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.