Country Doctor Community Health Centers and Swedish Cherry Hill Family Medicine Residency, Seattle, WA 98122, USA.
Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA 94720, USA.
Int J Environ Res Public Health. 2017 Dec 18;14(12):1566. doi: 10.3390/ijerph14121566.
Over 50% of mothers in rural Mexico have high depressive symptoms, and their children's health and development are likely to be negatively affected. A critical question is whether children vary in their vulnerability to the effects of high maternal depressive symptoms according to their indigenous ethnicity, maternal education, or household wealth. Our sample included 4442 mothers and 5503 children from an evaluation of Mexico's social welfare program. Maternal depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) Scale, and child behavior was measured using an adapted version of the Behavior Problems Index (BPI). Multiple linear regression models were used to explore the associations between maternal depressive symptoms and child behavior problems, and the heterogeneity of associations by indigenous ethnicity, maternal education, and household assets. We found that having greater maternal depressive symptoms was significantly associated with having a child with more behavior problems ( = 0.114, < 0.0001, [95% CI 0.101, 0.127]), in adjusted models. In tests of heterogeneity, the association between maternal depressive symptoms and child behavior problems was strongest in households with indigenous ethnicity, low maternal education, or in households with fewer assets. These results strengthen the case for effective mental health interventions in low- and middle-income countries, particularly among the most vulnerable families where mothers and children appear to be at the greatest risk.
超过 50%的墨西哥农村地区母亲患有高度抑郁症状，这可能会对其子女的健康和发育产生负面影响。一个关键问题是，儿童是否因其土著民族、母亲教育程度或家庭财富的不同而对高度母亲抑郁症状的影响存在差异。我们的样本包括来自墨西哥社会福利计划评估的 4442 名母亲和 5503 名儿童。使用流行病学研究抑郁量表（CES-D）评估母亲的抑郁症状，使用行为问题指数（BPI）的改编版本测量儿童的行为。使用多元线性回归模型探讨了母亲抑郁症状与儿童行为问题之间的关联，以及土著民族、母亲教育程度和家庭资产对关联的异质性。我们发现，母亲抑郁症状越严重，其子女的行为问题越多（ = 0.114， < 0.0001，[95%CI 0.101，0.127]），在调整后的模型中。在异质性检验中，母亲抑郁症状与儿童行为问题之间的关联在具有土著民族、母亲教育程度较低或家庭资产较少的家庭中最强。这些结果加强了在中低收入国家实施有效的心理健康干预措施的理由，特别是在那些母亲和子女面临最大风险的最脆弱家庭中。
