Department of Psychiatry, Larkin Community Hospital, United States of America; Department of Global Health, University of Washington, United States of America.
Health Systems and Research Ethics Department, KEMRI-Wellcome Trust Research Programme, Kenya.
J Affect Disord. 2023 Feb 15;323:368-377. doi: 10.1016/j.jad.2022.10.051. Epub 2022 Nov 24.
Poor maternal mental health during childhood hospitalization is associated with post-discharge child mortality. We aimed to establish if maternal PHQ-9 scores during hospitalization are associated with acute stressors or longer trends in mental health status.
Mothers of children admitted to nine hospitals in six countries completed a PHQ-9 assessment during hospitalization and 45-days post-discharge. Community participants were recruited from homes near the hospitalized children. The prevalence and correlates of high PHQ-9 scores among hospitalized and community mothers were compared.
Among 2762 mothers of hospitalized children, 514 (19 %) had PHQ-9 scores ≥10, significantly more than the 116 (10 %, p < 0·001) of 1159 community participants. Recruitment site and food insecurity were PHQ-9 correlates in both groups. Correlates of higher mean PHQ-9 scores among the hospitalized cohort included maternal illness (mean difference [MD]: 1·27, 95%CI: 0·77, 1·77), pregnancy (MD: 0·77, 95%CI: 0·27, 1·28), child HIV-infection (MD: 2·51. 95%CI: 1·55, 3·52), and lower child weight-for-height (MD: 0·21, 95%CI: 0·32, 0·11). Marriage (MD -0·92, 95%CI: -1·36, -0·48) and a positive malaria test (MD: -0·63, 95%CI: -1·15, -0·10) were associated with lower PHQ-9 scores among mothers of hospitalized children. Among mothers with PHQ-9 ≥10 during admission, 410 had repeat assessments 45-days after their child's discharge, and 108 (26 %) continued to meet the high PHQ-9 criterion.
Among mothers of hospitalized children, there are subgroups with transient and persistent depressive symptoms. Interventions tailored to address acute stressors may improve post-discharge pediatric and maternal health outcomes.
Bill & Melinda Gates Foundation OPP1131320.
儿童住院期间较差的产妇心理健康与出院后儿童死亡率有关。我们旨在确定产妇在住院期间的 PHQ-9 评分是否与急性应激源或心理健康状况的长期趋势有关。
在六个国家的九家医院住院的儿童的母亲在住院期间和出院后 45 天完成 PHQ-9 评估。在住院儿童附近的家中招募社区参与者。比较住院和社区母亲中 PHQ-9 评分较高的患病率和相关因素。
在 2762 名住院儿童的母亲中，514 名（19%）PHQ-9 评分≥10，明显高于 1159 名社区参与者中的 116 名（10%，p<0·001）。招募地点和粮食不安全是两组的 PHQ-9 相关因素。住院队列中较高平均 PHQ-9 评分的相关因素包括产妇疾病（平均差异[MD]：1·27，95%CI：0·77，1·77）、妊娠（MD：0·77，95%CI：0·27，1·28）、儿童 HIV 感染（MD：2·51，95%CI：1·55，3·52）和较低的儿童体重身高比（MD：0·21，95%CI：0·32，0·11）。婚姻（MD-0·92，95%CI：-1·36，-0·48）和疟疾检测阳性（MD：-0·63，95%CI：-1·15，-0·10）与住院儿童母亲的 PHQ-9 评分较低有关。在入院时 PHQ-9≥10 的母亲中，410 人在孩子出院后 45 天进行了重复评估，108 人（26%）继续符合高 PHQ-9 标准。
在住院儿童的母亲中，存在亚组具有短暂和持续的抑郁症状。针对急性应激源的量身定制的干预措施可能会改善出院后儿科和产妇的健康结果。
比尔及梅琳达·盖茨基金会 OPP1131320。
