Depressive Symptoms in Parents of Children With Chronic Health Conditions

A Meta-analysis

Martin Pinquart, PHD

Disclosures

J Pediatr Psychol. 2019;44(2):139-149. 

In This Article

Limitations

Some limitations specific to the present study have to be mentioned. First, only a few studies were available for some chronic conditions, such as allergies and HIV infection/AIDS, and we were also not able to compute effect sizes for some chronic conditions, such as chronic fatigue syndrome. Second, as only 2.6% of the included studies provided rates of clinical depression, the pooled rates are less robust than the pooled estimates of elevated depressive symptoms. Third, fathers were underrepresented in most included studies. Fourth, as most data reflect a concurrent relationship between the child's chronic condition and parental depression, our data do not allow for testing causal relationships. Although there are good arguments for the suggestion that a child's chronic condition leads to greater parental depressive symptoms, parental depression can also have an effect on the course of a child's condition, for example when depression interferes with effective disease management (Eckshtain et al., 2010; Otsuki et al., 2010). When compared with matched controls, Enns et al. (2016) found elevated rates of parental depressive disorders in the 2 years before their child was burned, which may indicate that depressed parents did less to prevent the burn injury. Fifth, we could not test for moderator effects of severity and prognosis of the chronic condition, or parental psychological vulnerability (e.g., as indicated by psychological symptoms before the onset of the chronic condition of the child), because studies usually did not provide separate results for groups with different levels of these variables. Finally, we only assessed one domain of psychological symptoms. Anxiety and other symptoms have to be addressed in future meta-analyses.

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