Remission of maternal depression and child symptoms among single mothers: a STAR*D-Child report.
OBJECTIVE: Offspring of depressed parents are at increased risk for depressive and other disorders. We recently found that when depressed mothers reached full remission over 3 months of treatment, a significant improvement in the children's disorders occurred. Since only a third of the mothers remitted, factors related to maternal remission rates, and thereby child outcomes, were important. This report examined the relationship of the presence of a father in the household to maternal depression remission and child outcomes. METHOD: Maternal depression was measured using the 17-item Hamilton Rating Scale for Depression (HRSD(17)); social functioning was assessed using the Social Adjustment Scale-Self Report (SAS-SR). Children (age 7-17) were assessed independently, blind to maternal outcome, using the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS-PL) and the Child Global Assessment Scale (C-GAS). RESULTS: Single mothers (n = 50), as compared to those in two-parent households (n = 61), were more likely to discontinue treatment (31% vs. 16%, P = 0.04), and less likely to remit if they remained in treatment (20% vs. 43%, P = 0.013). These differences remained significant after adjusting for socioeconomic status and potential confounders, but were partially explained by the mother's pre-treatment social functioning. The reduction in child diagnoses following maternal remission was greater in two-parent than in single-parent households, although a formal test of interaction between the odds ratios was not significant. CONCLUSION: Single depressed mothers are more likely to drop out of treatment, and less likely to reach remission if they stay in treatment. This high-risk group requires vigorous treatment approaches.
Talati, A; Wickramaratne, PJ; Pilowsky, DJ; Alpert, JE; Cerda, G; Garber, J; Hughes, CW; King, CA; Malloy, E; Sood, AB; Verdeli, H; Trivedi, MH; Rush, AJ; Weissman, MM
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