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Year : 2019  |  Volume : 35  |  Issue : 4  |  Page : 249-250

Reply to comments on article titled “Study of depression, anxiety, and stress among Class-IV workers in a medical college in Delhi”

Department of Community Medicine, Maulana Azad Medical College, Delhi, India

Date of Submission09-Jan-2019
Date of Decision19-Jul-2019
Date of Acceptance01-Sep-2019
Date of Web Publication15-Nov-2019

Correspondence Address:
Dr. Prachie Garg
Department of Community Medicine, Maulana Azad Medical College, Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijsp.ijsp_65_19

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How to cite this article:
Garg P. Reply to comments on article titled “Study of depression, anxiety, and stress among Class-IV workers in a medical college in Delhi”. Indian J Soc Psychiatry 2019;35:249-50

How to cite this URL:
Garg P. Reply to comments on article titled “Study of depression, anxiety, and stress among Class-IV workers in a medical college in Delhi”. Indian J Soc Psychiatry [serial online] 2019 [cited 2022 Jan 24];35:249-50. Available from: https://www.indjsp.org/text.asp?2019/35/4/249/271100

Dear Sir,

The terminology used in the study coincides with the earlier classification of manual workers (skilled, semiskilled, or unskilled) into Class-IV workers[1] which has also been used by previous studies.[2],[3] However, the newer revised classification of these workers into Group D (IV) workers could also be used instead.

Class-IV workers were specifically chosen for this study due to a significant lack of data regarding the assessment of their mental health and/or its relationship with various sociodemographic variables as they forming the lowermost strata of employees working in an institution are at a higher risk of developing mental illnesses.

It is a preliminary cross-sectional study conducted with limited resources during a specific time and thus, due to the lack of voluntary consent and/or availability of the entire study universe during this period, the study sample was not matched with the overall universe in terms of sociodemographic characteristics. This approach is similar to previous studies done on Class-IV workers.[2],[3]

The study aimed at highlighting the role of certain sociodemographic and work-related factors on the overall mental health of Class-IV workers. Hence, other confounding factors such as medical conditions, mental health disorders, and substance abuse, were not included, thus creating scope for further research in this area to establish a stronger relationship of mental health in this group of workers with these variables, excluding the impact of the potential confounders.

The Hindi version of the DASS-21 scale used in this study has been provided by authors Singh et al.[4],[5] which showed fairly high validity and reliability scores in the Indian population, similar to the original scale in English.[5]

The study reported 51% of the Class-IV workers to be educated till high school (Xth class) or beyond, opposing our hypothesis. However, similar findings have also been reported by previous studies.[2],[3] This might be explained by the higher competition among workers seeking government jobs owing to the various benefits provided by them, including job security, incentives, and timely salary payments, and hence, workers with better education or skills being more likely to get employed. Additional research is required in this area to supplement and further explain the existing data in this population. The association of middle age and shorter commuting distance with depression and anxiety could be explained due to the lack of proper grouping of these variables and inadequate stratification to control for factors that may account for the observed differences, hence forming a limitation to our study. Age has also been shown to account for most of variance in the prevalence of depression across various studies.[6]


We wish to extend our sincere gratitude to all the participants for their valuable time and responses for this study. We would also like to thank the college authorities for their kindness of giving permission to conduct this study and for their cooperation.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Gazetted Officer (India). Wikipedia, The Free Encyclopedia. Available from: https://www.en.wikipedia.org/w/index.php?title=Gazetted_Officer_(India) and oldid=835983755. [Last updated on 2018 Apr 11; Last accessed on 2019 Jun 27].  Back to cited text no. 1
Chakor PV, Dehmoubed AS, Giri PA, Palwe NS. Study of socio-demographic determinants of class IV employees in a tertiary care teaching hospital in Mumbai. Int J App Basic Med Res 2014;4:39-43.  Back to cited text no. 2
Meshram PV, Tawale N, Jajulwar MB. Assessment of epidemiological factors and work related injuries amongst class IV workers involved in handling and disposal of biomedical wastes in a tertiary teaching hospital of Nagpur. Int J Community Med Public Health 2017;4:3243-6.  Back to cited text no. 3
Singh B. Hindi Translation of DASS. Available from: http://www2.psy.unsw.edu.au/dass/Hindi/Hindi.htm. [Last accessed on 2019 Jun 27].  Back to cited text no. 4
Singh B, Prabhuappa KP, Eqbal S, Singh AR. Depression, anxiety and stress scale: Reliability and validity of Hindi adaptation. Int J Educ Manage Stud 2013;3:446-9.  Back to cited text no. 5
Akhtar-Danesh N, Landeen J. Relation between depression and sociodemographic factors. Int J Ment Health Syst 2007;1:4.  Back to cited text no. 6

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