Sir,
I read carefully the article by Nagarkar et al.[1] in April–June 2014 issue of this journal which focuses on the prevalence of depression in mothers of the mentally retarded patients. I would like to acknowledge authors for evaluation of such largely unexplored area, especially in the Indian subcontinent in well-conceptualized manner. However, I would like to highlight certain issues which are as follows:
Lack of control population: Although it is very much logical to have depression in mothers of mentally retarded patients considering issues attributable to mental retardation, the lack of control populations deter us from concluding to what extent such contributions are responsible in the development of depression in mothers
Poor socioeconomic status: In the study, authors reported vast majority (67%) of mothers belong to poor socioeconomic group and family income <Rs. 5000/month. A systematic review by Patel and Kleinman[2] of common mental disorders in developing countries found strong relationships between the prevalence of common mental disorders and indicators of poverty including low educational levels, low income, lack of material possessions, lack of employment, and housing difficulties. Therefore, it would be very difficult to conclude how much these factors are contributing to the development of depression in mothers of mentally retarded patients other than experiencing distress due to irreversibility of the intellectual disability, social stigma, anticipation of future, and caring demand
Age of mothers: The authors have not mentioned about the age of mothers. This is important, especially in depression in women due to biologic factors, such hormonal fluctuations during menopausal transition may lead to common mental disorders. Review of longitudinal studies have demonstrated an association between the menopause transition and an increase in depressive symptoms.[3]
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
REFERENCES
- 1.Nagarkar A, Sharma JP, Tandon SK, Goutam P. The clinical profile of mentally retarded children in India and prevalence of depression in mothers of the mentally retarded. Indian J Psychiatry. 2014;56:165–70. doi: 10.4103/0019-5545.130500. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Patel V, Kleinman A. Poverty and common mental disorders in developing countries. Bull World Health Organ. 2003;81:609–15. [PMC free article] [PubMed] [Google Scholar]
- 3.Vivian-Taylor J, Hickey M. Menopause and depression: Is there a link? Maturitas. 2014;79:142–6. doi: 10.1016/j.maturitas.2014.05.014. [DOI] [PubMed] [Google Scholar]