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Michalczyk J, Miłosz A, Soroka E. Postpartum Psychosis: A Review of Risk Factors, Clinical Picture, Management, Prevention, and Psychosocial Determinants. Med Sci Monit 2023; 29:e942520. [PMID: 38155489 PMCID: PMC10759251 DOI: 10.12659/msm.942520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/11/2023] [Indexed: 12/30/2023] Open
Abstract
Postpartum psychosis is rare, but is a serious clinical and social problem. On its own, it is not included in DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) or ICD-10 (International Statistical Classification of Diseases and Related Health Problems) as a disease entity, and current diagnostic criteria equate it with other psychoses. This poses a serious legal problem and makes it difficult to classify. The disorder is caused by a complex combination of biological, environmental, and cultural factors. The exact pathophysiological mechanisms of postpartum psychosis remain very poorly understood. There is a need for further research and increased knowledge of the medical sector in the prevention and early detection of psychosis to prevent stigmatization of female patients during a psychiatric episode. It is necessary to regulate its position in the DSM5 and ICD-10. Attention should be paid to the social education of expectant mothers and their families. This article aims to review the current status of risk factors, prevention, and management of postpartum psychosis.
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Affiliation(s)
- Justyna Michalczyk
- II Department of Psychiatry and Psychiatric Rehabilitation, Student Scientific Association, Faculty of Medicine, Medical University of Lublin, Lublin, Poland
| | - Agata Miłosz
- II Department of Psychiatry and Psychiatric Rehabilitation, Student Scientific Association, Faculty of Medicine, Medical University of Lublin, Lublin, Poland
| | - Ewelina Soroka
- II Department of Psychiatry and Psychiatric Rehabilitation, Medical University of Lublin, Lublin, Poland
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White LK, Kornfield SL, Himes MM, Forkpa M, Waller R, Njoroge WFM, Barzilay R, Chaiyachati BH, Burris HH, Duncan AF, Seidlitz J, Parish-Morris J, Elovitz MA, Gur RE. The impact of postpartum social support on postpartum mental health outcomes during the COVID-19 pandemic. Arch Womens Ment Health 2023; 26:531-541. [PMID: 37268777 PMCID: PMC10238239 DOI: 10.1007/s00737-023-01330-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 05/17/2023] [Indexed: 06/04/2023]
Abstract
Social support is an influential component of postpartum recovery, adjustment, and bonding, which was disrupted by social distancing recommendations related to the COVID-19 pandemic. This study reports on changes in the availability of social support for postpartum women during the pandemic, investigates how those changes may have contributed to postpartum mental health, and probes how specific types of social support buffered against poor postpartum mental health and maternal-infant bonding impairment. Participants were 833 pregnant patients receiving prenatal care in an urban USA setting and using an electronic patient portal to access self-report surveys at two time points, during pregnancy (April-July 2020) and at ~12 weeks postpartum (August 2020-March 2021). Measures included an assessment of COVID-19 pandemic-related change in social support, sources of social support, ratings of emotional and practical support, and postpartum outcomes including depression, anxiety, and maternal-infant bonding. Overall self-reported social support decreased during the pandemic. Decreased social support was associated with an increased risk of postpartum depression, postpartum anxiety, and impaired parent-infant bonding. Among women reporting low practical support, emotional support appeared to protect against clinically significant depressive symptoms and impaired bonding with the infant. Decreases in social support are associated with a risk for poor postpartum mental health outcomes and impaired maternal-infant bonding. Evaluation and promotion of social support are recommended for healthy adjustment and functioning of postpartum women and families.
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Affiliation(s)
- Lauren K White
- Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Sara L Kornfield
- Penn Center for Women's Behavioral Wellness, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Megan M Himes
- Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Markolline Forkpa
- Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Rebecca Waller
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Wanjikũ F M Njoroge
- Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Policy Lab, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Ran Barzilay
- Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Barbara H Chaiyachati
- Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Heather H Burris
- Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Andrea F Duncan
- Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Jakob Seidlitz
- Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Julia Parish-Morris
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Michal A Elovitz
- Women's Biomedical Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Raquel and Jaime Gilinski Department of Obstetrics, Gynecology and Reproductive Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Raquel E Gur
- Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
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Low SR, Bono SA, Azmi Z. Prevalence and Factors of Postpartum Depression During the COVID-19 Pandemic: A Review. CURRENT PSYCHOLOGY 2023:1-18. [PMID: 36643791 PMCID: PMC9825082 DOI: 10.1007/s12144-022-04181-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2022] [Indexed: 01/09/2023]
Abstract
The COVID-19 (Coronavirus Disease 2019) pandemic has led to several mandatory prevention regulations, changes in healthcare services, unprecedented unemployment rates, financial stress, and emotional worries. Given the increasing cases of COVID-19, coupled with the drastic physical and psychological changes within postpartum mothers during the postpartum period, this paper aims to present an overview of the postpartum depression (PPD) among postpartum women during the COVID-19 pandemic. The postpartum period is characterized by drastic physical changes and substantial demands on parental role adjustment, and it places enormous stress on the mothers and makes them vulnerable to mental health problems. A literature search was conducted in four electronic databases (ScienceDirect, Scopus, Wiley, and SAGE) with different combinations of keywords were used. As the result, 25 articles that involved 10,515 postpartum women from 14 countries were extracted. Results have recorded PPD prevalence ranged from 6.4% to 56.9% during the COVID-19 pandemic. Limited social support, social isolation, fear of COVID-19 exposure, or infection for themselves, newborns, have worsening PPD symptoms among postpartum women. In brief, early detection, appropriate and timely intervention is needed to prevent and identify PPD among postpartum women during the COVID-19 pandemic. Supplementary Information The online version contains supplementary material available at 10.1007/s12144-022-04181-w.
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Affiliation(s)
- Su Rou Low
- School of Social Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | | | - Zaireeni Azmi
- Unit for Research on Women and Gender (KANITA), School of Social Sciences, Universiti Sains Malaysia, Penang, Malaysia
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Zhang X, Wang C, Zuo X, Aertgeerts B, Buntinx F, Li T, Vermandere M. Study characteristical and regional influences on postpartum depression before vs. during the COVID-19 pandemic: A systematic review and meta-analysis. Front Public Health 2023; 11:1102618. [PMID: 36875385 PMCID: PMC9975262 DOI: 10.3389/fpubh.2023.1102618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/23/2023] [Indexed: 02/17/2023] Open
Abstract
Background While the public is under serious pressure from the coronavirus disease 2019 (COVID-19), the final impact and possible contributing factors to postpartum depression symptoms (PPDS) remain unknown. Therefore, a meta-analysis to investigate the association between PPDS and the COVID-19 pandemic was carried out by comparing the data between pre-pandemic and post-pandemic timeframes and exploring the influencing factors. Methods This systematic review was prospectively registered and recorded in a study protocol (Prospero CRD42022336820, http://www.crd.york.ac.uk/PROSPERO). A comprehensive search of PubMed, Embase, Web of Science, CINALH, Cochrane and Scopus was cmpleted on June 6, 2022. Studies that compared the prevalence of PPD before and during the COVID-19 pandemic period were included. Results Of 1766 citations identified, 22 studies were included with 15,098 participates before the COVID-19 pandemic and 11,836 participants during the COVID-19 pandemic. Overall, the analysis showed that the epidemic crisis was associated with an increased prevalence of PPDS (OR: 0.81 [0.68, 0.95], P = 0.009, I 2 = 59%). Subgroup analysis was conducted according to the study characteristics and regions. Within the study characteristics classification, results showed an obvious increase in the prevalence of PPDS during the COVID-19 pandemic if PPDS cutoff was defined as Edinburgh postpartum depression score (EPDS) ≥13 points (OR: 0.72 [0.52, 0.98], P = 0.03, I 2 = 67%) and an increased prevalence in follow-ups that happened after 2 weeks (≥ 2 weeks postpartum) (OR: 0.81 [0.68, 0.97], P = 0.02, I 2 = 43%). Selected studies that were high-quality (OR: 0.79 [0.64, 0.97], P = 0.02, I 2 = 56%) demonstrated an increased prevalence of PPDS during the COVID-19 pandemic period. Sorting by regional factors, studies conducted in Asia (OR: 0.81 [0.70, 0.93], P = 0.003, I 2 = 0%) showed an increase of PPDS prevalence rates during the COVID-19 period, while studies conducted in Europe (OR: 0.82 [0.59, 1.13], P = 0.23, I 2 = 71%) and North America (OR: 0.66 [0.42, 1.02], P = 0.06, I 2 = 65%) showed no significant difference. All studies conducted in the developed (OR: 0.79 [0.64, 0.98], P = 0.03, I 2 = 65%) and developing countries (OR: 0.81 [0.69, 0.94], P = 0.007, I 2 = 0%) showed an increase of PPDS during the COVID-19 period. Conclusions The COVID-19 pandemic is associated with an increased prevalence of PPDS, especially after long-term follow-up and among the group with a high possibility of depression. The negative influence from the pandemic, causing more PPDS was significant in studies from Asia.
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Affiliation(s)
- Xiaoqian Zhang
- Department of Public Health and Primary Care, Academic Center for General Practice, Katholieke Universiteit Leuven, Leuven, Belgium.,Department of Family Medicine, Qingdao United Family Hospital, Qingdao, China
| | - Chun Wang
- Department of Obstetrics and Gynecology, Qingdao Municipal Hospital, Qingdao, China
| | - Xiaoli Zuo
- Department of Family Medicine, Qingdao United Family Hospital, Qingdao, China
| | - Bert Aertgeerts
- Department of Public Health and Primary Care, Academic Center for General Practice, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Frank Buntinx
- Department of Public Health and Primary Care, Academic Center for General Practice, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Tang Li
- Department of Pediatrics, Qingdao University Medical College, Qingdao, China
| | - Mieke Vermandere
- Department of Public Health and Primary Care, Academic Center for General Practice, Katholieke Universiteit Leuven, Leuven, Belgium
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Collart C, Craighead C, Rose S, Frankel R, Tucker Edmonds B, Perni U, Chien EK, Coleridge M, Ranzini A, Farrell RM. The Impact of Outpatient Prenatal Care Visitor Restrictions on Pregnant Patients and Partners During the COVID-19 Pandemic. WOMEN'S HEALTH REPORTS 2022; 3:718-727. [PMID: 36147830 PMCID: PMC9436262 DOI: 10.1089/whr.2022.0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 11/13/2022]
Abstract
Introduction: Methods: Results: Conclusions:
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Affiliation(s)
- Christina Collart
- Subspecialty Care for Women's Health, OB/GYN and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Caitlin Craighead
- Subspecialty Care for Women's Health, OB/GYN and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Susannah Rose
- Center for Patient Experience, Cleveland Clinic, Cleveland, Ohio, USA
| | - Richard Frankel
- Department of the Lerner Research Institute, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA
| | | | - Uma Perni
- Subspecialty Care for Women's Health, OB/GYN and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Edward K. Chien
- Subspecialty Care for Women's Health, OB/GYN and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Marissa Coleridge
- Subspecialty Care for Women's Health, OB/GYN and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio, USA
- Center for Personalized Genetic Healthcare, Department of Genomic Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Angela Ranzini
- Department of OB/GYN, MetroHealth Medical Center, Cleveland, Ohio, USA
| | - Ruth M. Farrell
- Subspecialty Care for Women's Health, OB/GYN and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio, USA
- Center for Personalized Genetic Healthcare, Department of Genomic Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA
- Center for Bioethics, Cleveland Clinic, Cleveland, Ohio, USA
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Hannon SE, Daly D, Higgins A. Resilience in the Perinatal Period and Early Motherhood: A Principle-Based Concept Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084754. [PMID: 35457631 PMCID: PMC9032587 DOI: 10.3390/ijerph19084754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 11/16/2022]
Abstract
A context-specific delineation of research approaches to resilience in the perinatal and early motherhood literature is currently lacking. A principle-based concept analysis was used to establish a description of how women's resilience is currently conceptualised and operationalised within empirical research in the perinatal period and early motherhood (defined as up to five-years postpartum). CINAHL, Medline, PsychInfo, EMBASE, ASSIA, Web of Science, Scielo, Maternity and Infant Care, the Cochrane Library, and the World Health Organization were systematically searched (January/February 2020 and March 2022). Fifty-six studies met the inclusion criteria. Analysis demonstrated interchangeable use of associated concepts such as 'coping', 'coping strategies', and 'adaptation'. Resilience was frequently operationalised as the absence of illness symptomatology, rather than the presence of mental well-being. Investigations of positive areas of functioning were predominately related to the mother's family role. There was limited qualitative exploration of women's perspectives. Recommendations for the pragmatic application of resilience research were not well developed. The narrow operationalisation of resilience by mental ill-health and parental role, and the distinct absence of women's perspectives, restricts the logical maturity and pragmatic application of the concept. Future research may benefit from exploration of women's insights on indicators that might best reflect positive functioning and resilience in this period.
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Rybińska A, Best DL, Goodman WB, Bai Y, Dodge KA. Transitioning to virtual interaction during the COVID-19 pandemic: Impact on the family connects postpartum home visiting program activity. Infant Ment Health J 2022; 43:159-172. [PMID: 34997622 PMCID: PMC8852842 DOI: 10.1002/imhj.21953] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 11/12/2021] [Indexed: 11/23/2022]
Abstract
In this paper, we analyze program activity for Family Connects (FC), an evidence-based postpartum home-visiting intervention, during the COVID-19 pandemic. When the pandemic began, FC transitioned to a virtual protocol which maintains key psychosocial components of the in-person protocol and adjusts health assessments to address the lack of in-person contact. Program performance is contrasted for periods before the pandemic onset (April 2019-March 2020) and after the onset (April 2020-March 2021), involving 10,280 scheduled visits and 6696 visited families (46% non-Hispanic white; 20% non-Hispanic Black; 23% Hispanic; and 10% other race). Post-pandemic onset, FC program participation rates were at 89.8% of pre-pandemic levels. Home visitors observed post-onset increases in families' concerns about home safety but declines in families' needs related to infant care. Community connections were facilitated for 42.9% of visited families post-pandemic onset compared to 51.1% pre-pandemic onset. We conclude that post-pandemic onset virtual delivery rates of FC declined but are high enough to merit continued implementation during a period when some families will decline in-person visits. When in-person visits are deemed safe per public health guidelines, the findings suggest a hybrid approach that could maximize program outreach by prioritizing in-person contact and offering virtual delivery as a second choice.
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Affiliation(s)
- Anna Rybińska
- Center for Child and Family PolicyDuke UniversityDurhamNorth CarolinaUSA
| | - Debra L. Best
- Department of PediatricsDuke UniversityDurhamNorth CarolinaUSA
| | | | - Yu Bai
- Center for Child and Family PolicyDuke UniversityDurhamNorth CarolinaUSA
| | - Kenneth A. Dodge
- Sanford School of Public PolicyDuke UniversityDurhamNorth CarolinaUSA
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