Depression in Parents of Children Diagnosed with Autism Spectrum Disorder

Background:  Raising a child with autism spectrum disorder (ASD) can be challenging for many parents and may potentially have an impact on their personal health. The challenges in identifying, accessing, and paying for ASD services, given the nature of these children’s needs, available resources, and complex financing arrangements, can place a substantial burden on caregivers. Previous studies have examined how ASD in children can affect parents’ health, but they are limited by small sample sizes and patient self-report.

Objectives:  The objective of this study was to determine whether there is an association between having a child with ASD and diagnosis of depression in the child’s mother and/or father.  We also determined whether the age of the child, as well as the number of children in the family, was associated with a diagnosis of depression in the parents.

Methods:  Retrospective analysis of health insurance claims data from the 2011 MarketScan database was performed.  ICD-9 codes were used to determine a primary or secondary diagnosis of ASD in children ages 0-17 and a diagnosis of depression in the parents of those children.  Rates of parental depression among children with ASD were compared to those of an age and gender matched control group of children without ASD. Chi-square and logistic regression analyses were performed to determine the association of having a child with ASD on parental depression, controlling for child and parent characteristics.

Results:  There were 42,662 case-control dyads, resulting in 85,324 unique families.  Among all families, 12,237 (14.3%) had at least one parent with a diagnosis of depression.  A diagnosis of depression was more than twice as common in parents of children with ASD (20.2%) than in parents who did not have a child with ASD (8.5%).  After controlling for other child, parent, and family characteristics, having a child with ASD almost tripled the odds (OR: 2.83; 95% CI: 2.71-2.96) of parental depression.  Mothers of children with ASD were 3 times more likely to have a diagnosis of depression than mothers of children without ASD (OR: 3.01; 95% CI: 2.86-3.17), and fathers of children with ASD were 2.4 times more likely to have a diagnosis of depression than fathers of children that did not have ASD (OR: 2.44; 95% CI 2.27-2.62). In addition, risk of depression increased when there was more than one child with ASD in the family (OR: 1.42; 95% CI: 1.27-1.60) and with child age.

Conclusions:  Both mothers and fathers of children with ASD were at increased risk of having depression than parents of children without ASD. Furthermore, the risk of depression increased if the parents had more than one child with ASD and with child age.  Support and education should therefore be provided to both mothers and fathers of children with ASD.