© 1996 Oxford University Press
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Mental Health of the Mothers of Malnourished Children
* Department of Psychiatry, Escola Paulista de Medicina S
o Paulo, Brazil.
** Center of Informatics, Escola Paulista de Medicina So Paulo, Brazil.
Department of Pediatrics, Escola Paulista de Medicina So Paulo, Brazil.
Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine.
Reprint requests to: Claudio T Miranda, Clinical Epidemiology Unit, Escola Paulista de Medicina Rua Botucatu 740, S{macron}o Paulo, SP, CEP 04023, 800, Brazil.
BACKGROUND: The objective of this study is to measure the association between protein-energy malnutrition (PEM) in children and their mothers' mental health, in a low income area in the city of Embú, S Paulo, Brazil.
METHODS: A case-control study was performed. Cases were 60 moderately and severely malnourished children(Gomez criteria) selected from two primary health care units. Controls consisted of 45 eutropic children attending the same units. The main outcome measure was for the mothers to present a mental health score >6 according with the ‘Adult Psychiatric Morbidity Questionnaire’ (QMPA), a psychiatric screening instrument.
RESULTS: Of mothers of children with PEM, 63% and 38% of mothers in the control group were QMPA positive: oddsratio (OR) = 2.8 (95% confidence interval (Cl): 1.2–6.9). Of PEM children, 27% had low birthweight (LBW = <2500 g) and 6% of the control group had LBW. Interactions were found between: mothers' mental health and number of children (with 
4 children OR = 20.0 (95% Cl: 2.1–274.2), with 
3 children: OR = 1.6 [95% Cl: 0.6–4.5), as well as mothers' mental health and maternal age (in women >30: OR = 12.5 [95% Cl: 2.0–93.4], in women 30: OR = 1.5 [95% Cl: 0.5–4.4].
CONCLUSIONS: Mothers of children with PEM showed a higher rate of mental disturbances than mothers of eutrophic children. Unlike LBW, maternal age and number of children interact with mothers' mental health, Increasing the association. Management of poor mental health may lead to mothers being better caretakers of their children and this may have a positive impact on PEM.
Keywords case-control, low birthweight, malnutrition, mental health
Revised 1 June 1995
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