May 5, 2003 -- The pediatric healthcare setting is an ideal place for resources to screen for maternal depression because moms are more likely to seek medical care for their kids than for themselves, a new study suggests.
Researchers found a high rate of depression among low-income mothers who brought their children for non-urgent medical services, and three out of four depressed moms said their mental state made it difficult to care for their children.
"Moms who are depressed are finding it very, very difficult to take care of things at home," lead researcher Jacqueline Grupp-Phelan, MD, MPH, tells WebMD. "They are far less likely to seek care for themselves than their children, but they might be more likely to take care of themselves if they understand that it will help them better take care of their kids."
Grupp-Phelan and colleagues at Cincinnati Children's Hospital Medical Center performed mental health screenings on 492 mother's seeking medical services for their children at the hospital's emergency department or pediatric clinic. Roughly one in five were judged to be depressed, and close to one in three women screened positive for either depression, anxiety disorder, panic disorder, or physical complaints thought to be linked to psychological distress.
Seventy-six percent of the depressed mothers said they found it difficult to care for their kids. Grupp-Phelan says this is of particular concern when children become ill.
"When a child has bronchitis, for example, we send mom's home with fairly complex discharge instructions," she says. "They are expected to suction the nose frequently, give medication every three to four hours, and monitor urine output. If they aren't able to handle the normal things, it is not likely they will do all this."
Although most of the women included in the survey were poor, Grupp-Phelan says other researchers report similarly high rates of maternal depression among higher income groups.
"Depression is highly prevalent in women during their childbearing years, regardless of their income status," she says. "That is why it is so important to come up with better ways of identifying the problem."
Maternal depression expert Diana Dell, MD, of Duke University, agrees that screening moms in pediatric settings makes sense because studies confirm that one in five mothers experience major depression by their child's first birthday. But she says identifying depression is only a first step.
"Screening is not a panacea," she tells WebMD. "Women are not always happy to be screened, and they may not be willing to agree to treatment."
Dell says increasing awareness about the prevalence of maternal depression is a key to addressing the problem. But she adds that being depressed doesn't necessarily make someone a poor mother. Dell is a professor of obstetrics and psychiatry at Duke University Medical Center.
"When a person is depressed, they tend to see themselves in a negative way, and that could explain why so many of these mothers felt they could not adequately care for their children," she says. "Many depressed women take good care of their kids. They just have to spend a lot of energy doing it."