Child Neurosciences Center, Department of Pediatrics, Manila Doctors Hospital, Manila, Philippines.
J Pediatr. 2013 Jan;162(1):189-94.e1. doi: 10.1016/j.jpeds.2012.06.047. Epub 2012 Aug 4.
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.
在 1-6 岁儿童的病历中识别与产妇抑郁症状相关的标志物。
采用病例对照研究方法,对 2006 年 6 月至 2008 年 6 月期间在一家市区儿科诊所接受儿童常规健康检查时使用贝克抑郁自评问卷(BDI)进行抑郁筛查的母亲进行分组,分为有抑郁症状的病例组(BDI 得分≥11)和无症状的对照组(BDI 得分≤5)。从儿童病历中收集潜在的产妇抑郁症状标志物,并分为 3 个领域:(1)儿童健康和发育(例如,母亲对孩子行为的担忧/负面归因);(2)儿童保健服务的使用(例如,错过预约);(3)产妇心理社会因素(例如,单亲)。使用多因素逻辑回归计算优势比(OR),以确定产妇抑郁症状与每个因素之间的关联。
产妇抑郁症状与对孩子行为的担忧/负面归因(OR,2.35;P=0.01)和对孩子语言(OR,2.40;P=0.04)和睡眠(OR,7.75;P<0.001)的担忧显著相关;这些症状是在进行抑郁筛查的就诊时报告的。其他关联因素包括产妇抑郁史(OR,4.94;P=0.001)和之前的社会福利机构转介(OR,1.98;P=0.01)。
儿科医生可获取的信息与产妇抑郁症状相关,可作为临床标志物,有助于在儿童常规健康检查期间识别高危产妇。