title: Mental health of the mothers of malnourished children.
abstract: 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, São 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 eutrophic 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: odds ratio (OR) = 2.8 (95% confidence interval [CI]: 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 > or = 4 children: OR = 20.0 [95% CI: 2.1-274.2], with < or = 3 children: OR = 1.6 [95% CI: 0.6-4.5), as well as mothers' mental health and maternal age (in women > 30: OR = 12.5 [95% CI: 2.0-93.4], in women < or = 30: OR = 1.5 [95% CI: 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.
authors.affiliation: Department of Psychiatry, Escola Paulista de Medicina, São Paulo, Brazil.
authors.forename: C T
authors.initials: CT
authors.lastname: de Miranda
authors.forename: G
authors.initials: G
authors.lastname: Turecki
authors.forename: J de J
authors.initials: Jde J
authors.lastname: Mari
authors.forename: S B
authors.initials: SB
authors.lastname: Andreoli
authors.forename: M A
authors.initials: MA
authors.lastname: Marcolim
authors.forename: S
authors.initials: S
authors.lastname: Goihman
authors.forename: R
authors.initials: R
authors.lastname: Puccini
authors.forename: B L
authors.initials: BL
authors.lastname: Strom
authors.forename: J A
authors.initials: JA
authors.lastname: Berlin
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D008429:Maternal Welfare; D008603:Mental Health; D009748:Nutrition Disorders / Q000453:epidemiology*; D016017:Odds Ratio; D015995:Prevalence