Study Finds Depressive Symptoms Common In Mothers of Toddlers

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"There is a high frequency of elevated depressive symptoms in mothers of toddlers and a moderate level of persistence of these symptoms," report the authors of a study published in the November issue of the Journal of the American Academy of Child and Adolescent Psychiatry. Noting a growing concern over the potential negative impact that maternal depression may have on the development of young children and the lack of basic information, such as the prevalence of maternal depression in the early childhood years, the authors examined the prevalence, persistence, and correlates of depressive symptoms in mothers of toddlers in a nationally representative sample.

The authors used the self-report components of two linked databases--the 1988 National Maternal and Infant Health Survey and the 1991 Longitudinal Followup--to assess the stability of maternal depressive symptoms across the two time points and maternal and child predictors of elevated depressive symptoms. Both surveys used the Center for Epidemiologic Studies Depression Scale (CES-D), a self-report instrument with 20 items, each rated according to the duration and/or frequency of each depressive symptom in the previous week.

Findings include the following:

• Prevalence: Rates of 23.7% and 16.6% for elevated depressive symptoms were obtained for time 1 and time 2, respectively.



• Persistence: 35.7% of mothers with the elevated depressive symptom classification at time 1 had the same classification at time 2; 26% of mothers with the very elevated depressive symptom classification had the same classification at time 2.



• Correlates: The strongest predictors of elevated depressive symptoms were lower educational attainment and poorer health status of the mother.

The authors found a high percentage of mothers who reported elevated and persistently elevated depression symptoms, suggesting that greater clinical attention should be directed toward this group, both for the mother's health and her child's health. They point out, however, that it may also be appropriate to consider the impact and need for treatment of mothers with elevated depressive symptoms that do not meet strict diagnostic criteria. Recent maternal and child health efforts, such as the national Healthy Start Initiative, are now focusing on such interventions (i.e., monitoring depressive symptoms) to improve the health of both new mothers and young children. The authors conclude, "Given the potential magnitude of the need, systematic clinical and public health approaches may be required."

McLennan JD, Kotelchuck M, Cho H. 2001. Prevalence, persistence, and correlates of depressive symptoms in a national sample of mothers with toddlers. Journal of the American Academy of Child and Adolescent Psychiatry 40(11):1316-1323.

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MCH Alert. 2001. Arlington, VA: National Center for Education in Maternal and Child Health. http://www.ncemch.org/alert.