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Gupta M, Patra M, Hamiduzzaman M, McLaren H, Patmisari E. Social Support Postpartum: Bengali Women from India on Their Coping Experiences following Childbirth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:557. [PMID: 38791772 PMCID: PMC11121678 DOI: 10.3390/ijerph21050557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/23/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024]
Abstract
Undertaken in Kolkata, India, our study aimed to explore the experiences of Bengali middle-class women on perceived stressful events, social support, and coping experiences following childbirth. Becoming a mother following childbirth is a shared phenomenon irrespective of culture, social strata, or country, while stress during the postpartum period or depression is not. Discrete medical intervention does not sufficiently address the complexities of postpartum experiences since influencing factors also include economic, political, cultural, and social backgrounds. Adopting a feminist and phenomenological approach, individual in-person interviews were conducted with twenty women recruited via snowball sampling. Our findings revealed that events experienced as stressful may lead to poor postpartum well-being. Underpinned by gendered discourse and biases, stressful events included familial imperatives for a male child, poor social and emotional support from the family, mostly partners and fathers, and systemic workplace barriers. The women in our study commonly resided with their mothers postpartum. They expressed feeling sheltered from these experiences, cared for, and supported. We discuss the women's experiences from a feminist pragmatic worldview, which advocates for a flexible feminism recognizant of the unique and nurturing relationship experiences between Bengali middle-class women and their mothers. In conclusion, we advocate for culturally sensitive, women-centered postpartum care practices that may entail the inclusion of intergenerational care during this critical phase of maternal well-being. These insights underscore the necessity of tailoring postpartum support systems to align with the cultural and familial contexts of the individuals they serve.
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Affiliation(s)
- Moumita Gupta
- Department of Anthropology, Dr. A.P.J. Abdul Kalam Government College, West Bengal State University, Rajarhat, Kolkata 7000163, India;
| | - Mahua Patra
- Department of Sociology, Maulana Azad College, University of Calcutta, Kolkata 700013, India;
| | - Mohammad Hamiduzzaman
- University Centre for Rural Health, School of Health Sciences, Faculty of Medicine & Health, The University of Sydney, Lismore, NSW 2480, Australia
| | - Helen McLaren
- College of Education, Psychology and Social Work, Flinders University, Adelaide, SA 5042, Australia
| | - Emi Patmisari
- College of Education, Psychology and Social Work, Flinders University, Adelaide, SA 5042, Australia
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Paley JL, Jones MA, Catov JM, Whitaker KM, Kozai AC, Barone Gibbs B. Associations of Physical Activity and Sedentary Behaviors with Depressive Symptoms and Mood Disturbance Throughout Pregnancy. J Womens Health (Larchmt) 2024. [PMID: 38324012 DOI: 10.1089/jwh.2023.0419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Abstract
Purpose: Mental health is critical for a healthy pregnancy, yet few studies have evaluated its associations with best practice, objectively measured moderate- to vigorous-intensity physical activity (MVPA) or sedentary behavior (SED). This study evaluated associations of MVPA and SED with mental health across pregnancy. Materials and Methods: Two cohort studies (total n = 125, mean [standard deviation] 31 [5] years, and 14.4% Black) measured MVPA (waist-worn ActiGraph GT3X) and SED (thigh-mounted activPAL) as well as self-reported depressive symptoms and mood disturbance in each trimester. Associations of group-based trajectories of MVPA and SED with depressive symptoms and mood disturbance were analyzed using regression analyses, both overall and by trimester. Results: Overall, the medium versus low trajectory of MVPA was associated with lower levels of depressive symptoms (B = -1.82, 95% confidence interval [CI] -2.97 to -0.68). In the second trimester, women in either the medium or high MVPA trajectories had lower levels of depressive symptoms compared with women in the low MVPA trajectory (B = -8.73, 95% CI -15.74 to -1.71; and B = -2.18, 95% CI -3.80 to -0.56). SED trajectories were not associated with depressive symptoms. Higher trajectories of MVPA and lower trajectories of SED were associated with lower total mood disturbance, with significant associations in the second trimester for MVPA and the first and second trimesters for SED. Higher MVPA trajectories were associated with higher tension, fatigue, and confusion subscales, while higher SED trajectories were associated with higher anger and fatigue and lower esteem and vigor subscales. Conclusions: MVPA and SED levels appear to affect mental health during pregnancy, although larger prospective studies are warranted. Clinical Trail Registration Number: NCT03084302.
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Affiliation(s)
- Joshua L Paley
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Melissa A Jones
- Department of Human Movement Science, Oakland University, Rochester, Michigan, USA
| | - Janet M Catov
- Department of Ob/Gyn and Reproductive Sciences, Magee-Womens Research Institute and Clinical and Translational Sciences Research Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kara M Whitaker
- Department of Human Movement Science, Oakland University, Rochester, Michigan, USA
- Department of Epidemiology, The University of Iowa, Iowa City, Iowa, USA
| | - Andrea C Kozai
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Bethany Barone Gibbs
- Department of Epidemiology and Biostatistics, West Virginia University School of Public Health, Morgantown, WV, USA
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Poo ZX, Quah PL, Chen H, Wright A, Teoh TG, Tan LK, Tan KH. Knowledge, Attitude and Perceptions Around Perinatal Mental Health Among Doctors in an Obstetrics and Gynaecology Academic Department in Singapore. Cureus 2023; 15:e38906. [PMID: 37303430 PMCID: PMC10257555 DOI: 10.7759/cureus.38906] [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: 05/11/2023] [Indexed: 06/13/2023] Open
Abstract
Background Frontline healthcare professionals who provide regular care to women in the antenatal and postnatal period play a critical role in the early detection and management of maternal perinatal mental health (PMH). This study aimed to assess the knowledge, attitudes, and perceptions of doctors around perinatal mental health in an obstetrics and gynaecology (O&G) department in Singapore. Methods Using an online survey, data was collected from 55 doctors who participated in the Doctor's Knowledge, Attitudes and Perceptions of Perinatal Mental Health (I-DOC) study. The survey questions assessed the knowledge, attitudes, perceptions and practices in relation to PMH among doctors in the O&G specialty. Descriptive data was presented as means and standard deviations (SDs), or frequency and percentages. Results Out of the 55 doctors, more than half (60.0%) were not aware of the adverse impacts of poor PMH; 83.7% of doctors were not confident in providing PMH advice and 65.5% did not routinely screen patients for PMH disorders. There was a lower percentage of doctors (10.9% vs. 34.5%, p<0.001) who discussed PMH issues in the antenatal period compared to the postnatal period and this was statistically significant. Majority of doctors (98.2%) agreed that having standardised PMH guidelines will be useful. All doctors agreed on the benefits of having PMH guidelines, education and routine screening for patients. Conclusion There is inadequate PMH literacy among O&G doctors and lack of emphasis on antenatal PMH disorder. The findings highlighted the need for increased education and development of perinatal mental health guidelines.
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Affiliation(s)
- Zi Xi Poo
- Department of Maternal Fetal Medicine, Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, SGP
| | - Phai Ling Quah
- Department of Maternal Fetal Medicine, Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, SGP
| | - Helen Chen
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore, SGP
| | - Ann Wright
- Department of Maternal Fetal Medicine, Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, SGP
| | - Tiong Ghee Teoh
- Department of Maternal Fetal Medicine, Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, SGP
| | - Lay Kok Tan
- Department of Maternal Fetal Medicine, Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, SGP
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, SGP
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Tan HS, Agarthesh T, Tan CW, Sultana R, Chen HY, Chua TE, Sng BL. Perceived stress during labor and its association with depressive symptomatology, anxiety, and pain catastrophizing. Sci Rep 2021; 11:17005. [PMID: 34417541 PMCID: PMC8379208 DOI: 10.1038/s41598-021-96620-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 08/13/2021] [Indexed: 12/24/2022] Open
Abstract
Perceived stress is a dimension of the maternal stress response, however little data is available on perceived stress levels and its associated psychological risk factors during labor. In this secondary data analysis from a prospective study evaluating epidural regimens, we investigated the potential associations between depressive symptomatology, anxiety, and pain catastrophizing with perceived stress during labor. Healthy nulliparous adult women with term singleton pregnancies requesting for epidural analgesia in early labor were included. Assessments were administered after epidural analgesia and adequate pain relief were achieved. Perceived stress (Perceived Stress Scale, PSS, high PSS ≥ 16), depressive symptomatology (Edinburgh Postnatal Depression Scale, EPDS, high EPDS ≥ 10), and pain catastrophizing (Pain Catastrophizing Scale, PCS, high total PCS ≥ 25) were assessed as categorical variables. Additionally, anxiety (State-trait Anxiety Inventory, STAI), PCS total and its subscales (rumination, magnification and helplessness) were analyzed as continuous variables. Univariate and multivariable logistic regression models were used to identify factors associated with high PSS. Of 801 women included, 411 (51.9%) had high PSS. High EPDS (OR 2.16, 95%CI 1.36–3.44), increasing trait anxiety (OR 1.17, 95%CI 1.14–1.20), and increasing pain magnification (OR 1.12, 95%CI 1.05–1.19) were independently associated with high PSS. Depressive symptomatology, trait anxiety, and pain magnification were associated with perceived stress during labor, providing impetus for future research aimed at detecting and alleviating stress and its psychological or pain association factors.
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Affiliation(s)
- Hon Sen Tan
- Department of Women's Anesthesia, KK Women's and Children's Hospital, Singapore, Singapore
| | - T Agarthesh
- Anesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Chin Wen Tan
- Department of Women's Anesthesia, KK Women's and Children's Hospital, Singapore, Singapore.,Anesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Rehena Sultana
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | - Helen Yu Chen
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore, Singapore.,Pediatrics Academic Clinical Program, Duke-NUS Medical School, 100 Bukit Timah Road, Singapore, 229899, Singapore
| | - Tze-Ern Chua
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore, Singapore.,Pediatrics Academic Clinical Program, Duke-NUS Medical School, 100 Bukit Timah Road, Singapore, 229899, Singapore
| | - Ban Leong Sng
- Department of Women's Anesthesia, KK Women's and Children's Hospital, Singapore, Singapore. .,Anesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.
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Li C, Huo L, Wang R, Qi L, Wang W, Zhou X, Zhou Y, Zhang X. The prevalence and risk factors of depression in prenatal and postnatal women in China with the outbreak of Corona Virus Disease 2019. J Affect Disord 2021; 282:1203-1209. [PMID: 33601697 PMCID: PMC7800140 DOI: 10.1016/j.jad.2021.01.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 01/03/2021] [Accepted: 01/07/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND The prevalence of depression increase with the outbreaks of epidemic disease. The prevalence of depression during the outbreak of Corona Virus Disease 2019 (COVID-19) in prenatal and postnatal women was examined in China. METHODS 2201 prenatal and postnatal women in mainland China were recruited in this cross-sectional study from February 28th to April 26th, 2020. The Patient Health Questionnaire (PHQ-9) was used to assess depression in prenatal and postnatal women. RESULTS The prevalence rate of depression was 35.4%. The risk factors for depression included drinking (p = 0.04; adjusted OR = 2.81, 95%CI: 1.26~6.24), nausea and vomiting during pregnancy (p < 0.001; adjusted OR = 3.54, 95%CI: 1.10~11.44), pregnancy's influence on mobility (p = 0.02; adjusted OR = 1.42, 95%CI: 1.11~1.83), anxiety (p < 0.001; adjusted OR = 1.66, 95%CI: 1.57~1.75), insomnia (p < 0.001; adjusted OR = 1.17, 95%CI: 1.14~1.21) and daily attention to fetal movement (p < 0.001; adjusted OR = 0.41, 95%CI: 0.31~0.56). LIMITATIONS This study used a cross-sectional design, and cannot compare changes in the incidence of depression before and after the COVID-19 outbreak. CONCLUSIONS During the COVID-19 outbreak, the prevalence rate of depression among Chinese prenatal and postnatal women was 35.4%. Moreover, anxiety, insomnia, drinking, nausea and vomiting during pregnancy, as well as the impaired movement and less daily monitoring of fetal movement were risk factors for depression.
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Affiliation(s)
- Chuanxiao Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China,Shenzhen Kangning Hospital, Shenzhen, Guangdong, China
| | - Lijuan Huo
- Department of Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China,The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Ruoxi Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ling Qi
- School of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, 430023, China
| | - Wenjia Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xin Zhou
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China
| | - Yongjie Zhou
- Department of Psychiatric Rehabilitation, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China.
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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Moss KM, Dobson AJ, Mishra GD. Testing the role of the timing and chronicity of maternal depressive symptoms in the associations with child behaviour and development. Paediatr Perinat Epidemiol 2020; 34:678-686. [PMID: 32535995 DOI: 10.1111/ppe.12681] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 03/04/2020] [Accepted: 03/08/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND There is debate regarding whether the association between maternal depressive symptoms (MDS) and child outcomes is due to the timing or chronicity of symptoms. OBJECTIVES To investigate whether critical periods, sensitive periods, or accumulation models provided the best explanation for the association between MDS and children's behaviour and development. METHODS Data on mothers (N = 892) were collected from 1996 to 2015 as part of the Australian Longitudinal Study on Women's Health, a prospective longitudinal epidemiological study. Data on children (N = 978, 2-12 years) were collected in 2016/17 as part of the Mothers and their Children's Health study. Mothers were categorised according to whether they reported MDS (scored ≥ 10 on the CESD-10) before pregnancy, during pregnancy, or in early childhood. Child outcomes were maternal-rated behaviour problems (Strengths and Difficulties Questionnaire; SDQ) and teacher-rated development (Australian Early Development Census; AEDC). We used a structured life course approach to rigorously test critical period, sensitive period, and accumulation (ie chronicity) theories by comparing the fit of a series of models. RESULTS Most mothers did not report MDS at any time (69.2%), 16.9% reported MDS before pregnancy, 13.2% during pregnancy, and 16.5% in early childhood. High/very high total behaviour problems were reported for 7.0% of children, and developmental vulnerability/risk was reported for 15.9% for social competence and 15.7% for emotional maturity. An accumulation model was the best fit, with each period of MDS associated with an increase of 1.71 points (95% CI 1.26, 2.17) on the SDQ and decreases of 0.31 (95% CI -0.50, -0.12) and 0.29 points (95% CI -0.49, -0.08) on AEDC social competence and emotional maturity, respectively. CONCLUSIONS Chronic MDS were associated with poorer child outcomes than MDS at any single time. Sensitive and critical period models were not supported. This suggests chronicity of symptoms may be more important than timing.
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Affiliation(s)
- Katrina M Moss
- School of Public Health, Centre for Longitudinal and Life Course Research, The University of Queensland, Brisbane, QLD, Australia
| | - Annette J Dobson
- School of Public Health, Centre for Longitudinal and Life Course Research, The University of Queensland, Brisbane, QLD, Australia
| | - Gita D Mishra
- School of Public Health, Centre for Longitudinal and Life Course Research, The University of Queensland, Brisbane, QLD, Australia
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Lim HA, Chua TE, Malhotra R, Allen JC, Teo I, Chern BSM, Tan KH, Chen H. Identifying trajectories of antenatal depression in women and their associations with gestational age and neonatal anthropometry: A prospective cohort study. Gen Hosp Psychiatry 2019; 61:26-33. [PMID: 31710855 DOI: 10.1016/j.genhosppsych.2019.09.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 09/11/2019] [Accepted: 09/11/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The present study sought to determine the longitudinal trajectories of antenatal depression and examine their associations with birth outcomes. METHOD 926 healthy women with uncomplicated singleton pregnancies within 14 weeks of gestation participated in this prospective cohort study. Women completed a sociodemographic and medical questionnaire and the locally-validated Edinburgh Postnatal Depression Scale (EPDS) in their first, second, and third trimesters, and prior to parturition. Gestational age and neonatal weight, length, and head circumference were recorded at birth. Group-based trajectory modelling characterized trajectories of antenatal depression. Analyses of covariance and covariate-adjusted linear regressions identified associations between trajectories and neonatal outcomes. RESULTS Four distinct non-fluctuating trajectories of depressive symptoms were identified, with 9% women suffering from probable clinical depression throughout the pregnancy. Women in this persistently-moderate depression trajectory delivered 2.48 days earlier than in other trajectories; a one-point increase in EPDS scores was associated with an adjusted reduction of 5.82 g in birthweight. CONCLUSIONS Although meaningful trajectories were identified, no clinically relevant associations between persistently-moderate depressive symptoms with neonatal outcomes were found. The stability of these trajectories, however, suggests the importance of screening for depressive symptoms early in pregnancy to identify women who may benefit from greater formal and informal support.
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Affiliation(s)
- Haikel A Lim
- Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore.
| | - Tze-Ern Chua
- Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore.
| | - Rahul Malhotra
- Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore.
| | - John C Allen
- Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore.
| | - Irene Teo
- Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore.
| | - Bernard S M Chern
- KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore.
| | - Kok Hian Tan
- Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore.
| | - Helen Chen
- Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore.
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Phoosuwan N, Eriksson L, Lundberg PC. Antenatal depressive symptoms during late pregnancy among women in a north-eastern province of Thailand: Prevalence and associated factors. Asian J Psychiatr 2018; 36:102-107. [PMID: 30055513 DOI: 10.1016/j.ajp.2018.06.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 06/24/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Globally, depression is prevalent during pregnancy and several factors have been associated with antenatal depressive symptoms (ADS). However, ADS have rarely been investigated in Thailand. This study aimed at exploring the prevalence of ADS and factors associated with these symptoms among Thai women in late pregnancy. METHODS A cross-sectional study including 449 women in late pregnancy was carried out. The Edinburgh Postnatal Depression Scale (EPDS) was used to detect depressive symptoms with a score of 10 points or higher. Socio-demographic characteristics and psychosocial risks were measured in association with ADS. Percentage and 95% confidence interval (CI) were used to assess the prevalence of ADS. Odds ratio (OR) and 95%CI were used to determine ADS-related risk factors among women. RESULTS The prevalence of ADS was 46.8% (95%CI 42.3-51.4). Pregnant women aged less than 20 years (OR 2.58, 95%CI 1.14-5.84) and those not having enough money (OR 2.71, 95%CI 1.22-6.05) had an increased risk of ADS. Psychosocial risks related to ADS for women were low psychological well-being (OR 3.12, 95%CI 1.75-5.58), low self-esteem (OR 2.08, 95%CI 1.24-3.49), and low sense of coherence (OR 1.82, 95%CI 1.12-2.95). CONCLUSIONS The prevalence of ADS among Thai women in their late pregnancy is high. Socio-demographic characteristics and psychosocial factors are independently associated with ADS. Healthcare providers in Thailand should consider EPDS as a standardised screening tool for ADS and use it at antenatal care clinics. Implementing programs focusing on both pregnant women and their family might increase the prevention of perinatal depression.
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Affiliation(s)
- Nitikorn Phoosuwan
- Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Sweden; Department of Community Health, Faculty of Public Health, Kasetsart University Chalermphrakiat Sakonnakhon Province Campus, Thailand.
| | - Leif Eriksson
- Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Sweden
| | - Pranee C Lundberg
- Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Sweden
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Ghaffar R, Iqbal Q, Khalid A, Saleem F, Hassali MA, Baloch NS, Ahmad FUD, Bashir S, Haider S, Bashaar M. Frequency and predictors of anxiety and depression among pregnant women attending tertiary healthcare institutes of Quetta City, Pakistan. BMC WOMENS HEALTH 2017; 17:51. [PMID: 28743261 PMCID: PMC5526273 DOI: 10.1186/s12905-017-0411-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 07/19/2017] [Indexed: 01/04/2023]
Abstract
Background Anxiety and depression (A&D) are commonly reported among pregnant women from all over the world; however, there is a paucity of workable data from the developing countries including Pakistan. The current study, therefore, aims to find out the frequency and predictors of A&D among pregnant women attending a tertiary healthcare institutes in the city of Quetta, in the Balochistan province, Pakistan. Methods A questionnaire based, cross-sectional survey was conducted. The pre-validated Hospital Anxiety and Depression Scale (HADS) were used to assess the frequency of A&D among study respondents. Anxiety and depression scores were calculated via standard scoring procedures while logistic regression was used to identify the predictors of A&D. SPSS v. 20 was used for data analysis and p < 0.05 was taken as significant. Results Seven hundred and fifty pregnant women responded to the survey. The majority of the respondents belonged to age group of 26–35 year (424, 56.4%) and had no formal education (283, 37.6%). Furthermore, 612 (81.4%) of the respondents were unemployed and had urban residencies (651, 86.6%). The mean anxiety score was 10.08 ± 2.52; the mean depression score was 9.51 ± 2.55 and the total HADS score was 19.23 ± 3.91 indicating moderate A&D among the current cohort. Logistic regression analysis reported significant goodness of fit (Chi square = 17.63, p = 0.030, DF = 3), indicating that the model was advisable. Among all variables, age had a significant association when compared with HADS scores [adjusted OR (odds ratios) = 1.23, 95% CI = 1.13–1.62, p < 0.001]. Conclusion Moderate A&D was reported among the study respondents. Furthermore, age was highlighted as a predictor of A&D. The evidence from this study provides a motion of support programs for anxious and depressed pregnant women. The benefits of implementing good mental health in antenatal care have long-lasting benefits for both mother and infant. Therefore, there is a need to incorporate A&D screening in the existing antenatal programs.
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Affiliation(s)
- Rahila Ghaffar
- Faculty of Pharmacy & Health Sciences, University of Balochistan, Quetta, Pakistan
| | - Qaiser Iqbal
- Faculty of Pharmacy & Health Sciences, University of Balochistan, Quetta, Pakistan
| | | | - Fahad Saleem
- Faculty of Pharmacy & Health Sciences, University of Balochistan, Quetta, Pakistan
| | | | | | - Fiaz Ud Din Ahmad
- Faculty of Pharmacy & Alternate Medicine, The Islamia University, Bahawalpur, Pakistan
| | - Sajid Bashir
- Faculty of Pharmacy, University of Sargodha, Punjab, Pakistan
| | - Sajjad Haider
- Faculty of Pharmacy & Health Sciences, University of Balochistan, Quetta, Pakistan
| | - Mohammad Bashaar
- SMART Afghan International Trainings & Consultancy, Kabul, Afghanistan.
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Roomruangwong C, Epperson CN. Perinatal depression in Asian women: prevalence, associated factors, and cultural aspects. ASIAN BIOMED 2017. [DOI: 10.5372/1905-7415.0502.024] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Abstract
Background and Objective: Although perinatal depression is a worldwide problem, most of the studies related to this issue have been conducted in Western countries. This paper summarizes the literature on the prevalence as well as associated factors among Asian countries where the cultural attitudes, customs, and norms are considerably different from those in Western countries.
Methods: We conducted a literature search using MEDLINE (PubMed) from 1968, PsychINFO from 1970, and SCOPUS database from 1982 using keywords “depression”, “antenatal”, “antepartum”, “pregnancy”, “postnatal”, “postpartum”, “perinatal”, “after childbirth” and “Asia”. Only the articles published in English were included.
Results: The overall prevalence of depression during pregnancy and postnatal period are about 20% and 21.8%, respectively. The factors related to perinatal depression can be grouped into the following categories, individual characteristics, husband/marital relationship, pregnancy-related, infant-related, and other psychosocial issues. While there is considerable overlap between Asian and Western countries with respect to risk factors for perinatal depression, premarital pregnancy, conflict with mother in-law, and dissatisfaction with infant’s gender are more specific to Asian cultures.
Conclusions: Studies conducted in Asian countries suggest that the prevalence of perinatal depression is slightly higher than in Western countries. There are several unique culturally related issues that clinicians treating pregnant and postpartum Asian women should be aware as they contribute to an increased risk of depression in these women.
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Affiliation(s)
- Chutima Roomruangwong
- MD, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - C. Neill Epperson
- Department of Psychiatry and Obstetrics/ Gynecology, University of Pennsylvania School of Medicine United States of America
- The Penn Center for Women’s Behavioral Wellness, Pennsylvania 19107, United States of America
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Yilmaz E, Yilmaz Z, Cakmak B, Karsli MF, Gultekin IB, Guneri Dogan N, Kara OF, Kucukozkan T. Nausea and Vomiting in Early Pregnancy of Adolescents: Relationship with Depressive Symptoms. J Pediatr Adolesc Gynecol 2016; 29:65-8. [PMID: 26143555 DOI: 10.1016/j.jpag.2015.06.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 06/16/2015] [Accepted: 06/22/2015] [Indexed: 11/26/2022]
Abstract
STUDY OBJECTIVE To determine the relationship between severity of nausea and vomiting during pregnancy (NVP) and depressive symptoms in pregnant adolescents. DESIGN Prospective cross-sectional study. SETTING A maternity research hospital outpatient clinic, Ankara, Turkey. PARTICIPANTS A total of 200 pregnant adolescents. INTERVENTIONS AND MAIN OUTCOME MEASURES Demographic features and obstetric histories of the participants were assessed. The Rhodes test was performed to determine nausea and vomiting severity in a face-to-face interview, and the self-reported Edinburgh Postnatal Depression Scale was administered with supervision. RESULTS The Rhodes test results showed that 52/200 patients (26%) were classified with none, 83/200 patients (41.5%) with mild, 48/200 patients (24.0%) with moderate, and 17/200 patients (8.5%) with severe symptoms. The mean depression score in the severe vomiting group was significantly higher than that in the no NVP and mild NVP groups (P = .028 and .041, respectively). No differences were found between the other groups. CONCLUSION Severe nausea and vomiting was associated with greater depressive symptom severity in pregnant adolescents.
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Affiliation(s)
- Elif Yilmaz
- Dr Sami Ulus Women's and Children's Health Teaching and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Zehra Yilmaz
- Dr Sami Ulus Women's and Children's Health Teaching and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Bulent Cakmak
- Dr Sami Ulus Women's and Children's Health Teaching and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey.
| | - Mehmet Fatih Karsli
- Dr Sami Ulus Women's and Children's Health Teaching and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Ismail Burak Gultekin
- Dr Sami Ulus Women's and Children's Health Teaching and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Nihan Guneri Dogan
- Dr Sami Ulus Women's and Children's Health Teaching and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Osman Fadil Kara
- Dr Sami Ulus Women's and Children's Health Teaching and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Tuncay Kucukozkan
- Dr Sami Ulus Women's and Children's Health Teaching and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey
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Sagayadevan V, Lee SP, Abdin E, Vaingankar J, Chen H, Chong SA, Subramaniam M. Retrospective observation of mental disorders during postpartum period: Results from the Singapore mental health study. BMC WOMENS HEALTH 2015; 15:119. [PMID: 26674202 PMCID: PMC4682228 DOI: 10.1186/s12905-015-0279-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 12/12/2015] [Indexed: 01/20/2023]
Abstract
Background The perinatal period has been identified as a period of vulnerability for various disorders (particularly anxiety and depressive disorders), which have been associated with negative outcomes for both mother and infant. The current study utilized data from the Singapore Mental Health Study (SMHS) to examine the temporal relationship between mental disorders and the perinatal period, as well as associated risk factors. Methods Life table estimation method was used to derive the estimated hazard rate for any mood or anxiety disorders following pregnancy. Multivariate logistic regression was used to examine the association between socio-demographic factors and onset of mental disorders after the first pregnancy. Results Among women with children (n = 2278), 1.5 % were found to have an onset of any mental disorder (i.e., mood disorders, anxiety disorders, alcohol use disorders), within 2 years after pregnancy. A peak in hazard rate was noted at approximately 1 year following pregnancy for anxiety disorders but not mood disorders. Women who were married, employed and physically healthy were less likely to have had developed any mental disorder. Conclusions The prevalence of mental disorders during pregnancy and postpartum was found to be low among women with children in our community sample, with increased vulnerability following delivery. The results offer some insight into the occurrence of mental disorders during the perinatal period among women in Singapore.
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Affiliation(s)
- Vathsala Sagayadevan
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Siau Pheng Lee
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Janhavi Vaingankar
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Helen Chen
- Department of Psychological Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore. .,Duke-National University of Singapore, 8 College Road, Singapore, 169857, Singapore.
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore.
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Tan EC, Chua TE, Lee TMY, Tan HS, Ting JLY, Chen HY. Case-control study of glucocorticoid receptor and corticotrophin-releasing hormone receptor gene variants and risk of perinatal depression. BMC Pregnancy Childbirth 2015; 15:283. [PMID: 26518448 PMCID: PMC4628323 DOI: 10.1186/s12884-015-0720-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 10/23/2015] [Indexed: 01/04/2023] Open
Abstract
Background Depression during pregnancy or after childbirth is the most frequent perinatal illness affecting women of reproductive age. It could result in unfavourable outcomes for both women and their newborns. The incidence of perinatal depression is higher for those with family history of depression and other mental illness, suggesting the contribution of genetic factors. There is postulation that disruption or fluctuation of reproductive hormones could play a part in women who are sensitive to such changes. Methods This is a case-control study comparing the frequencies of candidate gene variants in patients with perinatal depression with controls. Patients of Chinese descent (N = 725) were recruited from the outpatient clinics of the hospital between 2010 and 2013. Controls were patients who came for postnatal consultations at the obstetrics clinics and scored ≤ 7 on the Edinburgh Postnatal Depression Scale (EPDS) at the postnatal screening programme of the hospital. Cases with confirmed diagnosis of clinical (major) depression related to pregnancy/postpartum were recruited from the hospital’s outpatient clinic. Genomic DNA was extracted from saliva samples and genotyped for the polymorphisms of interest. Differences between groups were assessed by chi-square analysis. Results CRHR1 rs242939 and rs1876828 were not polymorphic in the study population. There was no statistically significant association of perinatal depression for CRHR1 rs242941 and GR rs41423247 (BclI). When all subjects were grouped based on family history of mental illness, there was a statistically significant association of CRHR1 rs242941 with family history regardless of depression status (P = 0.043). There was also a statistically significant difference for GR rs41423247 and regularity of menstrual periods (P < 0.000). Although not statistically significant, women with perinatal depression showed a trend towards higher frequency of self-reported menstrual irregularity. Conclusions No evidence was found for the association of any of the genetic markers with perinatal depression in this study cohort. Instead, the possible genetic links were found in women with positive family history of mental illness and menstrual irregularity, suggesting these could be identifying risk markers for women.
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Affiliation(s)
- Ene-Choo Tan
- KK Research Centre, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore. .,Paediatrics Academic Clinical Programme, SingHealth Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singapore.
| | - Tze-Ern Chua
- Paediatrics Academic Clinical Programme, SingHealth Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singapore. .,Department of Psychological Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.
| | - Theresa M Y Lee
- Paediatrics Academic Clinical Programme, SingHealth Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singapore. .,Department of Psychological Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.
| | - Hui-San Tan
- KK Research Centre, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.
| | - Joe L Y Ting
- KK Research Centre, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.
| | - Helen Y Chen
- Paediatrics Academic Clinical Programme, SingHealth Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singapore. .,Department of Psychological Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.
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Arnal-Remón B, Moreno-Rosset C, Ramírez-Uclés I, Antequera-Jurado R. Assessing depression, anxiety and couple psychological well-being in pregnancy: a preliminary study. J Reprod Infant Psychol 2014. [DOI: 10.1080/02646838.2014.986648] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Liu L, Setse R, Grogan R, Powe NR, Nicholson WK. The effect of depression symptoms and social support on black-white differences in health-related quality of life in early pregnancy: the health status in pregnancy (HIP) study. BMC Pregnancy Childbirth 2013; 13:125. [PMID: 23731625 PMCID: PMC3679771 DOI: 10.1186/1471-2393-13-125] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Accepted: 05/24/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lower physical and social functioning in pregnancy has been linked to an increased risk of preterm delivery and low birth weight infants, butt few studies have examined racial differences in pregnant women's perception of their functioning. Even fewer studies have elucidated the demographic and clinical factors contributing to racial differences in functioning. Our objective was to determine whether there are racial differences in health-related quality of life (HRQoL) in early pregnancy; and if so, to identify the contributions of socio-demographic characteristics, depression symptoms, social support and clinical factors to these differences. METHODS Cross-sectional study of 175 women in early pregnancy attending prenatal clinics in urban setting. In multivariate analysis, we assessed the independent relation of black race (compared to white) to HRQoL scores from the eight domains of the Medical Outcomes (SF-36) SURVEY: Physical Functioning, Role-Physical, Bodily Pain, Vitality, General Health, Social Functioning, Role-Emotional, and Mental Health. We compared socio-demographic and clinical factors and depression symptoms between black and white women and assessed the relative importance of these factors in explaining racial differences in physical and social functioning. RESULTS Black women comprised 59% of the sample; white women comprised 41%. Before adjustment, black women had scores that were 14 points lower in Physical Function and Bodily Pain, 8 points lower in General Health, 4 points lower in Vitality and 7 points lower in Social Functioning. After adjustment for depression symptoms, social support and clinical factors, black women still had HRQoL scores that were 4 to 10 points lower than white women, but the differences were no longer statistically significant. Level of social support and payment source accounted for most of the variation in Physical Functioning, Bodily Pain and General Health. Social support accounted for most of the differences in Vitality and Social Functioning. CONCLUSIONS Payment source and social support accounted for much of the racial differences in physical and social function scores. Efforts to reduce racial differences might focus on improving social support networks and Socio-economic barriers.
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Affiliation(s)
- Li Liu
- Department of International Health, Johns Hopkins University, Baltimore, USA
| | - Rosanna Setse
- Department of Epidemiology, Johns Hopkins University, Baltimore, USA
| | - Ruby Grogan
- Department of Medicine University of California, San Francisco, USA
- Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, USA
| | - Neil R Powe
- Department of Medicine University of California, San Francisco, USA
| | - Wanda K Nicholson
- Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, USA
- Center for Women’s Health Research, University of North Carolina, Chapel Hill, USA
- Diabetes Center, University of North Carolina, Chapel Hill, USA
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Chen H, Bautista D, Ch'ng YC, Li W, Chan E, Rush AJ. Screening for postnatal depression in Chinese-speaking women using the Hong Kong translated version of the Edinburgh Postnatal Depression Scale. Asia Pac Psychiatry 2013; 5:E64-72. [PMID: 23857814 DOI: 10.1111/appy.12080] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 03/13/2013] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The Edinburgh Postnatal Depression Scale (EPDS) may not be a uniformly valid postnatal depression (PND) screen across populations. We evaluated the performance of a Chinese translation of 10-item (HK-EPDS) and six-item (HK-EPDS-6) versions in post-partum women in Singapore. METHODS Chinese-speaking post-partum obstetric clinic patients were recruited for this study. They completed the HK-EPDS, from which we derived the six-item HK-EPDS-6. All women were clinically assessed for PND based on Diagnostic and Statistical Manual, Fourth Edition-Text Revision criteria. Receiver-operator curve (ROC) analyses and likelihood ratio computations informed scale cutoff choices. Clinical fitness was judged by thresholds for internal consistency [α ≥ 0.70] and for diagnostic performance by true-positive rate (>85%), false-positive rate (≤10%), positive likelihood ratio (>1), negative likelihood ratio (<0.2), area under the ROC curve (AUC, ≥90%) and effect size (≥0.80). RESULTS Based on clinical interview, prevalence of PND was 6.2% in 487 post-partum women. HK-EPDS internal consistency was 0.84. At 13 or more cutoff, the true-positive rate was 86.7%, false-positive rate 3.3%, positive likelihood ratio 26.4, negative likelihood ratio 0.14, AUC 94.4% and effect size 0.81. For the HK-EPDS-6, internal consistency was 0.76. At 8 or more cutoff, we found a true-positive rate of 86.7%, false-positive rate 6.6%, positive likelihood ratio 13.2, negative likelihood ration 0.14, AUC 92.9% and effect size 0.98. DISCUSSION The HK-EPDS (cutoff ≥13) and HK-EPDS6 (cutoff ≥8) are fit for PND screening for general population post-partum women. The brief six-item version appears to be clinically suitable for quick screening in Chinese speaking women.
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Affiliation(s)
- Helen Chen
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore.
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Li J, Mao J, Du Y, Morris JL, Gong G, Xiong X. Health-related quality of life among pregnant women with and without depression in Hubei, China. Matern Child Health J 2012; 16:1355-63. [PMID: 22045020 DOI: 10.1007/s10995-011-0900-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
The role of prenatal depression on physical and mental health among women in mainland China has not been previously investigated. The aim of this research was to (a) calculate the prevalence of depression during pregnancy, (b) explore the relationship between depression sample characteristics and quality of life and (c) identify predictors of physical and mental health among pregnant women. This study was designed as a cross-sectional and exploratory survey. A total of 454 pregnant women participated in the study between December 2009 and June 2010 in central China. The data was collected using the Medical Outcomes Study short form 36 v2 and the Edinburgh Postnatal Depression Scale. Participants were recruited at outpatient departments of obstetrics and gynecology. Findings show that almost 40% of pregnant women experience prenatal depression. Depression was significantly associated with physical and mental health-related quality of life (HRQoL). Depression, increased age, higher gestational age, being employed and married were significant predictors of lower physical HRQoL. Depression, lower BMI and having an unintended pregnancy were significant predictors of lower mental HRQoL. Prenatal depression is very common in women from mainland China. Depressed women suffer from impaired physical and mental health; prenatal depression has a negative impact on women's HRQoL. We recommend that antenatal services integrate screening for depression into routine antenatal care.
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Affiliation(s)
- Jie Li
- School of Nursing, TongJi Medical College, Huazhong University of Science and Technology, Wuhan, China
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Balestrieri M, Isola M, Bisoffi G, Calò S, Conforti A, Driul L, Marchesoni D, Petrosemolo P, Rossi M, Zito A, Zorzenone S, Di Sciascio G, Leone R, Bellantuono C, Petrosemolo P, Paola P, Rossi M, Michela R, Zito A, Adriana Z, Zorzenone S, Stefania Z, Di Sciascio G, Guido DS, Leone R, Roberto L, Bellantuono C, Cesario B. Determinants of ante-partum depression: a multicenter study. Soc Psychiatry Psychiatr Epidemiol 2012; 47:1959-65. [PMID: 22526826 DOI: 10.1007/s00127-012-0511-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Accepted: 03/27/2012] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Ante-partum depression (APD) is usually defined as a non-psychotic depressive episode of mild to moderate severity, beginning in or extending into pregnancy. APD has received less attention than postpartum depression. This is a cross-sectional study carried out in the Obstetrics and Gynaecology (OG) departments of four different general hospitals in Italy. METHODS Women attending consecutively the OG departments for their first ultrasound examination were asked to fill in the Edinburgh Postnatal Depression Scale (EPDS) in its Italian validated version. We used the total scores of the EPDS as a continuous variable for univariate and linear regression analyses; in accordance with the literature, the item analysis of EPDS was carried out by classifying the sample as women with "no depression" (scores 0-9), "possible depression" (scores 10-12), "probable depression" (scores 13+) and "probable APD" (scores 15+). RESULTS The number of women recruited was 1,608. The EPDS assessment classified 10.9 % of the women as possibly depressed, 8.3 % as probably depressed and 4.7 % probably affected from an APD. EPDS score distribution was associated with nationality (higher scores for foreigners), cohabitation (higher scores for women living with friends or in a community), occupation (higher scores for housewives), past episodes of depression and use of herbal drugs. Non-depressed women had significantly lower values on all ten items as compared with depressed women, however, the pattern of item distribution on the EPDS scale remained similar across depression severity groups. In all four groups item 4 (anxious depression) attained the highest scores, while item 10 (suicidality) attained the lowest scores.
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Affiliation(s)
- Matteo Balestrieri
- Department of Experimental and Clinical Medical Sciences, University of Udine, Udine, Italy.
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Ali NS, Azam IS, Ali BS, Tabbusum G, Moin SS. Frequency and associated factors for anxiety and depression in pregnant women: a hospital-based cross-sectional study. ScientificWorldJournal 2012; 2012:653098. [PMID: 22629180 PMCID: PMC3354685 DOI: 10.1100/2012/653098] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Accepted: 01/24/2012] [Indexed: 12/17/2022] Open
Abstract
Antepartum anxiety and/or depression is a major public health problem globally. The aim of this study was to estimate the frequency of antepartum anxiety and/or depression among pregnant women. This was a cross-sectional study conducted in a tertiary care hospital among pregnant women. A total of 165 pregnant women were interviewed by a clinical psychologist using HADS for assessing anxiety and/or depression and also collected information regarding sociodemographic, obstetric, family relationships, and home environment. Out of the total of 165 pregnant women about 70 percent of them were either anxious and/or depressed. The increasing age of women (P-value = 0.073), not having any live birth (P-value = 0.036), adverse pregnancy outcome in past including death of a child, stillbirth or abortion (P-value = 0.013), participant's role in household decision making (P-value = 0.013), and domestic violence (verbal or physical abuse towards mother or children by any family member) (P-value = 0.123). Our study highlights that anxiety and/or depression is quite common among pregnant women. Therefore, there is a need to incorporate screening for anxiety and depression in the existing antenatal programs and development of strategies to provide practical support to those identified.
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Affiliation(s)
- Niloufer S. Ali
- Department of Family Medicine, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan
| | - Iqbal S. Azam
- Department of Community Health Sciences, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan
| | - Badar S. Ali
- Department of Family Medicine, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan
| | - Ghurnata Tabbusum
- Department of Peadiatrics and Child Health, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan
| | - Sana S. Moin
- Department of Rheumatology, Waikato Hospital, Pembroke Street, Hamilton 3204, New Zealand
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Chen H, Wang J, Ch'ng YC, Mingoo R, Lee T, Ong J. Identifying mothers with postpartum depression early: integrating perinatal mental health care into the obstetric setting. ISRN OBSTETRICS AND GYNECOLOGY 2011; 2011:309189. [PMID: 21941662 PMCID: PMC3173886 DOI: 10.5402/2011/309189] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Accepted: 06/07/2011] [Indexed: 11/23/2022]
Abstract
With prevalence rates of postnatal depression (PND) as high as at least 7%, there was a need for early detection and intervention of postpartum mental illness amongst Singaporean mothers. This is a report on the first year results of our country's first PND Intervention Programme. The programme consists of two phases: (1) postpartum women were screened with the Edinburgh Postnatal Depression Scale and provided appropriate care plans; (2) individualized clinical intervention using a case management multidisciplinary team model. Screening for PND was generally acceptable, as 64% eligible women participated voluntarily. Nine percent (126) were identified as probable cases from 1369 women. Forty-one women accepted intervention and achieved 78% reduction in the EPDS symptom scores to below the cutoff of 13, 76% had improvement in GAF functioning scores, and 68% had improved health quality scores. Preliminary results are promising, and this intervention model can be replicated.
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Affiliation(s)
- Helen Chen
- Postnatal Depression Intervention Programme, Mental Wellness Service, Kandang Kerbau Women's and Children's Hospital (KKH), 100 Bukit Timah Road, Singapore 229899
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Depressive Symptoms and Resilience among Pregnant Adolescents: A Case-Control Study. Obstet Gynecol Int 2011; 2010:952493. [PMID: 21461335 PMCID: PMC3065659 DOI: 10.1155/2010/952493] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2010] [Accepted: 12/31/2010] [Indexed: 11/18/2022] Open
Abstract
Background. Data regarding depression and resilience among adolescents is still lacking. Objective. To assess depressive symptoms and resilience among pregnant adolescents. Method. Depressive symptoms and resilience were assessed using two validated inventories, the 10-item Center for Epidemiologic Studies Short Depression Scale (CESD-10) and the 14-item Wagnild and Young Resilience Scale (RS), respectively. A case-control approach was used to compare differences between adolescents and adults. Results. A total of 302 pregnant women were enrolled in the study, 151 assigned to each group. Overall, 56.6% of gravids presented total CESD-10 scores 10 or more indicating depressed mood. Despite this, total CESD-10 scores and depressed mood rate did not differ among studied groups. Adolescents did however display lower resilience reflected by lower total RS scores and a higher rate of scores below the calculated median (P < .05). Logistic regression analysis could not establish any risk factor for depressed mood among studied subjects; however, having an adolescent partner (OR, 2.0 CI 95% 1.06-4.0, P = .03) and a preterm delivery (OR, 3.0 CI 95% 1.43-6.55, P = .004) related to a higher risk for lower resilience. Conclusion. In light of the findings of the present study, programs oriented at giving adolescents support before, during, and after pregnancy should be encouraged.
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Goyal D, Gay C, Lee KA. How much does low socioeconomic status increase the risk of prenatal and postpartum depressive symptoms in first-time mothers? Womens Health Issues 2010; 20:96-104. [PMID: 20133153 DOI: 10.1016/j.whi.2009.11.003] [Citation(s) in RCA: 236] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2009] [Revised: 11/10/2009] [Accepted: 11/11/2009] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine socioeconomic status (SES) as a risk factor for depressive symptoms in late pregnancy and the early postpartum period. A secondary objective was to determine whether SES was a specific risk factor for elevated postpartum depressive symptoms beyond its contribution to prenatal depressive symptoms. DESIGN Quantitative, secondary analysis, repeated measures, descriptive design. SETTING Participants were recruited from paid childbirth classes serving upper middle class women and Medicaid-funded hospitals serving low-income clients in Northern California. PARTICIPANTS A sample of 198 first-time mothers was assessed for depressive symptoms in their third trimester of pregnancy and at 1, 2, and 3 months postpartum. MAIN OUTCOME MEASURE Depressive symptoms were measured with the Center for Epidemiological Studies-Depression (CES-D) Scale. RESULTS Low SES was associated with increased depressive symptoms in late pregnancy and at 2 and 3 months, but not at 1 month postpartum. Women with four SES risk factors (low monthly income, less than a college education, unmarried, unemployed) were 11 times more likely than women with no SES risk factors to have clinically elevated depression scores at 3 months postpartum, even after controlling for the level of prenatal depressive symptoms. CONCLUSION Although new mothers from all SES strata are at risk for postpartum depression, SES factors including low education, low income, being unmarried, and being unemployed increased the risk of developing postpartum depressive symptoms in this sample.
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Affiliation(s)
- Deepika Goyal
- California State University, San Jose, School of Nursing, San Jose, CA 95192, USA.
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Klainin P, Arthur DG. Postpartum depression in Asian cultures: A literature review. Int J Nurs Stud 2009; 46:1355-73. [DOI: 10.1016/j.ijnurstu.2009.02.012] [Citation(s) in RCA: 204] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2008] [Revised: 02/14/2009] [Accepted: 02/23/2009] [Indexed: 11/25/2022]
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Faisal-Cury A, Menezes P, Araya R, Zugaib M. Common mental disorders during pregnancy: prevalence and associated factors among low-income women in São Paulo, Brazil: depression and anxiety during pregnancy. Arch Womens Ment Health 2009; 12:335-43. [PMID: 19468824 DOI: 10.1007/s00737-009-0081-6] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2008] [Accepted: 05/08/2009] [Indexed: 01/28/2023]
Abstract
To estimate the prevalence of common mental disorders (CMD) and factors associated with these disorders among pregnant women of low socio-economic status (SES) in São Paulo. We performed a cross-sectional study with 831 women in their 20th to 30th weeks of pregnancy, who were attending antenatal clinics in primary care in São Paulo, Brazil. CMD were assessed with the Clinical Interview Schedule-Revised. Crude and adjusted prevalence ratios and 95%CI were calculated to examine the association between CMD and exposure variables. The prevalence of CMD was 20.2% (95%CI 17.5 to 23.0). Age at current pregnancy and at first delivery, current obstetric complications, not having friends in the community, living in a crowded household, lower occupational status and history of previous psychiatric treatment were all independently associated with increased prevalence of CMD. CMD is highly prevalent among pregnant women of low SES seen in primary care settings in São Paulo. A combination of distal and proximal psychosocial factors increase the risk for CMD. Primary health care professionals need to be aware of how common CMD in such settings and properly trained to deal with CMD during pregnancy.
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van Bussel JCH, Spitz B, Demyttenaere K. Depressive symptomatology in pregnant and postpartum women. An exploratory study of the role of maternal antenatal orientations. Arch Womens Ment Health 2009; 12:155-66. [PMID: 19266251 DOI: 10.1007/s00737-009-0061-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2008] [Accepted: 02/18/2009] [Indexed: 11/27/2022]
Abstract
Little is known about how an expecting woman's view of pregnancy, the child, and motherhood relates to antenatal and postpartum depressive symptomatology. In this study, we investigated the influence of the maternal orientations, as described by Raphael-Leff (Psychological processes of childbearing. The Anna Freud Centre, London, 2005), on the prevalence of depressive symptoms in pregnant and postpartum women. Four hundred three pregnant women participated in a longitudinal study and completed the EPDS and the HADS-D in each pregnancy trimester and between 8 to 12 and 20 to 25 weeks postpartum. In addition, measures of maternal orientation (PPQ), personality (NEO-FFI), coping styles (UCL), adult attachment (RQ), and parental bonding (PBI) were completed antenatally. Bivariate and multivariate analyses revealed that Neuroticism and the Regulator orientation are positively associated with the EPDS and HADS-D in both pregnant and postpartum women. These associations decreased in strength but remained significant after controlling for previous responses on the EPDS and HADS-D. Small negative associations were found between the Facilitator orientation and the HADS-D scores during pregnancy and the early postpartum period. However, this association did not hold its statistical significance within the hierarchical multiple regression models. The maternal orientations have a small but significant and independent contribution in the variance of depressive symptomatology in pregnant and postpartum women.
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Affiliation(s)
- Johan C H van Bussel
- Katholieke Universiteit Leuven, Faculty of Medicine, Institute of Family and Sexuality Studies, Kapucijnenvoer 33, 3000, Leuven, Belgium.
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Golbasi Z, Kelleci M, Kisacik G, Cetin A. Prevalence and correlates of depression in pregnancy among Turkish women. Matern Child Health J 2009; 14:485-91. [PMID: 19238527 DOI: 10.1007/s10995-009-0459-0] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2008] [Accepted: 02/08/2009] [Indexed: 11/30/2022]
Abstract
The aim of this study was to evaluate prevalence and correlates of depression in pregnancy among Turkish women in Sivas, a semi-urban region consisting partly of people with low or middle socioeconomic status. This cross-sectional population-based study was conducted in 19 primary health care centers from urban areas of Sivas in Turkey. Two hundred fifty-eight eligible pregnant women were interviewed at their home to gather the study data. A questionnaire was used to determine the socio-demographics and obstetric characteristics of the study sample. The Turkish version of the Edinburg Postnatal Depression Scale (EPDS) was used to estimate the prevalence of depression. The Multidimensional Scale of Perceived Social Support (MSPSS) was used to determine the social support of pregnant women. We found that with the cutoff of 13, of 258 pregnant women, 71 (27.5%) had prenatal depression. Mean EPDS score of the study population was 9.5 +/- 5.2. We found a significant positive mild-moderate correlation between the EPDS score and maternal age (r = 0.30; P = 0.000). Significant positive mild correlations were found between the EPDS score and gravidity (r = 0.26; P = 0.000) and number of living children (r = 0.15; P = 0.042). There was a significant negative moderate correlation between the EPDS score and perceived social support score (r = -0.43; P = 0.000). The EPDS score of multiparas was significantly higher than that of primiparas (P = 0.000). EPDS scores of women with unplanned pregnancy were higher than those of women with planned pregnancies (P = 0.006). EPDS scores of women with a history of stillbirth were higher than those of women with no history of stillbirth (P = 0.044). Depression is a major public concern that needs to be at the forefront of antenatal assessments in Turkey as in other countries. Health professionals, especially nurses in prenatal settings, are in a unique position to detect antenatal depression. Nurses need to monitor pregnant women for depressive symptoms, especially those who are at increased risk of developing depression.
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Affiliation(s)
- Zehra Golbasi
- Department of Nursing, Cumhuriyet University Faculty of Health Sciences, Sivas 58140, Turkey.
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Setse R, Grogan R, Pham L, Cooper LA, Strobino D, Powe NR, Nicholson W. Longitudinal Study of Depressive Symptoms and Health-Related Quality of Life During Pregnancy and After Delivery: The Health Status in Pregnancy (HIP) Study. Matern Child Health J 2008; 13:577-87. [DOI: 10.1007/s10995-008-0392-7] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Dennis CL, Allen K. Interventions (other than pharmacological, psychosocial or psychological) for treating antenatal depression. Cochrane Database Syst Rev 2008:CD006795. [PMID: 18843730 DOI: 10.1002/14651858.cd006795.pub2] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Although pregnancy was once thought of as a time of emotional well-being for many women, conferring 'protection' against psychiatric disorders, a recent meta-analysis of 21 studies suggests the mean prevalence rate for depression across the antenatal period is 10.7%, ranging from 7.4% in the first trimester to a high of 12.8% in the second trimester. Due to maternal treatment preferences and potential concerns about fetal and infant health outcomes, non-pharmacological treatment options are needed. OBJECTIVES To assess the effects, on mothers and their families, of non-pharmacological/psychosocial/psychological interventions compared with usual antepartum care in the treatment of antenatal depression. SEARCH STRATEGY We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (August 2007), the Cochrane Collaboration Depression Anxiety and Neurosis Group's Trials Registers (CCDANCTR-Studies and CCDANCTR-References) (January 2007), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, Issue 3), MEDLINE (1966 to January 2007), EMBASE (1980 to January 2007) and CINAHL (1982 to January 2007). We scanned secondary references and contacted experts in the field to identify other published or unpublished trials. SELECTION CRITERIA All published, unpublished and ongoing randomised controlled trials of non-pharmacological/psychosocial/psychological interventions to treat antenatal depression. DATA COLLECTION AND ANALYSIS All review authors independently participated in the evaluation of methodological quality and data extraction. . MAIN RESULTS We included one US three-armed randomised controlled trial in this review, incorporating 61 outpatient antenatal women who met Diagnostic and Statistical Manual for Mental Disorders-IV criteria for major depression. Maternal massage, compared to non-specific acupuncture (control group), did not significantly decrease the number of women diagnosed with clinical depression immediately post-treatment (one trial, n = 38; risk ratio (RR) 0.80, 95% confidence interval (CI) 0.25 to 2.53) or at final assessment at 10 weeks' postpartum (one trial, n = 32; RR 1.93, 95% CI 0.37 to 10.01). Acupuncture specifically treating symptoms of depression, compared to non-specific acupuncture, did not significantly decrease the number of women diagnosed with clinical depression immediately post-treatment (one trial, n = 35; RR 0.48, 95% CI 0.11 to 2.13) or at final assessment at 10 weeks' postpartum (one trial, n = 32; RR 0.64, 95% CI 0.06 to 6.39). AUTHORS' CONCLUSIONS The evidence is inconclusive to allow us to make any recommendations for massage therapy or depression-specific acupuncture for the treatment of antenatal depression. The included trial was too small with a non-generalisable sample, to make any recommendations.
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Affiliation(s)
- Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, Ontario, Canada, M5T 1P8.
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Dennis CL, Ross LE, Grigoriadis S. Psychosocial and psychological interventions for treating antenatal depression. Cochrane Database Syst Rev 2007:CD006309. [PMID: 17636841 DOI: 10.1002/14651858.cd006309.pub2] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Although pregnancy was once thought of as a time of emotional wellbeing for many women, conferring 'protection' against psychiatric disorders, a recent meta-analysis of 21 studies suggests the mean prevalence rate for depression across the antenatal period is 10.7%, ranging from 7.4% in the first trimester to a high of 12.8% in the second trimester. Due to maternal treatment preferences and potential concerns about fetal and infant health outcomes, non-pharmacological treatment options are needed. OBJECTIVES The primary objective of this review is to assess the effects, on mothers and their families, of psychosocial and psychological interventions compared with usual antepartum care in the treatment of antenatal depression. SEARCH STRATEGY We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (September 2006), the Cochrane Collaboration Depression Anxiety and Neurosis Group's Trials Registers (CCDANCTR-Studies and CCDANCTR-References) (July 2006), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, Issue 3), MEDLINE (1966 to July 2006), EMBASE (1980 to July 2006) and CINAHL (1982 to July 2006). We also scanned secondary references and contacted experts in the field to identify other published or unpublished trials. SELECTION CRITERIA All published, unpublished and ongoing randomised controlled trials of preventive psychosocial or psychological interventions in which the primary or secondary aim is to treat antenatal depression. We excluded quasi-randomised trials (for example, those randomised by delivery date, or odd versus even medical record numbers) from the analysis. DATA COLLECTION AND ANALYSIS All review authors participated in the evaluation of methodological quality and data extraction. Results are presented using relative risk for categorical data and weighted mean difference for continuous data. MAIN RESULTS One US trial was included in this review, incorporating 38 outpatient antenatal women who met Diagnostic and Statistical Manual for Mental Disorders-IV criteria for major depression. Interpersonal psychotherapy, compared to a parenting education program, was associated with a reduction in the risk of depressive symptomatology immediately post-treatment using the Clinical Global Impression Scale (one trial, n = 38; relative risk (RR) 0.46, 95% confidence interval (CI) 0.26 to 0.83) and the Hamilton Rating Scale for Depression (one trial, n = 38; RR 0.82, 95% CI 0.65 to 1.03). AUTHORS' CONCLUSIONS The evidence is inconclusive to allow us to make any recommendations for interpersonal psychotherapy for the treatment of antenatal depression. The one trial included was too small, with a non-generalisable sample, to make any recommendations.
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Affiliation(s)
- C-L Dennis
- University of Toronto, Faculty of Nursing, 155 College Street, Toronto, Ontario, Canada, M5T 1P8.
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Abstract
OBJECTIVES This study describes the patterns of sleep disturbance and depressive symptoms in a sample of childbearing women from the third trimester through the postpartum period. The relationship between sleep and depressive symptoms is also examined. A secondary aim of this study was to examine the relationship between self-report measures of sleep and depressive symptoms between women with depressive symptoms in comparison with women with minimal or no depressive symptoms in the third trimester and in the third month postpartum. METHODS This longitudinal, descriptive study followed 124 primiparous women from their last month of pregnancy through 3 months postpartum. Questionnaires on sleep and depressive symptoms were completed during the third trimester (Time 1), 1 month postpartum (Time 2), 2 months postpartum (Time 3), and during the third month postpartum (Time 4). Sleep measures in a subset of women with depressive symptoms were compared with those of women with minimal or no symptoms at Time 1 and Time 4. RESULTS AND CONCLUSIONS Sleep disturbance and depressive symptoms were associated at Time 1 and Time 4. For new mothers, a complaint of trouble falling asleep (delayed sleep onset latency) may be the most relevant screening question in relation to their risk for postpartum depression.
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Affiliation(s)
- Deepika Goyal
- Department of Family Health Care Nursing, University of California, San Francisco, CA 94143, USA
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Dennis CL, Ross LE, Grigoriadis S. Psychosocial and psychological interventions for treating antenatal depression. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2007. [DOI: 10.1002/14651858.cd006309] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Nicholson WK, Setse R, Hill-Briggs F, Cooper LA, Strobino D, Powe NR. Depressive Symptoms and Health-Related Quality of Life in Early Pregnancy. Obstet Gynecol 2006; 107:798-806. [PMID: 16582115 DOI: 10.1097/01.aog.0000204190.96352.05] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Depressive symptoms can be associated with lower health-related quality of life in late pregnancy. Few studies have quantified the effect of depressive symptoms in early pregnancy or among a racially and economically diverse group. Our goal was to estimate the independent association of depressive symptoms with health-related quality of life among a diverse group of women in early pregnancy. METHODS We conducted a cross-sectional study of 175 pregnant women receiving prenatal care in a community and university-based setting. We related the presence of depressive symptoms, defined as a Center for Epidemiologic Studies Depression Scale score of 16 or more to health-related quality of life scores from the 8 Medical Outcomes Study Short Form domains: Physical Functioning, Role-Physical, Bodily Pain, Vitality, General Health, Social Functioning, Role-Emotional, and Mental Health. Quantile regression was used to measure the independent association of depressive symptoms with each of the 8 domains. RESULTS The study sample was 49% African American, 38% white, and 11% Asian. Mean (+/- standard deviation) gestational age was 14 +/- 6 weeks. The prevalence of depressive symptoms was 15%. Women with depressive symptoms had significantly lower health-related quality of life scores in all domains except Physical Functioning. After adjustment for sociodemographic, clinical, and social support factors, depressive symptoms were associated with health-related quality of life scores that were 30 points lower in Role-Physical, 19 points lower in Bodily Pain, 10 points lower in General Health, and 56 points lower in Role-Emotional. CONCLUSION Women in early pregnancy with depressive symptoms have poor health-related quality of life. Early identification and management of depressive symptoms in pregnant women may improve their sense of well-being. LEVEL OF EVIDENCE II-2.
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Affiliation(s)
- Wanda K Nicholson
- Department of Gynecology and Obstetrics, Welch Center for Prevention, Epidemiology, Clinical Research, the Johns Hopkins School of Medicine, Baltimore, Maryland 21287, USA.
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Murthy RS, Lakshminarayana R. Is it possible to carry out high-quality epidemiological research in psychiatry with limited resources? Curr Opin Psychiatry 2005; 18:565-71. [PMID: 16639120 DOI: 10.1097/01.yco.0000179499.23311.f3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW This review covers the epidemiological research from developing countries to identify the scope of research in the various aspects of epidemiology and the strengths of research. The period covered is June 2004 to June 2005. The literature survey used searches of Medline, key psychiatric journals and personal correspondence with leading psychiatric researchers from developing countries. RECENT FINDINGS There is a new interest in epidemiological studies in developing countries. These studies have been driven by three factors, namely international collaboration; specific situations like disasters, terrorism and severe acute respiratory syndrome; and international attention to specific topics like maternal depression. There is limited long-term research on specific conditions. There are a number of leads suggesting local social-cultural factors contribute to the distribution of psychiatric problems. Child psychiatry continues to be low in priority. There is also lack of research in areas such as personality disorders and organic psychiatric disorders. SUMMARY It is possible to carry out high quality epidemiological research in developing countries. Such research has provided new insights into the distribution, causation, course and outcome of mental disorders. There is need for greater attention to the development of epidemiological assessment tools to suit local conditions. Specific centers/institutions developing long-term research interests on specific subjects would be valuable for future efforts. There is also need to widen the conditions to be studied.
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Affiliation(s)
- R Srinivasa Murthy
- STP-Mental Health and Rehabilitation of Psychiatric Services, Regional Office for the Eastern Mediterranean, World Health Organization, Naser City, Cairo, Egypt.
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