Saúde mental de crianças desnutridas: estudo caso controle

Abstract

Introduction - Chronic malnutrition is a serious public health problem in the developing countries. However, little is known about its relationship with child mental health problems. This study has as hypothesis that even living in an environment of social vulnerability, malnourished children are more likely to be associated with mental health problems than normal children. Objective - To compare the mental health of malnourished children with mental health of euthrophic children living in an environment of social vulnerability taking into account selected psychosocial factors. Methods- This was a case-control study where cases-48 malnourished children i48 to 72 months of age,attending the Center for Nutritional Recovery and Education (CREN), , were compared with controls 50 children attending kindergarten and the Basic Health Unit located in the same neighborhood of CREN. The child's nutritional status were evaluated using the criteria of the WHO. Child mental health was assessed through the Strengths and Difficulties Questionnaire (Strength and Difficulties Questionnaire, SDQ), maternal mental health through the "Self Report Questionnaire" - 20 (SRQ-20 ) and associated disability through "Sheehan disability Scale" (SDS). Also selected socioeconomic aspects were evaluated. Results - Variables with an odds ratio (OR) significant in the univariate analysis, when compared between cases and controls were: the mother's education (OR: 2.96, 95% CI: 1.30 to 6.75), the number of residents in the household (OR: 0.32, 95% CI: 0.14 to 0.74), the number of children in the household (OR: 0.25, CI: 95%: 0.10 to 0 , 61), social class (OR: 2.30, 95% CI: 1.02 -5.18). Dimensions assessed by the SDQ, the one who tended to be statistically significant association with malnutrition were conduct problems (p = 0.08). The disability associated with probable maternal common mental disorders (CMD) also showed statistically significant association (p = 0.02). In the Logistic regression remained associated with child malnutrition, child conduct problems and disability associated with probable maternal CMD. Conclusions - This study contributed to the confirmation of an association of conduct problems in malnourished children and disability associated with maternal mental disorder. Longitudinal studies are needed to confirm these hypotheses. If so, it will help in the improvement of the children's mental health care.