In the article on maternal depression and primary healthcare use for children by Lyngsøe et al1 we suggest that the severity of depression could have been included within the categories measured. The ICD-10 defines depression as mild, moderate, and severe, as within each of these categories there is a drastic variation in the presentation and severity of the symptoms. This could have had an effect on the likelihood and frequency of mothers requiring healthcare services for their child and would allow for a useful comparison between severity of mental state and use of primary healthcare services.
Second, we think that physical comorbidities should have been considered as a covariate. Physical illness could be a confounding factor for two reasons: the mother’s physical health could have affected the child’s, and also that acutely unwell mothers may have discussed their child’s health at their own consultation. These factors would have affected the number of contacts recorded and help to explain the higher rate of positive tests in these children.
Lastly, we feel that it is important to explore whether the findings and trends persist after the first 6 years of life before being able to generalise to all children in Denmark.
- © British Journal of General Practice 2019
