Hoffmann Elis Viviane, Duarte Cristiane S, Matsuzaka Camila T, Milani Ana Carolina Coelho, Fossaluza Victor, Mello Andrea F, Mello Marcelo F
Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil.
Department of Child and Adolescent Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, NY, USA.
Braz J Psychiatry. 2022 Jul 11;44(6):590-601. doi: 10.47626/1516-4446-2022-2498.
Children of depressed mothers are at risk of developing mental health problems. We sought to determine whether treatment for maternal depression delivered by community health workers (CHW) would decrease behavioral/emotional symptoms in their child. An intervention treating maternal depressive symptoms in a low-middle-income country can have a high global impact.
CHW were trained to deliver a psychosocial intervention for mothers with depression in a primary care setting. 49 mothers and 60 children were assessed pre-intervention, post-intervention, and at a 6-months follow-up. Child behavioral/emotional symptoms were evaluated by type of change in maternal depressive symptoms: remission and response.
An overall decrease in maternal depressive symptoms from baseline to post-intervention and 6-month follow-up were found. Remission and response of maternal depression was associated with better outcomes related to child´s behavioral/emotional symptoms at the 6-month follow-up (p = 0.0247, Cohen's d: 0.76; p = 0.0224, Cohen's f: 0.44) but not at post-intervention (p = 0.1636, Cohen's d: 0.48; p = 0.0720, Cohen's f: 0.33).
Maternal depression improvement was related to their child's decreased behavioral/emotional symptoms. Our results suggest that interventions addressing maternal depression in primary care is a viable strategy to prevent behavioral/emotional symptoms in the next generation.
母亲患有抑郁症的儿童有出现心理健康问题的风险。我们试图确定社区卫生工作者(CHW)对母亲抑郁症的治疗是否会减少其子女的行为/情绪症状。在低收入和中等收入国家对母亲抑郁症进行治疗可能会产生重大的全球影响。
培训社区卫生工作者在初级保健机构为患有抑郁症的母亲提供心理社会干预。在干预前、干预后和6个月随访时对49名母亲和60名儿童进行评估。根据母亲抑郁症状的变化类型(缓解和反应)评估儿童的行为/情绪症状。
发现从基线到干预后以及6个月随访时母亲抑郁症状总体下降。母亲抑郁症的缓解和反应与6个月随访时儿童行为/情绪症状的更好结果相关(p = 0.0247,科恩d值:0.76;p = 0.0224,科恩f值:0.44),但在干预后不相关(p = 0.1636,科恩d值:0.48;p = 0.0720,科恩f值:0.33)。
母亲抑郁症的改善与其子女行为/情绪症状的减少有关。我们的结果表明,在初级保健中针对母亲抑郁症的干预是预防下一代行为/情绪症状的可行策略。