Academic journal article East Asian Archives of Psychiatry

Prevalence of Maternal Affective Disorders in Chinese Mothers of Preschool Children with Autism Spectrum Disorders

Academic journal article East Asian Archives of Psychiatry

Prevalence of Maternal Affective Disorders in Chinese Mothers of Preschool Children with Autism Spectrum Disorders

Article excerpt


Autism spectrum disorders (ASD) are lifelong neurodevelopmental disabilities characterised by impairment in reciprocal social interactions and communication, as well as stereotypical behaviour. Mothers raising young children with ASD face unique caregiving challenges due to difficulties in the daily management of the child's behavioural and emotional symptoms, and the burden of coordinating various specialised services. (1) According to the international literature, parents of autistic children consistently report an increased level of parenting stress and a higher rate of affective symptoms. Compared with parents of typically developing children and those with other physical disabilities, a higher prevalence of psychiatric disorders, particularly depressive and anxiety disorders among parents of autistic individuals is consistently reported in the Caucasian population. (2,3) Nonetheless, local research in Chinese families is scarce.

The association between maternal depression and adverse child outcomes is well established in the literature. Children's exposure to chronic maternal depression is associated with more cognitive and emotional problems for children since depression interferes with a mother's ability to respond sensitively and consistently over time. (4,5) Inconsistent maternal emotional responsiveness resulting from maternal depression may affect the fostering of a secure attachment in the mother-child dyadic interaction. Moreover, maternal psychological distress has been shown to be associated with non-compliance with both clinic-based and parent-mediated early intervention programmes for autistic preschoolers. (6) Maternal depression has also been shown to be associated with higher rates of child abuse and neglect. (7) Thus, providing early detection and timely treatment to depressed mothers is of paramount importance for improving the overall illness outcome for both the child and the mother.

In view of limited local research in this area and the clinical importance of maternal affective disorders, the current study aimed to evaluate the prevalence of affective disorders among mothers of preschool children diagnosed with ASD in Hong Kong and to identity their associated factors.


Study Design

This was a cross-sectional descriptive study conducted in the ASD multidisciplinary clinic at the United Christian Hospital (UCH) of the Hospital Authority in Hong Kong. This clinic acts as a tertiary psychiatric centre for the assessment and management of preschool children in the Kowloon East Cluster who present with autistic features. Study approval was obtained from the Research Ethics Committee of the Hospital Authority.

Study Population

All consecutive first-appointment patients at the ASD Multidisciplinary Clinic of UCH from August 2012 to June 2013 were screened. Patients diagnosed with ASD were identified and their mothers were invited to participate in this study. Diagnosis of ASD was made by a specialist psychiatrist according to the DSM-IV criteria. Subjects were excluded if they were non-Chinese, unable to comprehend Chinese language, or had significant cognitive impairment or communication difficulties.


The authors attended the ASD Multidisciplinary Clinic over the study period. All patients and their mothers were approached by and screened for eligibility. All participants completed the following self-rated questionnaires, including: (1) Developmental Behaviour Checklist, Primary Carer Version (DBC-P); (2) Chinese Ways of Coping Questionnaire (CWCQ); and (3) 22-item Affiliate Stigma Scale. The authors then interviewed all subjects using the Chinese-Bilingual Structured Clinical Interview for DSM-IV Axis I Disorders (CB-SCID-I/P), and psychiatric diagnoses, if any, were ascertained.

Data Analysis

The Statistical Package for the Social Sciences, Windows version 19 (SPSS Inc. …

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