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Naheed A, Islam MS, Hossain SW, Ahmed HU, Uddin MMJ, Tofail F, Hamadani JD, Hussain AHME, Munir K. Burden of major depressive disorder and quality of life among mothers of children with autism spectrum disorder in urban bangladesh. Autism Res 2019; 13:284-297. [PMID: 31647184 DOI: 10.1002/aur.2227] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 10/02/2019] [Indexed: 12/14/2022]
Abstract
This cross-sectional study examined the burden of depression and quality of life (QoL) among mothers of children with autism spectrum disorder (ASD) attending six schools offering special educational services for children with ASD in urban Dhaka, Bangladesh. All consenting mothers were 18 years of age and older and met criteria for major depressive disorder (MDD) on the Structured Interview for DSM-V-TR Research Version-non patient edition administered by trained raters. QoL was assessed by the EuroQol five-dimensional standardized questionnaire. MDD was diagnosed in 45% of mothers and was proportionally higher among those who did not work outside the home, had no childcare support at home, expressed low level of satisfaction with the quality of providers when they had sought care for their children with ASD, and reported being recipient of negative attitudes from neighbors toward their children with ASD. QoL was negatively associated with MDD, mothers' illness, and low satisfaction with the health care providers for children with ASD, as well as experiencing a negative attitude by neighbors toward their children. QoL was positively associated with the reported family monthly income and improvement of the children with ASD on school attendance. The prevalence of MDD among mothers of children with ASD was high and associated with poor QoL. Integrating mental health services and supports for mothers in the ASD care of children is likely to address the high burden of depression they face, and improve their overall quality of life. Autism Res 2020, 13: 284-297. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: The levels of depression were assessed among mothers of children with autism spectrum disorder (ASD) attending six schools offering special educational services for children with ASD in urban Dhaka, Bangladesh. Almost one in two mothers was found to have major depression. The quality of life of these mothers was generally poor. Integrating mental health services for mothers with ASD care in children is likely to address the burden of depression among the mothers of children with ASD and improve overall quality of life.
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Affiliation(s)
- Aliya Naheed
- Initiative for Non-Communicable Diseases, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md Saimul Islam
- Initiative for Non-Communicable Diseases, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Helal Uddin Ahmed
- National Institute of Mental Health, Bangladesh (NIMH,B), Sher-E-Bangla Nagar, Dhaka, Bangladesh
| | - M M Jalal Uddin
- National Institute of Neurosciences & Hospital, Bangladesh (NINS,B), Sher-E-Bangla Nagar, Dhaka, Bangladesh
| | - Fahmida Tofail
- NCSD Administration, Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Jena Derakhshani Hamadani
- Maternal and Neonatal Health, Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - A H M Enayet Hussain
- Planning and Development, Director General of Health Services (DGHS), Dhaka, Bangladesh
| | - Kerim Munir
- Division of Developmental Medicine, Boston Children's Hospital and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.,Division of Developmental Medicine, Boston Children's Hospital and Department and Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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Hossain MD, Ahmed HU, Jalal Uddin MM, Chowdhury WA, Iqbal MS, Kabir RI, Chowdhury IA, Aftab A, Datta PG, Rabbani G, Hossain SW, Sarker M. Autism Spectrum disorders (ASD) in South Asia: a systematic review. BMC Psychiatry 2017; 17:281. [PMID: 28826398 PMCID: PMC5563911 DOI: 10.1186/s12888-017-1440-x] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 07/23/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Autism spectrum disorders (ASD) are a group of complex neurodevelopmental disorders. The prevalence of ASD in many South Asian countries is still unknown. The aim of this study was to systematically review available epidemiological studies of ASD in this region to identify gaps in our current knowledge. METHODS We searched, collected and evaluated articles published between January 1962 and July 2016 which reported the prevalence of ASD in eight South Asian countries. The search was conducted in line with the PRISMA guidelines. RESULTS We identified six articles from Bangladesh, India, and Sri Lanka which met our predefined inclusion criteria. The reported prevalence of ASD in South Asia ranged from 0.09% in India to 1.07% in Sri Lanka that indicates up to one in 93 children have ASD in this region. Alarmingly high prevalence (3%) was reported in Dhaka city. Study sample sizes ranged from 374 in Sri Lanka to 18,480 in India. The age range varied between 1 and 30 years. No studies were found which reported the prevalence of ASD in Pakistan, Nepal, Bhutan, Maldives and Afghanistan. This review identifies methodological differences in case definition, screening instruments and diagnostic criteria among reported three countries which make it very difficult to compare the studies. CONCLUSIONS Our study is an attempt at understanding the scale of the problem and scarcity of information regarding ASD in the South Asia. This study will contribute to the evidence base needed to design further research and make policy decisions on addressing this issue in this region. Knowing the prevalence of ASD in South Asia is vital to ensure the effective allocation of resources and services.
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Affiliation(s)
- Mohammad Didar Hossain
- James P. Grant School of Public Health, BRAC University, 68 Shahid Tajuddin Ahmed Sharani, Dhaka, Bangladesh
- Foundation for Advancement of Innovations in Technology and Health (faith), Bangladesh, Iqbal Road, Mohammadpur, Dhaka, 1207 Bangladesh
| | - Helal Uddin Ahmed
- National Institute of Mental Health, Bangladesh (NIMH,B), Sher-E-Bangla Nagar, Dhaka, 1207 Bangladesh
| | - M M Jalal Uddin
- National Institute of Neurosciences & Hospital, Bangladesh (NINS,B), Sher-E-Bangla Nagar, Dhaka, 1207 Bangladesh
| | - Waziul Alam Chowdhury
- Bangladesh Association of psychiatrists, National Institute of Mental Health, Bangladesh (NIMH,B), Sher-E-Bangla Nagar, Dhaka, 1207 Bangladesh
| | - Mohd S Iqbal
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Razin Iqbal Kabir
- James P. Grant School of Public Health, BRAC University, 68 Shahid Tajuddin Ahmed Sharani, Dhaka, Bangladesh
| | - Imran Ahmed Chowdhury
- James P. Grant School of Public Health, BRAC University, 68 Shahid Tajuddin Ahmed Sharani, Dhaka, Bangladesh
| | - Afzal Aftab
- James P. Grant School of Public Health, BRAC University, 68 Shahid Tajuddin Ahmed Sharani, Dhaka, Bangladesh
- Foundation for Advancement of Innovations in Technology and Health (faith), Bangladesh, Iqbal Road, Mohammadpur, Dhaka, 1207 Bangladesh
| | - Pran Gopal Datta
- Shuchona Foundation, Bangabandhu Memorial Trust Building, 2nd floor, 8 Rd No 11, Dhaka, 1209 Bangladesh
- Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, 1000 Bangladesh
| | - Golam Rabbani
- Neuro-Developmental Disability Protection Trust, Department of Social Services Building, Agargaon, Sher-e-Bangla Nagar, Dhaka, 1207 Bangladesh
| | - Saima Wazed Hossain
- Shuchona Foundation, Bangabandhu Memorial Trust Building, 2nd floor, 8 Rd No 11, Dhaka, 1209 Bangladesh
- Expert Advisory Panel on Mental Health; Global Autism Advocate, World Health Organization, Dhaka, Bangladesh
- National Advisory Committee for Autism and Neurodevelopmental Disorders, Ministry of Health and Family Welfare, Government of Bangladesh, Dhaka, Bangladesh
| | - Malabika Sarker
- James P. Grant School of Public Health, BRAC University, 68 Shahid Tajuddin Ahmed Sharani, Dhaka, Bangladesh
- Institute of Public Health, University of Heidelberg, Im Neuenheimer Feld, Heidelberg, 69120 Germany
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