318

Highlights

There is co-morbidity between parental depression and childhood conduct disorder
This method was used because non-parametric tests did not allow for comparisons of service use between participants who scored above clinical cut-off on the Beck Depression Inventory II (BDI II) [24], and those intervention participants who scored below across all four time-points
BDI II [24] clinical cut-off was shown to impact upon service use; with parents who scored above the clinical cut-off utilising more services than parents who scored below the cut-off; findings are discussed in more detail below

Summary

Introduction

There is co-morbidity between parental depression and childhood conduct disorder. The Incredible Years (IY) parenting programmes reduce both conduct disorder in children and depression in their parents. This paper explores whether an above clinical cut-off score on the Beck Depression Inventory II (BDI II) is associated with high or low parental health and social care service use in high-risk families receiving the IY Basic Programme. Conduct disorder (CD) is defined as a persistent pattern of aggressive and destructive behaviours [1]. It is the most common psychiatric disorder in children [2]. There is a high rate of co-morbidity between depression in parents and CD in children [4,5,6]. Parents in socially-disadvantaged areas have higher prevalence of parental depression [7] and children in those areas have higher levels of CD [8]

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