Depressive symptoms among mothers with hospitalized children in South Asia and sub-Saharan Africa

Elshafei A, Jemutai J, Tickell KD, Sukhtankar P, Bhat A, Molyneux S, Berkley JA, Walson JL, Collins PY, Childhood Acute Illness Nutrition Network Investigators
J Affect Disord. 2022;323

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BACKGROUND: Poor maternal mental health during childhood hospitalization is associated with post-discharge child mortality. We aimed to establish if maternal PHQ-9 scores during hospitalization are associated with acute stressors, or longer trends in mental health status. METHOD: Mothers of children admitted to nine hospitals in six countries completed a PHQ-9 assessment during hospitalization, and 45-days post-discharge. Community participants were recruited from homes near the hospitalized children. The prevalence and correlates of high PHQ-9 scores among hospitalized and community mothers were compared. OUTCOMES: Among 2762 mothers of hospitalized children, 514 (19 %) had PHQ-9 scores >/=10, significantly more than the 116 (10 %, p < 0.001) of 1159 community participants. Recruitment site and food insecurity were PHQ-9 correlates in both groups. Correlates of higher mean PHQ-9 scores among the hospitalized cohort included maternal illness (mean difference [MD]: 1.27, 95%CI: 0.77, 1.77), pregnancy (MD: 0.77, 95%CI: 0.27, 1.28), child HIV-infection (MD: 2.51. 95%CI: 1.55, 3.52), and lower child weight-for-height (MD: 0.21, 95%CI: 0.32, 0.11). Marriage (MD -0.92, 95%CI: -1.36, -0.48) and a positive malaria test (MD: -0.63, 95%CI: -1.15, -0.10) were associated with lower PHQ-9 scores among mothers of hospitalized children. Among mothers with PHQ-9 >/=10 during admission, 410 had repeat assessments 45-days after their child's discharge, and 108 (26 %) continued to meet the high PHQ-9 criterion. INTERPRETATION: Among mothers of hospitalized children, there are subgroups with transient and persistent depressive symptoms. Interventions tailored to address acute stressors may improve post-discharge paediatric and maternal health outcomes. FUNDING: Bill & Melinda Gates Foundation OPP1131320.