1. Children exposed to maternal depression during middle childhood were more likely to engage in both violent and non-violent health risk behaviors.
2. Being exposed to maternal depression during middle childhood was associated with earlier onset of substance use.
Evidence Rating Level: 2 (Good)
Study Rundown: It is known that maternal depression is associated with adolescent depression and substance use. This study attempted to further elucidate the link between maternal depression and risky teen behaviors by prospectively surveying mothers and their teens.
Children exposed to maternal depressive symptoms during middle childhood were the most likely to engage in both violent and non-violent risky behaviors as teens. However, children who were exposed to increasing levels of maternal depression throughout their childhood were no more likely to engage in risky behavior than those exposed to low depressive symptoms. Furthermore, children exposed to maternal depression in middle childhood engaged in substance use (including cigarettes, marijuana and alcohol) at an earlier age than other children.
This large study is strengthened by its prospective nature and careful statistical analysis. However, both maternal and adolescent symptoms were self-reported and there was significant attrition over the long study period which may be attributed to depressive symptoms.
This study strengthens the relationship between maternal depression and adolescent behaviors and suggests that physicians should focus attention on maternal well-being, especially during the vulnerable middle childhood period.
In-Depth [prospective cohort study]: Survey results for children and their mothers were obtained every two years from the National Longitudinal Survey of Children and Youth, a representative sample (N = 2910) of Canadian youth, between 1994 (at ages 2 to 5) and 2009 (at ages 16 to 17). The self-reported survey examined health risk behaviors in teens and symptoms of depression in mothers. Maternal depression was modeled, grouping children into different trajectories of exposure to depression (low-stable, mild stable, increasing, middle childhood and recurrent exposure) and then these models were correlated with health risk behaviors during adolescence. Exposure during middle childhood was found to be associated with higher substance abuse (P = 0.005) as well as higher violent delinquent behavior (P = 0.02) when compared to adolescents exposed to very few maternal depressive symptoms. In addition, children exposed during middle childhood were more likely to engage in alcohol, cigarette and marijuana use at earlier age when compared to low-exposure teens (aHR = 1.43, P < 0.05; aHR = 2.15 P < 0.05; aHR = 1.91 P < 0.04, respectively)
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