6.162 CHILD PSYCHOPATHOLOGY AFTER TREATMENT OF MATERNAL DEPRESSION IN PRIMARY CARE IN BRAZIL

Objectives: The presence of psychopathology in children of depressed mothers is a consistent finding. This underscores the potential of treating maternal depressive symptoms as a high impact intervention if it can be widely delivered, however, this assumption has not been tested in a low-middle- income (LMIC) setting. Using a randomized clinical trial design, we sought to determine whether treatment for maternal depression in primary care in Brazil would decrease psychiatric symptoms in their child. Methods: Mothers with depression (N=45), assessed with the Hamilton Rating Scale for Depression (HRSD), were part of a randomized, doubleblinded 3-week treatment comparing interpersonal counseling (IPC) with enhanced treatment as usual in a low-income primary care setting. Depressed mothers and their children (N=60; ages 6-14 years) presenting psychiatric symptoms were assessed with the Child Behavior Checklist preintervention, post-intervention and 6-month follow-up. Child outcomes were evaluated by type of change in maternal depressive symptoms: remission was defined as an HRSD score of 7 or less and response was defined as a 50% or greater reduction of the baseline HRSD score. Results: An overall decrease in depressive symptoms from baseline to 6- month follow-up was found in mothers (mean HRSD score pre/post-treatment:17.2 SD=5.84; 12.5 SD=8.03). Remission of maternal depression was associated with improvement (p=0.03) in child psychiatric symptoms at the 6-month follow-up compared to non-remission group. This association remained statistically significant in a linear regression adjusted for other variables (p=.007). Maternal response was also significantly correlated to a decrease in child psychopathology (p=.01). Importantly, among children whose mothers increased their symptoms at 6-month follow-up, an increase in the rates of psychiatric symptoms was observed. Conclusions: Maternal remission and response to depression treatment is related to a decrease in psychiatric symptoms in their child. This was true when mothers were treated by a brief intervention in a LMIC in primary care. Our results suggest that treating maternal depression in primary care is a viable strategy to improve access to mental health care with impact for the prevention of psychiatric disorders in the next generation.