Prevalence of Major Depressive Disorder among Mothers of Children and Adolescents with Attention Deficit Hyperactivity Disorder Attending a Tertiary Care Centre
Keywords:
Attention Deficit Hyperactivity Disorder; Major Depressive Disorder, Scholastic performance, Sociodemographic and clinical variables
Abstract
Abstract
Introduction : Attention deficit hyperactivity disorder (ADHD) accounts for the majority of referrals to child and adolescent psychiatry services because of the associated poor scholastic performance. Despite the possibility of depressive symptoms in caregivers, there is a paucity of studies on major depressive disorder among mothers of children and adolescents with ADHD in our setting
Objectives : Assessing the prevalence of major depressive disorder and the association of sociodemographic and clinical variables among mothers of children & adolescents with ADHD attending a tertiary care centre.
Studying the correlation between the severity of ADHD and maternal depression.
Methods: Cross-sectional study on 150 mothers of children and adolescents aged 5-18 years with ADHD attending the Child and Adolescent Psychiatry Clinic of the Govt. Medical College, Thiruvananthapuram.
Results : The prevalence of Major Depressive Disorder among mothers belonging to the age group of 30‒39 years was found to be 20%. Across age groups, 28.7% of the subjects had minimal depressive symptoms, while 10% each had mild and moderate symptoms. We found a positive correlation between the severity of maternal depression and the child’s ADHD. The association of major depressive disorder with medical comorbidities and having another offspring with ADHD was statistically significant.
Conclusion: Owing to the statistically high prevalence of depressive disorders, routine screening for the depressive symptoms has to be considered for mothers when the children are diagnosed with ADHD, with the provision for appropriate intervention.
Keywords: Attention Deficit Hyperactivity Disorder; Major Depressive Disorder, Scholastic performance, Sociodemographic and clinical variables,
Downloads
Download data is not yet available.
References
1. Tasman A, Kay J, Lieberman JA, First MB, Riba MB. Psychiatry. 4th ed. John Wiley & Sons, Ltd; 2015
2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Association; 2013.
3. Kessler RC, Adler L, Barkley R, Biederman J, Conners CK, Demler O, Faraone SV, Greenhill LL, Howes MJ, Secnik K, Spencer T, Ustun TB, Walters EE, Zaslavsky AM. The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. Am J Psychiatry. 2006 Apr;163(4):716-23.
4. Willcutt EG. The prevalence of DSM-IV attention-deficit/hyperactivity disorder: a meta-analytic review. Neurotherapeutics. 2012 Jul;9(3):490-9.
5. Spencer TJ, Biederman J, Mick E. Attention-deficit/hyperactivity disorder: diagnosis, lifespan, comorbidities, and neurobiology. J Pediatr Psychol. 2007 Jul;32(6):631-42.
6. Biederman J, Faraone SV, Spencer TJ, Mick E, Monuteaux MC, Aleardi M. Functional impairments in adults with self-reports of diagnosed ADHD: A controlled study of 1001 adults in the community. J Clin Psychiatry. 2006 Apr;67(4):524-40.
7. Flick GL. Power Parenting for Children with ADD/ADHD: A Practical Parent’s Guide for Managing Difficult Behaviours. The Center for Applied Research in Education, New York.
8. Chen WL, Tsai ST, Chou FH. [Depression and related factors in mothers of school-aged children with attention-deficit hyperactivity disorder]. Hu Li Za Zhi. 2015 Feb;62(1):39-49.
9. McCormick LH. Depression in mothers of children with attention deficit hyperactivity disorder. Fam Med. 1995 Mar;27(3):176-9.
10. Soltanifar A, Moharreri F, Soltanifar A. Depressive and anxiety symptoms in mothers of children with Attention Deficit Hyperactivity Disorder compared to a control group. 2009. 4:112-115
11. World Health Organisation. The International Classification of Diseases - 10 Classification of Mental and Behavioural Disorders: Clinical descriptions and diagnostic guideline. Geneva. 1992.
12. World Health Organisation. Depression and other common mental disorders: Global health estimates. Geneva. 2017.
13. Murthy RS. National Mental Health Survey of India 2015-2016. Indian J Psychiatry. 2017 Jan-Mar; 59(1):21-26.
14. Shidhaye R, Gangale S, Patel V. Prevalence and treatment coverage for depression: a population-based survey in Vidarbha, India. Soc Psychiatry Psychiatr Epidemiol. 2016 Jul;51(7):993-1003.
15. Rathode et al. Treatment contact coverage for probable depressive and probable alcohol use disorders in four low- and middle- income country districts: The PRIME cross-sectional community surveys. PLoS ONE. 11(9): e0162038.
16. Iyer RS, Rekha M, Kumar TS, Sarma PS, Radhakrishnan K. Primary care doctors' management behavior with respect to epilepsy in Kerala, southern India. Epilepsy Behav. 2011 Jun; 21(2):137-42.
17. D'Costa G, Nazareth I, Naik D, Vaidya R, Levy G, Patel V, King M. Harmful alcohol use in Goa, India, and its associations with violence: a study in primary care. Alcohol Alcohol. 2007 Mar-Apr;42(2):131-7.
18. Musa RB & Shafiee Z. Depressive, anxiety and stress levels among mothers of ADHD children and their relationships to ADHD symptoms; ASEAN Journal of Psychiatry 2007:8 (1):20-28.
19. Chen VC, Yeh CJ, Lee TC, Chou JY, Shao WC, Shih DH, Chen CI, Lee PC. Symptoms of attention deficit hyperactivity disorder and quality of life of mothers of school-aged children: the roles of child, mother, and family variables. Kaohsiung J Med Sci. 2014 Dec; 30(12):631-8.
20. Segenreich D, Fortes D, Coutinho G, Pastura G, Mattos P. Anxiety and depression in parents of a Brazilian non-clinical sample of attention-deficit/ hyperactivity disorder (ADHD) students. Braz J Med Biol Res. 2009. May;42(5):465-9.
21. Harrison C, Sofronoff K. Attention Deficit Hyperactivity Disorder and parental psychological distress: Role of demographics, child behavioural characteristics and parental cognition. J Am Acad Child Adolesc. Psychiatry. 2002; 41(6):703-711
22. Shafaat A, Tirgari A. Prevalence of depression symptoms among mothers of children with Attention Deficit Hyperactivity Disorder. J Mazand Univ Med Sci. 2012; 22(supple 1):66-72
23. Bawalsah J. Levels of depression in parents of children with Attention Deficit Hyperactivity Disorder in Jordan. International Journal of Adult and Non-formal Education. Apr 2014; 2(2):031-042
24. Brown RT, Pacini JN. Perceived family functioning, marital status, and depression in parents of boys with attention deficit disorder. J Learn Disabil. 1989 Nov;22(9):581-7.
25. Khademloo M, Ahmadi M, Bagheri N. Mental health and resilience among mothers of children with ADHD and mothers of normal children: A causal-comparative study. American Journal od Paediatrics. 2016; 2(6):23-28
26. Breen MJ, Barkley RA. Child psychopathology and parenting stress in girls and boys having attention deficit disorder with hyperactivity. J Pediatr Psychol. 1988 Jun;13(2):265-80.
27. Befera MS, Barkley RA. Hyperactive and normal girls and boys: mother-child interaction, parent psychiatric status and child psychopathology. J Child Psychol Psychiatry. 1985 May;26(3):439-52.
28. Narkunam N, Hashim AH, Sachdev MK, Pillai SK, Ng CG. Stress among parents of children with attention deficit hyperactivity disorder, a Malaysian experience. Asia Pac Psychiatry. 2014 Jun;6(2):207-16.
29. Yousefia S, Far AS, Abdolahian E. Parenting stress and parenting styles in mothers of ADHD with mothers of normal children. Procedia – Social and Behavioural Sciences. 2011; 30:1666-1671.
30. Sethi S, Gandhi R, Anand V. Study of level of stress in the parents of children with Attention-Deficit/ Hyperactivity Disorder. J Indian Assoc Child Adolesc Mental Health. 2012; 8(2):25-37.
31. Anastopoulos AD, Guevremont DC, Shelton TL, DuPaul GJ. Parenting stress among families of children with attention deficit hyperactivity disorder. J Abnorm Child Psychol. 1992 Oct;20(5):503-20.
32. Peters K, Jackson D. Mothers' experiences of parenting a child with attention deficit hyperactivity disorder. J Adv Nurs. 2009 Jan;65(1):62-71.
33. Barkley et al. Adolescents with Attention Deficit Hyperactivity Disorder: mother-adolescent interactions, family beliefs and conflicts and maternal psychopathology. Journal of Abnormal Child Psychology. 1992; 20(3).
34. Chronis et al. Maternal depression and early positive parenting predict future conduct problems in young children with Attention-Deficit/ Hyperactivity Disorder. Devlop. Psychology. 2007; 43(1):70-82.
35. Nicholson JS, Deboeck PR, Farris JR, Boker SM, Borkowski JG. Maternal depressive symptomatology and child behavior: transactional relationship with simultaneous bidirectional coupling. Dev Psychol. 2011 Sep; 47(5):1312-23.
36. Muñoz-Navarro R, Cano-Vindel A, Medrano LA, Schmitz F, Ruiz-Rodríguez P, Abellán-Maeso C, Font-Payeras MA, Hermosilla-Pasamar AM. Utility of the PHQ-9 to identify major depressive disorder in adult patients in Spanish primary care centres. BMC Psychiatry. 2017 Aug 9;17(1):291.
37. Kroenke, K. & Spitzer, R.L. (2002). The PHQ-9: A new depression and diagnostic severity measure. Psychiatric Annals, 32, 509-521.
38. DuPaul GJ, Power TJ, Anastopoulos AD, Reid R. ADHD Rating Scale IV Checklists, Norms and Clinical Interpretation. New York: The Guilford Press;1998
39. DuPaul GJ, Power TJ, Mcgoey K, Ikeda M, Anastopoulos AD; Reliability and Validity of Parent and Teacher Ratings of Attention Deficit Hyperactivity Disorder Symptoms; J Psychoeduc Assess; 1998; 16:55-68
40. DuPaul GJ; Parent Teacher Ratings of ADHD Symptoms: Psychometric Properties in a Community Based Sample. J Clin Child Psychol; 1991; 20(3):245-53
41. Ministry of Home Affairs, Government of India. 2011 Census Data. Available from: http://www.censusindia.gov.in/2011census/population_ enumeration.html
42. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 3rd edition Revised. American Psychiatric Association; 1987.
43. Russ SA, Larson K, Halfon N. A national profile of childhood epilepsy and seizure disorder. Pediatrics. 2012 Feb;129(2):256-64.
44. Reilly et al. Neurobehavioural comorbidities in children with active epilepsy: a population based study. Pediatrics. 2014; 133(6);e1586-e1593.
45. Cohen R, Senecky Y, Shuper A, Inbar D, Chodick G, Shalev V, Raz R. Prevalence of epilepsy and attention-deficit hyperactivity (ADHD) disorder: a population-based study. J Child Neurol. 2013 Jan; 28(1):120-3.
46. Department of Economics and Statistics Kerala. Gender Statistics 2014-15 Available from: http://www.ecostat.kerala.gov.in/docs/pdf/reports/others/ gender_statistics1415.pdf [Assessed 26th November 2017].
47. Ministry of Health and Family Welfare, Government of India. Integrated Disease Surveillance Project: Non communicable disease risk factor survey 2007-2008. Available from: http://www.icmr.nic.in/final/IDSP-NCD Reports/Phase-1 States of India.pdf [Assessed 26th November 2017]. K Vidhukumar, E Nazeer, P Anil. Prevalence and Pattern of alcohol use in Kerala – a district based survey. International Journal of Recent Trends in Science and Technology. 2016 Mar; 18(2): 363-367.
48. Usha Menon V, Sundaram KR, Unnikrishnan AG, Jayakumar RV, Nair V, Kumar H. High prevalence of undetected thyroid disorders in an iodine sufficient adult south Indian population. J Indian Med Assoc. 2009 Feb;107(2):72-7.
49. Thankappan KR, Shah B, Mathur P, Sarma PS, Srinivas G, Mini GK, Daivadanam M, Soman B, Vasan RS. Risk factor profile for chronic non-communicable diseases: results of a community-based study in Kerala, India. Indian J Med Res. 2010 Jan;131:53-63.
50. Shah B, Mathur P. Surveillance of cardiovascular disease risk factors in India: the need & scope. Indian J Med Res. 2010 Nov;132:634-42. Review.
2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Association; 2013.
3. Kessler RC, Adler L, Barkley R, Biederman J, Conners CK, Demler O, Faraone SV, Greenhill LL, Howes MJ, Secnik K, Spencer T, Ustun TB, Walters EE, Zaslavsky AM. The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. Am J Psychiatry. 2006 Apr;163(4):716-23.
4. Willcutt EG. The prevalence of DSM-IV attention-deficit/hyperactivity disorder: a meta-analytic review. Neurotherapeutics. 2012 Jul;9(3):490-9.
5. Spencer TJ, Biederman J, Mick E. Attention-deficit/hyperactivity disorder: diagnosis, lifespan, comorbidities, and neurobiology. J Pediatr Psychol. 2007 Jul;32(6):631-42.
6. Biederman J, Faraone SV, Spencer TJ, Mick E, Monuteaux MC, Aleardi M. Functional impairments in adults with self-reports of diagnosed ADHD: A controlled study of 1001 adults in the community. J Clin Psychiatry. 2006 Apr;67(4):524-40.
7. Flick GL. Power Parenting for Children with ADD/ADHD: A Practical Parent’s Guide for Managing Difficult Behaviours. The Center for Applied Research in Education, New York.
8. Chen WL, Tsai ST, Chou FH. [Depression and related factors in mothers of school-aged children with attention-deficit hyperactivity disorder]. Hu Li Za Zhi. 2015 Feb;62(1):39-49.
9. McCormick LH. Depression in mothers of children with attention deficit hyperactivity disorder. Fam Med. 1995 Mar;27(3):176-9.
10. Soltanifar A, Moharreri F, Soltanifar A. Depressive and anxiety symptoms in mothers of children with Attention Deficit Hyperactivity Disorder compared to a control group. 2009. 4:112-115
11. World Health Organisation. The International Classification of Diseases - 10 Classification of Mental and Behavioural Disorders: Clinical descriptions and diagnostic guideline. Geneva. 1992.
12. World Health Organisation. Depression and other common mental disorders: Global health estimates. Geneva. 2017.
13. Murthy RS. National Mental Health Survey of India 2015-2016. Indian J Psychiatry. 2017 Jan-Mar; 59(1):21-26.
14. Shidhaye R, Gangale S, Patel V. Prevalence and treatment coverage for depression: a population-based survey in Vidarbha, India. Soc Psychiatry Psychiatr Epidemiol. 2016 Jul;51(7):993-1003.
15. Rathode et al. Treatment contact coverage for probable depressive and probable alcohol use disorders in four low- and middle- income country districts: The PRIME cross-sectional community surveys. PLoS ONE. 11(9): e0162038.
16. Iyer RS, Rekha M, Kumar TS, Sarma PS, Radhakrishnan K. Primary care doctors' management behavior with respect to epilepsy in Kerala, southern India. Epilepsy Behav. 2011 Jun; 21(2):137-42.
17. D'Costa G, Nazareth I, Naik D, Vaidya R, Levy G, Patel V, King M. Harmful alcohol use in Goa, India, and its associations with violence: a study in primary care. Alcohol Alcohol. 2007 Mar-Apr;42(2):131-7.
18. Musa RB & Shafiee Z. Depressive, anxiety and stress levels among mothers of ADHD children and their relationships to ADHD symptoms; ASEAN Journal of Psychiatry 2007:8 (1):20-28.
19. Chen VC, Yeh CJ, Lee TC, Chou JY, Shao WC, Shih DH, Chen CI, Lee PC. Symptoms of attention deficit hyperactivity disorder and quality of life of mothers of school-aged children: the roles of child, mother, and family variables. Kaohsiung J Med Sci. 2014 Dec; 30(12):631-8.
20. Segenreich D, Fortes D, Coutinho G, Pastura G, Mattos P. Anxiety and depression in parents of a Brazilian non-clinical sample of attention-deficit/ hyperactivity disorder (ADHD) students. Braz J Med Biol Res. 2009. May;42(5):465-9.
21. Harrison C, Sofronoff K. Attention Deficit Hyperactivity Disorder and parental psychological distress: Role of demographics, child behavioural characteristics and parental cognition. J Am Acad Child Adolesc. Psychiatry. 2002; 41(6):703-711
22. Shafaat A, Tirgari A. Prevalence of depression symptoms among mothers of children with Attention Deficit Hyperactivity Disorder. J Mazand Univ Med Sci. 2012; 22(supple 1):66-72
23. Bawalsah J. Levels of depression in parents of children with Attention Deficit Hyperactivity Disorder in Jordan. International Journal of Adult and Non-formal Education. Apr 2014; 2(2):031-042
24. Brown RT, Pacini JN. Perceived family functioning, marital status, and depression in parents of boys with attention deficit disorder. J Learn Disabil. 1989 Nov;22(9):581-7.
25. Khademloo M, Ahmadi M, Bagheri N. Mental health and resilience among mothers of children with ADHD and mothers of normal children: A causal-comparative study. American Journal od Paediatrics. 2016; 2(6):23-28
26. Breen MJ, Barkley RA. Child psychopathology and parenting stress in girls and boys having attention deficit disorder with hyperactivity. J Pediatr Psychol. 1988 Jun;13(2):265-80.
27. Befera MS, Barkley RA. Hyperactive and normal girls and boys: mother-child interaction, parent psychiatric status and child psychopathology. J Child Psychol Psychiatry. 1985 May;26(3):439-52.
28. Narkunam N, Hashim AH, Sachdev MK, Pillai SK, Ng CG. Stress among parents of children with attention deficit hyperactivity disorder, a Malaysian experience. Asia Pac Psychiatry. 2014 Jun;6(2):207-16.
29. Yousefia S, Far AS, Abdolahian E. Parenting stress and parenting styles in mothers of ADHD with mothers of normal children. Procedia – Social and Behavioural Sciences. 2011; 30:1666-1671.
30. Sethi S, Gandhi R, Anand V. Study of level of stress in the parents of children with Attention-Deficit/ Hyperactivity Disorder. J Indian Assoc Child Adolesc Mental Health. 2012; 8(2):25-37.
31. Anastopoulos AD, Guevremont DC, Shelton TL, DuPaul GJ. Parenting stress among families of children with attention deficit hyperactivity disorder. J Abnorm Child Psychol. 1992 Oct;20(5):503-20.
32. Peters K, Jackson D. Mothers' experiences of parenting a child with attention deficit hyperactivity disorder. J Adv Nurs. 2009 Jan;65(1):62-71.
33. Barkley et al. Adolescents with Attention Deficit Hyperactivity Disorder: mother-adolescent interactions, family beliefs and conflicts and maternal psychopathology. Journal of Abnormal Child Psychology. 1992; 20(3).
34. Chronis et al. Maternal depression and early positive parenting predict future conduct problems in young children with Attention-Deficit/ Hyperactivity Disorder. Devlop. Psychology. 2007; 43(1):70-82.
35. Nicholson JS, Deboeck PR, Farris JR, Boker SM, Borkowski JG. Maternal depressive symptomatology and child behavior: transactional relationship with simultaneous bidirectional coupling. Dev Psychol. 2011 Sep; 47(5):1312-23.
36. Muñoz-Navarro R, Cano-Vindel A, Medrano LA, Schmitz F, Ruiz-Rodríguez P, Abellán-Maeso C, Font-Payeras MA, Hermosilla-Pasamar AM. Utility of the PHQ-9 to identify major depressive disorder in adult patients in Spanish primary care centres. BMC Psychiatry. 2017 Aug 9;17(1):291.
37. Kroenke, K. & Spitzer, R.L. (2002). The PHQ-9: A new depression and diagnostic severity measure. Psychiatric Annals, 32, 509-521.
38. DuPaul GJ, Power TJ, Anastopoulos AD, Reid R. ADHD Rating Scale IV Checklists, Norms and Clinical Interpretation. New York: The Guilford Press;1998
39. DuPaul GJ, Power TJ, Mcgoey K, Ikeda M, Anastopoulos AD; Reliability and Validity of Parent and Teacher Ratings of Attention Deficit Hyperactivity Disorder Symptoms; J Psychoeduc Assess; 1998; 16:55-68
40. DuPaul GJ; Parent Teacher Ratings of ADHD Symptoms: Psychometric Properties in a Community Based Sample. J Clin Child Psychol; 1991; 20(3):245-53
41. Ministry of Home Affairs, Government of India. 2011 Census Data. Available from: http://www.censusindia.gov.in/2011census/population_ enumeration.html
42. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 3rd edition Revised. American Psychiatric Association; 1987.
43. Russ SA, Larson K, Halfon N. A national profile of childhood epilepsy and seizure disorder. Pediatrics. 2012 Feb;129(2):256-64.
44. Reilly et al. Neurobehavioural comorbidities in children with active epilepsy: a population based study. Pediatrics. 2014; 133(6);e1586-e1593.
45. Cohen R, Senecky Y, Shuper A, Inbar D, Chodick G, Shalev V, Raz R. Prevalence of epilepsy and attention-deficit hyperactivity (ADHD) disorder: a population-based study. J Child Neurol. 2013 Jan; 28(1):120-3.
46. Department of Economics and Statistics Kerala. Gender Statistics 2014-15 Available from: http://www.ecostat.kerala.gov.in/docs/pdf/reports/others/ gender_statistics1415.pdf [Assessed 26th November 2017].
47. Ministry of Health and Family Welfare, Government of India. Integrated Disease Surveillance Project: Non communicable disease risk factor survey 2007-2008. Available from: http://www.icmr.nic.in/final/IDSP-NCD Reports/Phase-1 States of India.pdf [Assessed 26th November 2017]. K Vidhukumar, E Nazeer, P Anil. Prevalence and Pattern of alcohol use in Kerala – a district based survey. International Journal of Recent Trends in Science and Technology. 2016 Mar; 18(2): 363-367.
48. Usha Menon V, Sundaram KR, Unnikrishnan AG, Jayakumar RV, Nair V, Kumar H. High prevalence of undetected thyroid disorders in an iodine sufficient adult south Indian population. J Indian Med Assoc. 2009 Feb;107(2):72-7.
49. Thankappan KR, Shah B, Mathur P, Sarma PS, Srinivas G, Mini GK, Daivadanam M, Soman B, Vasan RS. Risk factor profile for chronic non-communicable diseases: results of a community-based study in Kerala, India. Indian J Med Res. 2010 Jan;131:53-63.
50. Shah B, Mathur P. Surveillance of cardiovascular disease risk factors in India: the need & scope. Indian J Med Res. 2010 Nov;132:634-42. Review.
How to Cite
1.
Dr Sarika P, Gopalan DMRG. Prevalence of Major Depressive Disorder among Mothers of Children and Adolescents with Attention Deficit Hyperactivity Disorder Attending a Tertiary Care Centre. Int J Med Res Rev [Internet]. 2023Jun.21 [cited 2024Nov.22];11(3):56-4. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/1363
Section
Original Article
Copyright (c) 2023 Author (s). Published by Siddharth Health Research and Social Welfare Society
This work is licensed under a Creative Commons Attribution 4.0 International License.
OAI - Open Archives Initiative
