The following is a summary of the “Impact of Caregiver Depression on Child Asthma Outcomes: Pathways and Mechanisms,” published in the January 2023 issue of Allergy and Clinical Immunology by Brown, et al.

Caregivers’ depression is widespread in families with asthma and is linked to worse results for the kid. However, there is a lack of longitudinal research into the relationship between a caregiver’s remission of depression and an improvement in their child’s asthma control. Therefore, the purpose of this 2-site study was to see if the length of time a caretaker spent in remission from depression was a reliable predictor of the degree.

Major depressive disorder was monitored in 205 carers and their 7-17 year old children with chronic asthma for 52 weeks at 4-week intervals. The Hamilton Depression Rating Scale (a 17-item scale) was used to assess carer depression Hamilton Rating Scale for Depression (HRSD). 

They used the (Childhood) Asthma Control Test (cACT/ACT) and spirometry to evaluate the child’s asthma and the Children’s Depression Inventory to evaluate the Children’s Depression Inventory (CDI). The proportion of time the carer was in remission (HRSD score 7) was used as the predictor in linear regression analysis (HRSD score ≤ 7) with the change in cACT/ACT, CDI, and forced expiratory volume in 1 second (FEV₁)% predicted as outcomes. In addition, adherence to asthma controller medication and child depression symptoms were analyzed using multilevel mediation analysis. 

Children were, on average, 54.1% female and 11 years old. Improvements in cACT/ACT, CDI, and FEV₁% predicted were significantly predicted by the percentage of time a carer spent in remission of depression as determined by HRSD. Caregiver HRSD levels were associated with better asthma control in children, but this was not mediated by medication adherence. Reducing the severity of the child’s depressed symptoms is one mechanism through which an increase in the caregiver’s mood can positively affect the child’s asthma outcomes. Improvements in children’s asthma outcomes may result from the screening and treatment of carers for depression.

Source: sciencedirect.com/science/article/abs/pii/S2213219822009527