Effects on Children of Treating Their Mothers' Depression: Results of a 12-Month Follow-Up
Effects on Children of Treating Their Mothers' Depression: Results of a 12-Month Follow-Up
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DOI：
10.1176/appi.ps.201100126
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发表时间：
2012-04-01
影响因子：
3.8
通讯作者：
Miranda, Jeanne
中科院分区：
文献类型：
--
作者：
Coiro, Mary Jo;Riley, Anne;Miranda, Jeanne
目的：本研究采用对照研究设计，探讨治疗母亲抑郁症和缓解母亲抑郁症对儿童的影响。方法：样本包括60名患有重度抑郁症的低收入女性，她们主要来自少数民族，以及她们4至11岁的孩子。妇女被随机分配接受两种积极治疗（药物或认知行为治疗）或转诊到现有的社区服务。采用汉密尔顿抑郁量表自评母亲抑郁状况，采用儿童行为评估系统评估母亲在基线、6个月和12个月的症状和适应能力。结果：混合效应的随机截距和随机斜率重复测量分析，使用意向治疗的方法表明，积极治疗的母亲并没有改善他们的孩子的行为问题或适应能力。然而，在6个月和12个月的随访中，无论治疗分配如何，抑郁症缓解的母亲的孩子的行为问题明显少于母亲仍然抑郁的孩子。结论：研究结果支持需要扩大获得，并支持参与，抑郁症治疗的低收入妇女从少数民族。虽然单独治疗这一治疗不足的人群与儿童结局的改善无关，但这是预防抑郁父母后代精神病理学的必要的第一步。（Psychiatric Services 63：357-363，2012; doi：10.1176/appi.ps.201100126）
Objective: This study used a controlled research design to examine the effects on children of treating their mothers' depression and of remission of the mothers' depression. Method: The sample consisted of 60 low-income women with major depression, who were predominantly from minority racial-ethnic groups, and their children ages four to 11. Women were randomly assigned to receive one of two active treatments (medication or cognitive-behavioral therapy) or a referral to existing community services. The mothers' depression was assessed by self-report on the Hamilton Depression Rating Scale, and the children's symptoms and adaptive skills were assessed by their mothers at baseline and six-month and 12-month follow-ups with the Behavior Assessment System for Children. Results.: Mixed-effects random intercept and random slope repeated-measures analyses using an intent-to-treat approach indicated that active treatment of mothers did not result in improvement in their children's behavior problems or adaptive skills. However, at both the six- and the 12-month follow-ups, children of mothers whose depression had remitted, regardless of treatment assignment, had significantly fewer behavior problems than children whose mothers remained depressed. Conclusions: The results support the need to expand access to, and support participation in, depression treatment among low-income women from minority racial-ethnic groups. Although treatment alone of this undertreated population was not associated with improvement in children's outcomes, it is a necessary first step to prevent psychopathology among offspring of depressed parents. (Psychiatric Services 63:357-363, 2012; doi: 10.1176/appi.ps.201100126)