The relationship of life stressors and maternal depression to pediatric asthma morbidity in a subspecialty practice

Objective.-To examine the relationships among demographic characteristics, caregiver life stressors, and depressive symptoms of mothers and their chil dren's asthma morbidity. Setting.-Three pediatric asthma subspecialty programs, 2 in the inner city and 1 in the suburbs. Design.-Cross-sectional census sample of caregivers of children with asthma : interviews mostly with mothers (N = 123) regarding their children's asthm a symptoms and health care utilization. Information collected on demographi cs and caregivers' own recent life stressors and depressive symptoms. Subjects.-Caregivers of children ages 18 months to 12 years with asthma at their subspecialty visit. Measures.-Structured interviews: a survey instrument prepared for this stud y and standardized instruments for depression (Center for Epidemiologic Stu dies-Depression) and life stressors (Crisis in Family Systems). Results.-A total of 32% of respondents' children had high asthma morbidity, 28% intermediate, and 40% low. Caregiver life stressors and depression and the children's sex showed the strongest relationships to asthma morbidity in a model that also included race, residence, and Medicaid status. Childre n were more likely to have high morbidity if they had caregivers with more depressive symptoms and negative life stressors and if they were female. Conclusions.-Respondents experienced many life stressors and symptoms of de pression while managing their children's illness. Caregivers' lives may aff ect their children's asthma morbidity, offering empirical evidence for the potential value of targeted case management for children in subspecialty ca re.