Gender differences in the risk of depressive disorders following the loss of a young child: a nationwide population-based longitudinal study

Table 2 Child loss in relation to subsequent treatment of major depressive disorders in mothers (N = 19,499)

			Crude HR	P-value	Model I^a		Model II^a
Variables	n	%	Crude HR	P-value	aHR	95% CI	aHR	95% CI
Children’s characteristics
Death
Yes	2987	15.32	6.54	< 0.001	6.06^***	4.47–8.21	4.71^***	3.35–6.64
No	16,512	84.68	1.00		1.00		1.00
Diagnosis of catastrophic illness
One year or more	1198	6.14	4.86	< 0.001	1.32	0.93–1.87	1.17	0.80–1.73
Less than one year	576	2.95	2.72	< 0.001	0.77	0.44–1.34	0.58	0.30–1.10
No	17,725	90.90	1.00		1.00		1.00
Family characteristics
Income level^b
High	5708	29.27	1.00		1.00		1.00
Medium	9605	49.26	1.43	0.025	1.21	0.88–1.67	1.40	0.98–2.00
Poverty	3686	18.90	2.32	< 0.001	1.30	0.91–1.88	1.20	0.80–1.81
Urbanization^b
Urban	5655	29.00	1.00		1.00		1.00
Suburban	12,124	62.18	1.31	0.068	1.33	0.99–1.78	1.36	0.99–1.88
Rural	1444	7.41	1.62	0.042	1.50	0.94–2.41	1.61	0.94–2.75
Linkage with father in health insurance
Yes	12,105	62.08	1.00		1.00		1.00
No	7394	37.92	1.33	0.021	1.00	0.77–1.29	0.98	0.70–1.36
Maternal characteristics
Age at child’s death
< 35 years	11,300	57.95	1.00				1.00
≥ 35 years	8199	42.05	1.35	0.018			1.26	0.94–1.69
Premium payer (mother)^c
Yes	12,386	63.52	1.00				1.00
No	6753	34.63	1.14	0.293			1.34	0.97–1.86
Depression disorders^d
Yes	165	0.85	65.1	< 0.001			39.2^***	26.6–57.8
No	19,334	99.15	1.00				1.00
Chronic physical condition^e
Yes	2935	15.05	8.15	< 0.001			3.72^***	2.80–4.94
No	16,564	84.95	1.00				1.00

^a Model I adjusted for children’s listed characteristics, gender, and age; Model II adjusted for children’s and maternal characteristics; ^***P < 0.001; ^**P < 0.01; ^*P < 0.05
^b Within the year before the index child’s death
^c “No” refers to health insurance covered by the father, children themselves, and grandparents
^d Depressive disorder (ICD-9-CM codes: 296.2X, 296.3X, 300.4X, and 311) is confirmed by receiving a diagnosis by a psychiatrist in (i) two or more outpatient services or (ii) one inpatient service within three years before the index child’s death
^e Chronic physical condition — including malignant neoplasms, chronic liver disease and cirrhosis, heart disease, cerebrovascular disease, diabetes, hypertensive disease, bronchitis, emphysema, asthma, and atherosclerosis — were obtained from the three-year reimbursement records prior to the index child’s death

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