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Depressive Symptoms in Mothers of Infants Identified as Genetically at Risk for Type 1 Diabetes

¹ Pediatric and Adolescent Unit, Genetics and Epidemiology Section, Behavioral Research and Mental Health Section, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts
² Department of Medical Humanities and Social Sciences, College of Medicine, Florida State University, Tallahassee, Florida
³ Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta, Georgia
⁴ Department of Pediatrics, College of Medicine, University of Florida, Gainesville, Florida

Address correspondence and reprint requests to Korey K. Hood, PhD, Pediatric & Adolescent Unit, Joslin Diabetes Center, One Joslin Place, Boston, MA 02115. E-mail: korey.hood{at}joslin.harvard.edu

OBJECTIVE—This study describes maternal depression associated with newborn genetic screening for type 1 diabetes after risk notification.

RESEARCH DESIGN AND METHODS—Mothers of at-risk infants (n = 192), identified through newborn genetic screening as part of the Prospective Assessment of Newborns for Diabetes Autoimmunity study, were administered a structured telephone interview assessing maternal depressive symptoms 1 and 3.5 months after risk notification. Statistical analyses were conducted to examine predictors and correlates of maternal depressive symptoms.

RESULTS—For the total sample, maternal depressive symptoms in response to infant risk status were not elevated at 1 and 3.5 months after risk notification. However, at the first interview, mothers from ethnic minority backgrounds (P < 0.002), with limited education (P < 0.001), and with postpartum depression symptomatology (P < 0.001) reported significantly more depressive symptoms in response to risk notification (r² = 0.354). At the second interview, postpartum depression symptomatology remained a powerful predictor of depressive symptoms in response to risk notification (P < 0.001). In addition, certain coping styles (wishful thinking, self-blame, and seeking social support) were associated with increased depressive symptoms. A history of major depression was a correlate of both postpartum depressive symptomatology (r = 0.26) and maternal depressive response to risk notification (r = 0.21).

CONCLUSIONS—For the most part, mothers of infants genetically at risk for type 1 diabetes do not appear to evidence elevated depressive symptoms. This suggests that most mothers are resilient when notified of infant risk. However, certain maternal characteristics such as ethnic minority status, less than a high school education, postpartum depression symptomatology, a history of major depression, and certain coping strategies (wishful thinking, self-blame, and seeking social support) appear to be associated with a more difficult maternal response to the news of an infant’s increased genetic risk for type 1 diabetes.

Abbreviations: CES-D, Center for Epidemiologic Studies–Depression Scale • EPDS, Edinburgh Postnatal Depression Scale • NMIHS, National Maternal and Infant Health Survey • PANDA, Prospective Assessment of Newborns for Diabetes Autoimmunity • SCID, Structured Clinical Interview for DSM-IV Axis I Disorders • WCC, Ways of Coping Checklist

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