Skip to main content

Advertisement

Log in

Anxiety and Depression in Mothers and Fathers of a Chronically Ill Child

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

We aimed to determine the levels of anxiety and depression in mothers and fathers of a chronically ill child (0–18 years) and to study which parental and child variables are associated with anxiety and depression. In a cross-sectional design, anxiety and depression were assessed with the Hospital Anxiety and Depression Scale. Scores were compared to a Dutch reference group by analysis of variance and logistic regression analysis. Linear regression analyses were performed to examine which variables were associated with anxiety and depression. Mothers of a chronically ill child (n = 566) scored significantly higher than the reference group (p < .001) on anxiety (Mean 5.9 vs 4.8) and depression (Mean 4.5 vs 3.1). Fathers (n = 123) had higher depression scores (Mean 4.5 vs 3.6; p < .05), but fathers’ anxiety scores were comparable to the reference group. The percentages of mothers in the clinical range of anxiety (31.8 vs 20.7 %, OR 2.03, 95 % CI 1.46–2.83) and depression (23.0 vs 12.0 %, OR 2.76, 95 % CI 1.84–4.13) were higher (p < .001) than in the reference group. No differences were found for fathers in the clinical range for anxiety and depression. Practical problems in daily life (a: β = .33, d: β = .25) and parenting stress (a: β = .30, d: β = .32) showed the strongest association with anxiety and depression for parents as a group. Illness-related characteristics of the child were not related. Parents of a chronically ill child, especially mothers, reported high levels of anxiety and depression. Awareness about parental anxiety and depression in pediatrics is important as well as targeted interventions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Mokkink, L. B., van der Lee, J. H., Grootenhuis, M. A., Offringa, M., & Heymans, H. S. (2008). Defining chronic diseases and health conditions in childhood (0–18 years of age): National consensus in the Netherlands. European Journal of Pediatrics, 167(12), 1441–1447.

    Article  PubMed  Google Scholar 

  2. Perrin, J. M., Bloom, S. R., & Gortmaker, S. L. (2007). The increase of childhood chronic conditions in the United States. JAMA, 297(24), 2755–2759.

    Article  PubMed  CAS  Google Scholar 

  3. Cousino, M. K., & Hazen, R. A. (2013). Parenting stress among caregivers of children with chronic illness: A systematic review. Journal of Pediatric Psychology, 38(8), 809–828.

    Article  PubMed  Google Scholar 

  4. Wallander, J. L., & Varni, J. W. (1998). Effects of pediatric chronic physical disorders on child and family adjustment. Journal of Child Psychology and Psychiatry, 39(1), 29–46.

    Article  PubMed  CAS  Google Scholar 

  5. Grootenhuis, M. A., & Bronner, M. B. (2009). Paediatric illness! Family matters. Acta Paediatrica, 98(6), 940–941.

    Article  PubMed  Google Scholar 

  6. Hatzmann, J., Heymans, H. S., Carbonell, A., van Praag, B. M., & Grootenhuis, M. A. (2008). Hidden consequences of success in pediatrics: Parental health-related quality of life—results from the Care Project. Pediatrics, 122(5), e1030–e1038.

    Article  PubMed  Google Scholar 

  7. Kazak, A. E., Kassam-Adams, N., Schneider, S., Zelikovsky, N., Alderfer, M. A., & Rourke, M. (2006). An integrative model of pediatric medical traumatic stress. Journal of Pediatric Psychology, 31(4), 343–355.

    Article  PubMed  Google Scholar 

  8. Haverman, L., van Oers, H. A., Limperg, P. F., Houtzager, B. A., Huisman, J., Darlington, A. S., et al. (2013). Development and validation of the Distress Thermometer for Parents of a chronically ill child. Journal of Pediatrics, 163(4), 1140–1146.

    Article  PubMed  Google Scholar 

  9. Lovejoy, M. C., Graczyk, P. A., O’Hare, E., & Neuman, G. (2000). Maternal depression and parenting behavior: A meta-analytic review. Clinical Psychology Review, 20(5), 561–592.

    Article  PubMed  CAS  Google Scholar 

  10. Dix, T., Gershoff, E. T., Meunier, L. N., & Miller, P. C. (2004). The affective structure of supportive parenting: Depressive symptoms, immediate emotions, and child-oriented motivation. Developmental Psychology, 40(6), 1212–1227.

    Article  PubMed  Google Scholar 

  11. Bartlett, S. J., Krishnan, J. A., Riekert, K. A., Butz, A. M., Malveaux, F. J., & Rand, C. S. (2004). Maternal depressive symptoms and adherence to therapy in inner-city children with asthma. Pediatrics, 113(2), 229–237.

    Article  PubMed  Google Scholar 

  12. Feldman, J. M., Steinberg, D., Kutner, H., Eisenberg, N., Hottinger, K., Sidora-Arcoleo, K., et al. (2013). Perception of pulmonary function and asthma control: The differential role of child versus caregiver anxiety and depression. Journal of Pediatric Psychology, 38(10), 1091–1100.

  13. Barakat, L. P., Patterson, C. A., Weinberger, B. S., Simon, K., Gonzalez, E. R., & Dampier, C. (2007). A prospective study of the role of coping and family functioning in health outcomes for adolescents with sickle cell disease. Journal of Pediatric Hematology/Oncology, 29(11), 752–760.

    Article  PubMed  Google Scholar 

  14. Raina, P., O’Donnell, M., Rosenbaum, P., Brehaut, J., Walter, S. D., Russell, D., et al. (2005). The health and well-being of caregivers of children with cerebral palsy. Pediatrics, 115(6), 626–636.

    Article  Google Scholar 

  15. King, G., King, S., Rosenbaum, P., & Goffin, R. (1999). Family-centered caregiving and well-being of parents of children with disabilities: Linking process with outcome. Journal of Pediatric Psychology, 24(1), 41–53.

    Article  Google Scholar 

  16. Hatzmann, J., Maurice-Stam, H., Heymans, H. S., & Grootenhuis, M. A. (2009). A predictive model of Health Related Quality of life of parents of chronically ill children: The importance of care-dependency of their child and their support system. Health Qual Life Outcomes, 7, 72.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Bronner, M. B., Peek, N., Knoester, H., Bos, A. P., Last, B. F., & Grootenhuis, M. A. (2010). Course and predictors of posttraumatic stress disorder in parents after pediatric intensive care treatment of their child. Journal of Pediatric Psychology, 35(9), 966–974.

    Article  PubMed  Google Scholar 

  18. Manuel, J. C. (2001). Risk and resistance factors in the adaptation in mothers of children with juvenile rheumatoid arthritis. Journal of Pediatric Psychology, 26(4), 237–246.

    Article  PubMed  CAS  Google Scholar 

  19. Vermaes, I. P., Janssens, J. M., Mullaart, R. A., Vinck, A., & Gerris, J. R. (2008). Parents’ personality and parenting stress in families of children with spina bifida. Child: Care, Health and Development, 34(5), 665–674.

    CAS  Google Scholar 

  20. Yilmaz, O., Sogut, A., Gulle, S., Can, D., Ertan, P., & Yuksel, H. (2008). Sleep quality and depression-anxiety in mothers of children with two chronic respiratory diseases: Asthma and cystic fibrosis. Journal of Cystic Fibrosis, 7(6), 495–500.

    Article  PubMed  Google Scholar 

  21. Besier, T., Born, A., Henrich, G., Hinz, A., Quittner, A. L., & Goldbeck, L. (2011). Anxiety, depression, and life satisfaction in parents caring for children with cystic fibrosis. Pediatric Pulmonology, 46(7), 672–682.

    Article  PubMed  Google Scholar 

  22. Gallagher, S., Phillips, A. C., Oliver, C., & Carroll, D. (2008). Predictors of psychological morbidity in parents of children with intellectual disabilities. Journal of Pediatric Psychology, 33(10), 1129–1136.

    Article  PubMed  Google Scholar 

  23. Kashdan, T. B., Jacob, R. G., Pelham, W. E., Lang, A. R., Hoza, B., Blumenthal, J. D., et al. (2004). Depression and anxiety in parents of children with ADHD and varying levels of oppositional defiant behaviors: Modeling relationships with family functioning. Journal of Clinical Child and Adolescent Psychology, 33(1), 169–181.

    Article  PubMed  Google Scholar 

  24. Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scand, 67(6), 361–370.

    Article  CAS  Google Scholar 

  25. Spinhoven, P., Ormel, J., Sloekers, P. P., Kempen, G. I., Speckens, A. E., & Van Hemert, A. M. (1997). A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects. Psychological Medicine, 27(2), 363–370.

    Article  PubMed  CAS  Google Scholar 

  26. Vingerhoets, A. J. J. M. (2012). Normdata HADS.

  27. Abidin, R. R. (1990). Parenting stress index/short form. Lutz: Psychological Assessment Resources Inc.

    Google Scholar 

  28. Brock A. J. J. L. d., Vermulst A. A., Gerris J. R. M., Abidin R. R. (1992). NOSI: Nijmeegse ouderlijke stress index. Lisse: Swets & Zeitlinger.

  29. Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Hilldale: Lawrence Erlbaum Associates.

    Google Scholar 

  30. Helgeson, V. S., Becker, D., Escobar, O., & Siminerio, L. (2012). Families with children with diabetes: Implications of parent stress for parent and child health. Journal of Pediatric Psychology, 37(4), 467–478.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Kong, L. P., Cui, Y., Qiu, Y. F., Han, S. P., Yu, Z. B., & Guo, X. R. (2013). Anxiety and depression in parents of sick neonates: A hospital-based study. Journal of Clinical Nursing, 22(7–8), 1163–1172.

    Article  PubMed  Google Scholar 

  32. Bayat, M., Erdem, E., & Gul, K. E. (2008). Depression, anxiety, hopelessness, and social support levels of the parents of children with cancer. Journal of Pediatric Oncology Nursing, 25(5), 247–253.

    Article  PubMed  Google Scholar 

  33. Chiu, M. C., Ng, C. F., Lee, L. P., Lai, W. M., & Lau, S. C. (2007). Automated peritoneal dialysis in children and adolescents—benefits: A survey of patients and parents on health-related quality of life. Peritoneal Dialysis International, 27(Suppl 2), 138–142.

    Google Scholar 

  34. Norberg, A. L., Lindblad, F., & Boman, K. K. (2006). Support-seeking, perceived support, and anxiety in mothers and fathers after children’s cancer treatment. Psychooncology, 15(4), 335–343.

    Article  PubMed  Google Scholar 

  35. Eccleston, C., Palermo, T. M., Fisher, E. & Law, E. (2012). Psychological interventions for parents of children and adolescents with chronic illness. Cochrane Database of Systematic Reviews, 8, CD009660.

  36. Dissanayaka, N. N., O’Sullivan, J. D., Silburn, P. A., & Mellick, G. D. (2011). Assessment methods and factors associated with depression in Parkinson’s disease. Journal of the Neurological Sciences, 310(1–2), 208–210.

    Article  PubMed  Google Scholar 

  37. Field, T., Diego, M., & Hernandez-Reif, M. (2010). Prenatal depression effects and interventions: A review. Infant Behavior and Development, 33(4), 409–418.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Britton, J. R. (2008). Maternal anxiety: Course and antecedents during the early postpartum period. Depression and Anxiety, 25(9), 793–800.

    Article  PubMed  Google Scholar 

  39. Cosco, T. D., Doyle, F., Ward, M., & McGee, H. (2012). Latent structure of the Hospital Anxiety and Depression Scale: A 10-year systematic review. Journal of Psychosomatic Research, 72(3), 180–184.

    Article  PubMed  Google Scholar 

  40. Doyle, F., Cosco, T., & Conroy, R. (2012). Why the HADS is still important: Reply to Coyne & van Sonderen. Journal of Psychosomatic Research, 73(1), 74–78.

    Article  PubMed  Google Scholar 

  41. Coyne, J. C., & van Sonderen, E. (2012). No further research needed: Abandoning the Hospital and Anxiety Depression Scale (HADS). Journal of Psychosomatic Research, 72(3), 173–174.

    Article  PubMed  Google Scholar 

  42. Bjelland, I., Dahl, A. A., Haug, T. T., & Neckelmann, D. (2002). The validity of the Hospital Anxiety and Depression Scale. An updated literature review. Journal of Psychosomatic Research, 52(2), 69–77.

    Article  PubMed  Google Scholar 

  43. Kazak, A. E., Cant, M. C., Jensen, M. M., McSherry, M., Rourke, M. T., Hwang, W. T., et al. (2003). Identifying psychosocial risk indicative of subsequent resource use in families of newly diagnosed pediatric oncology patients. Journal of Clinical Oncology, 21(17), 3220–3225.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to thank all the parents and patient associations who participated in this study. In addition, we wish to thank Biomedia/Artsen voor kinderen for the web design. Furthermore, we would like to thank Carline Tacke, Hennie Knoester, Lûte Kaales and Sophia Barrow for their support during the data collection. Finally, we would like to thank Ad Vingerhoets for providing the HADS reference group.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to H. A. van Oers.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

van Oers, H.A., Haverman, L., Limperg, P.F. et al. Anxiety and Depression in Mothers and Fathers of a Chronically Ill Child. Matern Child Health J 18, 1993–2002 (2014). https://doi.org/10.1007/s10995-014-1445-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-014-1445-8

Keywords

Navigation