Associations between early exposure to intimate partner violence, parental depression and subsequent mental health outcomes

Abstract

Objective: To examine the association between parent reports of intimate partner violence (IPV) and depressive symptoms within the first 3 years of a child’s life with subsequent mental health conditions and psychotropic drug treatment. Design: Prospective cohort study linking parental IPV and depression with subsequent billing and pharmacy data. Setting: 4 pediatric clinics between November 2004 and June 2012 Patients/Participants: 2,422 children Main Exposure: Any report of IPV and/or parental depressive symptoms from birth to 3 years of age. Main Outcome Measures: ICD-9 mental health diagnoses and any psychotropic drug treatment between 3 and 6 years of age. Results: 2.4% of caregivers (n=58) reported both IPV and depressive symptoms before their children were 3 years of age, 3% (n=69) of caregivers reported IPV only, 29% (n=704) reported depressive symptoms only, and 65.7% (n=1,591) reported neither exposure. Children of parents reporting both IPV and depressive symptoms were more likely to have a diagnosis of attention deficit hyperactivity disorder (ADHD) (AOR 4.0; 95% CI: 1.5-10.9), even after adjusting for child gender, race/ethnicity, and insurance type. Children whose parents reported depressive symptoms were more likely to have been prescribed psychotropic medication (AOR 1.9; 95% CI: 1.0-3.4). Conclusions: Exposure to both IPV and depression before 3 years is associated with preschool onset ADHD; and early exposure to parental depression is associated with being prescribed psychotropic medication.