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Mwita M, Patten S, Dewey D. Prevalence and predictors of postpartum depression and generalized anxiety symptoms among women who delivered at a tertiary hospital in Mwanza Tanzania: a cross-sectional study. DISCOVER MENTAL HEALTH 2024; 4:21. [PMID: 38849688 PMCID: PMC11161451 DOI: 10.1007/s44192-024-00074-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 06/03/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND Postpartum depression and anxiety are major public health concerns that affect 3-39% of women after childbearing and can adversely affect maternal and child health. Most studies have investigated postpartum depression and anxiety and their associated factors among women 4-12 weeks after delivery. There is a scarcity of research among women immediately after delivery from low- and middle-income countries, the gap this study aimed to fill. METHODS A descriptive cross-sectional study was conducted among 386 postpartum women within one week after delivery. The Edinburg Postnatal Depression Scale was used to assess depressive symptoms and the Generalized Anxiety Disorder - 7 scale was used to screen for symptoms of generalized anxiety disorder. Participants were systematically selected from the postnatal wards and interviewed by trained research assistants from November 2019 to March 2020. RESULTS Using standard cut points, the prevalence of depressive and anxiety symptoms was 25.39%, and 37.31% respectively. Having a baby with a weight of 2.5 kgs or more and having partner support were associated with decreased odds of both depression and anxiety symptoms. In contrast, complications during delivery, caesarian section, marital status, and partner violence, were associated with increased odds of depressive and anxiety symptoms post-delivery. CONCLUSION There was a high prevalence of postpartum depression and anxiety symptoms among the study participants in the first week post-delivery, with delivery complications and outcome and psychosocial supports identified as associated factors for depression and anxiety symptoms. These findings highlight the need for early screening to identify those at risk for appropriate intervention.
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Affiliation(s)
- Matiko Mwita
- Catholic University of Health and Allied Sciences (CUHAS), Mwanza, Tanzania.
- Psychiatry Department, Bugando Medical Centre (BMC), Mwanza, Tanzania.
- Department of Psychiatry, Catholic University of Health and Allied Sciences, P.O.Box 1464, Mwanza, Tanzania.
| | - Scott Patten
- Departments of Community Health Sciences and Psychiatry, University of Calgary, Calgary, Canada
| | - Deborah Dewey
- Departments of Pediatrics and Community Health Sciences, University of Calgary, Calgary, Canada
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Sarem S, Neyazi A, Mohammadi AQ, Neyazi M, Ahamdi M, Razaqi N, Wali S, Timilsina S, Faizi H, Griffiths MD. Antenatal depression among pregnant mothers in Afghanistan: A cross-sectional study. BMC Pregnancy Childbirth 2024; 24:342. [PMID: 38704557 PMCID: PMC11069254 DOI: 10.1186/s12884-024-06548-2] [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: 09/14/2023] [Accepted: 04/28/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Approximately one in five pregnant women experience antenatal depression globally. The purpose of the present study was to estimate the prevalence of antenatal depression and explore its relationship between various demographic variables, recent sexual engagement, and recent adverse life events among pregnant Afghan women. METHODS A cross-sectional survey study was carried out between January, 2023 and April 2023 among 460 women aged 15-45 years who were recruited using convenience sampling from Herat province (Afghanistan). Logistic regression models were utilized to explore the relationship between antenatal depression and socio-demographic characteristics among the participants. RESULTS The prevalence of antenatal depression symptoms was 78.5%. Multiple regression analysis indicated that antenatal depression was significantly associated with (i) being aged 30-45 years (AOR: 4.216, 95% CI: 1.868-9.515, p = .001), (ii) being of low economic status (AOR:2.102, 95% CI: 1.051-4.202, p = .036), (iii) not being employed (AOR: 2.445, 95% CI:1.189-5.025, p = .015), (iv) not having had sex during the past seven days (AOR: 2.335, 95% CI: 1.427-3.822, p = .001), and (v) not experiencing a traumatic event during the past month (AOR:0.263, 95% CI: 0.139-0.495, p < .001). CONCLUSION The present study provides insight into the factors associated with the high prevalence of antenatal depression among pregnant Afghan women (e.g., demographic variables, recent adverse life events, and recent sexual engagement). It highlights the urgency of addressing antenatal depression in Afghanistan and provides a foundation for future research and interventions aimed at improving the mental health and well-being of pregnant women in the Afghan context.
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Affiliation(s)
| | - Ahmad Neyazi
- Afghanistan Center for Epidemiological Studies, Herat, Afghanistan.
| | | | - Mehrab Neyazi
- Afghanistan Center for Epidemiological Studies, Herat, Afghanistan
| | - Mozhgan Ahamdi
- Afghanistan Center for Epidemiological Studies, Herat, Afghanistan
| | - Nosaibah Razaqi
- Afghanistan Center for Epidemiological Studies, Herat, Afghanistan
| | - Sadaf Wali
- Afghanistan Center for Epidemiological Studies, Herat, Afghanistan
| | | | - Hamida Faizi
- Afghanistan Center for Epidemiological Studies, Herat, Afghanistan
| | - Mark D Griffiths
- Department of Psychology, Nottingham Trent University, Nottingham, UK
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Wang Y, Wei R, Chen Z, Tang Y, Liu L, Qiao P, Ren C, Yu Z, Lu C. The association between the number of pregnancies and depressive symptoms: A population-based study. J Affect Disord 2024; 350:411-419. [PMID: 38244784 DOI: 10.1016/j.jad.2024.01.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 12/05/2023] [Accepted: 01/14/2024] [Indexed: 01/22/2024]
Abstract
BACKGROUND Depression is a psychosomatic disorder that affects reproductive health. The number of pregnancies is an important indicator of reproductive health. Multiple pregnancies and births may aggravate the risk of depression in females. However, the evidence of the connection between the number of pregnancies and depression is unclear. We aimed to investigate the relationship between the number of pregnancies and depressive symptoms. METHODS We used the National Health and Nutrition Examination Survey (NHANES) data with a total of 17,216 women from 2005 to 2020. The number of pregnancies obtained from the self-report questionnaire. Depressive symptoms were measured by the nine-item patient health questionnaire (PHQ-9). Multivariate logistic regression models were used to examine the risk factors of depression. The restricted cubic spline (RCS) was applied to explore the nonlinear relationship. In addition, subgroup analysis was used to support the accuracy of our findings. RESULTS We found that the number of pregnancies is positively associated with the prevalence of depression. According to the multivariable logistic regression analysis, pregnant women was 1.52-fold higher than the normal group to experience depression in the fully-adjusted model. No interaction between number of pregnancies and covariates in subgroups. LIMITATIONS This study was cross-sectional, which limits its ability to draw conclusions about the causal relationship between the number of pregnancies and depression. CONCLUSION In the United States, the number of pregnancies was positively associated with the prevalence of depression. It is critical to register the number of pregnancies for monitoring depressive symptoms.
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Affiliation(s)
- Yadi Wang
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, PR China; School of Clinical Medicine, Weifang Medical University, Weifang, Shandong Province, PR China
| | - Ran Wei
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, PR China; School of Clinical Medicine, Weifang Medical University, Weifang, Shandong Province, PR China
| | - Zhenna Chen
- School of Clinical Medicine, Weifang Medical University, Weifang, Shandong Province, PR China; Department of Ophthalmology, Afffliated Hospital of Weifang Medical University, Weifang, Shandong, PR China
| | - Yujie Tang
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, PR China; School of Clinical Medicine, Weifang Medical University, Weifang, Shandong Province, PR China
| | - Lu Liu
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, PR China; School of Clinical Medicine, Weifang Medical University, Weifang, Shandong Province, PR China
| | - Pengyun Qiao
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, PR China; School of Clinical Medicine, Weifang Medical University, Weifang, Shandong Province, PR China
| | - Chune Ren
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, PR China; School of Clinical Medicine, Weifang Medical University, Weifang, Shandong Province, PR China.
| | - Zhenhai Yu
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, PR China; School of Clinical Medicine, Weifang Medical University, Weifang, Shandong Province, PR China.
| | - Chao Lu
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, PR China; School of Clinical Medicine, Weifang Medical University, Weifang, Shandong Province, PR China.
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Al-Abri K, Edge D, Armitage CJ. Prospective analysis of factors associated with perinatal depression. Midwifery 2024; 128:103871. [PMID: 37967499 DOI: 10.1016/j.midw.2023.103871] [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: 02/11/2023] [Revised: 09/13/2023] [Accepted: 11/01/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Perinatal depression is a significant public health problem that has adverse effects on both mothers and infants. Little research has been conducted on how depressive symptoms change throughout the perinatal period, especially in the Middle East. This study examines changes in depressive symptoms from pregnancy to the postnatal period, and what explains these changes. METHODS This prospective study recruited 306 Omani women in the third trimester of pregnancy and followed them up two to eight weeks after delivery. The Edinburgh Postnatal Depression Scale (EPDS), with a cut-off of ≥12, was used to assess depressive symptoms in both the antenatal and postnatal periods. Independent t-tests, one-way ANOVA, Tukey's honestly significant difference test and Chi-square tests were used to analyse the data. RESULTS The prevalence of depressive symptoms was 27.12 % (n = 83) during late pregnancy and 29.30 % (n = 81) during the postnatal period. Four groups of women were identified based on the EPDS scores: 1) antenatal depression group (8.82 %; n = 27); 2) ante- and postnatal depression group (14.38 %; n = 44); 3) postnatal depression group (12.09 %; n = 37); and 4) non-depression group (54.90 %; n = 168). Depressive symptoms were associated with low birth weight babies (d = 0.50), which confirms the negative effects of depression on perinatal health outcomes. When compared to the non-depression group, the three depressed groups had higher antenatal Perceived Stress Scale (PSS) scores (ds > 0.52), while the non-depression group had higher antenatal and postnatal Maternity Social Support Scale (MSSS) scores (ds > 0.63), and better relationships with the mother-in-law antenatally (d= 0.57). CONCLUSION The present study of this Middle Eastern cohort shows that there were distinct groups of women experiencing perinatal depressive symptoms, influenced by various psychosocial and obstetric factors, which were comparable to those identified in more regularly studied populations. However, this study also identified other novel factors, such as the quality of family relationships. There is a need for additional research into the factors associated with these groups in order to develop appropriate interventions.
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Affiliation(s)
- Khalood Al-Abri
- Division of Psychology and Mental Health, University of Manchester, G35 Coupland 1 Building, Manchester, UK; Department of Community and Mental Health, College of Nursing, Sultan Qaboos University, Oman.
| | - Dawn Edge
- Division of Psychology and Mental Health, University of Manchester, G35 Coupland 1 Building, Manchester, UK; Equality, Diversity & Inclusion Research Unit, Greater Manchester Mental Health NHS Trust, UK
| | - Christopher J Armitage
- Division of Psychology and Mental Health, University of Manchester, G35 Coupland 1 Building, Manchester, UK; Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, UK; NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, UK
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Ohashi Y, Takegata M, Takeda S, Hada A, Usui Y, Kitamura T. Is Your Pregnancy Unwanted or Unhappy? Psychological Correlates of a Cluster of Pregnant Women Who Need Professional Care. Healthcare (Basel) 2023; 11:2196. [PMID: 37570436 PMCID: PMC10418804 DOI: 10.3390/healthcare11152196] [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] [Received: 05/09/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND A negative response towards a current pregnancy consists of two elements: unwantedness of and unhappiness about the current pregnancy. Little is clear about whether pregnant women can be categorized in terms of unwantedness and unhappiness as well as what the correlates are of these categories. METHODS An internet survey of 696 women in their first trimester of pregnancy examined the participants' intention of and emotional reaction towards pregnancy, borderline personality traits, adult attachment style, depression, fear of childbirth, obsessive-compulsive symptoms, fetal bonding disorder, avoidance of taking part in child care, and consideration about termination of pregnancy (TOP). About one third of the participants were followed up with in their second trimester. RESULTS Two-step cluster analysis using the participants' intention of and emotional reaction towards pregnancy revealed three groups of pregnant women: those who wanted and were happy about the pregnancy (Cluster 1), those who were unhappy about the pregnancy (Cluster 2), and those who did not intend to be pregnant but were happy about pregnancy (Cluster 3). Cluster 2 women, but not Cluster 3 women, were likely to be single, with borderline personality traits as well as unstable adult attachment styles, accompanied by depression, fear of childbirth, obsessive-compulsive symptoms, and fetal bonding disorder. They were more likely to avoid caring for the baby after childbirth and consider TOP. CONCLUSION Expectant women who were unhappy about their pregnancy were at risk of psychological adjustment and need specific perinatal mental health assessment and care.
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Affiliation(s)
- Yukiko Ohashi
- Faculty of Nursing, Josai International University, Togane 283-8555, Japan;
- Kitamura Institute of Mental Health Tokyo, Tokyo 151-0063, Japan; (M.T.); (A.H.)
| | - Mizuki Takegata
- Kitamura Institute of Mental Health Tokyo, Tokyo 151-0063, Japan; (M.T.); (A.H.)
| | - Satoru Takeda
- Department of Obstetrics & Gynecology, Faculty of Medicine, Juntendo University, Tokyo 113-8421, Japan;
- Aiiku Research Institute for Maternal, Child Health and Welfare, Imperial Gift Foundation Boshi-Aiiku-Kai, Tokyo 106-8580, Japan
| | - Ayako Hada
- Kitamura Institute of Mental Health Tokyo, Tokyo 151-0063, Japan; (M.T.); (A.H.)
- Kitamura KOKORO Clinic Mental Health, Tokyo 151-0063, Japan
- Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8553, Japan
| | - Yuriko Usui
- Department of Midwifery and Women’s Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan;
| | - Toshinori Kitamura
- Kitamura Institute of Mental Health Tokyo, Tokyo 151-0063, Japan; (M.T.); (A.H.)
- Kitamura KOKORO Clinic Mental Health, Tokyo 151-0063, Japan
- T. and F. Kitamura Foundation for Studies and Skill Advancement in Mental Health, Tokyo 151-0063, Japan
- Department of Psychiatry, Graduate School of Medicine, Nagoya University, Nagoya 464-8601, Japan
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Saito T, Sakanashi K, Tanaka T, Kitamura T. Factor Structure and Measurement and Structural Invariance of the Edinburgh Postnatal Depression Scale during the Perinatal Period among Japanese Women: What Is the Best Model? Healthcare (Basel) 2023; 11:1671. [PMID: 37372789 DOI: 10.3390/healthcare11121671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 05/24/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
The Edinburgh Postnatal Depression Scale (EPDS) is a widely used screening tool for perinatal depression. Its factor structure is still a debatable topic. Our study aimed to examine the factor structure and measurement invariances of the Japanese version of the EPDS from late pregnancy to early postpartum. A total of 633 women were followed with the EPDS at three times over the perinatal period: late pregnancy (n = 633), 5 days after childbirth (n = 445), and 1 month after childbirth (n = 392). We randomly divided the participants into two groups: one for exploratory factor analyses (EFAs) and another for confirmatory factor analyses (CFAs). The result of the EFAs indicated different factor models at each time point. Hence, CFAs were performed using the second sample set to compare different models including the ones previously reported. A 3-factor model consisting of depression (items 7, 9), anxiety (items 4, 5), and anhedonia (items 1, 2) (Kubota et al., 2018) was consistently stable during the whole perinatal period. Kubota's 3-factor model showed invariance across the perinatal period.
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Affiliation(s)
- Tomomi Saito
- Department of Obstetrics and Gynaecology, School of Medicine, Juntendo University, Tokyo 113-8421, Japan
- Kitamura Institute of Mental Health Tokyo, Tokyo 151-0063, Japan
- Kitamura KOKORO Clinic Mental Health, Tokyo 151-0063, Japan
- Department of Perinatal Mental Health of Aiiku Clinic, Aiiku Maternal and Child Health Center, Tokyo 105-8321, Japan
- Aiiku Research Institute for Maternal, Child Health and Welfare Imperial Gift Foundation Boshi-Aiiku-Kai, Tokyo 106-0047, Japan
| | - Kyoko Sakanashi
- Graduate School of Health Sciences, Kumamoto University, Kumamoto 860-0811, Japan
| | | | - Toshinori Kitamura
- Kitamura Institute of Mental Health Tokyo, Tokyo 151-0063, Japan
- Kitamura KOKORO Clinic Mental Health, Tokyo 151-0063, Japan
- T. and F. Kitamura Foundation for Studies and Skill Advancement in Mental Health, Tokyo 151-0063, Japan
- Department of Psychiatry, Graduate School of Medicine, Nagoya University, Nagoya 464-8601, Japan
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Kawaguchi H, Shinohara R, Akiyama Y, Kushima M, Matsuda Y, Yoneyama M, Yamamoto T, Yamagata Z. Developing an obstetric care screening tool to improve social support access for pregnant women: A prospective cohort study. Front Glob Womens Health 2023; 3:921361. [PMID: 36817871 PMCID: PMC9929063 DOI: 10.3389/fgwh.2022.921361] [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: 04/19/2022] [Accepted: 12/26/2022] [Indexed: 02/04/2023] Open
Abstract
Background This study aimed to develop an efficient interview sheet during pregnancy and screening tool to identify pregnant women needing social support at obstetric institutions. Moreover, we investigate the perinatal factors associated with the Edinburgh postnatal depression scale (EPDS). Methods This prospective cohort study was conducted at three medical institutions that commonly encounter cases with social issues. Pregnant women were assessed using an interview sheet at the first visit (n = 678), at approximately 28 weeks gestation (n = 495), 36 weeks gestation (n = 296), and the postpartum period (n = 822). We investigated the important items identified on the new screening questionnaire (NEW interview sheets) for women needing social support. The items on the interview sheet were scored by multiple linear regression analysis, and the cutoff values were calculated using the receiver operating characteristic curve. The association between perinatal factors and EPDS was assessed using multiple logistic regression analyses. Results The study included 166 cases for which all NEW interview sheets for all periods were available. NEW interview sheets and stepwise screening tools during the first and second trimester were developed in which 2.5% of pregnant women were identified as requiring social support, respectively. The factors associated with EPDS ≧ 9 were "Women who felt confused/troubled or did not feel anything to be pregnant" (adjusted odds ratio [aOR]: 6.51, 95% confidence interval [CI]: 1.62-26.15), "Maternal mental disorder" (aOR 4.38; CI 1.06-18.10), "Consultation request at first visit" (aOR 3.22; CI 1.09-9.45), and "Women who have difficulty or anxiety about pregnancy during the second trimester" (aOR 3.14; CI 1.29-7.67). Conclusions We created the NEW interview sheets and screening tools during the first and the second trimester. Future studies are needed to validate these screening tools.
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Affiliation(s)
- Haruna Kawaguchi
- Department of Maternal-Fetal Medicine, Osaka Women's and Children's Hospital, Osaka, Japan,Correspondence: Haruna Kawaguchi
| | - Ryoji Shinohara
- Center for Birth Cohort Studies, University of Yamanashi, Yamanashi, Japan
| | - Yuka Akiyama
- Department of Health Sciences, School of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Megumi Kushima
- Center for Birth Cohort Studies, University of Yamanashi, Yamanashi, Japan
| | - Yoshio Matsuda
- Department of Obstetrics, Toho Medical Clinic, Tokyo, Japan
| | - Marie Yoneyama
- Postgraduate School of Healthcare, Division of Midwifery/ Innovative Nursing Practice, Tokyo Healthcare University, Tokyo, Japan
| | - Tomomi Yamamoto
- Department of Nursing, International Catholic Hospital, Tokyo, Japan
| | - Zentaro Yamagata
- Department of Health Sciences, School of Medicine, University of Yamanashi, Yamanashi, Japan
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Relationships between Depression, Fear of Childbirth, and Obsessive-Compulsive Symptoms among Pregnant Women under the COVID-19 Pandemic in Japan. Healthcare (Basel) 2023; 11:healthcare11030361. [PMID: 36766936 PMCID: PMC9914326 DOI: 10.3390/healthcare11030361] [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: 12/03/2022] [Revised: 01/17/2023] [Accepted: 01/24/2023] [Indexed: 02/03/2023] Open
Abstract
Little is known about the causality of antenatal depression (AND). We focused on the causal relationships between AND, fear of childbirth (FOC), and obsessive-compulsive symptoms (OCS) during the COVID-19 pandemic in Japan. We also examined whether the perceived threat of COVID-19 is associated with AND. Participants were recruited for an Internet survey conducted in December 2020. A total of 245 pregnant women completed the online survey at 12 to 15 weeks' gestational age (Time 1) and approximately 10 weeks later (Time 2). AND was estimated using the first two diagnostic items of Major Depressive Episode. The estimated prevalence of AND was 4.5% and 2.9% at Time 1 and Time 2, respectively. At both time points, no association was found between AND and the perception of COVID-19 threat. Structural equation modeling showed that AND predicted OCS (β = 0.16, p < 0.001), which, in turn, predicted FOC (β = 0.09, p = 0.042); FOC, in turn, predicted AND (β = 0.23, p < 0.001). AND, OCS, and FOC were predicted by borderline personality traits. Insecure adult attachment influenced AND and FOC via the perceived negative impact of the current pregnancy. Perinatal care providers should assess the personality and perception of pregnancy to prevent depression and pay attention to symptoms such as FOC and OCS in addition to those of depression.
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Akaishi T, Tarasawa K, Fushimi K, Hamada H, Saito M, Kobayashi N, Kikuchi S, Tomita H, Ishii T, Fujimori K, Yaegashi N. Risk Factors Associated With Peripartum Suicide Attempts in Japan. JAMA Netw Open 2023; 6:e2250661. [PMID: 36633845 PMCID: PMC9857025 DOI: 10.1001/jamanetworkopen.2022.50661] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
IMPORTANCE Peripartum suicide attempt is a major psychiatric complication associated with pregnancy, but the risk factors remain largely uncertain. OBJECTIVE To identify the demographic characteristics and predisposing risks for peripartum suicide attempts and postpartum depression. DESIGN, SETTING, AND PARTICIPANTS This cohort study used retrospective data on pregnant women who delivered children between April 1, 2016, and March 31, 2021, at 712 hospitals in Japan. The nationwide Diagnosis Procedure Combination database was used. EXPOSURES Psychiatric and nonpsychiatric medical history, age, alcohol and tobacco use, and obstetric complications and procedures. MAIN OUTCOMES AND MEASURES Data on admissions for prepartum suicide attempt and delivery during the same hospital stay and readmissions for depression or suicide attempt within 1 year post partum were collected. Comparisons of prevalence of each study variable were performed, and multivariable logistic regression analyses were used to determine risk factors. RESULTS From a total of 39 908 649 hospitalization episodes, 804 617 cumulative pregnant women (median [IQR] age at childbirth, 33 [29-36] years) who delivered at the enrolled hospitals were identified, including 1202 who were admitted for suicide attempt and delivery during the same hospital stay and 111 readmitted for suicide attempt within 1 year post partum. Risk factors associated with prepartum suicide attempts included younger age (adjusted odds ratio [aOR], 0.99; 95% CI, 0.98-1.00) and histories of personality disorder (aOR, 10.81; 95% CI, 5.70-20.49), depression (aOR, 3.97; 95% CI, 2.35-6.70), schizophrenia (aOR, 2.89; 95% CI, 1.52-5.50), and adjustment disorder (aOR, 2.66; 95% CI, 1.07-6.58). Risk factors associated with postpartum suicide attempts included younger age (aOR, 0.96; 95% CI, 0.93-1.00), heavy tobacco use (aOR, 23.09; 95% CI, 5.46-97.62), and histories of alcohol use disorder (aOR, 163.54; 95% CI, 28.30-944.95), personality disorder (aOR, 10.28; 95% CI, 3.29-32.10), anxiety disorders (aOR, 8.13; 95% CI, 2.88-22.98), depression (aOR, 7.27; 95% CI, 2.95-17.91), schizophrenia (aOR, 5.77; 95% CI, 2.17-15.38), bipolar disorder (aOR, 3.98; 95% CI, 1.36-11.67), and insomnia (aOR, 3.17; 95% CI, 1.30-7.78). On sensitivity analysis, risk factors associated with postpartum depression after excluding those with prenatal depression included histories of personality disorder, adjustment disorder, bipolar disorder, insomnia, and anxiety disorders. CONCLUSIONS AND RELEVANCE The findings of this cohort study suggest that histories of smoking and prenatal psychiatric disorders are potential risk factors for peripartum suicide attempts and may require additional treatment and prevention interventions.
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Affiliation(s)
- Tetsuya Akaishi
- Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan
| | - Kunio Tarasawa
- Department of Health Administration and Policy, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan
| | - Hirotaka Hamada
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masatoshi Saito
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Natsuko Kobayashi
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Saya Kikuchi
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Tomita
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tadashi Ishii
- Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan
| | - Kenji Fujimori
- Department of Health Administration and Policy, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Nobuo Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Hada A, Minatani M, Wakamatsu M, Kitamura T. Disability during Early Pregnancy: Using the Sheehan Disability Scale during the First Trimester in Japan. Healthcare (Basel) 2022; 10:healthcare10122514. [PMID: 36554038 PMCID: PMC9777738 DOI: 10.3390/healthcare10122514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 12/08/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
Background: Many pregnant women experience impairments in social, occupational, or other important functioning. Aim: This study aimed to confirm measurement and structural invariance of the Sheehan Disability Scale (SDS) and its validity during early pregnancy. Design: Longitudinal study with two observations. Methods: Questionnaires were distributed to pregnant women attending antenatal clinics at gestational weeks 10-13. Of 382 respondents, 129 responded to the SDS again 1 week later. Results: Confirmatory factor analysis shows good fit with the data: χ2/df = 0, comparative fit index (CFI) = 1.000, standardized root mean square residual (SRMR) = 0, and root mean square error of approximation (RMSEA) = 0.718. There is acceptable configural, measurement, and structural invariance of the factor structure between primiparas and multiparas as well as between two observation occasions. The Pregnancy-Unique Quantification of Emesis and Nausea, Patient Health Questionnaire-9, and Insomnia Severity Index subscales explain 47% of the variance in SDS scores. Conclusion: Perinatal health care professionals should pay more attention to the difficulties and disabilities that pregnant women face.
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Affiliation(s)
- Ayako Hada
- Kitamura Institute of Mental Health Tokyo, Tokyo 151-0063, Japan
- Kitamura KOKORO Clinic Mental Health, Tokyo 151-0063, Japan
- Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8553, Japan
| | - Mariko Minatani
- Life Value Creation Unit, NTT DATA Institute of Management Consulting, Inc., Tokyo 102-0093, Japan
| | - Mikiyo Wakamatsu
- Department of Reproductive Health Care Nursing, Kagoshima University Faculty of Medicine School of Health Sciences, Kagoshima 890-8544, Japan
| | - Toshinori Kitamura
- Kitamura Institute of Mental Health Tokyo, Tokyo 151-0063, Japan
- Kitamura KOKORO Clinic Mental Health, Tokyo 151-0063, Japan
- T. and F. Kitamura Foundation for Studies and Skill Advancement in Mental Health, Tokyo 151-0063, Japan
- Department of Psychiatry, Graduate School of Medicine, Nagoya University, Nagoya 466-8550, Japan
- Correspondence:
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11
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Nishi D, Imamura K, Watanabe K, Obikane E, Sasaki N, Yasuma N, Sekiya Y, Matsuyama Y, Kawakami N. The preventive effect of internet-based cognitive behavioral therapy for prevention of depression during pregnancy and in the postpartum period (iPDP): a large scale randomized controlled trial. Psychiatry Clin Neurosci 2022; 76:570-578. [PMID: 36114656 PMCID: PMC9826475 DOI: 10.1111/pcn.13458] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/30/2022] [Accepted: 07/27/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Prevention of perinatal depression beginning from the antenatal period is essential. Therefore, this study aimed to investigate the effectiveness of recently developed internet-delivered cognitive behavioral therapy (iCBT) for preventing the onset of a major depressive episode (MDE) in the third trimester and at 3 months postpartum. METHODS This is a two-arm, parallel-group, general-information controlled, randomized controlled trial. Participants were 5017 pregnant women at 16-20 weeks' gestation without MDE at baseline. They were randomly assigned to an iCBT (intervention; n = 2509) or general-information (control; n = 2508) group, stratified by psychological distress at baseline. The primary outcomes were the numbers of new MDE onsets, measured using the World Health Organization Composite International Diagnostic Interview 3.0, at 32 weeks' gestation and at 3 months postpartum. RESULTS New MDE onset was reported by 59 participants (2.35%) in the intervention group and 73 (2.91%) in the control group during follow-up. Compared with the control group, the hazard ratio (HR) of MDE in the intervention group was 0.85 (95% CI 0.61-1.20), which was not significantly different. Among participants who scored between 5 and 8 on K6 at baseline, 10 (1.37%) in the intervention group reported new onset of MDE, compared with 28 (3.81%) in the control group, and the HR of MDE was 0.38 (95%CI 0.19-0.79). CONCLUSIONS No intervention effect was found for iCBT in preventing new onset of perinatal MDE. iCBT might prevent perinatal depression only among pregnant women with subthreshold depressive symptoms. TRIAL REGISTRATION UMIN000038190.
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Affiliation(s)
- Daisuke Nishi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Public Mental Health Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kotaro Imamura
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuhiro Watanabe
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
| | - Erika Obikane
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Natsu Sasaki
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Yuki Sekiya
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yutaka Matsuyama
- Department of Biostatistics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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12
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Hada A, Imura M, Kitamura T. Development of a scale for parent-to-baby emotions: Concepts, design, and factor structure. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2022; 1:e30. [PMID: 38868703 PMCID: PMC11114277 DOI: 10.1002/pcn5.30] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/18/2022] [Accepted: 06/07/2022] [Indexed: 06/14/2024]
Abstract
Aim Although infant crying is a prerequisite for a baby's survival, it often leads to negative consequences for the caregivers. We hypothesized that this would be mediated by a primary emotion that we feel directly in response to an internal or external event. Hence, this study aimed to develop a new scale to measure basic and self-conscious emotions as primary emotions towards an infant's cry. Methods We conducted a cross-sectional web survey including the scale for parent-to-baby emotions (SPBE)-with 73 items elicited from a literature review-targeted at mothers at 1 month after childbirth (N = 879). A series of explanatory and confirmatory factor analyses were conducted using item parcels. Internal consistency of the scale was calculated by omega indices. We also examined measurement invariance of the scale. Results The theory-driven six basic emotions bifactor model (comparative fit index [CFI] = 0.968, root mean square of error approximation [RMSEA] = 0.070) and four self-conscious emotions factor model (CFI = 0.973, RMSEA = 0.079) were judged as the best models. They were stable in terms of configural, measurement, and structural invariances across parity. Conclusion The SPBE we created is a psychometrically robust measure to assess the primary emotions under the rubric of parent-to-baby emotions. It is a promising tool for measuring parent-to-baby emotions in clinical and research settings.
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Affiliation(s)
- Ayako Hada
- Kitamura Institute of Mental Health TokyoTokyoJapan
- Kitamura KOKORO Clinic Mental HealthTokyoJapan
- Department of Community Mental Health and Law, National Institute of Mental HealthNational Center of Neurology and PsychiatryTokyoJapan
| | - Masumi Imura
- Global Health Care and Midwifery Graduate School of NursingJapanese Red Cross College of NursingTokyoJapan
| | - Toshinori Kitamura
- Kitamura Institute of Mental Health TokyoTokyoJapan
- Kitamura KOKORO Clinic Mental HealthTokyoJapan
- T. and F. Kitamura Foundation for Mental Health Research and Skill AdvancementTokyoJapan
- Department of Psychiatry, Graduate School of MedicineNagoya UniversityNagoyaJapan
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13
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Ohsuga T, Egawa M, Kii M, Ikeda Y, Ueda A, Chigusa Y, Mogami H, Mandai M. Association between nonanemic iron deficiency in early pregnancy and perinatal mental health: A retrospective pilot study. J Obstet Gynaecol Res 2022; 48:2730-2737. [DOI: 10.1111/jog.15397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/07/2022] [Accepted: 08/01/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Takuma Ohsuga
- Department of Gynecology and Obstetrics Kyoto University Graduate School of Medicine Kyoto Japan
| | - Miho Egawa
- Department of Gynecology and Obstetrics Kyoto University Graduate School of Medicine Kyoto Japan
| | - Misato Kii
- Faculty of Medicine Kyoto University Kyoto Japan
| | - Yumie Ikeda
- Department of Gynecology and Obstetrics Kyoto University Graduate School of Medicine Kyoto Japan
- Department of Health Informatics Kyoto University School of Public Health Kyoto Japan
| | - Akihiko Ueda
- Department of Gynecology and Obstetrics Kyoto University Graduate School of Medicine Kyoto Japan
| | - Yoshitsugu Chigusa
- Department of Gynecology and Obstetrics Kyoto University Graduate School of Medicine Kyoto Japan
| | - Haruta Mogami
- Department of Gynecology and Obstetrics Kyoto University Graduate School of Medicine Kyoto Japan
| | - Masaki Mandai
- Department of Gynecology and Obstetrics Kyoto University Graduate School of Medicine Kyoto Japan
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14
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Kigawa M, Tsuchida A, Matsumura K, Kasamatsu H, Tanaka T, Hamazaki K, Adachi Y, Inadera H. Predictors of non-response to successive waves of surveys in the Japan Environment and Children's Study during the 3-year postpartum period: a longitudinal cohort study. BMJ Open 2022; 12:e050087. [PMID: 35777875 PMCID: PMC9252206 DOI: 10.1136/bmjopen-2021-050087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES We examined changes in factors related to non-response to successive waves of the nationwide birth cohort study, the Japan Environment and Children's Study (JECS), during the first 3 years after childbirth. DESIGN Longitudinal cohort study. SETTING As the baseline survey, mothers completed self-administered questionnaires distributed by hand during pregnancy or 1 month after delivery. The self-administered questionnaires that we used in this study were then distributed by mail every 6 months until the children were 3 years old, for a total of six times. PARTICIPANTS Of 103 060 mothers who consented to participate in the JECS during pregnancy, 88 489 mothers were included in the study after excluding those with multiple births, miscarriages or stillbirths and those who withdrew from the study within 3 years after providing informed consent. PRIMARY AND SECONDARY OUTCOME MEASURES Data were collected at the baseline survey on participants' socioeconomic status, medical history, health status, health-related behaviours and their children's health conditions and living situations. The strength of the impact of related factors and the prediction of response status were examined and compared using binominal logistic regression analysis. RESULTS For all six follow-up questionnaire surveys, higher maternal age was strongly associated with providing a response. Factors that were strongly associated with mothers not providing a response were smoking after childbirth and having more children. The concordance rate of response status based on the presented model was about 70%, suggesting that the response status for the first 3 years after birth can be predicted from the information collected in the baseline survey. CONCLUSION By identifying predictors of non-response from information obtained in baseline surveys, researchers may be able to reduce non-response to successive survey waves by issuing reminders, reviewing data collection methods and providing appropriate financial and/or non-financial incentives.
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Affiliation(s)
- Mika Kigawa
- Graduate Course of Health and Social Services, Kanagawa University of Human Services Graduate School, Yokosuka, Kanagawa, Japan
| | - Akiko Tsuchida
- Department of Public Health, University of Toyama Faculty of Medicine Graduate School of Medicine and Pharmaceutical Science for Education, Toyama, Toyama, Japan
| | - Kenta Matsumura
- Department of Public Health, University of Toyama Faculty of Medicine Graduate School of Medicine and Pharmaceutical Science for Education, Toyama, Toyama, Japan
| | - Haruka Kasamatsu
- Toyama Regional Center for Japan Environment and Children's Study, University of Toyama Faculty of Medicine Graduate School of Medicine and Pharmaceutical Science for Education, Toyama, Toyama, Japan
| | - Tomomi Tanaka
- Toyama Regional Center for Japan Environment and Children's Study, University of Toyama Faculty of Medicine Graduate School of Medicine and Pharmaceutical Science for Education, Toyama, Toyama, Japan
- Department of Pediatrics, University of Toyama Faculty of Medicine Graduate School of Medicine and Pharmaceutical Science for Education, Toyama, Toyama, Japan
| | - Kei Hamazaki
- Department of Public Health, Gunma University Graduate School of Medicine School of Medicine Faculty of Medicine, Maebashi, Gunma, Japan
| | - Yuichi Adachi
- Department of Pediatrics, University of Toyama Faculty of Medicine Graduate School of Medicine and Pharmaceutical Science for Education, Toyama, Toyama, Japan
| | - Hidekuni Inadera
- Department of Public Health, University of Toyama Faculty of Medicine Graduate School of Medicine and Pharmaceutical Science for Education, Toyama, Toyama, Japan
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15
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Noda M, Sato Y, Suetsugu Y, Morokuma S. Interoception is associated with anxiety and depression in pregnant women: A pilot study. PLoS One 2022; 17:e0267507. [PMID: 35522683 PMCID: PMC9075621 DOI: 10.1371/journal.pone.0267507] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 04/08/2022] [Indexed: 11/19/2022] Open
Abstract
Pregnancy and postpartum are periods in which women develop psychosocially. However, becoming a mother is stressful, and mood disorders related to anxiety and depression often develop. In recent years, research on interoception-sensations related to the body's internal physiological state-has attracted attention. Interoception has multifaceted characteristics. It involves directly perceiving information in the body while also inferring and evaluating it. In this study, we examined interoception, anxiety, and depression in Japanese pregnant women. Empirical examinations and questionnaire surveys were used to measure interoception in 32 pregnant women not at high risk of pregnancy. A Japanese adaption of the Multidimensional Assessment of Interoceptive Awareness was used to measure interoceptive sensibility, and a heartbeat counting task performance was used to measure interoceptive accuracy. Anxiety and depression were measured using the Japanese versions of the State-Trait Anxiety Inventory and the Edinburgh Postnatal Depression Scale, respectively. A correlation analysis was performed between interoception, anxiety and depression and between differences between sensibility and accuracy of interoception, anxiety and depression. We revealed that interoceptive sensibility and differences between sensibility and accuracy of interoception were associated with anxiety. Based on results of this pilot study, it is necessary to investigate using longitudinal studies whether interoception might be an effective predictor tool for early detection of anxiety during pregnancy and postpartum.
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Affiliation(s)
- Minami Noda
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoko Sato
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- * E-mail:
| | - Yoshiko Suetsugu
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Seiichi Morokuma
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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16
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Elrassas H, Taha GR, Soliman AEDM, Madbole SAEK, Mahmoud DAM. Prevalence and related factors of perinatal depression in Egyptian mothers. MIDDLE EAST CURRENT PSYCHIATRY 2022. [DOI: 10.1186/s43045-022-00203-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Early detection of perinatal depression and its cultural determinants could reduce its sequalae on mothers and their babies. This study investigated the prevalence of perinatal depression in Egyptian mothers and compare women with and without perinatal depression regarding the psychosocial factors.
Three-hundred one women were recruited (166 were pregnant and 135 were in postpartum period) from a primary healthcare unit. Full sociodemographic data, Social Classification Scale, Dyadic Adjustment Scale (DAS), and the Edinburgh Postnatal Depression Scale (EPDS) were completed. Subjects with EPDS score > 9 answered the structured clinical interview (SCID-I) for diagnosis of depression and Hamilton Rating Scale for Depression (HRSD) for depression severity.
Results
Depression with mild to moderate severity was reported in 5.4% and 3.7% of women during pregnancy and postpartum period, respectively. There was a statistically significant association between depression and employment (p = 0.031), mother-in-law disputes (p = 0.002), stigma of being the second wife (p = 0.047), and having financial burdens (p = 0.001). Marital satisfaction was a protective factor for depression (p < 0.001).
Conclusions
Prevalence of perinatal depression was comparable to other developing countries. It was strongly linked to culturally related factors including marital women’s employment, mother-in-law disputes, being the second wife, and socioeconomic burdens. Early detection of perinatal depression and its culturally related factors is important for its management.
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17
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Kawashima A, Detsuka N, Yano R. Sleep deprivation and fatigue in early postpartum and their association with postpartum depression in primiparas intending to establish breastfeeding. J Rural Med 2022; 17:40-49. [PMID: 35047101 PMCID: PMC8753258 DOI: 10.2185/jrm.2021-027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/23/2021] [Indexed: 11/27/2022] Open
Abstract
Objective: To examine the association of objective sleep and fatigue in the
early postpartum period with postpartum depression in Japanese primiparas intending to
establish breastfeeding. Materials and Methods: The participants were 34 primiparas who were in the
postnatal ward after vaginal delivery and responsively breastfeeding their rooming-in
baby. Actigraphy data for objective sleep were collected for three consecutive days
starting from the first day postpartum. Fatigue and postpartum depression were assessed
using the Postpartum Fatigue Scale and Edinburgh Postnatal Depression Scale, respectively,
on numerous days between the first day postpartum and the one-month checkup. Breastfeeding
and rooming-in data were also collected. Results: The mean total sleep time was 252.0 ± 73.1 min/day. Mean
breastfeeding frequency was 12.4 ± 3.2 times/day and mean total breastfeeding time was
247.4 ± 101.8 min/day. Among the participants, 67.6% were exclusively breastfeeding on the
discharge day. Fatigue scores were significantly higher during the hospital stay, compared
with one month postpartum. Multiple regression analysis showed that sleep frequency on the
third day postpartum and mean total breastfeeding time and fatigue on the fifth day
postpartum were factors affecting the Edinburgh Postnatal Depression Scale score. Conclusion: The association between postpartum depression among
breastfeeding primiparas in the early postpartum period and objective sleep, fatigue, and
total breastfeeding time per day was suggested. An environment wherein breastfeeding
mothers can rest and sleep without hesitation will be beneficial. Moreover, the importance
of sleep during pregnancy and the early postpartum period must be highlighted. Midwifery
and/or nursing care starting while the mother is in a postnatal hospital stay can play a
key role in preventing postpartum depression.
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Affiliation(s)
- Ai Kawashima
- Graduate School of Health Sciences, Hokkaido University, Japan
| | | | - Rika Yano
- Faculty of Health Sciences, Hokkaido University, Japan
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18
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Liu C, Butwick A, Sand A, Wikström AK, Snowden JM, Stephansson O. The association between postpartum hemorrhage and postpartum depression: A Swedish national register-based study. PLoS One 2021; 16:e0255938. [PMID: 34379698 PMCID: PMC8357098 DOI: 10.1371/journal.pone.0255938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 07/27/2021] [Indexed: 11/30/2022] Open
Abstract
Background Postpartum hemorrhage is an important cause of maternal death and morbidity. However, it is unclear whether women who experience postpartum hemorrhage are at an increased risk of postpartum depression. Objectives To examine whether postpartum hemorrhage is associated with postpartum depression. Methods We conducted a national register-based cohort study of 486,476 Swedish-born women who had a singleton livebirth between 2007 and 2014. We excluded women with pre-existing depression or who filled a prescription for an antidepressant before childbirth. We classified postpartum depression up to 12 months after giving birth by the presence of an International Classification of Diseases, version 10 (ICD-10) diagnosis code for depression or a filled outpatient prescription for an antidepressant. We used Cox proportional hazard models, adjusting for maternal sociodemographic and obstetric factors. Results Postpartum depression was identified in 2.0% (630/31,663) of women with postpartum hemorrhage and 1.9% (8601/455,059) of women without postpartum hemorrhage. In our unadjusted analysis, postpartum hemorrhage was not associated with postpartum depression (unadjusted hazard ratio (HR) = 1.06, 95% confidence interval (CI) 0.97–1.15). After adjusting for maternal age, parity, education, cohabitation status, maternal smoking status, and early pregnancy maternal BMI, gestational age, and birthweight, the association did not appreciably change, with confidence intervals overlapping the null (adjusted HR = 1.08, 95% CI 0.99, 1.17). Conclusions Within a population-based cohort of singleton women in Sweden with no prior history of depression, postpartum hemorrhage was not associated with postpartum depression.
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Affiliation(s)
- Can Liu
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- * E-mail:
| | - Alexander Butwick
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, United States of America
| | - Anna Sand
- Department of Women’s Health, Karolinska University Hospital, Stockholm, Sweden
| | - Anna-Karin Wikström
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Jonathan M. Snowden
- School of Public Health, Oregon Health & Science University–Portland State University, Portland, Oregon, United States of America
| | - Olof Stephansson
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Women’s Health, Karolinska University Hospital, Stockholm, Sweden
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19
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Generalized anxiety symptoms among women attending antenatal clinic in Mwanza Tanzania; a cross-sectional study. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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20
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Mwita M, Kasongi D, Bernard E, Gunda D, Mmbaga B. The magnitude and determinants of antepartum depression among women attending antenatal clinic at a tertiary hospital, in Mwanza Tanzania: a cross-sectional study. Pan Afr Med J 2021; 38:258. [PMID: 34104306 PMCID: PMC8164423 DOI: 10.11604/pamj.2021.38.258.27023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 02/05/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction there is an increased vulnerability for the development of common mental disorders during the peripartum period as evidenced in depressive disorder. Methods a cross sectional study was used to determine the prevalence and risk factors associated with depression among pregnant women attending antenatal clinic (ANC) at Bugando Medical Centre (BMC), a tertiary level hospital in Mwanza Tanzania. A total of 380 pregnant women were recruited and interviewed by using Edinburg Postnatal Depression Scale. The sample size was randomly selected from the clinic. Results the mean age of the participants was 30.35 years, with minimum and maximum age of 20 years and 47 years respectively with 89.74% of the participants being married. Almost half of the participants, 53.68% were on the third trimester, with about two-third of the participants, 76.84% reports to have planned for their current pregnancies. The overall prevalence of depression was 15% with middle age of the partner (31-40 years), been married, high level of education, partner and family support were found to be statistically protective for depression while polygamy and partner violence were statistically risk factor for depression. Conclusion the results showed high prevalence of antepartum depression which emphasizes the importance of earlier screening, detection and intervention to reduce the burden of morbidity and disability.
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Affiliation(s)
- Matiko Mwita
- Catholic University of Health and Allied Sciences, Mwanza, Tanzania.,Bugando Medical Centre, Psychiatry Department, Mwanza, Tanzania
| | - Doreen Kasongi
- Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Eliya Bernard
- Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Daniel Gunda
- Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Blandina Mmbaga
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
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21
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Tanoue K, Watanabe Z, Nishigori H, Iwama N, Satoh M, Murakami T, Tanaka K, Sasaki S, Sakurai K, Ishikuro M, Obara T, Saito M, Sugawara J, Tatsuta N, Kuriyama S, Arima T, Nakai K, Yaegashi N, Metoki H. The prevalence of psychological distress during pregnancy in Miyagi Prefecture for 3 years after the Great Eas t Japan Earthquake. Environ Health Prev Med 2021; 26:27. [PMID: 33637036 PMCID: PMC7913250 DOI: 10.1186/s12199-021-00944-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 02/03/2021] [Indexed: 11/10/2022] Open
Abstract
Background To examine changes in psychological distress prevalence among pregnant women in Miyagi Prefecture, which was directly affected by the Great East Japan Earthquake and tsunami, and compare it with the other, less damaged areas of Japan. Methods This study was conducted in conjunction with the Japan Environment and Children`s Study. We examined 76,152 pregnant women including 8270 in Miyagi Regional Center and 67,882 in 13 other regional centers from the all-birth fixed data of the Japan Environment and Children’s Study. We then compared the prevalence and risk of distress in women in Miyagi Regional Center and women in the 13 regional centers for 3 years after the disaster. Results Women in the Miyagi Regional Center suffered more psychological distress than those in the 13 regional centers: OR 1.38 (95% CI, 1.03–1.87) to 1.92 (95% CI, 1.42–2.60). Additionally, women in the inland area had a consistently higher prevalence of psychological distress compared to those from the 13 regional centers: OR 1.67 (95% CI, 1.18–2.38) to 2.19 (95% CI, 1.60–2.99). Conclusions The lack of pre-disaster data in the Japan Environment and Children’s Study made it impossible to compare the incidence of psychological distress before and after the March 2011 Great East Japan Earthquake. However, 3 years after the Great East Japan Earthquake, the prevalence of pregnant women with psychological distress did not improve in Miyagi Regional Center. Further, the prevalence of mental illness in inland areas was consistently higher than that in the 13 regional centers after the disaster.
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Affiliation(s)
- Kaou Tanoue
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Zen Watanabe
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Hidekazu Nishigori
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.,Environment and Genome Research Center, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Fukushima Medical Center for Children and Women, Fukushima Medical University, 1 Hikariga-oka, Fukushima, 960-1295, Japan
| | - Noriyuki Iwama
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Michihiro Satoh
- Division of Public Health, Hygiene and Epidemiology, Tohoku Medical Pharmaceutical University, 1-15-1 Fukumuro, Sendai, Miyagi, 983-8536, Japan
| | - Takahisa Murakami
- Division of Public Health, Hygiene and Epidemiology, Tohoku Medical Pharmaceutical University, 1-15-1 Fukumuro, Sendai, Miyagi, 983-8536, Japan
| | - Kousuke Tanaka
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.,Department of Obstetrics and Gynecology, Hachinohe City Hospital, 3-1-1, Tamukai, Hachinohe, Aomori, 031-8555, Japan
| | - Satomi Sasaki
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Kasumi Sakurai
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
| | - Mami Ishikuro
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
| | - Taku Obara
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Department of Pharmaceutical Sciences, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Masatoshi Saito
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Junichi Sugawara
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.,Environment and Genome Research Center, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
| | - Nozomi Tatsuta
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
| | - Shinichi Kuriyama
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
| | - Takahiro Arima
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
| | - Kunihiko Nakai
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
| | - Nobuo Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.,Environment and Genome Research Center, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.,Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
| | - Hirohito Metoki
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan. .,Division of Public Health, Hygiene and Epidemiology, Tohoku Medical Pharmaceutical University, 1-15-1 Fukumuro, Sendai, Miyagi, 983-8536, Japan. .,Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.
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22
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Suicide attempts during pregnancy and perinatal outcomes. J Psychiatr Res 2021; 133:101-105. [PMID: 33338731 DOI: 10.1016/j.jpsychires.2020.12.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 11/19/2020] [Accepted: 12/09/2020] [Indexed: 11/24/2022]
Abstract
Maternal and fetal outcomes of suicide attempts during pregnancy have rarely been examined. We examined the clinical characteristics (maternal age, gestational age in pregnancy, psychoneurological comorbidities, methods of suicide attempts) and critical perinatal outcomes among hospitalized pregnant women who attempted suicide. The current study was a nationwide retrospective cohort study using the Diagnosis Procedure Combination database, a national database for acute-care inpatients in Japan. We identified all pregnant women who were admitted to participating hospitals because of suicide attempts from January 2016 to March 2018. Main composite outcome was defined as critical perinatal outcomes including any of the following: induced or spontaneous abortion, intrauterine fetal death and maternal death. There were 319 eligible patients, of whom 126 (39.5%) had mental and behavioral disorders on admission. Blood transfusion for mother, intrauterine fetal death, and maternal death were more likely to occur in women with violent methods of suicide attempts than in women with non-violent methods. A multivariable logistic regression analysis showed that violent methods of suicide attempts (OR = 3.57 [95% CI = 1.15-11.1]) were significantly associated with critical perinatal outcomes. Healthcare providers should pay attention to mental health among pregnant women, regardless of complications of mental and behavioral disorders. The finding of associations between violent methods of suicide attempts and critical perinatal outcomes may be helpful for healthcare providers.
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23
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Motegi T, Watanabe Y, Fukui N, Ogawa M, Hashijiri K, Tsuboya R, Sugai T, Egawa J, Araki R, Haino K, Yamaguchi M, Nishijima K, Enomoto T, Someya T. Depression, Anxiety and Primiparity are Negatively Associated with Mother-Infant Bonding in Japanese Mothers. Neuropsychiatr Dis Treat 2020; 16:3117-3122. [PMID: 33364763 PMCID: PMC7751780 DOI: 10.2147/ndt.s287036] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/27/2020] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Postpartum depression is a well-known risk factor, and postpartum anxiety and parity are potential risk factors, for mother-infant bonding disorder. However, few studies have focused on the relationships among these factors and mother-infant bonding. This cross-sectional study explored the associations between depression, anxiety and parity, and mother-infant bonding. MATERIALS AND METHODS Japanese mothers, both primiparas and multiparas, completed the Mother-to-Infant Bonding Scale (MIBS) and the Hospital Anxiety and Depression Scale (HADS) one month after childbirth. We performed a stepwise multiple regression analysis with the forward selection method to assess the effects of HADS anxiety and depression scores and parity as independent variables on mother-infant bonding as the dependent variable. RESULTS A total of 2379 Japanese mothers (1116 primiparas and 1263 multiparas) took part in the study. MIBS score (2.89 ± 2.68 vs 1.60 ± 2.11; p < 0.0001) was significantly higher in primiparas than in multiparas. HADS anxiety (6.55 ± 4.06 vs 4.63 ± 3.41; p < 0.0001) and depression (6.56 ± 3.43 vs 5.98 ± 3.20; p < 0.0001) scores were also significantly higher in primiparas than in multiparas. A stepwise multiple regression analysis with the forward selection method revealed that HADS depression and anxiety scores and parity were significantly associated with MIBS score (p = 0.003, 0.015 and 0.023). CONCLUSION Depression, anxiety and primiparity were negatively associated with mother-infant bonding one month after childbirth.
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Affiliation(s)
- Takaharu Motegi
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yuichiro Watanabe
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Naoki Fukui
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Maki Ogawa
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Koyo Hashijiri
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Ryusuke Tsuboya
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takuro Sugai
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Jun Egawa
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Rie Araki
- Nursing, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Kazufumi Haino
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Masayuki Yamaguchi
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Koji Nishijima
- General Center for Perinatal, Maternal and Neonatal Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Toshiyuki Someya
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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24
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Starcevic V, Eslick GD, Viswasam K, Berle D. Symptoms of Obsessive-Compulsive Disorder during Pregnancy and the Postpartum Period: a Systematic Review and Meta-Analysis. Psychiatr Q 2020; 91:965-981. [PMID: 32445002 DOI: 10.1007/s11126-020-09769-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The main aim of this systematic review and meta-analysis was to calculate and compare the frequencies of obsessions and compulsions in women with obsessive-compulsive disorder (OCD) during pregnancy (OCD-P), the postpartum period (OCD-PP) and when they are neither pregnant nor postpartum (OCD-NPP). Fourteen studies were selected after applying the inclusion and exclusion criteria. The meta-analysis showed that aggressive obsessions were much more common in OCD-PP than in OCD-P and OCD-NPP and that washing/cleaning compulsions were less frequent in OCD-PP than in OCD-P and OCD-NPP. These differences were significant, whereas the frequencies of various obsessions and compulsions did not distinguish between OCD-P and OCD-NPP. Obsessions about accidental harm to the infant and other infant-focused obsessions, checking compulsions, self-reassurance and seeking reassurance from others were also relatively common in OCD-PP. Clinical manifestations of OCD-PP are relatively specific and differ from those of OCD-P and OCD-NPP, whereas OCD-P does not seem to have distinct clinical features. Although these findings do not necessarily suggest that OCD-PP is a distinct subtype of OCD, they have important conceptual and clinical implications.
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Affiliation(s)
- Vladan Starcevic
- Faculty of Medicine and Health, Sydney Medical School, Nepean Clinical School, Discipline of Psychiatry, University of Sydney, Penrith, Sydney, NSW, Australia. .,Department of Psychiatry, Nepean Hospital, PO Box 63, Penrith, NSW, 2751, Australia.
| | - Guy D Eslick
- Faculty of Medicine and Health, Sydney Medical School, Nepean Clinical School, The Whiteley-Martin Research Centre, Discipline of Surgery, University of Sydney, Penrith, NSW, Australia
| | - Kirupamani Viswasam
- Faculty of Medicine and Health, Sydney Medical School, Nepean Clinical School, Discipline of Psychiatry, University of Sydney, Penrith, Sydney, NSW, Australia.,Department of Psychiatry, Nepean Hospital, PO Box 63, Penrith, NSW, 2751, Australia
| | - David Berle
- Discipline of Clinical Psychology, University of Technology Sydney, Sydney, NSW, Australia.,School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
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25
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Miller ML, O’Hara MW. Obsessive-compulsive symptoms, intrusive thoughts and depressive symptoms: a longitudinal study examining relation to maternal responsiveness. J Reprod Infant Psychol 2020; 38:226-242. [PMID: 31431052 PMCID: PMC7031018 DOI: 10.1080/02646838.2019.1652255] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 07/30/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND The postpartum period is a vulnerable time for the development of depression. While perinatal depression has been well studied, intrusive thoughts related to the infant and classic obsessive-compulsive (OC) symptoms (e.g. chequering, ordering and cleaning) are also common in the postpartum and less well understood. OBJECTIVE The present study investigated the associations among depressive symptoms, intrusive thoughts, and OC symptoms and their relation to the quality of the mother-infant relationship, particularly in the realm of maternal responsiveness. METHODS Participants (N = 228) were recruited after delivery from a large Midwestern academic medical centre. At 2 and 12-week postpartum, participants completed self-report questionnaires that assessed demographics, depressive and OC symptoms, postpartum-specific intrusive thoughts and accompanying neutralising strategies, and maternal responsiveness. RESULTS At 12-week postpartum, maternal responsiveness was significantly lower for participants that endorsed intrusive thoughts, neutralising strategies or OC symptoms of clinical significance. More severe intrusive thoughts and neutralising strategies were associated with maternal responsiveness but not predictive after accounting for depressive symptoms; depressive symptoms were associated with lower levels of maternal responsiveness across the postpartum. CONCLUSIONS A sizable number of postpartum women experience clinically significant postpartum-specific intrusive thoughts and utilise neutralising strategies, especially in the context of postpartum depressive symptoms. Depressive symptoms have the most influence on maternal responsiveness but it is also important to target intrusive thoughts and OC symptoms in the context of postpartum depression to promote the welfare of new mothers and their offspring.
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Affiliation(s)
- Michelle L. Miller
- Department of Psychological and Brain Sciences, W311 Seashore Hall, University of Iowa, Iowa City, IA, 52242, USA
| | - Michael W. O’Hara
- Department of Psychological and Brain Sciences, W311 Seashore Hall, University of Iowa, Iowa City, IA, 52242, USA
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26
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Validation and factor structure of the Japanese version of the inventory to diagnose depression, lifetime version for pregnant women. PLoS One 2020; 15:e0234240. [PMID: 32525958 PMCID: PMC7289376 DOI: 10.1371/journal.pone.0234240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 05/21/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction A history of major depressive disorder before pregnancy is one risk factor for peripartum depression. Therefore, the purpose of the present study was to examine the validation and factor structure of the Japanese version of the Inventory to Diagnose Depression, Lifetime version (IDDL) for pregnant women. Methods The study participants were 556 pregnant women. Factor analysis was performed to identify the factor structure, construct validity was examined based on the results of the factor analysis, and reliability was examined using Cronbach’s α coefficient. Results Based on the results of the factor analysis of the IDDL, a bifactor model composed of a single general dimension along with the following five factors was extracted: (1) depression, anxiety, and irritability (items 1, 2, 8–10, and 19–21); (2) retardation, decreased concentration, indecisiveness, and insomnia (items 4, 11, 12, and 17); (3) decrease in appetite/significant weight loss (items 13 and 14); (4) increase in appetite/significant weight gain (items 15 and 16); and (5) diminished interest, pleasure, and libido (items 5–7). Cronbach’s α coefficients for these five factors were as follows: 0.910, 0.815, 0.780, 0.683, and 0.803, respectively. Conclusions The reliability, construct validity, and factor structure of the Japanese version of the IDDL were confirmed in pregnant women.
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27
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Seidler Y, Seiler-Ramadas R, Kundi M. 'No Austrian Mother Does This to Sleep Without a Baby!' Postnatal Acculturative Stress and 'Doing the Month' Among East Asian Women in Austria: Revisiting Acculturation Theories From a Qualitative Perspective. Front Psychol 2020; 11:977. [PMID: 32477230 PMCID: PMC7240129 DOI: 10.3389/fpsyg.2020.00977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 04/20/2020] [Indexed: 11/15/2022] Open
Abstract
Acculturative stress is a phenomenon describing negative emotions experienced by immigrants in their socio-cultural and psychological adaptation process to the host society’s dominant culture and its population. Acculturative stress is assumed to be one the reasons for higher prevalence of postnatal depression among immigrant women compared to non-immigrant women. Theories and models of acculturation and coping strategies suggest that certain cultural orientations or behaviors could mitigate acculturative stress and postnatal depression. Nevertheless, quantitative studies applying these theories have so far revealed inconsistent results. Given this background, we ask: what can a qualitative study of immigrant women’s postnatal experiences tell us about the interrelationships between immigrant mothers’ acculturation behaviors or cultural orientations, and maternal psychological health? Particularly, we explore the postnatal experiences of Chinese and Japanese women who gave birth in Austria, focusing on their experiences and behaviors influenced by their heritage culture’s postnatal practices (zuò yuè zi and satogaeri). Theoretically, we apply Berry’s acculturation model through a focus on what we call ‘Postnatal Acculturative Stress’ (PAS). By doing so, we identify factors that prevent or mitigate PAS. Another aim of this article is to critically reassess Berry’s model in the context of postnatal care and maternal psychological health. Data were analyzed using a combination of deductive and inductive method through the application of directed content analysis and phenomenological approach. Women’s postnatal experiences were summarized as an ‘unexpected solitary struggle in the midst of dual identity change’ in four specific domains: postnatal rest and diet, social support, feelings toward significant others and identity. Preventive and mitigating factors against PAS included trust (in self and one’s health beliefs) and mutual respectful relationships with and between the significant others. The application of Berry’s acculturation model provided a useful framework of analysis. Nevertheless, the multifarious complexity involved in the process of acculturation as well as different power dynamics in the family and healthcare settings makes it difficult to draw causal relationships between certain acculturation behaviors or cultural orientations with specific health outcomes. Health professionals should be aware of the complex psychosocial processes, contexts as well as social environment that shape immigrants’ acculturative behaviors.
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Affiliation(s)
- Yuki Seidler
- Center for Public Health, Medical University of Vienna, Vienna, Austria.,Department of Development Studies, University of Vienna, Vienna, Austria.,Center for Health and Migration, Vienna, Austria
| | | | - Michael Kundi
- Center for Public Health, Medical University of Vienna, Vienna, Austria
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28
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Nakano M, Sourander A, Luntamo T, Chudal R, Skokauskas N, Kaneko H. Early risk factors for postpartum depression: A longitudinal Japanese population-based study. J Affect Disord 2020; 269:148-153. [PMID: 32339130 DOI: 10.1016/j.jad.2020.03.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/06/2020] [Accepted: 03/09/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Postpartum depression (PPD) negatively impacts maternal health, parenting and development of children. Most previous studies on PPD risk factors are based on Western populations. Additionally, little is known about the association between psychosocial factors during early pregnancy period and PPD. We aimed to identify early risk factors for PPD until three months after delivery using a longitudinal population-based sample from Japan. METHODS The data was collected from 1050 mothers at four time points: first trimester, after the birth, and one and three months post-delivery. Mothers who had a Japanese Edinburgh Postnatal Depression Scale (EPDS) cutoff score above 9 at one or 3 months after delivery were recognized as having PPD (n = 91/8.7%). RESULTS Negative feelings about pregnancy, combined breast and bottle feeding, first-time motherhood, motherhood 24 or less years old, perceived maternal mental illness before pregnancy, and lack of social support were all significantly associated with PPD at three months after delivery. LIMITATIONS The data was collected from one city in Japan, which limits the generalization of the findings. Additionally, PPD was assessed by an EPDS questionnaire, and not by a clinical interview. CONCLUSIONS Even after controlling for the perceived mental illness before pregnancy, several risk factors as early as in the first trimester were associated with PPD. These risk factors should be identified and the mothers should be offered a suitable intervention, in order to prevent the development of PPD.
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Affiliation(s)
- Mami Nakano
- Graduate School of Education and Human Development, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8601, Japan.
| | - Andre Sourander
- Research Center for Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori 3rd Floor, Turku 20014, Finland.
| | - Terhi Luntamo
- Research Center for Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori 3rd Floor, Turku 20014, Finland.
| | - Roshan Chudal
- Research Center for Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori 3rd Floor, Turku 20014, Finland.
| | - Norbert Skokauskas
- Centre for Child and Adolescent Mental Health and Child Protection, Faculty of Medicine, NTNU, NO-7491, Trondheim, Norway.
| | - Hitoshi Kaneko
- Psychological Support and Research Center for Human Development, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8601, Japan.
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Labrague LJ, McEnroe-Petitte D, Tsaras K, Yboa BC, Rosales RA, Tizon MM, D'souza MS. Predictors of postpartum depression and the utilization of postpartum depression services in rural areas in the Philippines. Perspect Psychiatr Care 2020; 56:308-315. [PMID: 31355473 DOI: 10.1111/ppc.12428] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 06/07/2019] [Accepted: 07/14/2019] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study explored the prevalence and predictors of postpartum depression (PPD) as well as the utilization and evaluation of PPD services among postpartum women in rural areas of the Philippines. DESIGN AND METHODS A cross-sectional study was conducted. One hundred sixty-five women who visited maternal facilities in the rural areas of the Central Philippines completed the Edinburgh Postnatal Depression Scale (EPDS). FINDINGS The prevalence of PPD was 16.4% at the sixth postpartum week. Occupation and marital status had significant direct influences on PPD. PPD services were not routinely provided by doctors and nurses. PRACTICE IMPLICATIONS Our results highlight a greater need to intensify government programs relative to PPD services, specifically related to the early detection and screening of PPD among high-risk pregnancies.
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Affiliation(s)
- Leodoro J Labrague
- Department of Fundamentals and Administration, College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman
| | | | - Konstantinos Tsaras
- Department of Nursing, Technological Educational Institute of Thessaly, Larissa, Greece
| | - Begonia C Yboa
- College of Nursing and Health Sciences, Catbalogan, Philippines
| | | | - Maricel M Tizon
- College of Nursing and Health Sciences, Catbalogan, Philippines
| | - Melba S D'souza
- School of Nursing, Thompson Rivers University, Kamloops, British Columbia, Canada
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30
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Özdemir K, Menekşe D, Çınar N. Development of obsessive and compulsive behaviors scale of mothers in postpartum period regarding baby care: Validity and reliability. Perspect Psychiatr Care 2020; 56:379-385. [PMID: 31617593 DOI: 10.1111/ppc.12445] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 09/11/2019] [Accepted: 10/05/2019] [Indexed: 01/30/2023] Open
Abstract
PURPOSE This study was made to develop a scale instrument to determine obsessive and compulsive behaviors of mothers in the postpartum period with regard to baby care. DESIGN AND METHODS This methodologically was conducted with 233 mothers between February and October 2017. FINDINGS Age average of the women was detected as 28.47 ± 15.47. Four items were removed from the scale because their factor load was under 0.400. It was determined that scale consists of nine items and sole factor. Cronbach alpha internal consistency reliability coefficient is 75. PRACTICAL IMPLICATIONS Results of this study demonstrate that "Obsessive and Compulsive Behaviors Scale of Mothers in Postpartum Period Regarding Baby Care" is a valid and reliable measurement instrument.
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Affiliation(s)
- Kevser Özdemir
- Department of Midwifery, Faculty of Health Sciences, Sakarya University, Sakarya, Turkey
| | - Dilek Menekşe
- Department of Pediatric Nursing, Faculty of Health Sciences, Sakarya University, Sakarya, Turkey
| | - Nursan Çınar
- Department of Pediatric Nursing, Faculty of Health Sciences, Sakarya University, Sakarya, Turkey
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31
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Palumbo G, Mirabella F, Gigantesco A. Positive screening and risk factors for postpartum depression. Eur Psychiatry 2020; 42:77-85. [DOI: 10.1016/j.eurpsy.2016.11.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 11/15/2016] [Accepted: 11/19/2016] [Indexed: 11/29/2022] Open
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32
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Hirose A, Terauchi M, Odai T, Kato K, Miyasaka N. Depressive symptoms at postpartum are associated with those at the second trimester of pregnancy and the antioxidant activity immediately after delivery. J Psychosom Obstet Gynaecol 2020:1-7. [PMID: 31902269 DOI: 10.1080/0167482x.2019.1709817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 12/20/2019] [Accepted: 12/23/2019] [Indexed: 10/25/2022] Open
Abstract
Objective: This study aimed to investigate whether depressive symptoms at postpartum are associated with oxidative stress and antioxidant activity, as well as the symptoms during pregnancy.Methods: This longitudinal study enrolled 84 women in their second trimester of pregnancy. Their depressive symptoms were assessed using Edinburgh postnatal depression scale (EPDS), and their oxidative stress and antioxidant activity were assessed using reactive oxygen metabolites/8-hydroxy-2'-deoxyguanosine and biological antioxidant potential (BAP) at around 26 and 36 weeks (time points 1 and 2) of gestation, and 3-6 days and 1 month (time points 3 and 4) postpartum. We evaluated the associations between EPDS at time point 4 and various parameters at the other time points.Results: Multiple regression analysis revealed that EPDS at time point 1 (adjusted odds ratio: 1.06 per 0.1 point increase; 95% confidence interval [CI]: 1.03-1.11) and BAP at time point 3 (adjusted odds ratio: 0.93 per 10 μmol/L increase; 95% CI: 0.87-0.97) were independent predictors of EPDS at time point 4.Conclusion: Depressive symptoms at the second trimester of pregnancy and the antioxidant activity immediately after delivery could predict postpartum depression. TRIAL REGISTRATION: UMIN-CTR UMIN000022367.
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Affiliation(s)
- Asuka Hirose
- Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Women's Health, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masakazu Terauchi
- Department of Women's Health, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tamami Odai
- Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kiyoko Kato
- Department of Women's Health, Tokyo Medical and Dental University, Tokyo, Japan
| | - Naoyuki Miyasaka
- Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Tokyo, Japan
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33
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Impact of intention and feeling toward being pregnant on postpartum depression: the Japan Environment and Children's Study (JECS). Arch Womens Ment Health 2020; 23:131-137. [PMID: 30591966 PMCID: PMC6987065 DOI: 10.1007/s00737-018-0938-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 12/12/2018] [Indexed: 11/12/2022]
Abstract
Pregnancy intention is reported to be associated with the risk of postpartum depression (PPD), but the impact of feelings toward being pregnant on PPD is unknown. We aimed to examine whether feelings toward being pregnant are associated with PPD at 1 month after childbirth. In our nationwide study between 2011 and 2014 in Japan, we used multivariate logistic regression analyses to examine the associations between pregnancy intention and feelings toward being pregnant with PPD [Edinburgh Postnatal Depression Scale (EPDS score > 9 or > 12)] among Japanese women. Among 92,431 women, 14.0 and 5.4% had PPD with EPDS scores > 9 and > 12, respectively. Compared with women who felt very happy to be pregnant, those whose pregnancy was unintended but happy, unintended and confused, those who felt troubled, and those who felt no emotion toward being pregnant had increased risks of PPD [multivariable odds ratios (95% confidence intervals (CIs)) = 1.17 (1.11-1.22), 1.39 (1.29-1.49), 1.74 (1.42-2.14), and 1.58 (1.22-2.02), respectively, for EPDS score > 9]. Those associations were more evident without antenatal possible mental illness (K6 score < 13). Women whose pregnancy was unintended should be regarded as targets for the early detection and prevention of PPD irrespective of whether they felt happy or confused.
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Perinatal Depressive Symptoms: Prevalence and Associated Psychosocial Factors. ACTA ACUST UNITED AC 2019; 48:166-173. [PMID: 31426919 DOI: 10.1016/j.rcp.2017.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 07/08/2017] [Accepted: 09/13/2017] [Indexed: 11/21/2022]
Abstract
Perinatal depression is a major depression episode that starts during pregnancy and the postpartum period; and is an important cause of health risks in women and infants. A cross-sectional observational study was conducted with information from the records of 112 pregnant women or in the immediate postpartum period who were surveyed to determine the possible association between perinatal depressive symptoms and psychosocial factors occurring in the last year. The prevalence of clinically significant perinatal depressive symptoms using the Edinburgh scale was of 22.36%. The logistic regression model found association between clinically significant perinatal depressive symptoms (score on the Edinburgh scale ≥ 12 and the following psychosocial factors: end of the couple's relationship (OR=6.26; 95% CI, 1.91-20.49), severe economic problems (OR=6.61; 95% CI, 1.86-23.45), and the death of a family member (OR=3.79; 95% CI, 1.12-12.74). In this study one in four women had broken up with their partner and had severe economic problems during pregnancy, also one of ten had suffered the death of a loved one in the past year. These psychosocial factors were strongly associated with the presence of depressive symptoms with clinical importance. These finding offer the opportunity to consider psychosocial factors as a source of maternal stress that could be easily identified in the prenatal controls that pregnant women receive to identify women at risk of experiencing depressive symptoms in the perinatal period, which will enable appropriate treatment to be given to those who need it.
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Sonmez EO, Uguz F, Sahingoz M, Sonmez G, Kaya N, Camkurt MA, Gokmen Z, Basaran M, Gezginc K, Erdem SS, Dulger HH, Tasyurek E. Effect of Maternal Depression on Brain-derived Neurotrophic Factor Levels in Fetal Cord Blood. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2019; 17:308-313. [PMID: 30905131 PMCID: PMC6478092 DOI: 10.9758/cpn.2019.17.2.308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 05/27/2016] [Accepted: 06/16/2016] [Indexed: 12/30/2022]
Abstract
Objective We aimed to assess the association between cord blood brain-derived neurotrophic factor (BDNF) concentration and maternal depression during pregnancy. Methods A total of 48 pregnant women, admitted for elective caesarean section to Department of Obstetrics and Gynecology, The Konya Research and Training Hospital and Konya Necmettin Erbakan University Meram Medical Faculty, were included in this study. The study group included 23 women diagnosed as having depression during pregnancy and the control group included 25 pregnant women who did not experience depression during pregnancy. Results The groups had similar sociodemographic characteristics. Cord blood BDNF concentration was significantly lower in babies born to mothers with major depression as compared with those in the control group. We didn’t find any correlation between the umbilical cord blood BDNF levels and BDI scores. Conclusion The results suggest that the existence of major depression in pregnant women may negatively affect fetal circulating BDNF levels.
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Affiliation(s)
- Erdem Onder Sonmez
- Department of Psychiatry, Dr. Ekrem Tok Mental Health and Disease Hospital
| | | | | | | | | | | | | | | | | | - Sami Sait Erdem
- Department of Biochemistry, Konya Research and Training Hospital
| | - Hasan Haluk Dulger
- Department of Biochemistry, Meram Faculty of Medicine, Necmettin Erbakan University
| | - Erkan Tasyurek
- Department of Biochemistry, Meram Faculty of Medicine, Necmettin Erbakan University
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Changes in the association between postpartum depression and mother-infant bonding by parity: Longitudinal results from the Japan Environment and Children's Study. J Psychiatr Res 2019; 110:110-116. [PMID: 30616158 DOI: 10.1016/j.jpsychires.2018.11.022] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 11/22/2018] [Accepted: 11/23/2018] [Indexed: 11/23/2022]
Abstract
The results of several epidemiological studies have shown a moderate association between postpartum depression (PPD) and mother-infant bonding (MIB); however, associations and changes that longitudinally considered parity were not reported. We investigated the possible association between PPD and MIB at one month after birth, in addition, the changes of these indices by parity. From a dataset comprising 103,099 maternal registrations in The Japan Environment and Children's Study, the present study analyzed complete data on questionnaires for 76,363 women who participated once (cross-sectional group) and 3753 women who participated twice (follow-up subgroup). Edinburgh Postnatal Depression Scale (EPDS) scores and the Mother-to-Infant Bonding Scale-Japan (MIBS-J) scores were obtained one month after delivery. We identified the two factors of the MIBS-J, "lack of maternal feeling (LMF)" and "anxiety about caregiving (AC)" through confirmatory factor analysis. Associations between total EPDS and each factor of MIBS-J were evaluated using multiple regression analyses after adjusting for potential confounders. Total EPDS and both factors (LMF and AC) were positively related in the cross-sectional group (fully adjusted β = 0.26 and 0.39 for LMF and AC, respectively), in the follow-up subgroup at first participation (0.24 and 0.40, respectively) and at the second participation (0.25 and 0.39, respectively). Multiple regression analyses revealed a robust, moderate relationship between postpartum depression and mother-infant bonding. PPD and MIB scores were shown to decrease from the first child to the second in the follow-up subgroup. Consequently, interventions which would increase a mother's child care experience and expertise would prevent PPD and improve MIB.
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Effectiveness of Kangaroo Care for a Patient with Postpartum Depression and Comorbid Mother-Infant Bonding Disorder. Case Rep Psychiatry 2019; 2019:9157214. [PMID: 30937206 PMCID: PMC6413388 DOI: 10.1155/2019/9157214] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 11/21/2018] [Accepted: 02/12/2019] [Indexed: 11/18/2022] Open
Abstract
The presently reported patient was a 37-year-old married primipara with peripartum depression comorbid with bonding disorder. Care anxiety and a lack of affection towards her baby first appeared at around the time of delivery, and the patient developed major depression at one month after the birth of her healthy baby. At first, standard treatment for major depression including the use of antidepressants, electroconvulsive therapy, and supportive psychotherapy were provided. However, bonding problems appeared to impede and obstruct the amelioration of depression. Although treatment methods for bonding disorder have not yet been established, Kangaroo Care was introduced to facilitate skin-to-skin contact. We also educated her in better parenting behavior and provided repeated motivational interviews with her family because a lack of partner and social support and personal temperament (low self-directedness and cooperativeness) were thought to be related to her bonding disorder. This case suggests the effectiveness of Kangaroo Care, which promotes a humanizing maturation of both baby and parent alike, for mothers with postpartum depression and comorbid severe bonding disorder.
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Watanabe Z, Nishigori H, Tanoue K, Tanaka K, Iwama N, Satoh M, Murakami T, Nishigori T, Mizuno S, Sakurai K, Ishikuro M, Obara T, Tatsuta N, Saito M, Tachibana M, Fujiwara I, Arima T, Takeda T, Kuriyama S, Nakai K, Yaegashi N, Metoki H. Preconception dysmenorrhea as a risk factor for psychological distress in pregnancy: The Japan Environment and Children's Study. J Affect Disord 2019; 245:475-483. [PMID: 30428448 DOI: 10.1016/j.jad.2018.11.061] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 09/28/2018] [Accepted: 11/03/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND Dysmenorrhea influences emotional distress as well as physical suffering in young non-pregnant women. The aim of this study was to assess the potential association between preconception dysmenorrhea and the development of psychological distress during pregnancy. METHODS This study was a part of the Japan Environment and Children's Study (JECS), a nationwide birth cohort study conducted between 2011 and 2014 in Japan. A total of 87,102 pregnant Japanese women with no psychological distress (Kessler 6-item psychological distress scale [K6] score ≤ 12) in early pregnancy were eligible. Among these, 7626 had mild and 1638 had severe preconception dysmenorrhea. The prevalence and risk of maternal psychological distress (K6 scores ≥ 13) in the second or third trimester were compared among preconception dysmenorrhea severity groups. RESULTS A higher percentage of women with mild (2.6%) or severe preconception dysmenorrhea (3.6%) suffered psychological distress during pregnancy compared to that in women without dysmenorrhea (2.1%). A multilevel logistic regression model, adjusting for baseline characteristics and the K6 score at enrollment, showed that the severity of dysmenorrhea was associated with psychological distress (mild dysmenorrhea: adjusted odds ratio [aOR], 1.154; 95% confidence interval [95% CI], 0.980-1.359; and severe dysmenorrhea: aOR, 1.457; 95% CI, 1.087-1.951). LIMITATIONS Information about dysmenorrhea was obtained during early pregnancy. The JECS did not have clear diagnostic criteria for dysmenorrhea. CONCLUSIONS Preconception dysmenorrhea is associated with an elevated incidence of psychological distress during pregnancy. Additionally, expectant mothers with a history of severe dysmenorrhea symptoms before pregnancy have a higher risk of developing psychological distress.
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Affiliation(s)
- Zen Watanabe
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine. 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Hidekazu Nishigori
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine. 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan; Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Kaou Tanoue
- Department of Obstetrics and Gynecology, Japanese Red Cross Ishinomaki Hospital. 71 Nishimichishita Hebita, Ishinomaki, Miyagi 986-8522, Japan
| | - Kosuke Tanaka
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine. 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Noriyuki Iwama
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine. 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan; Department of Obstetrics and Gynecology, Osaki Citizen Hospital. 3-8-1 Furukawahonami, Osaki, Miyagi 989-6183, Japan
| | - Michihiro Satoh
- Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University Faculty of Medicine. 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi 983-8536, Japan
| | - Takahisa Murakami
- Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University Faculty of Medicine. 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi 983-8536, Japan
| | - Toshie Nishigori
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine. 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Satoshi Mizuno
- Tohoku Medical Megabank Organization, Tohoku University. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Kasumi Sakurai
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Mami Ishikuro
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Tohoku Medical Megabank Organization, Tohoku University. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Taku Obara
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Tohoku Medical Megabank Organization, Tohoku University. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Department of Pharmaceutical Sciences, Tohoku University Hospital. 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Nozomi Tatsuta
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Masatoshi Saito
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine. 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Masahito Tachibana
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine. 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Ikuma Fujiwara
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Takahiro Arima
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Takashi Takeda
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine. 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan; Division of Women's Health, Research Institute of Traditional Asian Medicine, Kindai University. 377-2 Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan
| | - Shinichi Kuriyama
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Tohoku Medical Megabank Organization, Tohoku University. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Division of Disaster Public Health, International Research Institute for Disaster Science, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Kunihiko Nakai
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Nobuo Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine. 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan; Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Tohoku Medical Megabank Organization, Tohoku University. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Hirohito Metoki
- Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University Faculty of Medicine. 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi 983-8536, Japan; Tohoku Medical Megabank Organization, Tohoku University. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan.
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Pampaka D, Papatheodorou SI, AlSeaidan M, Al Wotayan R, Wright RJ, Buring JE, Dockery DW, Christophi CA. Postnatal depressive symptoms in women with and without antenatal depressive symptoms: results from a prospective cohort study. Arch Womens Ment Health 2019; 22:93-103. [PMID: 29971553 DOI: 10.1007/s00737-018-0880-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 06/22/2018] [Indexed: 01/01/2023]
Abstract
Evidence exists that the risk factors for depression in the antenatal and postnatal period may differ, but only a handful of studies looked at depression longitudinally. The aims of this study were (1) to estimate the prevalence of postnatal depressive symptoms in Kuwait where data about postnatal depression are scarce and identify its determinants and (2) to compare these risk factors between women who had experienced antenatal depressive symptoms and those that did not. Data collected in the TRansgenerational Assessment of Children's Environmental Risk (TRACER) Study in Kuwait were used in this analysis. The sample was restricted to the 1348 women who answered the Edinburgh Postnatal Depression Scale (EPDS) both antenatally and postnatally. The prevalence of postnatal depressive symptoms, defined by an EPDS score ≥ 10, was 11.7%. Overall, antenatal depressive symptoms were the strongest determinant of postnatal depressive symptoms. Multivariable logistic regression analysis showed that in women with depressive symptoms in pregnancy, having a lower household income was the most significant risk factor for postnatal depressive symptoms. Among women without antenatal depressive symptoms, those who had lower income, were Kuwaitis, experienced other problems in pregnancy such as perceived stress, PTSD symptoms and social isolation, and those who delivered a boy had higher odds of postnatal depressive symptoms. Antenatal depressive symptoms and other psychosocial characteristics can predict postnatal depressive symptoms. Therefore, maternal mental health issues should be detected during the antenatal period and support should be provided in order to lower the risk of postnatal depression and its sequelae.
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Affiliation(s)
- Despina Pampaka
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 95 Eirinis Street, 3041, Limassol, Cyprus.
| | - Stefania I Papatheodorou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 95 Eirinis Street, 3041, Limassol, Cyprus
| | | | | | - Rosalind J Wright
- Department of Pediatrics and Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Julie E Buring
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Douglas W Dockery
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Costas A Christophi
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 95 Eirinis Street, 3041, Limassol, Cyprus.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Shibata Y, Suzuki S. Comparison of the Edinburgh Postnatal Depression Scale and the Whooley questions in screening for postpartum depression in Japan. J Matern Fetal Neonatal Med 2019; 33:2785-2788. [PMID: 30563400 DOI: 10.1080/14767058.2018.1560413] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: We examined the clinical utility of the Whooley questions in comparison with that of the Edinburgh Postnatal Depression Scale (EPDS) in Japan.Methods: We carried out mental health screening of all postnatal mothers (n = 258) who gave birth to singleton babies at term attending our hospital using the EPDS and the Whooley questions. For the EPDS, scores were calculated, and a score of nine points or more was regarded as "positive screening" according to the results of previous observations in Japan. For the Whooley questions, if at least one question was answered "yes," we diagnosed it as "positive screen."Results: The positive rate of the Whooley questions was 16.7%, while that of the EPDS (≥ 9 points) was 14.8% (p = .55). The incidence of postpartum depression was 5.4%. The difference in the sensitivity and positive predictive value of the two tools did not reach significance (p = .09 and .45, respectively).Conclusions: There were no significant differences in accuracy on comparing the two screening tools. We should examine how to use the two tools according to the regional support systems.
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Affiliation(s)
- Yoshie Shibata
- Department of Obstetrics, Japanese Red Cross Katsushika Maternity Hospital, Tokyo, Japan
| | - Shunji Suzuki
- Department of Obstetrics, Japanese Red Cross Katsushika Maternity Hospital, Tokyo, Japan
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Catala P, Peñacoba C, Carmona J, Marin D. Maternal Personality and Psychosocial Variables Associated with Initiation Compared to Maintenance of Breastfeeding: A Study in Low Obstetric Risk Women. Breastfeed Med 2018; 13:680-686. [PMID: 30403497 DOI: 10.1089/bfm.2018.0034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
INTRODUCTION The benefits of breastfeeding are well known for mother and child. Research about the predictive factors related to the initiation and maintenance of breastfeeding is of great interest to public health. AIM To analyze the factors associated with the timely initiation of breastfeeding at immediate postpartum and the variables that facilitate their maintenance 4 months after birth. MATERIALS AND METHODS A longitudinal prospective design was used, including four stages: first trimester of pregnancy (personality), third trimester (childbirth expectations, breastfeeding intention, pregnancy worries, and coping strategies), immediately after childbirth (initiation of breastfeeding and childbirth satisfaction), and 4 months after birth (continuation of breastfeeding). RESULTS A sample of 116 women took part in the study from the first trimester to 4 months after birth. Timely initiation of breastfeeding is associated with vaginal birth (p < 0.000) and with variables related to the absence of stress factors: fewer worries regarding childbirth (p = 0.009), higher satisfaction during birth in relation to holding the baby (p > 0.000), and the meeting of expectations (p = 0.017). These associations disappear when the type of birth is introduced. Maintenance of breastfeeding is associated with maternal personality and psychosocial variables: openness to experience (p = 0.007), increased worries about coping with the baby (p = 0.046), relationship with partner (p = 0.047), and overt emotional expression (p = 0.040). CONCLUSION Different factors are associated with initiation and maintenance of breastfeeding. Specific prevention strategies are needed, aimed toward health care staff for improving breastfeeding initiation and to empower women during the entire pregnancy for breastfeeding maintenance.
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Affiliation(s)
- Patricia Catala
- 1 Department of Medicine and Surgery, Public Health, Psychology and Immunology and Medical Microbiology, Odontology and Nursing, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Cecilia Peñacoba
- 1 Department of Medicine and Surgery, Public Health, Psychology and Immunology and Medical Microbiology, Odontology and Nursing, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Javier Carmona
- 2 Critical Care Unit, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - Dolores Marin
- 1 Department of Medicine and Surgery, Public Health, Psychology and Immunology and Medical Microbiology, Odontology and Nursing, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.,3 Obstetrics Department, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
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Zhang Y, Muyiduli X, Wang S, Jiang W, Wu J, Li M, Mo M, Jiang S, Wang Z, Shao B, Shen Y, Yu Y. Prevalence and relevant factors of anxiety and depression among pregnant women in a cohort study from south-east China. J Reprod Infant Psychol 2018; 36:519-529. [DOI: 10.1080/02646838.2018.1492098] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Youding Zhang
- Department of Neurology, Zhoushan Hospital, Zhoushan, China
| | - Xiamusiye Muyiduli
- Department of Epidemiology & Health Statistics, School of Public Health, School of medicine, Zhejiang University, Hangzhou, China
| | - Shuojia Wang
- Department of Epidemiology & Health Statistics, School of Public Health, School of medicine, Zhejiang University, Hangzhou, China
| | - Wen Jiang
- Department of Maternal Health, Zhoushan Maternal & Child Care Hospital, Zhoushan, China
| | - Jinhua Wu
- Department of Maternal Health, Zhoushan Maternal & Child Care Hospital, Zhoushan, China
| | - Minchao Li
- Department of Epidemiology & Health Statistics, School of Public Health, School of medicine, Zhejiang University, Hangzhou, China
| | - Minjia Mo
- Department of Epidemiology & Health Statistics, School of Public Health, School of medicine, Zhejiang University, Hangzhou, China
| | - Shuying Jiang
- Department of Epidemiology & Health Statistics, School of Public Health, School of medicine, Zhejiang University, Hangzhou, China
| | - Zhaopin Wang
- Department of Epidemiology & Health Statistics, School of Public Health, School of medicine, Zhejiang University, Hangzhou, China
| | - Bule Shao
- Department of Epidemiology & Health Statistics, School of Public Health, School of medicine, Zhejiang University, Hangzhou, China
| | - Yu Shen
- Department of Epidemiology & Health Statistics, School of Public Health, School of medicine, Zhejiang University, Hangzhou, China
| | - Yunxian Yu
- Department of Epidemiology & Health Statistics, School of Public Health, School of medicine, Zhejiang University, Hangzhou, China
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Perinatal Depression and Associated Factors among Mothers in Southern Ethiopia: Evidence from Arba Minch Zuria Health and Demographic Surveillance Site. PSYCHIATRY JOURNAL 2018; 2018:7930684. [PMID: 29854717 PMCID: PMC5954952 DOI: 10.1155/2018/7930684] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 02/21/2018] [Accepted: 03/15/2018] [Indexed: 11/18/2022]
Abstract
Background. Perinatal depression is a serious mental health problem that can negatively affect the lives of women and children. The adverse consequences of perinatal depression in high-income countries also occur in low-income countries. Objective. To assess the perinatal depression and associated factors among mothers in Southern Ethiopia. Methods. A community based cross-sectional study was conducted among selected 728 study participants in Arba Minch Zuria HDSS. A pretested questionnaire was used to collect the data. Data were analyzed using STATA version 12 software. Descriptive statistical methods were used to summarize the characteristics of the mothers. Bivariate and multivariable logistic regression was used for analysis. Results. The prevalence of perinatal depression among the study period was 26.7%. In the final multivariable logistic regression, monthly income AOR (95% C.I): 4.2 (1.9, 9.3), parity [AOR (95% C.I): 0.14 (0.03, 0.65)], pregnancy complications AOR (95% C.I): 5 (2.5, 10.4), husband smoking status [AOR (95% C.I): 4.12 (1.6, 10.6)], history of previous depression AOR (95% C.I): 2.7 (1.54, 4.8), and family history of psychiatric disorders were the independent factors associated with perinatal depression. Conclusion. The study showed a high prevalence of perinatal depression among pregnant mothers and mothers who have less than a one-year-old child.
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Demirkol ME, Şimşek L, Yılmaz H, Tamam L. Gebelik ve Postpartum Dönemde Obsesif Kompulsif Bozukluk. PSIKIYATRIDE GUNCEL YAKLASIMLAR 2018. [DOI: 10.18863/pgy.336626] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Effect of the 2015 Nepal Earthquakes on symptoms of common mental disorders among women who are pregnant. J Affect Disord 2018; 228:238-247. [PMID: 29277063 DOI: 10.1016/j.jad.2017.12.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 11/17/2017] [Accepted: 12/06/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND Antenatal mental health problems are of concern globally not only because of the burden and limits to participation experienced by women but also because of risks for foetal neurocognitive development and adverse birth outcomes. The aim was to describe the indicative prevalence of and risk and protective factors for clinically-significant symptoms of antenatal common mental disorders (CMDs) among women who experienced the 2015 Nepal earthquakes during pregnancy. METHODS A population-based cross-sectional study in Bhaktapur, one of 14 districts highly affected by the 2015 Nepal earthquakes. The primary outcome, clinically significant symptoms of CMDs, was ascertained using the Nepali validation of the Edinburgh Postnatal Depression Scale (EPDS-N). In order to investigate potential trauma reactions, a subset of EPDS items as indicators of trauma symptoms was constructed. Standardised instruments and study-specific questions were used to measure potential risk and protective factors. Data were collected in individual structured interviews by trained health researchers. Hierarchical multiple linear regression models were used to establish risk and protective factors for clinically significant symptoms of CMDs and indicators of post-earthquake trauma reaction. RESULTS Overall, 497/498 eligible pregnant women provided complete data. We found that 21.9% (95% CI, 18.4; 25.8) of participants had EPDS-N scores > 12 and another 17.1% (95% CI 13.9; 20.7) scored 10-12 indicating a high prevalence of clinically significant CMD symptoms. In total, 20 factors were included in the final hierarchical multiple linear regression model and together explained 33.3% of the variance in EPDS total scores; seven factors, including earthquake experiences and lifetime experience of intimate partner violence, increased risk and five including having income-generating work and a kind, and encouraging partner were protective. The association between earthquake experiences and the indicators of trauma symptoms was not significant in the hierarchical multiple linear regression analysis. LIMITATIONS The EPDS has not yet been formally validated in Nepal for use during pregnancy. Data were collected 6 months post-earthquake, so we were not able to capture the experiences of women who had spontaneous or induced abortions or premature births in the immediate aftermath of the earthquake. CONCLUSIONS In addition to the restoration of antenatal and obstetric services, the mental health of women who are pregnant requires specific consideration and interventions after natural disasters. This should take into account the additional adverse impact of violence perpetrated by an intimate partner.
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Uguz F. Better Tolerance of Citalopram in a Breastfed Infant Who Could Not Tolerate Sertraline and Paroxetine. Breastfeed Med 2018; 13:89-90. [PMID: 29185803 DOI: 10.1089/bfm.2017.0168] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Postpartum depression is frequently observed in women. First-line antidepressants in treatment of postpartum depression are selective serotonin reuptake inhibitors (SSRIs). Although SSRIs are well tolerated by most breastfed infants, some adverse events may arise in exposed infants. This report presents the case of an infant of a breastfeeding woman using citalopram without any problem after sertraline and paroxetine were discontinued due to adverse events in the infant.
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Affiliation(s)
- Faruk Uguz
- Department of Psychiatry, Meram Faculty of Medicine, Necmettin Erbakan University , Konya, Turkey
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Ogasawara K, Nakamura Y, Kimura H, Aleksic B, Ozaki N. Issues on the diagnosis and etiopathogenesis of mood disorders: reconsidering DSM-5. J Neural Transm (Vienna) 2017; 125:211-222. [PMID: 29275445 DOI: 10.1007/s00702-017-1828-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 12/12/2017] [Indexed: 10/18/2022]
Abstract
The authors present a narrative review from the diagnostic and nosologic viewpoints of mood disorders (bipolar and depressive ones) by revisiting the revision from the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, Text Revision to DSM-5, including the following: the separation of the bipolar and depressive sections; the addition of increased energy and continuation of symptoms to the hypo/manic criteria; the elimination of mixed episodes; the creation of new categories and specifiers ("other specified bipolar and related disorder", "disruptive mood dysregulation disorder", "with anxious distress", "with mixed features", "with peripartum onset"); the categorization of hypo/manic episodes during antidepressant treatment into bipolar disorder; the elimination of the "bereavement exclusion"; the ambiguous separation between bipolar I and II; the insufficient distinction between "other specified bipolar and related disorders" and major depressive disorder; the differentiation regarding borderline personality disorder; agitation; premenstrual dysphoric disorder; and society and psychiatry. Through this analysis, we point out both the achievements and limitations of DSM-5. In addition, to examine the future direction of psychiatry, we introduce our cohort study regarding maternal depression and an outline of the National Institute of Mental Health's Research Domain Criteria project in the US. Finally, we advocate the importance of elucidating etiopathogeneses by starting from or going beyond the DSM operational diagnostic system, which has shown great efficacy.
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Affiliation(s)
- Kazuyoshi Ogasawara
- Bioethics Research Center, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. .,Department of Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
| | - Yukako Nakamura
- Department of Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Hiroyuki Kimura
- Department of Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Branko Aleksic
- Department of Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
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Cross-National Differences in Psychosocial Factors of Perinatal Depression: A Systematic Review of India and Japan. Healthcare (Basel) 2017; 5:healthcare5040091. [PMID: 29207561 PMCID: PMC5746725 DOI: 10.3390/healthcare5040091] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 11/30/2017] [Accepted: 11/30/2017] [Indexed: 11/29/2022] Open
Abstract
Perinatal depression is prevalent worldwide. However, there are few available studies that discuss the different cultural factors affecting perinatal depression within Asian countries. This study aims to compare the literature regarding related factors relating to perinatal depression in India and Japan, and to synthesize the evidence common to both countries in addition to the country-specific evidence. We conducted a systematic review using several databases (CINAHL, MEDLINE, Pubmed, Ovid, SCOPUS, IndMED, and ICHUSI). Keywords were “antenatal depression” or “postpartum depression”, and “India” or “Japan”. Both Japanese and English language papers were reviewed. The identified evidence was compared between the two countries, as well as with non-Asian countries based on previous reports. In total, 15 articles on India and 35 on Japan were reviewed. Although several factors were shared between the two countries as well as with other non-Asian countries (vulnerable personality, being abused, age, marital conflict, and lower socio-demographic status), some differing factors were identified between India and Japan and non-Asian countries; India: poor socioeconomic status, living only with the husband, pregnancy not welcomed by the husband, a female baby, and poor relationship with in-laws; Japan: infertility treatment, conflict with work–life balance, poor relationships with biological mother or in-laws, and concerns about social relations with the other mother’s friends. To conclude, involving the family and community may be important for implementing both global standardized and culture-specific interventions. In India, treatment involving the in-laws may be effective because large family structure is a significant predictor of perinatal depression. In Japan, a family/community approach involving not only the mother’s family of origin but also the working environment is essential.
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Usuda K, Nishi D, Okazaki E, Makino M, Sano Y. Optimal cut-off score of the Edinburgh Postnatal Depression Scale for major depressive episode during pregnancy in Japan. Psychiatry Clin Neurosci 2017; 71:836-842. [PMID: 28767198 DOI: 10.1111/pcn.12562] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 07/04/2017] [Accepted: 07/28/2017] [Indexed: 11/30/2022]
Abstract
AIM Depression during pregnancy adversely affects both mother and child. As antenatal depression is a predictor of postnatal depression, early detection might prevent postnatal depression. The Edinburgh Postnatal Depression Scale (EPDS) is frequently used during the perinatal period, but the cut-off score during pregnancy has not been verified for the Japanese population. We aimed to clarify the optimal EPDS cut-off score in mid-pregnancy in Japan. METHODS We recruited pregnant women aged 20 years or older at 12-24 gestational weeks and those who scored ≥9 on the EPDS were invited to participate in this study. In parallel with the EPDS, the Japanese version of the Mini-International Neuropsychiatric Interview was administered to determine diagnosis of major depressive episode. We then calculated the receiver-operator curve, sensitivity and specificity, and positive and negative predictive values for the EPDS. RESULTS All 210 participants were in the second trimester except for one (12 gestational weeks). Twenty participants were diagnosed with major depressive episode. With a cut-off score set at 13 points, the area under the curve was 0.956; sensitivity and specificity were 90.0% and 92.1% [Correction added on 10 November 2017, after first online publication: The percentage for specificity has been corrected from 79.0% to 92.1%.], respectively; and positive and negative predictive values were 54.5% and 98.9%, respectively. CONCLUSION To our knowledge, this is the first study to clarify the optimal EPDS cut-off score in the second trimester for Japan. This finding will be helpful for appropriate screening for antenatal depression in Japan.
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Affiliation(s)
- Kentaro Usuda
- Toda Chuo Women's Hospital, Saitama, Japan.,Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry,, Tokyo, Japan
| | - Daisuke Nishi
- Toda Chuo Women's Hospital, Saitama, Japan.,Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry,, Tokyo, Japan
| | - Emi Okazaki
- Toda Chuo Women's Hospital, Saitama, Japan.,Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry,, Tokyo, Japan
| | - Miyuki Makino
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo,, Japan
| | - Yo Sano
- Toda Chuo Women's Hospital, Saitama, Japan
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Ohara M, Okada T, Kubota C, Nakamura Y, Shiino T, Aleksic B, Morikawa M, Yamauchi A, Uno Y, Murase S, Goto S, Kanai A, Masuda T, Ando M, Ozaki N. Relationship between maternal depression and bonding failure: A prospective cohort study of pregnant women. Psychiatry Clin Neurosci 2017; 71:733-741. [PMID: 28556440 DOI: 10.1111/pcn.12541] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 05/03/2017] [Accepted: 05/22/2017] [Indexed: 11/29/2022]
Abstract
AIM Although the association between maternal depression and bonding failure during pregnancy and after delivery has been investigated, the causal relationships remain unclear. METHODS A total of 751 women (mean [SD] age, 32.1 [4.4] years) completed the Mother-Infant Bonding Questionnaire and the Edinburgh Postnatal Depression Scale during early pregnancy before week 25 (T1), during late pregnancy around week 36 (T2), and at 5 days after delivery (T3). We created a structural regression model to clarify the relationships between depressive mood and bonding failure during pregnancy and at 5 days after delivery. The model was tested with structural equation modeling. RESULTS Our non-recursive model fit the data well, and we found that: (i) during T2, bonding failure predicted depressive mood (P < 0.01, r = 0.23); (ii) at T3, bonding failure predicted depressive mood (P < 0.05, r = 0.31); (iii) during T1, depressive mood was correlated with bonding failure (P < 0.01, r = 0.45); (iv) depressive mood during T1 predicted depressive mood during T2 (P < 0.01, r = 0.58); (v) depressive mood during T2 predicted depressive mood at T3 (P < 0.01, r = 0.45); (vi) bonding failure during T1 predicted bonding failure during T2 (P < 0.01, r = 0.84); and (vii) bonding failure during T2 predicted bonding failure at T3 (P < 0.01, r = 0.44). The determinant coefficients of depressive mood and bonding failure at T3 were 0.41 and 0.28, respectively. CONCLUSION Our large-scale cohort study indicates that bonding failure predicts depressive mood during pregnancy and 5 days after delivery. These findings suggest that protection and support for pregnant women with depressive mood and bonding failure may prevent both issues during pregnancy and the early stage after delivery.
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Affiliation(s)
- Masako Ohara
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takashi Okada
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Chika Kubota
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yukako Nakamura
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomoko Shiino
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Branko Aleksic
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mako Morikawa
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Aya Yamauchi
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yota Uno
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Satomi Murase
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Setsuko Goto
- Department of Nursing, Sugiyama Jogakuen University, Nagoya, Japan
| | - Atsuko Kanai
- Graduate School of Education and Human Development, Nagoya University, Nagoya, Japan
| | - Tomoko Masuda
- Graduate School of Law, Nagoya University, Nagoya, Japan
| | - Masahiko Ando
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
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