1
|
Yang Y, Wang T, Wang D, Liu M, Lun S, Ma S, Yin J. Gaps between current practice in perinatal depression screening and guideline recommendations: a systematic review. Gen Hosp Psychiatry 2024; 89:41-48. [PMID: 38733723 DOI: 10.1016/j.genhosppsych.2024.04.011] [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: 02/05/2024] [Revised: 04/29/2024] [Accepted: 04/29/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVE Screening for perinatal depression is recommended by many guidelines to reduce the disease burden, but current implementation practices require clarification. METHOD Fifteen databases were searched for observational studies using a pre-tested search strategy. In addition, the websites of academic organizations were searched for guidelines, recommendations, and reports. Literature published between January 1, 2010, and December 19, 2021, in either English or Chinese, was included. The standard form of the Joanna Briggs Institute (JBI) was used to assess risk of bias of the included studies. RESULTS The data analysis covered 103 studies, 21 guidelines, 11 recommendations, five position statements, three reports, two committee opinions, three consensuses, one consultation, and one policy statement. All but one guideline recommended that mothers be routinely screened for perinatal depression at least once during the perinatal period. In addition, 39 documents recommended that perinatal mothers at risk of perinatal depression be provided with or referred to counseling services. In original studies, however, only 8.7% of the original studies conducted routine screenings, and only one-third offered referral services after the screening process. The EPDS emerged as the most frequently used screening tool to measure perinatal depression. 32% (n = 33) of studies reported the technology used for screening. The most commonly used method was face-to-face interviews (n = 22). Screening personnel the agents conducting the screening comprised researchers (n = 26), nurses (n = 15), doctors (n = 11). CONCLUSIONS A significant disparity was observed between the recommendations and implementation of perinatal depression screening, highlighting the need to integrate routine screening and referral processes into maternal care services.
Collapse
Affiliation(s)
| | - Ting Wang
- School of Nursing, Dalian University, China
| | - Di Wang
- School of Nursing, Dalian University, China
| | | | - Shi Lun
- School of Nursing, Dalian University, China
| | - Shuang Ma
- School of Nursing, Dalian University, China
| | - Juan Yin
- School of Nursing, Dalian University, China.
| |
Collapse
|
2
|
Martínez-Borba V, Suso-Ribera C, Osma J. Current state and practical recommendations on reproductive mental health: a narrative review. Women Health 2024:1-20. [PMID: 38812266 DOI: 10.1080/03630242.2024.2360419] [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: 11/24/2023] [Accepted: 05/21/2024] [Indexed: 05/31/2024]
Abstract
Emotional disorders (EDs) are highly prevalent during the reproductive period, including pregnancy, postpartum, and women undergoing fertility treatments. International guidelines are increasingly suggesting the need to evaluate, prevent, and treat EDs in those women. The main aim of this narrative review is to summarize current practice in the field of EDs management during fertility treatments, pregnancy, and the postpartum and to propose a new technology-based model of care that helps to provide psychological care to all women who are in these periods. Four different databases (Pubmed, Scopus, Science Direct, Web of Science) were consulted. Selected keywords were related with infertility, pregnancy, postpartum, EDs, assessment, prevention, treatment, and technologies. We identified 1603 studies and 43 were included in this review. According to these studies, different face-to-face protocols already exist to manage EDs in women undergoing fertility treatments, pregnant or at the postpartum. We noticed an increased interest in developing technology-based solutions to overcome the limitations of traditional mental healthcare services. However, we also detected some issues in the use of technologies (i.e. increased attention to the postpartum or the lack of transdiagnostic approaches). Our results evidenced that there is still a need to develop modern, well-designed, and conceptually-relevant ICT-based programs to be used in women undergoing fertility treatments, pregnant or at the postpartum.
Collapse
Affiliation(s)
- V Martínez-Borba
- Departament of Psychology and Sociology, University of Zaragoza, Teruel, Spain
- Health Research Institute of Aragon, Zaragoza, Spain
| | - C Suso-Ribera
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Castellón de la Plana, Spain
| | - J Osma
- Departament of Psychology and Sociology, University of Zaragoza, Teruel, Spain
- Health Research Institute of Aragon, Zaragoza, Spain
| |
Collapse
|
3
|
Quiray J, Richards E, Navarro-Aguirre Y, Glazer D, Adachi J, Trujillo E, Perera D, Garcia EP, Bhat A. The role of doulas in supporting perinatal mental health - a qualitative study. Front Psychiatry 2024; 15:1272513. [PMID: 38487585 PMCID: PMC10937562 DOI: 10.3389/fpsyt.2024.1272513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 02/05/2024] [Indexed: 03/17/2024] Open
Abstract
Objective The perinatal period presents several opportunities to identify and treat perinatal mental health and substance use disorders by integrating into existing care pathways. We aimed to examine the role of birth doulas in supporting their clients' perinatal mental health. Methods Thematic content analysis of focus groups with doulas, and interviews with doula clients was used to characterize the doula-client relationship, investigate whether and how doulas provide mental health and substance use support, and identify barriers and recommendations for doulas to support their clients' mental health. Participants were doula clients from communities underserved due to race, income, language and culture. Results Doulas and clients reported positive relationships, supported by congruence in culture, language, and lived experiences. Doulas varied in their confidence in identifying perinatal mental health problems, though most agreed that doulas could support their clients' mental health to different degrees. Barriers to engaging in perinatal mental health treatments included low perceived need and socio-economic burden. Conclusions With adequate support and training, doulas can play an important role in supporting their client's emotional well-being.
Collapse
Affiliation(s)
- Joanne Quiray
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Elizabeth Richards
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Yesenia Navarro-Aguirre
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Debra Glazer
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Jamie Adachi
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Emily Trujillo
- Open Arms Perinatal Services, Seattle, WA, United States
| | - Dila Perera
- Open Arms Perinatal Services, Seattle, WA, United States
| | | | - Amritha Bhat
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| |
Collapse
|
4
|
Hoberg MG, Demirci JR, Sereika SM, Levine MD, DeVito Dabbs A. Mixed-Methods Assessment of Maternal Anxiety During the First 8 Weeks After Birth. J Obstet Gynecol Neonatal Nurs 2024:S0884-2175(24)00003-0. [PMID: 38325800 DOI: 10.1016/j.jogn.2024.01.003] [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: 08/25/2023] [Revised: 01/05/2024] [Accepted: 01/11/2024] [Indexed: 02/09/2024] Open
Abstract
OBJECTIVE To describe and compare the experiences of postpartum anxiety among women with generalized anxiety and postpartum-specific anxiety. DESIGN Prospective, longitudinal, mixed methods. SETTING Academic tertiary center in the mid-Atlantic United States. Study activities were remote. PARTICIPANTS Women at 1 to 8 weeks after birth (N = 34). METHODS We used mobile surveys to measure daily anxiety ratings and responses to open-ended, theory-driven questions about anxiety. We used the cutoff scores on the State-Trait Anxiety Inventory and Postpartum Specific Anxiety Scale administered 8 weeks after birth to determine the presence of generalized and postpartum-specific anxiety. Participants' responses were analyzed with qualitative description and sorted by anxiety questionnaire scores at 8 weeks after birth. We compared qualitative findings between participants with generalized anxiety and postpartum-specific anxiety. RESULTS Participants with generalized anxiety had high levels of overwhelm and felt ill-equipped to handle daily stressors, whereas those with postpartum-specific anxiety felt adept at coping. Participants with generalized anxiety lacked emotional and physical support, and those with postpartum-specific anxiety reported more physical but variable emotional support. Sources of daily anxiety in participants with postpartum-specific anxiety were infant-centric (e.g., infant health, end of maternity leave, breastfeeding), whereas anxiety sources for participants with generalized anxiety were varied (e.g., self-health, partner concerns). Participants with generalized anxiety versus postpartum-specific anxiety were more likely to be multiparous and have comorbid depression symptoms. CONCLUSION Symptoms, levels of perceived support, and sources of anxiety differed between participants with generalized versus postpartum-specific anxiety. Our findings can inform postpartum anxiety screening strategies and support interventions.
Collapse
|
5
|
D'Agostino A, Garbazza C, Malpetti D, Azzimonti L, Mangili F, Stein HC, Del Giudice R, Cicolin A, Cirignotta F, Manconi M. Optimal risk and diagnosis assessment strategies in perinatal depression: A machine learning approach from the life-ON study cohort. Psychiatry Res 2024; 332:115687. [PMID: 38157709 DOI: 10.1016/j.psychres.2023.115687] [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: 07/17/2023] [Revised: 12/15/2023] [Accepted: 12/20/2023] [Indexed: 01/03/2024]
Abstract
This study aimed to assess the concordance of various psychometric scales in detecting Perinatal Depression (PND) risk and diagnosis. A cohort of 432 women was assessed at 10-15th and 23-25th gestational weeks, 33-40 days and 180-195 days after delivery using the Edinburgh Postnatal Depression Scale (EPDS), Visual Analogue Scale (VAS), Hamilton Depression Rating Scale (HDRS), Montgomery-Åsberg Depression Rating Scale (MADRS), and Mini International Neuropsychiatric Interview (MINI). Spearman's rank correlation coefficient was used to assess agreement across instruments, and multivariable classification models were developed to predict the values of a binary scale using the other scales. Moderate agreement was shown between the EPDS and VAS and between the HDRS and MADRS throughout the perinatal period. However, agreement between the EPDS and HDRS decreased postpartum. A well-performing model for the estimation of current depression risk (EPDS > 9) was obtained with the VAS and MADRS, and a less robust one for the estimation of current major depressive episode (MDE) diagnosis (MINI) with the VAS and HDRS. When the EPDS is not feasible, the VAS may be used for rapid and comprehensive postpartum screening with reliability. However, a thorough structured interview or clinical examination remains necessary to diagnose a MDE.
Collapse
Affiliation(s)
- Armando D'Agostino
- Department of Health Sciences, Università degli Studi di Milano, Italy; Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Milan, Italy.
| | - Corrado Garbazza
- Centre for Chronobiology, University of Basel, Basel, Switzerland; Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland; Sleep Medicine Unit, Neurocenter of Southern Switzerland, Lugano, Switzerland
| | - Daniele Malpetti
- Istituto Dalle Molle di Studi sull'Intelligenza Artificiale (IDSIA), USI/SUPSI, Lugano, Switzerland
| | - Laura Azzimonti
- Istituto Dalle Molle di Studi sull'Intelligenza Artificiale (IDSIA), USI/SUPSI, Lugano, Switzerland
| | - Francesca Mangili
- Istituto Dalle Molle di Studi sull'Intelligenza Artificiale (IDSIA), USI/SUPSI, Lugano, Switzerland
| | | | - Renata Del Giudice
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Milan, Italy
| | - Alessandro Cicolin
- Department of Neuroscience, Sleep Medicine Center, University of Turin, Turin, Italy
| | | | - Mauro Manconi
- Sleep Medicine Unit, Neurocenter of Southern Switzerland, Lugano, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland; Department of Neurology, University Hospital, Inselspital, Bern, Switzerland
| |
Collapse
|
6
|
da Fonseca Cumerlato CB, Cademartori MG, Barros FC, Dâmaso AH, da Silveira MF, Hallal PC, Demarco FF, Corrêa MB. Maternal depression in first 1000 days of life and early childhood caries prevalence at 48 months of age. Clin Oral Investig 2023; 27:7625-7634. [PMID: 37897660 DOI: 10.1007/s00784-023-05351-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 10/18/2023] [Indexed: 10/30/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the effect of maternal's depression trajectory in the first 1000 days of the child's life on the prevalence of early childhood dental caries (ECC), in a birth cohort. MATERIALS AND METHODS All infants born in Pelotas in 2015 were identified, and the mothers were invited to participate in the cohort. A total of 3645 children were included in the study. The outcome was ECC at 48 months of age assessed according to ICDAS. Maternal depression was collected using Edinburgh Postnatal Depression Scale (EPDS) antenatally, at 3, 12, and 24 months of age. Maternal depressive symptom trajectory variables were created using group-based trajectory models and adopting two cutoff points. Poisson regression model with robust variance was used to identify the total effect of maternal depressive symptom trajectories on ECC, adjusting by confounders. RESULTS A total of 29.2% of the mothers presented a high trajectory for screening of depression, and 18.8% presented a high trajectory of depression diagnosis. The prevalence of ECC was 26.7%. After adjusted analysis, maternal depression trajectories (screening and diagnosis) from pregnancy to 24 months increased the risk for ECC at 48 months of age (RR = 1.14; 95% CI 1.02-1.28 and RR = 1.19; 95% CI 1.05-1.35). CONCLUSIONS Children from mothers with high depression trajectory had higher risk of having dental caries at 48 months compared to children from mothers with low depression trajectory. CLINICAL RELEVANCE Strategies of early detection and treatment of maternal mental disorders during the Golden Period should be considered of high priority in health services since it could impact positively in children's life.
Collapse
Affiliation(s)
| | - Mariana Gonzalez Cademartori
- Graduate Program in Dentistry, Federal University of Pelotas, Rua Gonçalves Chaves, 457, 5th floor, Pelotas, RS, 96015560, Brazil
| | - Fernando Celso Barros
- Catholic University of Pelotas, Gonçalves Chaves, 373, Pelotas, RS, 96015560, Brazil
| | - Andréa Homsi Dâmaso
- Graduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro, 1160, 3rd floor, Pelotas, RS, 96020220, Brazil
| | - Mariângela Freitas da Silveira
- Graduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro, 1160, 3rd floor, Pelotas, RS, 96020220, Brazil
| | - Pedro Curi Hallal
- Graduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro, 1160, 3rd floor, Pelotas, RS, 96020220, Brazil
| | - Flávio Fernando Demarco
- Graduate Program in Dentistry, Federal University of Pelotas, Rua Gonçalves Chaves, 457, 5th floor, Pelotas, RS, 96015560, Brazil
- Graduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro, 1160, 3rd floor, Pelotas, RS, 96020220, Brazil
| | - Marcos Britto Corrêa
- Graduate Program in Dentistry, Federal University of Pelotas, Rua Gonçalves Chaves, 457, 5th floor, Pelotas, RS, 96015560, Brazil.
| |
Collapse
|
7
|
Poo ZX, Quah PL, Chen H, Wright A, Teoh TG, Tan LK, Tan KH. Knowledge, Attitude and Perceptions Around Perinatal Mental Health Among Doctors in an Obstetrics and Gynaecology Academic Department in Singapore. Cureus 2023; 15:e38906. [PMID: 37303430 PMCID: PMC10257555 DOI: 10.7759/cureus.38906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2023] [Indexed: 06/13/2023] Open
Abstract
Background Frontline healthcare professionals who provide regular care to women in the antenatal and postnatal period play a critical role in the early detection and management of maternal perinatal mental health (PMH). This study aimed to assess the knowledge, attitudes, and perceptions of doctors around perinatal mental health in an obstetrics and gynaecology (O&G) department in Singapore. Methods Using an online survey, data was collected from 55 doctors who participated in the Doctor's Knowledge, Attitudes and Perceptions of Perinatal Mental Health (I-DOC) study. The survey questions assessed the knowledge, attitudes, perceptions and practices in relation to PMH among doctors in the O&G specialty. Descriptive data was presented as means and standard deviations (SDs), or frequency and percentages. Results Out of the 55 doctors, more than half (60.0%) were not aware of the adverse impacts of poor PMH; 83.7% of doctors were not confident in providing PMH advice and 65.5% did not routinely screen patients for PMH disorders. There was a lower percentage of doctors (10.9% vs. 34.5%, p<0.001) who discussed PMH issues in the antenatal period compared to the postnatal period and this was statistically significant. Majority of doctors (98.2%) agreed that having standardised PMH guidelines will be useful. All doctors agreed on the benefits of having PMH guidelines, education and routine screening for patients. Conclusion There is inadequate PMH literacy among O&G doctors and lack of emphasis on antenatal PMH disorder. The findings highlighted the need for increased education and development of perinatal mental health guidelines.
Collapse
Affiliation(s)
- Zi Xi Poo
- Department of Maternal Fetal Medicine, Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, SGP
| | - Phai Ling Quah
- Department of Maternal Fetal Medicine, Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, SGP
| | - Helen Chen
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore, SGP
| | - Ann Wright
- Department of Maternal Fetal Medicine, Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, SGP
| | - Tiong Ghee Teoh
- Department of Maternal Fetal Medicine, Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, SGP
| | - Lay Kok Tan
- Department of Maternal Fetal Medicine, Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, SGP
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, SGP
| |
Collapse
|
8
|
Hoberg MG, Demirci JR, Sereika SM, Levine MD, DeVito Dabbs A. Descriptive Exploratory Study to Understand Postpartum Anxiety Using Multiple Measures. J Obstet Gynecol Neonatal Nurs 2023; 52:50-61. [PMID: 36356652 PMCID: PMC9839497 DOI: 10.1016/j.jogn.2022.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/07/2022] [Accepted: 09/15/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To compare a general anxiety instrument plus a depression instrument with a specific postpartum anxiety instrument plus a depression instrument to detect postpartum anxiety and to explore trends in daily postpartum anxiety. DESIGN Prospective, longitudinal cohort study. SETTING Academic tertiary center in the mid-Atlantic United States. Study activities were remote. PARTICIPANTS Pregnant women (N = 73) in the third trimester of pregnancy. METHODS We administered the State-Trait Anxiety Inventory (STAI), Postpartum Specific Anxiety Scale (PSAS), and Edinburgh Postnatal Depression Scale (EPDS) at 1 and 8 weeks after birth. We used mobile ecological momentary assessment prompts to measure daily anxiety levels (0-10) from 1 to 8 weeks after birth. We defined the presence of anxiety and depression by using the established instrument cutoff scores. We used repeated-measures analysis of variance and dependent-samples t tests to determine the stability of the determined anxiety instruments during the study time frame. We used linear mixed modeling to explore mobile ecological momentary assessment anxiety trends. RESULTS The PSAS and EPDS detected more participants with anxiety and/or depression (26.8%, 19/71) than the STAI and EPDS (23.9%, 17/71) at 8 weeks after birth. PSAS scores increased from 1 to 8 weeks after birth (p = .003); STAI scores decreased (p = .01). Daily anxiety ratings changed nonlinearly during the study period, were greatest at 2 weeks, declined and stabilized, and then trended upward toward Week 8. CONCLUSION Detection of postpartum anxiety in clinical settings can be improved through addition of the PSAS in routine screening. Timing of anxiety assessment should be considered between 6 to 8 weeks after birth.
Collapse
|
9
|
Dörsam AF, Bye A, Graf J, Howard LM, Throm JK, Müller M, Wallwiener S, Zipfel S, Micali N, Giel KE. Screening instruments for eating disorders in pregnancy: Current evidence, challenges, and future directions. Int J Eat Disord 2022; 55:1208-1218. [PMID: 35844188 DOI: 10.1002/eat.23780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 06/30/2022] [Accepted: 06/30/2022] [Indexed: 11/10/2022]
Abstract
Pregnancy is a vulnerable period for eating disorder (ED) occurrence and maternal EDs are associated with heightened risk of adverse pregnancy and infant outcomes. This highlights the need to identify pregnant women with past or current EDs in order to offer appropriate support. However, there is a knowledge and practice gap on screening pregnant women for EDs. Clinical guidance is lacking in international treatment guidelines, which is unsurprising given that no validated ED screening tool specifically designed for use in antenatal populations exists. Moreover, data on the effectiveness of general population screening tools for identifying EDs in pregnant women are scarce. This article provides a synthesis of current evidence, treatment guidelines, and data on the diagnostic accuracy for screening for EDs in antenatal samples from three studies with different screening approaches. We outline recommendations for future steps to tackle the knowledge and practice gap on screening for EDs in pregnant women, including next steps for the development of a pregnancy-specific ED screener and the use of general mental health screeners to detect EDs during pregnancy. Up-to-date, the jury is still out as how to best identify current or past EDs in pregnancy. More research is needed to assess the efficacy of using general mental health screeners versus ED-specific screening instruments to detect ED in pregnancy. Additionally, clinicians have to be trained on how to assess and manage EDs during pregnancy. PUBLIC SIGNIFICANCE: Identifying pregnant women with eating disorders (EDs) is a public health concern which can be addressed using multiple approaches, including implementation of general and specific assessments within routine antenatal care, and training of healthcare professionals.
Collapse
Affiliation(s)
- Annica Franziska Dörsam
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany.,Center of Excellence for Eating Disorders (KOMET), Tübingen, Germany
| | - Amanda Bye
- Department of Psychological Medicine, Division of Academic Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Johanna Graf
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
| | - Louise M Howard
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jana Katharina Throm
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany.,Center of Excellence for Eating Disorders (KOMET), Tübingen, Germany
| | - Mitho Müller
- Department of Psychology, Ludwig Maximilian University, Munich, Germany
| | - Stephanie Wallwiener
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany.,Center of Excellence for Eating Disorders (KOMET), Tübingen, Germany
| | - Nadia Micali
- Department of Psychiatry, University of Geneva, Geneva, Switzerland.,Department of Pediatrics, Obstetrics and Gynecology, University of Geneva, Geneva, Switzerland.,Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany.,Center of Excellence for Eating Disorders (KOMET), Tübingen, Germany
| |
Collapse
|
10
|
Jiang C, Zhuang Y, Li Z, Lin W, Huang P, Feng Y, Liu S, Zhang L. Posttraumatic growth and postpartum depression in women after childbirth: The moderating role of postpartum negative life events. J Obstet Gynaecol Res 2022; 48:2392-2404. [PMID: 35708214 DOI: 10.1111/jog.15328] [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: 07/16/2021] [Revised: 05/15/2022] [Accepted: 05/30/2022] [Indexed: 11/29/2022]
Abstract
AIM This study aimed to investigate the implications of postpartum negative life events on postpartum depression and posttraumatic growth in women after childbirth. METHODS A sample of 280 postpartum women at a level III hospital in China provided data on postpartum depression, negative life events, and posttraumatic growth with a cross-sectional design. RESULTS The scores of both postpartum depression and negative life events exhibited a quadratic correlation with posttraumatic growth in women after childbirth, and negative life events significantly moderated the associations between depression and overall posttraumatic growth and its three dimensions: personal strength, spirit change, and relating to others. CONCLUSIONS Women can experience positive psychological growth after childbirth, and this study provides new evidence of an interaction between postpartum depression and negative life events in the prediction of psychological growth, highlighting the moderating role of negative life events. This study could help direct mental health professionals to target interventions that provide more psychological support to reduce the impact of depression and negative life events, which will be conducive to improving women's psychological growth.
Collapse
Affiliation(s)
- Cuiting Jiang
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Youqing Zhuang
- Obstetric Department, Guangdong Maternal and Child Hospital, Guangzhou, China
| | - Zhiyun Li
- Obstetric Department, Guangdong Maternal and Child Hospital, Guangzhou, China
| | - Wenxuan Lin
- Nursing Department, Guangdong Maternal and Child Hospital, Guangzhou, China
| | - Pei Huang
- Obstetric Department, Guangdong Maternal and Child Hospital, Guangzhou, China
| | - Yongshen Feng
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Shaofei Liu
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Lifeng Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
11
|
A Comparison of Three Measures to Identify Postnatal Anxiety: Analysis of the 2020 National Maternity Survey in England. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116578. [PMID: 35682163 PMCID: PMC9180011 DOI: 10.3390/ijerph19116578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 12/10/2022]
Abstract
Perinatal anxiety affects an estimated 15% of women globally and is associated with poor maternal and infant outcomes. Identifying women with anxiety is essential to prevent these adverse associations, but there are a number of challenges around measurement. We used data from England’s 2020 National Maternity Survey to compare the prevalence of anxiety symptoms at six months postpartum using three different measures: the two-item Generalised Anxiety Disorders Scale (GAD-2), the anxiety subscales of the Edinburgh Postnatal Depression Scale (EPDS-3A) and a direct question. The concordance between each pair of measures was calculated using two-by-two tables. Survey weights were applied to increase the representativeness of the sample and reduce the risk of non-response bias. The prevalence of postnatal anxiety among a total of 4611 women was 15.0% on the GAD-2, 28.8% on the EPDS-3A and 17.1% on the direct question. Concordance between measures ranged between 78.6% (95% CI 77.4–79.8; Kappa 0.40) and 85.2% (95% CI 84.1–86.2; Kappa 0.44). Antenatal anxiety was the strongest predictor of postnatal anxiety across all three measures. Women of Black, Asian or other minority ethnicity were less likely to report self-identified anxiety compared with women of White ethnicity (adjusted odds ratio 0.44; 95% CI 0.30–0.64). Despite some overlap, different anxiety measures identify different groups of women. Certain population characteristics such as women’s ethnicity may determine which type of measure is most likely to identify women experiencing anxiety.
Collapse
|
12
|
Oh R, Khang YH, Kim YM. Edinburgh Postnatal Depression Scale used in South Korea. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2021. [DOI: 10.5124/jkma.2021.64.10.699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: The Edinburgh Postnatal Depression Scale (EPDS), a validated screening tool for prenatal and postnatal depression, was included as a reimbursable item by the National Health Insurance Service of Korea in 2020. However, multiple Korean versions of the EPDS are used for public health programs and research. This study aimed to summarize the use of this scale in Korea and evaluate the distribution of validities, depression scores, and prevalence of depression according to Korean versions of the EPDS.Methods: Korean versions of the EPDS most frequently used in public health policies and programs were summarized through internet searches using snowball strategy. A systematic literature review was conducted to evaluate the prenatal and postnatal depression scores and prevalence of depression measured using different Korean versions of the scale.Results: We identified four Korean versions of the EPDS that are commonly used in public health programs and research. Among them, published evidence regarding validity and reliability was available for two versions. A review of 19 papers that assessed prenatal and postnatal depression using these versions showed large heterogeneity in scores and the prevalence of depression.Conclusion: When measuring prenatal and postnatal depression using the EPDS, characteristics of the scale must be considered when interpreting results. A standardized Korean version of the EPDS needs to be developed by comparing the validity and reliability of different Korean versions. A field manual for screening should also be developed and distributed.
Collapse
|