Indian Journal of Social Psychiatry

LETTER TO EDITOR
Year
: 2019  |  Volume : 35  |  Issue : 4  |  Page : 247--248

Comments on “Study of depression, anxiety and stress among Class IV workers in a medical college in Delhi”


Arun Enara, Kumar Thamaraiselvan Santhosh, Hari Hara Suchandra, Vinay Basavaraju, Guru S Gowda 
 Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India

Correspondence Address:
Dr. Guru S Gowda
Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru - 560 029, Karnataka
India




How to cite this article:
Enara A, Santhosh KT, Suchandra HH, Basavaraju V, Gowda GS. Comments on “Study of depression, anxiety and stress among Class IV workers in a medical college in Delhi”.Indian J Soc Psychiatry 2019;35:247-248


How to cite this URL:
Enara A, Santhosh KT, Suchandra HH, Basavaraju V, Gowda GS. Comments on “Study of depression, anxiety and stress among Class IV workers in a medical college in Delhi”. Indian J Soc Psychiatry [serial online] 2019 [cited 2021 May 6 ];35:247-248
Available from: https://www.indjsp.org/text.asp?2019/35/4/247/271099


Full Text



Sir,

An article titled “Study of depression, anxiety and stress among Class IV workers in a medical college in Delhi” was published by Garg and Kumar.[1] It is very commendable that the authors studied the mental health problems among professionals working in a medical college. However, there are few concerns that we would like to bring to the attention of the scientific forum. We would like to suggest that the terminology of Class 1V could have been avoided and the government-designated terminology such as multitasking skilled worker or Group D (IV) employee would have been a more polished way of addressing the said sample.

The need for the study stems from the assumption that “Class-IV workers tend to have poor socioeconomic status, low levels of education, and long erratic working shifts” as mentioned in the abstract. The study sample has around 51% belonging to upper lower class and 51% educated till high school and beyond. Both of those would not qualify for poor socioeconomic status or low levels of education. If the authors wanted to look at the influence of economic status and educational levels, they should not have restricted their sample to Class IV workers as their primary objective would not get served by doing so.

In the methodology, the authors collected the study sample in three stipulated meeting over a 3-month period, with an overall participation rate of 51%. The question of whether the 51% of the sample represent the overall study sample in terms of age, gender, occupation, and economic status is unanswered, and hence, the findings cannot be generalized. The authors also fail to mention the exclusion criteria for the sample, if any, for other associated causes of depression and anxiety such as chronic medical conditions (diabetes, thyroid disorders, chronic kidney disorders, cardiac disorders, and chronic pain disorders), substance use and drug causing depression and anxiety.[2],[3]

The study used Hindi-translated Depression Anxiety Stress Scales-21 to screen the depression, anxiety, and stress among the Class 4 workers. The authors should have used a validated tool translated in Hindi used in the Indian population with good psychometric properties[4] than self-translated Hindi tool. It is also evident that the authors lack professional experience in treating patients with mental health problems, and hence, the relevance of a self-translated Hindi tool of the Depression Anxiety Stress Scale-21 is questionable. This study found that 17% of the sample had anxiety, 15% of them had depression, and 6% had a stress. It is commendable that the authors discussed the public health implications such as creating awareness, stress risk assessment, problem-solving technique, and multidisciplinary care. However, the authors have not mentioned any attempts made to involve a psychiatrist or mental health professional for providing care to the risk group with depression, anxiety, and stress.

The authors concluded that higher socioeconomic status and middle age were found to be associated with depression, and lower educational status correlated well with abnormal anxiety levels. They also concluded that longer the distances to the workplace, less likely the individual suffered from anxiety and depression. These findings should be taken into consideration with caution since it does not have clinical or social relevance in line with the existing scientific literatures, poor sample selection, and methodological design.[5]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Garg P, Kumar R. Study of depression, anxiety and stress among Class IV workers in a medical college in Delhi. Indian J Soc Psychiatry 2019;35:57-63. Available from: http://www.indjsp.org/text.asp?2019/35/1/57/255000. [Last accessed on 2019 May 29].
2DeJean D, Giacomini M, Vanstone M, Brundisini F. Patient experiences of depression and anxiety with chronic disease: A systematic review and qualitative meta-synthesis. Ont Health Technol Assess Ser 2013;13:1-33.
3Scott KM, Bruffaerts R, Tsang A, Ormel J, Alonso J, Angermeyer MC, et al. Depression-anxiety relationships with chronic physical conditions: Results from the world mental health surveys. J Affect Disord 2007;103:113-20.
4Kumar K, Kumar S, Mehrotra D, Tiwari SC, Kumar V, Dwivedi RC. Reliability and psychometric validity of Hindi version of depression, anxiety and stress scale-21 (DASS-21) for Hindi speaking head neck cancer and oral potentially malignant disorders patients. J Cancer Res Ther 2019;15:653-8.
5Akhtar-Danesh N, Landeen J. Relation between depression and sociodemographic factors. Int J Ment Health Syst 2007;1:4.