PEDIATRICS Vol. 102 No. 6 December 1998, pp. 1394-1400
Depressive Symptoms in Inner-city Mothers of Young Children: Who Is at Risk?
Received Oct 24, 1997; accepted Jul 1, 1998.
, and
From the * Department of Pediatrics, Albert Einstein College of
Medicine, Bronx, New York; and the Department of Neurology, New York
University, Hospital for Joint Diseases, New York, New York.
Objective. To identify factors associated with depressive symptoms in inner-city mothers of young children.
Design. A cross-sectional survey was administered to a
convenience sample of English-speaking mothers attending a well-child
visit for a child aged 6 months to 3 years in a hospital-based,
inner-city, general pediatric clinic. The maternal interview collected
data on sociodemographic characteristics, and mothers' health and
financial status. Mothers completed the Psychiatric Symptom Index
(PSI), a 29-item checklist shown to have very good validity and
reliability in a multicultural population. A total score of 
20
represents high levels of symptoms; scores 30 strongly suggest major
depression.
Results. Two hundred seventy-nine mothers completed the
PSI. Mothers ranged in age from 14 to 48 years (mean, 27 years).
Seventy-one percent were unmarried; 57% received public assistance.
Forty-two percent of mothers were Hispanic, 40% black, 9% white, and
10% mixed or other races. Forty-eight percent were foreign-born.
Twenty-four percent reported having a medical condition; 6% had
activity limitation because of illness. The mean PSI score was 19; 18%
of mothers had a PSI score 30 and 39% scored 20. PSI scores did
not vary by age, race, birthplace, educational level, employment,
marital status, or family composition. PSI scores were higher for
mothers receiving public assistance (21 vs 17), with self-reports of
poor or fair financial status (22 vs 15) and poor health status (52 vs
17). Mothers with activity limitations because of illness had significantly higher PSI scores (34 vs 18). Multiple regression analyses confirmed the independent relationships of these maternal characteristics to high PSI scores.
Conclusions. Depressive symptoms in inner-city mothers of young children are common. In this population of women with many risk factors, traditional sociodemographic risk factors did not successfully identify those who are depressed. However, mothers' self-reports of poor financial status, health status, or activity limitation because of illness were associated with higher levels of depressive symptoms. These findings may assist clinicians in distinguishing which mothers are likely to be depressed when almost all are at high risk. Key words: depression, screening, mothers.
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