Bailey Donald B, Golden Robert N, Roberts Jane, Ford Amy
RTI International, Research Triangle Park, NC 27709-2194, USA.
Ment Retard Dev Disabil Res Rev. 2007;13(4):321-9. doi: 10.1002/mrdd.20172.
Maternal depression in families having a child with a disability has been the subject of considerable research over the past 25 years. This review was designed to describe the literature on maternal depression, critique its research methodology, identify consensus findings across studies, and make recommendations for future research. A particular emphasis is on the distinction between exhibiting depressive symptoms and meeting clinical criteria for a depressive disorder, how or whether research studies made this distinction, and implications for our understanding of maternal adaptation to disability in a family member. Of the 42 articles reviewed, only eight were clinically diagnosed depression; most of them used a scale rating depressive symptoms. Across the studies, mothers of children with disabilities generally exhibited a higher than average rate of depressive symptoms and are more at risk for clinical depression, but the incidence may be lower than reported in previous literature. Child behavior problems, maternal stress, coping style, and support were consistently associated with depressive symptoms. We conclude that we know relatively little about clinical depression in mothers of children with disabilities. The distinction between clinical depression and depressive symptoms may be important in conceptualizing how a child with a disability can influence family members and the nature of support that may need to be provided. Future research should incorporate gold standard diagnostic tools and assess history, severity, and type of depression. Research is also needed to study treatments to reduce the occurrence of both depressive symptoms and clinical depression.
在过去25年里,家中有残疾儿童的母亲患抑郁症一直是大量研究的主题。本综述旨在描述关于母亲抑郁症的文献,批评其研究方法,确定各项研究的共识性发现,并为未来研究提出建议。特别强调表现出抑郁症状与符合抑郁症临床标准之间的区别,研究是如何或是否做出这种区分的,以及这对我们理解母亲如何适应家中有残疾成员的情况的影响。在所审查的42篇文章中,只有8篇是临床诊断的抑郁症;其中大多数使用抑郁症状量表评分。在各项研究中,残疾儿童的母亲通常表现出高于平均水平的抑郁症状发生率,且患临床抑郁症的风险更高,但发病率可能低于以往文献报道。儿童行为问题、母亲压力、应对方式和支持与抑郁症状始终相关。我们得出结论,我们对残疾儿童母亲的临床抑郁症了解相对较少。临床抑郁症与抑郁症状之间的区别在概念化残疾儿童如何影响家庭成员以及可能需要提供的支持性质方面可能很重要。未来的研究应采用金标准诊断工具,并评估抑郁症的病史、严重程度和类型。还需要开展研究以探讨减少抑郁症状和临床抑郁症发生的治疗方法。