Parental Depressive Symptoms and Physical-Mental Multimorbidity in Children

Abstract

Background: Children with a chronic physical illness represent a substantial proportion of the child population. These children are at an elevated risk for mental illness (i.e., physical-mental multimorbidity). Additionally, their parents may experience elevated levels of depressive symptoms. Parental depression is a robust risk factor for mental illness in children; an association that is stronger when a child has a chronic physical illness. Unfortunately, current research assessing parental depressive symptoms and child physical-mental multimorbidity is primarily cross-sectional, focuses on specific chronic physical illnesses, and excludes children under 10 years of age, limiting the generalizability of study findings. Objectives: The objectives of this work were to: (1) delineate trajectories of depressive symptoms among parents of children with a chronic physical illness over 24 months; (2) identify baseline factors predictive of trajectory group membership; and (3) examine the association between trajectory group membership and child physical-mental multimorbidity. Methods: Data came from a longitudinal study of 246 children and their parents recruited from outpatient clinics at McMaster Children’s Hospital. Latent class growth modelling identified trajectories of parental depressive symptoms. Multinomial logistic regression determined baseline predictors of trajectory group membership, and logistic regression examined the association between trajectory group membership and child physical-mental multimorbidity. Results: Three trajectory groups were identified based on level of symptomatology: low (52%), subclinical (32%), and clinical (16%). Predictors of parental depressive symptom trajectories were more parental anxiety symptoms (OR = 1.55, 95% CI = 1.31-1.83 [subclinical]; OR = 1.81, 95% CI = 1.48-2.21 [clinical]), poorer parental physical health (OR = 0.94, 95% CI = 0.90-0.99; OR = 0.88, 95% CI = 0.82-0.95), living in areas with more residential instability (OR = 1.93, 95% CI = 1.17-3.20; OR = 3.15, 95% CI = 1.54-6.46), and more parenting stress (OR = 1.11, 95% CI = 1.02-1.19 [clinical]). Parental depressive symptom trajectory group membership was not associated with child physical-mental multimorbidity. Conclusion: Findings suggest that most parents do not present with elevated levels of depressive symptoms. Predictors of parental depressive symptom trajectories and child physical-mental multimorbidity may help identify individuals with an increased susceptibility for poorer mental health outcomes. These findings highlight the need to integrate physical and mental health services as well as parental mental health services within pediatric settings. Future research should explore additional predictors of parental depressive symptom trajectories and child physical-mental multimorbidity.