Exploring the association between maternal mental health and housing conditions during early childhood and anxiety and depression at age 15

摘要

Objective: The purpose of this investigation is to explore the independent and combined impact, if any, of adverse living conditions and maternal depression or anxiety during early childhood on the development of anxiety and depression in adolescents at age 15.;Design: Use of secondary data from study participants from the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective birth cohort study of children born between April 1, 1991 and December 31, 1992.;Methods: The subset of the sample used for this analysis had self-reported responses to the DAWBA anxiety and depression questionnaires at age 15 and was comprised of 5,367 male and female adolescents. Frequency distributions and other descriptive statistics of all covariates of interest were examined. Bivariate analyses including chi-square tests were used to investigate associations between the exposures and outcomes of interest, as well as associations between other covariates and both exposures and outcomes. Both logistic regression and ordered logistic regression were performed with dichotomous and DAWBA band outcomes, respectively. A stepwise regression model using backward elimination was used. In addition, we assessed for effect modification of the relation between adverse housing conditions and child mental health by mother's mental health status, by including an interaction term between our two primary exposure variables in the final adjusted models. Goodness of fit of the final models was assessed using the Hosmer and Lemeshow goodness of fit test for the logistic regression models and the score test for the proportional odds assumption for the ordered logistic regression models.;Results: Among the 5,367 children studied, 47.4% were male, 52.6% were female, 95.9% were white and 4.1% were non-white. Only a minority of children met criteria for a probable diagnosis of anxiety (11.1%) or depression (9.3%) at age 15 years. Significant predictors of self-reported anxiety at age 15 were: maternal self-reported anxiety or depression (aOR = 1.47, 95% CI = 1.14--1.89), rodent/insect infestation or mold problems (aOR = 1.23 CI, 95% CI 1.01--1.50), female gender (aOR = 3.07, 95% CI = 2.46--3.82), and non-white race (aOR = 1.60, 95% CI = 1.03--2.48, vs. white). For self-reported depression at age 15 as the outcome, significant predictors were: maternal self-reported anxiety or depression (aOR = 1.48, 95% CI = 1.14--1.92), rodent/insect infestation or mold problems (aOR = 1.23, 95% CI =1.01--1.51), female gender (aOR = 2.52, 95% CI= 1.81--2.81) and younger maternal age at delivery (aOR = 0.96 for each year, 95% CI = 0.94--0.98).;Conclusion: The findings of this study suggest adverse housing conditions and maternal psychopathology during early childhood are risk factors for anxiety and depression among children at age 15 and provides possible areas for intervention programs.