January 15, 2016
Purpose: We address the significant gaps in knowledge of
prevalence and correlates of child mental health (CMH) problems outside of high
income countries. We describe the prevalence of CMH problems and their
correlates with a focus on the association with maternal depression in a sample
of seven-year-old children in rural Pakistan.
Methods: This study was nested in a long-term follow-up of a
perinatal depression intervention together with a reference group of
non-depressed women, yielding a population representative sample. The Total
Difficulties (TD) and component scores of the Strength and Difficulties
Questionnaire (SDQ) were used to measure emotional and behavioral difficulties.
Results: The mean SDQ TD score was 10.6 (standard deviation
= 8.3), with 12.5 % of children categorized as “abnormal” using standard
cutoffs. Boys had a roughly 1 point higher (worse) SDQ TD score than girls (p
value = 0.04). Children of mothers who were depressed prenatally as well as
currently had SDQ TD scores 2.87 points higher than children whose mothers were
not depressed at either time point (p value < 0.01). This association was
stronger for boys. There was no evidence of elevated SDQ TD score among
children whose mothers were depressed only prenatally or only currently. Some
deviations from this pattern were observed with specific components of the SDQ.
Conclusions: In this low resource, South Asian setting, we
found evidence of elevated levels of emotional and behavioral problems,
highlighting the need for effective interventions. Given the strong association
of CMH with maternal depression, any intervention efforts should give strong
consideration to maternal mental health.
Social Psychiatry and Psychiatric Epidemiology
Volume and page numbers
Volume: 51 , p.49 -62