A subsample of one such survey specifically identified the parental status of these adults. Parents (with at least one child under age 18) have similar rates of depression compared to the entire U.S. adult population, including similar disparities in depression rates for selected population characteristics such as sex, age, and marital status. In general, social disadvantage has been positively associated with higher prevalence rates of depression in adults except in the case of newly arrived immigrants. Further, a majority of individuals with major depression also had at least one additional mental health or substance abuse diagnosis. Thus, comorbidity between mental disorders tends to be the norm rather than the exception.

Depression, due to its recurrent nature, leads to sustained individual, family, and societal costs. Furthermore, depression in parents or other caregivers can have serious biological, psychological, behavioral, and social consequences especially for children. More longitudinal and cross-sectional data are needed to further document and clarify the prevalence, incidence, disparities, causes, and consequences of depression in adults who are parents. Individual-, provider-, and system-level barriers exist that decrease the access to and quality of care for depressed adults. These institutional and sociocultural barriers are responsible for causing and maintaining existing disparities. Without a system of care that supports a family’s environment, economic resources and relationships with family, coworkers, the community, and society, such disparities may increase.

Ultimately depression is a good and effectively identified indicator of a problem that could trigger a system of care (if it is in place) that intervenes not only by treating depression in the parent but also by enhancing parenting skills and alleviating other stresses, co-occurring conditions, and social contexts, as well as identifying children at risk.

ORGANIZATION OF THE REPORT

Following this introduction, Chapter 2 describes new approaches to tackling parental depression as well as issues and standards in evaluating this literature. Chapter 3 reviews the causes of depression, and Chapter 4 reviews the effects of depression on parenting and child health and psychological functioning. Chapter 5 reviews strategies to identify and assess depression, and Chapter 6 reviews strategies for the treatment of depression in parents and their families. Chapter 7 reviews strategies for preventing depression in parents, with a special emphasis on the prevention or reduction of adverse outcomes in children of parents who are depressed. Chapter 8 describes an ideal vision of a depression care intervention system, highlighting important components of this system that are emerging in selected service settings as well as through state and European initiatives, and reviewing federal-level initiatives that have supported this knowledge



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