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First, the authors have used a screening instrument that is, by definition, meant to pick up "spectrum disorders" rather than rigorously defined bipolar disorder. Hence, the "prevalence" estimate that they provide is of limited use. All "screen positive" cases should have been confirmed using standard diagnostic criteria.
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Secondly, the authors have not confirmed if this instrument is valid in non-Western cultures. A perusal of the scale shows that it can easily be misunderstood and that some of the terms in it are hard to translate. It is tautological and more than a little foolish to claim that "mental illness" increases the risk for bipolar disorder. Bipolar disorder is, itself, a mental illness! If the authors mean "comorbid mental illness" such as an anxiety disorder then this must be mentioned using appropriate terms.
Otherwise, it is a serious error which reflects badly on the credibility of the researchers. Similarly, the authors have used simplistic, non-standard terminology "rich" vs "poor" for income, "good" vs "poor" for quality of the marital relationship that makes the data analyses difficult to interpret. The writing style and grammar are poor, and the article would benefit from the assistance of a writer skilled in scientific writing in English.
Finally, there are serious ethical concerns about the inclusion of victims of child marriage age 15 in a study of this sort.
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Authors have mentioned randomization was done at all three stages. It would be appreciated if they mention what method of randomization was used. A brief description of the process would help readers as well as future researchers. Regarding the questionnaire, it is not clear whether the 66 items semi structured questionnaire had 20 items of BSDS or it was separately administered. Please clarify. I think they should have some level of education to collect data. In the methodology result and discussion section the authors have looks into different factors mainly social and have concluded the precipitating factors, vulnerability.
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However the factors may have just association rather than direct precipitation. The authors have completely missed the biological and psychological factors. If not studied these could be the domains for discussion. This might be misleading as there is no any rational pathway for this.
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Hence I would recommend to take literature review in consideration before doing statistical tests and making an inference. PLOS authors have the option to publish the peer review history of their article what does this mean? If published, this will include your full peer review and any attached files. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.
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We have modified and revised the manuscript accordingly, and detailed corrections point-by-point is given below:. We have provided our data. Our data in SPSS file, we have provided data as supplementary file data. The scientific validity and specificity of BSDS in screening bipolar disorder have been discussed with references [Page , Line ].
The translation adaptation process has been described in the manuscript [Page Line ]. We have corrected these accordingly throughout the manuscript. The term rich and poor are very well known for socio-economic class measured by family income, and it has been used in different publications. Some researchers used the term good and poor for measuring status of marital relationship, and most of the researchers used the term healthy and unhealthy for marital relationship.
We have revised and put healthy and unhealthy instead of good and poor respectively for marital relationship throughout the manuscript. We have described with references about this issue [Page 7, Line ]. We have described the randomization process [Page 6, Line ]. We have corrected it.
We have revised to make clear [Page , Line ]. We have mentioned in page 7 line However, the factors may have just association rather than direct precipitation.
Several limitations of this study should be noted. We think Figure 3 is not necessary, Fig. The DLM is a novel and flexible modelling structure for dealing with lagged relations between or among time series structures. Koirala Institute of Health Sciences. However, this study also had some limitations. Marital life sometimes becomes stressful and can trigger onset or relapse of mental illness such as BPD; on the other hand, marriage can also protect couples from mental disorders [ 48 ]. Our Bangladesh airfare deals cut out the hassle of finding a great ticket price and put the savings out front.
We have looked into many factors but considered only the significant factors in our result and discussion sections. Our aim was to investigate the associated factors and we made corrections in this regard as per your advice.
We did not focus on biological factors. Some psychological factors were considered.
We would like to thank the editor and reviewers for the valuable comments. We have revised the documents to the best of our ability, but we will definitely be happy to provide further improvement if there are further clarifications required. E-mail: moc. Submitted filename: Response to Editor and Reviewers. The authors have incorporated most of the comments in the revised manuscript; however, some of the writing is a bit imprecise, the manuscript be edited by a professional English language editor before publication.
We would appreciate receiving your revised manuscript by Mar 09 PM. Thank you very much for providing your comments on our manuscript. He has revised English throughout the manuscript. We are pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it complies with all outstanding technical requirements.
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Rezaul Karim. Masud Rana. Golam Hossain. Nagendra P. Luitel, Editor. Author information Article notes Copyright and License information Disclaimer. Competing Interests: The authors have declared that no competing interests exist. Received Sep 19; Accepted Feb 8. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Attachment: Submitted filename: Response to Editor and Reviewers.
Abstract Background Bipolar disorder BPD is a major mental disorder which not only affects the personal and social functioning of an individual, but also inflicts a huge economic burden on the family.
Methods We conducted a cross-sectional study, selecting households in Rajshahi City using a multi-stage random sampling design. Limitations Our survey involved self-reporting, which is typically affected by differing levels of understanding and bias. Conclusion This study laid down the foundation for conducting further research on identifying different factors affecting BPD, and for studying other issues related to BPD among married women in Bangladesh.
Introduction Bipolar disorder BPD is a major psychiatric illness characterized by fluctuations of mood. Materials and methods We conducted a cross-sectional household study. Sample size determination Rajshahi is one of the four big cities of Bangladesh having an area of Sampling method The survey participants were selected using a multistage random sampling Fig 1. Open in a separate window. Fig 1.
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Data collection For data collection, we used a semi-structured questionnaire, which was originally written in English and later translated into Bangla to help participants understand it easily. Independent variables Based on similar studies conducted in the past and keeping in view the objectives of our study, some socio-economic, demographic, anthropometric, familial and psycho-social factors were considered as independent variables in this study. Statistical analysis A frequency distribution was used to determine BPD prevalence.