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. 2007 Dec;42(12):962-71.
doi: 10.1007/s00127-007-0262-4. Epub 2007 Oct 12.

Remission of maternal depression and child symptoms among single mothers: a STAR*D-Child report

Ardesheer Talati  1 , Priya J Wickramaratne, Daniel J Pilowsky, Jonathan E Alpert, Gabriele Cerda, Judy Garber, Carroll W Hughes, Cheryl A King, Erin Malloy, A Bela Sood, Helen Verdeli, Madhukar H Trivedi, A John Rush, Myrna M Weissman
Affiliations

Remission of maternal depression and child symptoms among single mothers: a STAR*D-Child report

Ardesheer Talati et al. Soc Psychiatry Psychiatr Epidemiol. 2007 Dec.

Erratum in

  • Soc Psychiatry Psychiatr Epidemiol. 2007 Dec;42(12):971

Abstract

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.

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Figures

Fig. 1
Fig. 1
Percent of mothers responding to treatment. Single mothers are shown in the gray columns, and mothers residing with a father are shown in white. The response level indicates the percent decrease of baseline symptoms on the HAMD17 scale from the baseline to the 3-month evaluation. The “<0” category represents mothers whose symptoms increased over the 3 months. A successful response was defined a priori by STAR*D as a 50% or greater reduction in symptoms. Based on these criteria, 52% of mothers living in dual-parent households, but only 28% of single mothers, successfully responded to treatment (P = 0.009). The rates for full remission of symptoms were 43% and 20% respectively (P = 0.013). Change in maternal depression severity in relation to father’s presence
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