Mother's Depression a Risk Factor in Childhood Asthma Symptoms, Study Suggests

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Mother's Depression a Risk Factor in Childhood Asthma Symptoms, Study

Suggests

ScienceDaily (Nov. 20, 2009) — Asthma symptoms can worsen in children with

depressed mothers, according to research from s Hopkins Children's

Center published online in the Journal of Pediatric Psychology.

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Analyzing data from interviews with 262 mothers of African-American

children with asthma -- a population disproportionately affected by this

inflammatory airway disorder -- the Hopkins investigators found that children

whose

mothers had more depressive symptoms had more frequent asthma symptoms

during the six-months of the study. Conversely, children whose mothers reported

fewer depressive symptoms had less frequent asthma symptoms.

Researchers tracked ups and downs in maternal depression as related to the

frequency of symptoms among children.

" Even though our research was not set up to measure just how much a mom's

depression increased the frequency of her child's symptoms, a clear pattern

emerged in which the latter followed the earlier, " says senior investigator

Riekert, Ph.D., a pediatric psychologist and co-director of the

s Hopkins Adherence Research Center.

But while maternal depression appeared to aggravate a child's asthma, the

opposite was not true: How often a child had symptoms did not seem to affect

the mother's depressive symptoms, an important finding that suggests

maternal depression is an independent risk factor that can portend a child's

symptoms, researchers say.

Past studies have shown that children with chronic health conditions fare

worse if their primary caregiver is depressed, but none have teased out the

exact interplay between the two.

" Intuitively, it may seem that we're dealing with a chicken-egg situation,

but our study suggests otherwise, " Riekert says. " The fact that mom's

depression was not affected by how often her child had symptoms really caught

us

off guard, but it also suggested which factor comes first. "

Researchers did not study why and how a mother's depression affects a

child's asthma status, but because depression often involves fatigue, memory

lapses and difficulty concentrating, it can affect a parent's ability to

manage the child's chronic condition, which can involve daily, and sometimes

complex, drug regimens and frequent visits to the doctor.

" Mom is the one who must implement the doctor's recommendations for

treatment and follow-up, and if she is depressed she can't do it well, so the

child will suffer, " says lead investigator Michiko Otsuki, Ph.D., a behavioral

medicine fellow at s Hopkins at the time of the study, now at the

University of South Florida St. sburg.

Investigators say their findings should prompt pediatricians who treat

children with asthma to pay close attention to the child's primary caregiver --

whether or not it is the mother -- and screen and refer them for treatment

if needed.

" We ask these parents if they are smokers all the time, so maybe it's time

to start asking them if they are coping well emotionally, " said

co-investigator Arlene Butz, Sc.D., a pediatric asthma specialist at s

Hopkins

Children's Center. " Doctors are trained to pick up on subtle clues, so if they

see a red flag in mom, they should follow-up with a depression screener

and referral if needed. "

Treating depressed mothers whose children are at high-risk for asthma

complications will likely benefit both mother and child, researchers say, while

providing a clear treatment target to help reduce the burden of asthma in

the United States. Asthma is the country's leading pediatric chronic

illness, affecting 6.5 million children under the age of 18, according to the

CDC.

The Hopkins study included only mothers but investigators believe a similar

pattern would emerge regardless of who the primary caregiver is.

Researchers caution that the mothers in their study were screened for

depression with a standard questionnaire, which is a reliable detector of

symptoms but not a firm diagnosis.

The Hopkins findings came from a high-risk, inner-city population and thus

cannot be statistically extended to other ethnic and socioeconomic groups,

but researchers say the effect of caregiver depression on a child's asthma

likely transcends demographics.

The research was funded by the National Heart Lung Blood Institute.

Other Hopkins researchers involved in the study included Eakin,

Ph.D., Arceneaux, Psy.D., Rand, Ph.D.