Maternal somatic symptoms, psychosocial correlates, and subsequent pediatric emergency department use

Somatization is associated with increased health care use in adults. Whether mothers with somatic symptoms use more health care resources for their children has not been investigated.

This study aimed to explore the association of maternal somatic symptoms and emergency department (ED) use.

Mothers from a cohort of 319 mother-child dyads were screened for somatic symptoms using the Patient Health Questionnaire 15. Dyads were followed up for 3 years after the initial ED visit to record ED use. The outcome variable was ED use (lower ED use, 0-3 visits, higher ED use, 4+ visits). The primary independent variable was somatization, with a dichotomous variable analyzing the Patient Health Questionnaire 15 symptom count of less than 7 symptoms (lower somatization) and 7 or more symptoms (higher somatization [HISOM]). Secondary independent variables included demographic data, maternal major depression, and maternal difficulty in taking care of the child or themselves. Statistical analysis included bivariate and multivariate analyses.

Mothers with HISOM symptoms did not demonstrate an increased use of the ED in bivariate analysis. Higher somatization mothers did show an increased (1) endorsement of maternal major depression symptoms and (2) maternal perception of difficulty in taking care of the child and themselves. When adjusted for these and other covariates, HISOM mothers were more likely to be in the higher ED use group (1.83; 95% confidence interval, 0.99-3.38) P = 0.055).

Mothers with higher somatic symptom loads were more likely to screen positive for depression and to report difficulty caring for their child and for themselves. A trend toward higher use of the pediatric ED warrants further study.