113 J I M D C   2 0 1 7  113 

Op e n  Ac c e ss  
F u l l  L e n g t h  A r t i c l e  

Frequency of Depression in Mothers of Learning-Disabled 
Children 

 Muhammad Fahim1, Fatima Aamir Khan2, Asad Tamizuddin Nizami3 

1,2 Assistant Professor of Psychiatry, Wah Medical College, POF Wah Cantt 
3 Assistant Professor of Psychiatry, Rawalpindi Medical College, Rawalpindi 

A B S T R A C T  

Objective: To determine the frequency of depression in mothers caring for learning-disabled children. 

Subjects and Methods: This cross-sectional study was conducted at Department of Psychiatry, Benazir Bhutto Hospital 

Rawalpindi from May 2011 till 14th January 2012. In total 96 mothers of Learning disabled children, were consecutively 

recruited, from out patient department of Institute of Psychiatry, Benazir Bhutto Hospital. After obtaining written informed 

consent, Beck Depression Inventory (BDI) Urdu version was administered to assess the severity of depression; rated as 

‘mild’. ‘mild-moderate’, moderate- severe’ and ‘severe’ depression. The data were entered on SPSS version 10 for 

further analysis. 

Results: In total 89.6% of the mothers were found depressed. Among these 27.1% had mild- moderate depression, 

26.4% had moderate-severe depression and 36.1% were found to have severe depression. 

Conclusion: A high frequency of depression was observed in mothers caring for learning disabled children; frequency 

steadily increasing with severity of depression. This issue thus needs immediate attention for better heath related quality 

of mothers and better childcare. 

Key words: Anxiety, Caregiver burden, Depression, Maternal depression.  

Author`s Contribution 
1Acquisition of data and compilation of results 
2Final review of draft before submission 
3Conception and design of article  

Address of Correspondence 
 Dr Asad Tamizuddin Nizami 
drasadnizami@gmail.com 

Article info. 
Received: Oct 25, 2016 
Accepted: April 4, 2017 
 

Cite this article: Fahim M, Khan FA, Nizami AT. Frequency of Depression in Mothers of Learning 
Disabled Children JIMDC. 2017; 6(2):113-116. 

Funding Source: Nil 
Conflict of Interest: Nil 

I n t r o d u c t i o n  
 

Care giving and care receiving can occur at any point in 

the life-course, particularly in chronic diseases or 

disabilities, leading to losses of independence and 

disturbed overall functioning.1 No consistent and standard 

definition of family care giving exists, thus the meaning of 

the term is still unclear and varies considerably.2 

Successful management of major mental illness in the 

community depends largely on an informal or non-

professional network of caregivers. The needs and 

experiences of such caregivers have not been extensively 

studied with respect to major chronic mood disorders.3 

Care giving itself neither causes depression nor everyone 

who offer care, experience the negative emotions 

associated with depression. However, in order to offer the 

best possible care for a close family member, caregivers 

might have to sacrifice their own physical and emotional 

needs. Moreover, the overall experience of providing care 

would strain even the most capable and emotionally 

strong person, leading to negative emotions, irritability, 

and easy fatigability etc. which are clear warning signs of 

depression.4 

Learning Disability offers tremendous caregiver burden 

particularly on the part of mothers. The combined effect of 

stigmatization plus the burden of caring for the 

intellectually challenged child leads them to develop a 

variety of stress related symptoms including anxiety and 

depression.5 

O R I G I N A L  A R T I C L E  

mailto:drasadnizami@gmail.com


 

                           114 J I M D C   2 0 1 7  114 

Previous studies revealed that the mothers of children 

with language developmental disorders had a higher 

incidence of anxiety and depression. Therefore, while 

managing such cases, this issue must be given serious 

consideration.6 Studies have revealed a poor quality of life 

in mothers of mentally and physically handicapped 

children matched with controls.7,8 A study conducted in 

Iran revealed the prevalence of depression in mothers of 

children with serious physical conditions to be 46.3%.9 

Similarly, a high prevalence of anxiety and depression 

was found amongst the caregivers of individuals with 

mental illness, in another study from Pakistan.4 

To date, very little data is available regarding the 

prevalence of depression in the mothers caring for their 

learning-disabled children. The current study will be a 

useful study, as it would indicate the frequency and 

severity of depression in such mothers. It would also 

highlight the importance of diagnosing and treating 

depression in the mothers of learning-disabled children, 

which thus has an impact on the care of these patients. 

S u b j e c t s  a n d  M e t h o d s  

This cross-sectional, descriptive study was carried out at 

the Institute of Psychiatry, Benazir Bhutto Hospital, a 

tertiary care setting, for a period of 8 months from 14 May 

2011 until 14 January 2012. The study was conducted 

after seeking Hospital Ethical Committee approval. The 

total sample included 96 mothers who had been caring for 

learning-disabled children, recruited through consecutive, 

non-probability sampling method, after obtaining written 

informed consent.  

Mothers ages 65 years and above, with severe cognitive 

impairment, and those who could not speak in Urdu, were 

excluded from the study. 

Urdu version of Beck Depression Inventory was 

administered to diagnose and rate the severity of 

Depression. The mothers filled in socio-demographic 

proforma to obtain basic demographic details. All data 

was entered and analyzed in SPSS 10.0. 

R e s u l t s  

The mean age of the participants was 39.12(SD±13.04), 

with an age range of 19-60 years. 

 

Amongst the participants, 10(10.4%) had no depression, 

whereas 86(89.6%) had been diagnosed with Depression. 

Among these, 26(27.1%) had mild- moderate depression, 

25(26.4%) had moderate-severe depression and 

35(36.1%) had severe depression.  (Table 1) 

Table 1: Frequency of different grades of depression 

amongst the study participants (n=96) 

Diagnosis  Frequency (%) 

No depression 10(10.4%) 

Depression 86(89.6% 

Mild-moderate depression 26(27.1%) 

Moderate-severe depression 25(26.4% 

Severe depression 35(36.1% 

There were 80 true positive cases and 16 false positive 

cases, 78 true negative and 18 false negative cases. The 

BDI Questionnaire showed a sensitivity of 81.63% ( 

determined by the formula ( True positive cases-TP/True 

positive + True Negative X 100), specificity of 82.98% 

determined by the formula ( True Negative cases / False 

positive + True negative cases), positive predictive value 

of  83.33% determined by the formula (True Positive 

cases / True positive + False positive cases) and negative 

predictive value of 81.25% determined by the formula ( 

True Negative cases / True negative + False negative 

cases). 

D i s c u s s i o n  

In this study, the primary aim was to determine the 

frequency and severity of depression in mothers of 

children with Learning Disability. Overall, the study found 

that 89.6% of the mothers were depressed. Among these 

27.1% had mild- moderate depression, 26.4% had 

moderate-severe depression and 36.1% were found to 

have severe depression. This finding is of great 

significance and calls for more attention to be paid to this 

vulnerable group, in order to ensure early interventions for 

better mental health and wellbeing of the mothers and 

improved care of the mentally disabled children. This 

finding is comparable to a number of local and 

international studies that would be highlighted in this 

section. 

Nazish Imran conducted a research on 100 primary 

caregivers of mentally unwell patients in Mayo Hospital, 

and found higher rates of anxiety and depression i.e 85% 



 

                           115 J I M D C   2 0 1 7  115 

and 86% respectively, based on Hamilton Anxiety and 

Depression Scale scores.10 This finding is comparable 

with our finding, showing high frequency of depression i.e 

89.6%. However, unlike our study, the aforementioned 

study sought to probe into other aspects too, for example 

caregiver burden, quality of life, all of which were found 

impaired. 

Previously a research was conducted at the Institute of 

Psychiatry, Benazir Bhutto Hospital, which also supports 

the finding of higher rates of anxiety and depression 

among the caregivers of mentally unwell children.4 This 

supports the current research finding of a higher 

frequency of depression in mothers of learning disabled 

children, but unlike our research, the aforementioned 

study has looked into factors affecting caregiver burden, 

for example, long duration of mental illness. Another local 

study has findings similar to the current research of higher 

caregiver burden in parents caring for chronic mental 

illnesses.11 

At this point now, it is worthwhile to discuss a few 

international studies on this subject and see how they 

compare with the findings of the current study. Cadman, 

et al found parents of children with disabilities were more 

likely to experience depression and distress than parents 

of children without disabilities, and therefore supports the 

current research finding.12 However, in our study, we did 

not have a control group for comparison, which poses a 

methodological weakness to our study. Similarly, Dyson 

et al in his research found significantly higher degree of 

parental stress in parents of children with disabilities, who 

were also found to have negative and pessimistic views 

about the future.13 The family functioning in this study was 

also found to be markedly impaired. 

Moreover, the parents' perception of how tough it was to 

care for the child was related to feelings of depression.14 It 

has been shown that these mothers are more stressed 

than mothers of children without disabilities due to the 

extra daily tasks which leaves very little time for the 

mothers to take care of themselves.15 This is thus a 

clinically useful study and has important implications for 

clinical practice. The study found a high frequency of 

depression among mothers caring for learning disabled 

children. This calls for immediate attention by the 

healthcare providers for early interventions and early 

detection and treatment of maternal depression thus 

leading to decreased caregiver stress and burden with 

improved quality of caring for these mentally challenged, 

vulnerable children. 

However, there are certain limitations of the study. Firstly, 

the sample size was small thus limiting generalizability of 

results/findings of the study. Secondly, the study did not 

have a control group for comparison. Moreover, we did 

not address various factors associated with maternal 

depression while caring for the learning-disabled children. 

C o n c l u s i o n  

The study found a high frequency of depression in 

mothers caring for learning disabled children. This is a 

finding of striking significance as it calls for immediate 

intervention by the mental health care 

providers/psychiatrists for early recognition and prompt 

treatment of maternal depression, which would lead to 

lessened caregiver burden and improved quality of care 

for the mentally challenged, vulnerable children and 

improved quality of life. Further studies with large sample 

size, including control group and addressing various 

factors associated with maternal depression in the study 

population, are suggested.  

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J Nurs Stud. 2013;50(3):431-41.   

2. Rigaux N. Informal care: burden or significant experience? 

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subjective burden of mothers of children with 

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4. Basheer S, Niazi RS, Minhas FA, Ali W, Najam N. 

Depression and Anxiety in the caregivers of mentally ill 

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5. Abasiubong F, Obembe A, Ekpo M. A controlled study of 

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