Maternal depressive symptoms and emergency department use among inner-citychildren with asthma

Context: Inner-city minority children with asthma use emergency departments (ED) frequently. Objective: To examine whether maternal depressive symptoms are associated w ith ED use. Design, setting, and Patients: Baseline and 6-month surveys were administer ed to mothers of children with asthma in inner-city Baltimore, Md, and Wash ington, DC. Main Outcome Measures: Use of the ED at B-month follow-up was examined. Ind ependent variables included asthma morbidity, age, depressive symptoms, and other psychosocial data. Results: Among mothers, nearly half reported significant levels of depressi ve symptoms. There were no demographic or asthma-related differences betwee n the children of mothers with high and low depressive symptoms. However, i n bivariate analyses, mothers with high depressive symptoms were 40% (preva lence ratio [PR], 1.4; 95% confidence interval [CI], 1.0-3.6; P=.04) more l ikely to report taking their child to the ED. Mothers aged 30 to 35 years w ere more than twice as likely (PR, 2.2; 95% CI, 1.9-9.3; P=.001) to report ED use, as were children with high morbidity (PR, 1.9, 95% CI, 1.4-7.1; P=. 006). Child age and family income were not predictive of ED use. After cont rolling for asthma symptoms and mother's age, mothers with depressive sympt oms were still 30% more likely to report ED use. Conclusions: Depression is common among inner-city mothers of children with asthma. Beyond asthma morbidity, maternal age and depressive symptoms are strong predictors of reports of ED visits. Identifying and addressing poor psychological adjustment in mothers may reduce unnecessary ED visits and op timize asthma management among inner-city children.