Family Practice ©Oxford University Press 1990 Vol. 7, No. 2 Printed in Great Britain Psychological Health Status of Mothers and the Admission of Children to Hospital for Gastroenteritis MICHAEL FITZGERALD* AND HANNAH M MCGEE" Fitzgerald M and McGee H. Psychological health status of mothers and the admission of children to hos- pital for gastroenteritis. Family Practice 1990; 7: 116-120. The prevalence of psychological distress was measured by the 30-item general health questionnaire in two populations of mothers: those who had children hospitalized for gastroenteritis and those who cared for children with gastroenteritis at home. Significant differences emerged, with mothers of hospi- talized children reporting higher levels of psychological distress. There were no differences in severity of the children's illness between the two groups as indicated by blind ratings of symptomatology from six infectious diseases hospital doctors. Thus hospitalization of children for gastroenteritis was not con- tingent on medical symptomatology. Instead the evidence indicates that the psychological status of mothers may influence doctors' management decisions on childhood gastroenteritis. Significant posi- tive associations between poor psychological status and poor social resources illustrate the social con- text in which maternal vulnerability may influence child health care generally. The impact of maternal psychological status on decisions about paediatric care is discussed. Long or repeated admissions of children to hospital has been shown to be associated with increased rates of psychiatric disturbance in later childhood and ado- lescence. 1 - 2 It has been estimated that 4.3% of the child population experiences multiple hospitalization and 40% of children with repeated hospitalization show disturbed behaviour in late childhood. 2 Thus some 1.7% of the total child population show disturbances which have arisen from repeated admissions to hospi- tal. Gastroenteritis is one relatively minor childhood problem resulting in many hospitalizations. In a longi- tudinal national study of over 13 000 British children in the early 1970s, 2.7% were admitted to hospital for gastroenteritis at least once in their first five years; 1.5% in the first year alone. 3 Maternal psychological health status has been shown to be related to the health of children; for instance poor psychological health is associated with increased numbers of accidents to children; the ratio being 2.2:1 for mothers in the lower social classes and 5:1 for the middle classes. 4 Children of women using psychotropic medication have twice the average con- sultation rate for respiratory illness at general prac- • Chil d and Family Centre, Ballyfermot, Dublin 10, Ireland. "Department of Psychology, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland. tice. 5 Mothers are also more likely to bring a child to a child guidance clinic if they themselves are depressed. 6 Furthermore it has been shown that poor mental health is associated with the nurturant role that women occupy in their care of small children; 7 mothers with small children to look after are more likely to be depressed than those without. The lack of a confidant has also been shown to be associated with increasing levels of depression in mothers. 8 Finally, mothers with recurrent or chronic depressive disorder tend to be less appropriately responsive to their children, less likely to sustain positive interaction, less able to put their chil- dren's experiences into a personal context and more often involved in unsuccessful attempts to control their children. 910 The present study is part of a larger investigation designed to evaluate factors influencing the hospital- ization or non-hospitalization of children for gastro- enteritis. The study examined various non-medical reasons for the differential treatment of two groups of children with gastroenteritis." As part of this examin- ation the psychological health status of mothers was investigated. It was hypothesized that mothers having a child admitted to hospital would show significantly higher levels of psychological distress on the general health questionnaire (GHQ) 12 than would mothers managing their children at home. 116