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Parental Depressive Symptoms and Children’s School Attendance and Emergency Department Use: A Nationally Representative Study

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Abstract

We sought to assess the association between parental depressive symptoms and school attendance and emergency department (ED) use among children with and without chronic health conditions. Secondary analysis of the 1997–2004 National Health Interview Survey, a nationally representative survey. Parental depressive symptoms were measured by three questions assessing sadness, hopelessness, or worthlessness in the past month. Children with and without asthma or attention-deficit/hyperactivity disorder (ADHD) were identified, and their school attendance and ED visits were reported by adult household respondents. Children with information on parental depressive symptoms, health conditions, and services use were eligible. We incorporated weights available in the survey for each eligible child to reflect the complex sampling design. 104,930 eligible children were identified. The point prevalence of parental depressive symptoms was low (1.8 %, 95 % CI 1.7–2.0), but greater among children with asthma (2.7 %, 95 % CI 2.4–3.0) and ADHD (3.8 %, 95 % CI 3.2–4.4) than among other children (1.6 %, 95 % CI 1.5–1.7). After adjustment for potential confounders, children whose parents reported depressive symptoms most or all of the time were more likely to report an ED visit (adjusted incident rate ratio [IRR] 1.18, 95 % CI 1.06–1.32) or school absence (adjusted IRR 1.36, 95 % CI 1.14–1.63) than children whose parents did not. The effect of parental depressive symptoms was not modified by child health conditions. Parental depressive symptoms were adversely associated with school attendance and ED use in children. These results suggest the importance of measuring depressive symptoms among adult caregivers of children.

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Authors and Affiliations

  1. PolicyLab: Center to Bridge Research, Practice, and Policy, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    James P. Guevara, Shooshan Danagoulian & Jacqueline Reyner

  2. Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA

    James P. Guevara, David Mandell & Susmita Pati

  3. Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    James P. Guevara & David Mandell

  4. Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    David Mandell

  5. Division of Primary Care Pediatrics, State University of New York at Stony Brook and Stony Brook Long Island Children’s Hospital, Stony Brook, NY, USA

    Susmita Pati

  6. Division of General Pediatrics, The Children’s Hospital of Philadelphia, CHOP North, Room 1531, Philadelphia, PA, USA

    James P. Guevara

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  1. James P. Guevara
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  2. David Mandell
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Correspondence to James P. Guevara.

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Guevara, J.P., Mandell, D., Danagoulian, S. et al. Parental Depressive Symptoms and Children’s School Attendance and Emergency Department Use: A Nationally Representative Study. Matern Child Health J 17, 1130–1137 (2013). https://doi.org/10.1007/s10995-012-1109-5

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  • DOI: https://doi.org/10.1007/s10995-012-1109-5

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