Department of Psychology, Loyola University Maryland, 5911 York Rd, Suite 100, Baltimore, MD 21212, USA.
Psychiatr Serv. 2012 Apr;63(4):357-63. doi: 10.1176/appi.ps.201100126.
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.
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.
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.
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.
本研究采用对照研究设计，考察了治疗母亲抑郁和母亲抑郁缓解对儿童的影响。
样本包括 60 名患有重度抑郁症的低收入妇女，她们主要来自少数族裔群体，以及她们 4 至 11 岁的子女。妇女被随机分配接受两种积极治疗（药物或认知行为疗法）或转介到现有的社区服务。母亲的抑郁程度通过 Hamilton 抑郁评定量表的自我报告进行评估，儿童的症状和适应技能由母亲在基线、6 个月和 12 个月随访时使用儿童行为评估系统进行评估。
采用意向治疗方法的混合效应随机截距和随机斜率重复测量分析表明，母亲的积极治疗并未导致其子女的行为问题或适应技能得到改善。然而，在 6 个月和 12 个月的随访中，无论治疗分配如何，母亲抑郁缓解的儿童的行为问题明显少于母亲仍处于抑郁状态的儿童。
结果支持需要扩大对少数族裔低收入妇女获得和支持抑郁治疗的机会。尽管对这一治疗不足的人群进行单独治疗与儿童结果的改善无关，但这是预防抑郁父母子女出现精神病理学的必要第一步。
