Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, United States.
School of Social Work, Boston University, Boston, MA, United States.
J Affect Disord. 2018 Aug 1;235:72-75. doi: 10.1016/j.jad.2018.04.028. Epub 2018 Apr 5.
Prior research has examined the association between low-income status and maternal depression; however, important questions remain in terms of trends in the prevalence of major depressive episodes (MDE) and treatment seeking among mothers in the United States. The objective of the present study is to examine trends in MDE among low-income mothers and explore perceived barriers to mental health treatment seeking.
Using data from the National Survey on Drug Use and Health (NSDUH; 2005-2015), we examined the prevalence of past-year MDE among mothers living in poverty (0-99% federal poverty line [FPL]; n = 23,264) and near-poverty (100-200% FPL; n = 21,655). Consistent with the Center for Disease Control and Prevention (CDC) guidelines, we conducted survey-adjusted logistic regression analyses to examine the significance of survey year in relation to MDE while controlling for key social demographic correlates.
The overall decreasing MDE trend was found only among mothers in near-poverty, not mothers in poverty. Only for mothers in poverty, financial (AOR = 0.70, 95% CI = 0.52-0.95) and information barriers (AOR = 0.53, 95% CI = 0.39-0.73) were associated with mental health service use.
Self-reports of depressive symptoms and service receipt may have led to over or underreporting due to recall or social desirability bias. Additionally, NSDUH data are cross-sectional and thereby limit our ability to make causal inferences.
Greater attention should be paid to the prevention/treatment of depression among mothers in poverty. Efforts may include expanding financial assistance for mental health service use and educational campaigns to increase awareness of services available.
先前的研究已经考察了低收入状况与产妇抑郁之间的关系；然而，在美国，关于母亲重度抑郁发作（MDE）的流行率和寻求治疗的趋势仍存在一些重要问题。本研究的目的是检验贫困母亲中 MDE 的趋势，并探讨寻求心理健康治疗的感知障碍。
我们利用全国毒品使用和健康调查（NSDUH；2005-2015 年）的数据，考察了生活在贫困线以下（0-99%联邦贫困线[FPL]；n=23264）和接近贫困线（100-200%FPL；n=21655）的母亲中过去一年 MDE 的流行率。根据疾病控制与预防中心（CDC）的指导方针，我们进行了经过调查调整的逻辑回归分析，以检验调查年份与 MDE 的关系的显著性，同时控制关键的社会人口统计学相关性。
仅在接近贫困线的母亲中发现 MDE 呈总体下降趋势，而在贫困线母亲中则没有。只有贫困线母亲的经济（AOR=0.70，95%CI=0.52-0.95）和信息障碍（AOR=0.53，95%CI=0.39-0.73）与精神卫生服务的使用有关。
抑郁症状和服务获得的自我报告可能因回忆或社会期望偏差而导致过度或低估报告。此外，NSDUH 数据是横断面的，因此限制了我们做出因果推断的能力。
应更加关注贫困母亲的抑郁预防/治疗。努力可能包括扩大对精神卫生服务使用的财政援助和开展提高对现有服务认识的宣传运动。
