depression are more likely to use a variety of acute health care services. For older children and adolescents, there is limited evidence to suggest that depression plays a role in visits for stress-related health conditions and increased health care utilization. Adverse health outcomes of accidents, childhood asthma, child maltreatment, and adolescent tobacco and substance use occur more often when a parent is depressed.

  • Maternal depression symptoms (and stress) levels are high among caregivers of children with chronic conditions.

  • Depression in parents is associated with maladaptive patterns of health care utilization for children. Infants and young children of mothers with depression are more likely to use a variety of acute health care services. For older children and adolescents, there is limited evidence to suggest impact on health care utilization.

  • Depression in parents has been consistently found to be associated with children’s early signs of (or vulnerabilities to) more “difficult” temperament; more insecure attachment; affective functioning (more negative affect, more dysregulated aggression and heightened emotionality, more dysphoric and less happy affect, particularly for girls; lower cognitive/intellectual/academic performance, cognitive vulnerabilities to depression (more self-blame, more negative attributional style, lower self-worth); poorer interpersonal functioning; and abnormalities in psychobiological systems, including poorer functioning stress response systems (neuroendocrine and autonomic) and cortical activity.

  • Depression in parents has been consistently associated with a number of behavior problems and psychopathology in children, including higher rates of depression, earlier age of onset, longer duration, greater functional impairment, higher likelihood of recurrence, higher rates of anxiety, and higher rates and levels of severity of internalizing and externalizing symptoms and disorders in children and adolescents.

Mediators and Moderators

  • Depression in parents is more likely to be associated with adverse outcomes in children with the presence of additional risk factors (e.g., poverty, exposure to violence, marital conflict, comorbid psychiatric disorders, absence of father when the mother has depression, and clinical characteristics of the depression, such as severity and duration) than with depression that occurs in the context of more protective factors.



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