Open Access Research article

Parental depression and child conduct problems: evaluation of parental service use and associated costs after attending the Incredible Years Basic Parenting Programme

Joanna M Charles1*, Tracey J Bywater2, Rhiannon Tudor Edwards1, Judy Hutchings3 and Lu Zou4

Author Affiliations

1 Centre for Health Economics and Medicines Evaluation (CHEME), Institute of Medical and Social Care Research, Bangor University, Dean Street Building, LL57 1UT Bangor, Gwynedd, UK

2 Institute for Effective Education, University of York, Heslington, York, UK

3 School of Psychology, Bangor University, Bangor, Gwynedd, UK

4 Biostatistician at Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK

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BMC Health Services Research 2013, 13:523  doi:10.1186/1472-6963-13-523

Published: 18 December 2013



There is co-morbidity between parental depression and childhood conduct disorder. The Incredible Years (IY) parenting programmes reduce both conduct disorder in children and depression in their parents. Recent U.K. and Ireland trials of the effectiveness and cost-effectiveness of IY parenting programmes have assessed children’s health and social care service use, but little is known about the programme’s impact on parental service use. This paper explores whether an above clinical cut-off score on the Beck Depression Inventory II (BDI II) is associated with high or low parental health and social care service use in high-risk families receiving the IY Basic Programme.


This is a secondary analysis of a subsample (N = 119) from the first U.K. community-based randomised controlled trial of the 12-week IY Basic Programme (N = 153). Parents with children at risk of developing conduct disorder were randomised to receive the programme or to a waiting-list control group. BDI II total and BDI II clinical depression cut-off scores were compared to frequencies and costs of parents’ service use, at baseline, six, twelve and eighteen months post-baseline for the intervention group and at baseline and six months post-baseline for the control group.


Intervention group parents who scored above the clinical cut-off on the BDI II at baseline used more health and social care services than those who scored below at baseline, six and eighteen months. Significant reductions in service use frequencies were found for the intervention group only.


Parents with higher levels or depression used more health and social care service and parenting programmes have been shown to reduce parental depression and also health and social service use. However, further exploration of depressed parents’ service use and the cost implications for publically funded health and social care services is needed.

Trial registration

Registration of the original RCT of the IY Basic Parenting Programme - Current Controlled Trials ISRCTN46984318

Parenting; Depression; Service use; Health economics; Child conduct problems