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

Women's Health Collection

Journal article

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

Abstract:: 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 pediatric and maternal health outcomes.

Funding: Bill & Melinda Gates Foundation OPP1131320.

Publication status:: Published

Peer review status:: Peer reviewed

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APA Style

Elshafei, A., Jemutai, J., Tickell, K. D., Sukhtankar, P., Bhat, A., Molyneux, S., Berkley, J. A., Walson, J. L., & Collins, P. Y. (2022). Depressive symptoms among mothers with hospitalized children in South Asia and sub-Saharan Africa. Journal of Affective Disorders, 323, 368–377.

MLA Style

Elshafei, A, et al. “Depressive Symptoms among Mothers with Hospitalized Children in South Asia and Sub-Saharan Africa.” Journal of Affective Disorders, vol. 323, 2022, pp. 368–77.

Chicago Style

Elshafei, A, J Jemutai, KD Tickell, et al. 2022. “Depressive Symptoms among Mothers with Hospitalized Children in South Asia and Sub-Saharan Africa.” Journal of Affective Disorders 323: 368–77.
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