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Medline ® Abstracts for References 21,22

of 'Screening for depression in adults'

Association between parental depression and children's health care use.
Sills MR, Shetterly S, Xu S, Magid D, Kempe A
Pediatrics. 2007 Apr;119(4):e829-36.
OBJECTIVE: The objective of this study was to determine the association between parental depression and pediatric health care use patterns.
METHODS: We selected all children who were 0 to 17 years of age, enrolled in Kaiser Permanente of Colorado during the study period July 1997 to December 2002, and linked to at least 1 parent/subscriber who was enrolled for at least 6 months during that period. Unexposed children were selected from a pool of children whose parents did not have a depression diagnosis. Outcome measures were derived from the child's payment files and electronic medical charts and included 5 categories of use: well-child-care visits, sick visits to primary care departments, specialty clinic visits, emergency department visits, and inpatient visits. We compared the rate of use per enrollment month for these 5 categories between exposed and unexposed children within each of the 5 age strata.
RESULTS: Our study population had 24,391 exposed and 45,274 age-matched, unexposed children. For the outcome of well-child-care visits, teenagers showed decreased rates of visits among exposed children. Therate of specialty department visits was higher in exposed children in the 4 oldest age groups. The rates of both emergency department visits and sick visits to primary care departments were higher for exposed children across all 5 age categories. The rate of inpatient visits was higher among exposed children in 2 of the 5 age groups.
CONCLUSIONS: Overall, having at least 1 depressed parent is associated with greater rate of emergency department and sick visits across all age groups, greater use of inpatient and specialty services in some age groups, and a lower rate of well-child-care visits among 13- to 17-year-olds. This pattern of increased use of expensive resources and decreased use of preventive services represents one of the hidden costs of adult depression.
Department of Pediatrics, University of Colorado at Denver and Health Sciences Center, Denver, Colorado 80218, USA. sills.marion@tchden.org
Parental depression, child mental health problems, and health care utilization.
Olfson M, Marcus SC, Druss B, Alan Pincus H, Weissman MM
Med Care. 2003 Jun;41(6):716-21.
BACKGROUND: Small controlled studies suggest that depression and other mental health problems are more common in children of parents with depression than in children of parents without depression.
OBJECTIVES: This article examines relationships between parental depression and children's mental health problems and health care utilization in a nationally representative household sample of parents and their children.
RESEARCH DESIGN: Cross sectional comparisons of sociodemographic characteristics, mental health problems and health expenditures of children whose parents either do or do not report depression in the 1997 Medical Expenditure Panel Survey data.
SUBJECTS: A nationally representative sample of children, 3 to 18 years of age (n = 8,360) with one or more parents living in the household.
MEASURES: Mental health problems, total health expenditures, and mental health expenditures.
RESULTS: Children of parents with depression were approximately twice as likely as children of parents without depression to have a variety of mental health problems and were 2.8 times more likely to use mental health services in adjusted analyses. Among children with health and mental health expenditures, those whose parents report depression had significantly higher mean total annual child health expenditures ($282 vs. $214, t = 3.5, P = 0.0006) and child mental health expenditures ($513 vs. $338, t = 2.0, P = 0.05) than children whose parents did not report depression.
CONCLUSIONS: Children of parents with depression are at increased risk for a range of health problems. Parental depression is also related to an increased child health and mental health service utilization and expenditure.
New York State Psychiatric Institute/Department of Psychiatry, College of Physicians&Surgeons of Columbia University, New York, USA. mo49@columbia.edu