Yale University School of Medicine
New Haven, Connecticut
Depression
Minority women with children
Project
Women receive screening and treatment for maternal depression in the context of their children’s health care.
Mothers at a pediatric clinic that provides care primarily for minority and high-risk populations are screened for depression during a regularly-scheduled office visit. Following the depression screening, a behavioral health clinician conducts a brief diagnostic interview at the clinic or home of mothers who were found to have symptoms of depression. Patients are invited to participate in six sessions of cognitive behavioral group therapy and case management. The group therapy sessions aim to help mothers develop skills to manage their depressive symptoms, handle life stress and improve their mother-child relationship.
Rationale
Pediatric primary care centers may be an important setting where mothers with depression can be diagnosed and treated: during the first three years of a child’s life, families frequently visit pediatricians, who may be the only medical professional to have regular contact with the family.
Cognitive behavioral therapy has been shown to significantly reduce symptoms of depression in low-income mothers and in mothers whose children have behavioral health problems. The brief group therapy provided in this study allows effective short-term treatment for depression to be provided in a primary care setting, allowing mothers to be treated at their pediatrician’s office, during their child’s check-up. Locating treatment at the pediatrician’s office may increase comfort and at times may remove logistical barriers to care.
Summary Results
Delivering short-term group cognitive behavioral therapy to depressed mothers in the context of their children’s health care was successful at decreasing depressive symptoms (-4 points in QIDS scores), but was no more effective than intensive case management alone (-2 points in QIDS scores). Women in the short-term cognitive behavioral therapy intervention groups, but not those in intensive case management, also reported significantly fewer behavioral health problems in their young children after treatment (-5 points on BITSEA score). This is a feasible intervention.
Publications
Young Child Socioemotional/Behavioral Problems And Cumulative Psychosocial Risk
Infant Mental Health Journal. 2014;35(1):1-9. Published online 2013 Nov 12.
Full Article (subscription may be required)
Markers of Maternal Depressive Symptoms in an Urban Pediatric Clinic
The Journal of Pediatrics. 2013;162(1):189–194. Published online 2012 Aug 4.
Full Article (subscription may be required)
The Association Between Parent Worry and Young Children’s Social-emotional Functioning
Journal of Developmental & Behavioral Pediatrics. 2011;32(9):660-667.
Full Article (subscription may be required)
Mothers’ Depression Can Go Well Beyond Children’s Infancy
Scientific American. Published online 2010 May 5.
Full Article
Principal Investigators
- Dr. Carol Weitzman
- Dr. Kim Yonkers