Depressive symptoms in inner-city mothers of young children: Who is at risk?

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 o f English-speaking mothers attending a well-child visit far 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 Psychiatr ic Symptom Index (PSI), a 29-item checklist shown to have very good validit y and reliability in a multicultural population A total score of greater th an or equal to 20 represents high levels of symptoms; scores greater than o r equal to 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 unma rried; 57% received public assistance, Forty-two percent of mothers were Hi spanic, 40% black, 9% white, and 10% mixed or other races. Forty-eight perc ent were foreign-born, Twenty-four percent reported having a medical condit ion; 6% had activity limitation because of illness. The mean PSI score was 19; 18% of mothers had a PSI score greater than or equal to 30 and 39% scor ed greater than or equal to 20, PSI scores did not vary by age, race, birth place, educational level, employment, marital status, or family composition . PSI stares were higher for mothers receiving public assistance (21 vs 17) , with self-reports of poor or fair financial status (22 vs 15) and poor he alth status (52 vs 17). Mothers with activity limitations because of illnes s had significantly higher PSI scores (34 vs 18), Multiple regression analy ses confirmed the independent relationships of these maternal characteristi cs to high PSI scores. Conclusions. Depressive symptoms in inner-city mothers of young children ar e common. In this population of women with many risk factors, traditional s ociodemographic risk factors did not successfully identify lose who are dep ressed. However, mothers' self-reports of poor financial status, health sta tus, or activity limitation because of illness were associated with higher levels of depressive symptoms. These findings may assist clinicians in dist inguishing which mothers are likely to be depressed when almost all are at high risk.