Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.
Children's Health Research Institute, Lawson Health Research Institute, London, Ontario, Canada.
Epilepsia. 2019 Feb;60(2):358-366. doi: 10.1111/epi.14638. Epub 2019 Jan 15.
Parental depression significantly impacts children's health and well-being. This study aimed to (1) estimate the prevalence of depressive symptoms, at six time points, among mothers over the first 10 years after their child was diagnosed with epilepsy; (2) identify trajectories of maternal depressive symptoms over time; and (3) identify baseline factors associated with each trajectory.
Data came from the Health-Related Quality of Life in Children with Epilepsy Study (HERQULES), a Canada-wide prospective cohort study. Data on child, parent, and family characteristics were collected at the time of diagnosis, and follow-ups at 0.5, 1, 2, 8, and 10 years. Maternal depressive symptoms were measured using the Center for Epidemiological Studies Depression Scale. Trajectories of depressive symptoms were evaluated using latent class growth modeling, and multinomial logistic regression was used to identify baseline factors associated with each trajectory.
A total of 356 mothers participated in the study, of whom 57% scored in the at-risk range for major depression disorder (period-prevalence). Four unique trajectories were identified as follows: "Low-Stable" (29% of mothers), "Intermediate-Stable" (46%), "High-Stable" (20%), and "High-Decreasing" (5%). Positive family environment was consistently associated with a better trajectory of depressive symptoms over time; other significant factors included type of seizures, child cognitive comorbidity, maternal age, and maternal education.
A substantial proportion of mothers of children with epilepsy are at risk for depression, and this risk is stable over the long term. Family environment at the time of diagnosis has long-term and persistent effects and may be an ideal target for interventions.
父母的抑郁会显著影响孩子的健康和幸福感。本研究旨在：（1）在孩子被诊断患有癫痫后的头 10 年的 6 个时间点，估计母亲抑郁症状的患病率；（2）确定母亲抑郁症状随时间的变化轨迹；（3）确定与每个轨迹相关的基线因素。
数据来自加拿大范围内的前瞻性队列研究——儿童癫痫相关生活质量研究（HERQULES）。在诊断时以及 0.5、1、2、8 和 10 年时收集了儿童、父母和家庭特征的数据。使用流行病学研究中心抑郁量表来测量母亲的抑郁症状。采用潜在类别增长建模来评估抑郁症状的轨迹，采用多项逻辑回归来确定与每个轨迹相关的基线因素。
共有 356 位母亲参与了研究，其中 57%的母亲处于重性抑郁障碍的高危范围（时期患病率）。确定了 4 种独特的轨迹：“低稳定”（29%的母亲）、“中稳定”（46%）、“高稳定”（20%）和“高下降”（5%）。积极的家庭环境始终与抑郁症状随时间的改善轨迹相关；其他重要因素包括发作类型、儿童认知合并症、母亲年龄和母亲教育程度。
相当一部分癫痫患儿的母亲有患抑郁症的风险，而且这种风险长期稳定存在。诊断时的家庭环境具有长期而持久的影响，可能是干预的理想目标。
