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Ajayi AI, Chamdimba E, Sawadogo N, Gitahi N, Tarnagda AM, Ilboudo AK, Munthali A, Thakwalakwa C, Otukpa EO, Ushie BA, Kabiru CW. Socio-ecological factors associated with probable depression among pregnant and parenting adolescent girls: findings from a cross-sectional study in Burkina Faso and Malawi. Reprod Health 2023; 20:38. [PMID: 36882850 PMCID: PMC9990966 DOI: 10.1186/s12978-023-01588-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 02/23/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Pregnant and parenting adolescent girls are at risk of poor mental health because of stigma and social exclusion. Despite one in four girls starting childbearing by the age of 19 in Africa, no study, to the best of our knowledge, has examined the multi-layered factors (individual, family, friends, and neighborhood-related factors) associated with depressive symptoms among pregnant and parenting girls in Africa. Our study contributes to addressing this gap by examining the socio-ecological factors associated with depression symptoms among pregnant and parenting adolescent girls. METHODS Our study adopted a cross-sectional design. Between March and September 2021, we interviewed 980 pregnant and parenting adolescent girls in Ouagadougou, Burkina Faso, and 669 in Blantyre, Malawi. We recruited pregnant and parenting adolescent girls in randomly selected urban and rural enumeration areas in Burkina Faso (n = 71) and Malawi (n = 66). We assessed depressive symptoms using the Patient Health Questionnaire (PHQ-9), which generated an overall score of 27. We considered a score of 10 or more as probable depression. We also obtained information on individual, family, friends, and neighborhood characteristics. We employed logistic regression models to examine the significant factors associated with probable depression among pregnant and parenting adolescent girls. RESULTS The prevalence of probable depression was 18.8% and 14.5% in Burkina Faso and Malawi, respectively. At the individual level, having secondary education was significantly associated with a lower likelihood of probable depression in Malawi (AOR: 0.47; 95% CI 0.27-0.82) but not in Burkina Faso. At the family level, denying paternity (AOR: 3.14; 95% CI 1.34-7.11 in Malawi) and no parental support (AOR: 2.08; 95% CI 1.22-3.55 in Burkina Faso) were associated with higher odds of probable depression. At the community level, perceived neighborhood safety was associated with a lower likelihood of probable depression in Malawi (AOR: 0.74; 95% CI 0.61-0.89) and Burkina Faso (AOR: 0.81; 95% CI 0.73-0.90). Having a safety net within the community was associated with lower odds of probable depression in Burkina Faso (AOR: 0.87; 95% CI 0.78-0.96) but not in Malawi. CONCLUSION Depressive symptoms are common among pregnant and parenting adolescents, suggesting the need to screen them regularly for depression during antenatal and postnatal visits. Factors associated with depression among pregnant and parenting girls operate at multiple levels suggesting a need for multilevel interventions that address all areas of vulnerabilities.
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Affiliation(s)
- Anthony Idowu Ajayi
- Sexual, Reproductive, Maternal, New-born, Child and Adolescent Health (SRMNCAH) Unit, African Population and Health Research Center, Manga Close, Nairobi, Kenya.
| | - Elita Chamdimba
- Centre for Social Research, University of Malawi, P. O. Box 280, Zomba, Malawi
| | - Nathalie Sawadogo
- Institut Supérieur des Sciences de La Population, Université Joseph Ki-Zerbo, B.P. 7118, Ouagadougou 03, Burkina Faso
| | - Nyawira Gitahi
- Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, ON, M5T 3M7, Canada
| | - Abdoul Moumini Tarnagda
- Institut Supérieur des Sciences de La Population, Université Joseph Ki-Zerbo, B.P. 7118, Ouagadougou 03, Burkina Faso
| | - Abdoul Kader Ilboudo
- Institut Supérieur des Sciences de La Population, Université Joseph Ki-Zerbo, B.P. 7118, Ouagadougou 03, Burkina Faso
| | - Alister Munthali
- Centre for Social Research, University of Malawi, P. O. Box 280, Zomba, Malawi
| | | | - Emmanuel Oloche Otukpa
- Sexual, Reproductive, Maternal, New-born, Child and Adolescent Health (SRMNCAH) Unit, African Population and Health Research Center, Manga Close, Nairobi, Kenya
| | - Boniface Ayanbekongshie Ushie
- Sexual, Reproductive, Maternal, New-born, Child and Adolescent Health (SRMNCAH) Unit, African Population and Health Research Center, Manga Close, Nairobi, Kenya
| | - Caroline W Kabiru
- Sexual, Reproductive, Maternal, New-born, Child and Adolescent Health (SRMNCAH) Unit, African Population and Health Research Center, Manga Close, Nairobi, Kenya
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Prevalence and correlates of depression among pregnant adolescents in primary maternal care in Nigeria. Arch Womens Ment Health 2022; 25:441-450. [PMID: 35089429 DOI: 10.1007/s00737-021-01198-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/16/2021] [Indexed: 11/02/2022]
Abstract
To examine the prevalence as well as the clinical and psychosocial factors associated with depression and depression severity in pregnant adolescents. Participants were consecutively registered pregnant adolescents presenting to 30 selected primary maternal and child healthcare centers in Ibadan, Nigeria, who were screened for enrolment into an intervention trial for perinatal depression (depression defined as a score of ≥ 12 on the Edinburg Postnatal Depression Scale [EPDS] and met the DSM-IV diagnostic criteria for depression). Of the 1359 pregnant adolescents screened, 246 (18.1%) had depression. Mean age was 18.4 (sd 1.00), 58.9% were either married or cohabiting, 91.4% were primipara, and the mean gestational age was 23.8 weeks (sd 5.4 weeks). Food insecurity (going to bed hungry at least once in the previous week because there was no food to eat) was reported by 13.3%. In bivariate analysis, younger age, not living with a partner, unemployment, and food insecurity were associated with depression. In bivariate analysis, younger age, not living with a partner, unemployment and food insecurity were associated with depression, while younger age, being single and food insecurity were independently associated with being depressed in multivariate analysis. Severity of depression was related to age, higher anxiety and disability scores, lower quality of life scores across all domains and poorer attitudes towards pregnancy. Depression was associated with indices of higher social disadvantage among adolescents. Delaying childbearing and measures aimed at alleviating poverty may be important in preventing depression in this vulnerable group.
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Astle SM, Duncan JC, Toews ML, Perez-Brena NJ, McAllister P, Maddy MA, E. Feinberg M. “A Little Bit Closer”: A Mixed Method Analysis of the Effect of the COVID-19 Pandemic on the Lives of Adolescent Parents. JOURNAL OF ADOLESCENT RESEARCH 2021. [DOI: 10.1177/07435584211062116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Using a Family Stress Model framework, we used quantitative and qualitative methods to investigate the impact of the pandemic on Latinx pregnant and parenting adolescents and their families. Participants were 406 adolescents (ages 14–19) in the southwestern U.S. who participated in a school-based relationship education program for pregnant and parenting adolescents. In the quantitative analysis, we compared self-reported mental health (depressive symptoms, worry, parental stress), coparental relationships (conflict and communication), and parenting of adolescents who participated prior to the pandemic ( N = 357; 83.6% female; 84.7% Latinx) with those who participated during the pandemic ( N = 49; 74.6% female; 87.8% Latinx). Unexpectedly, the pandemic-period cohort reported fewer depressive symptoms, less parental stress, more frequent coparental communication, and more positive coparental communication and conflict management than the pre-pandemic cohort. For the qualitative analysis, we conducted focus groups and individual interviews with 21 adolescent parents (95.2% female; 90.5% Latinx) from the pandemic-period cohort and analyzed the data using thematic analysis. Participants reported many negative effects of the pandemic including increased economic and health stress, yet also discussed reduced pressure with school and more time with family members. These findings have important implications for enhancing the well-being of adolescent parents and their children after the pandemic.
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Santacrose DE, Kia-Keating M, Lucio D. A systematic review of socioecological factors, community violence exposure, and disparities for Latinx youth. J Trauma Stress 2021; 34:1027-1044. [PMID: 34647363 DOI: 10.1002/jts.22733] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 01/02/2023]
Abstract
Community violence exposure poses a public health risk exacerbated by immigration-related stressors and environmental factors, including systemic racism and interpersonal discrimination, socioeconomic disparities, and anti-immigrant laws and policies, that disproportionately impact Latinx-immigrant and systematically minoritized youth. Using the ecological-transactional model of community violence as a conceptual framework, this systematic review was conducted to examine research on exposure to community violence, risk and protective factors, and associated health and mental health sequelae among Latinx youth. The initial search generated 2,152 articles, 291 of which were reviewed for detailed evaluation; ultimately, 59 articles were included. Mexican-origin youth and adolescent samples were the most represented in research studies. Across several studies, Latinx youth reported high rates of violence exposure and poor health or mental health outcomes. The findings revealed important gaps in socioecological factors, with a dearth of evidence establishing macrosystem factors or culturally salient and immigrant-related factors. Notable risk and protective factors at various ecological levels were identified and discussed as key opportunities for future research and points of intervention or prevention efforts for Latinx-immigrant and systematically minoritized youth.
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Affiliation(s)
- Diana E Santacrose
- Department of Psychology, Loyola Marymount University, Los Angeles, California, USA
| | - Maryam Kia-Keating
- Department of Counseling, Clinical and School Psychology, University of California, Santa Barbara, Santa Barbara, California, USA
| | - Daniella Lucio
- Department of Psychology, Loyola Marymount University, Los Angeles, California, USA
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Sangsawang B, Deoisres W, Hengudomsub P, Sangsawang N. Effectiveness of psychosocial support provided by midwives and family on preventing postpartum depression among first-time adolescent mothers at 3-month follow-up: A randomised controlled trial. J Clin Nurs 2021; 31:689-702. [PMID: 34196048 DOI: 10.1111/jocn.15928] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/15/2021] [Accepted: 06/04/2021] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To evaluate the effectiveness of a midwife-family provided social support programme (MFPSS programme) for first-time adolescent mothers on preventing postpartum depression (PPD) at 3-month postpartum. BACKGROUND Adolescent mothers with lack of social support are a high-risk group for increasing the development of PPD. Interventions designed to promote social support and provided to mothers following childbirth have a more effective role in preventing PPD. DESIGN The Consolidated Standards of Reporting Trials (CONSORT) guidelines for a single-blinded randomised controlled trial were conducted. METHODS Forty-two adolescent mothers were randomly assigned to 4-week MFPSS programme plus routine care (n = 21) and routine care only (n = 21). PPD was measured using the Edinburgh Postnatal Depression Scale (EPDS), rates and severity at baseline, post-test, 6-week and 3-month postpartum follow-ups. Repeated measures ANOVA and Cohen's d were used to analyse the data. RESULTS At the last follow-up, 20 (95.24%) participants remained in each group. Data were analysed based on 40 adolescent mothers. After the intervention, the mean EPDS scores in the intervention group were significantly lower than the same scores in the control group at post-test, 6-week and 3-month postpartum follow-ups. Similarly, the rates and severity of PPD in the intervention group were also lower than the control group at post-test, 6-week and 3-month postpartum follow-ups. CONCLUSION Psychosocial support interventions designed to incorporate support from midwives and family members is an effective intervention for preventing PPD in first-time adolescent mothers and the preventive effect is sustained for up to 3-month postpartum. RELEVANCE TO CLINICAL PRACTICE Midwives or nurses could apply the MFPSS programme to nursing care for adolescent mothers and family members by adding health information about PPD and promoting social support. CLINICAL TRIAL REGISTRATION The trial was registered with Thai Clinical Trials Registry (TCTR). The trial registration number is TCTR 20190206004.
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Affiliation(s)
- Bussara Sangsawang
- Department of Maternal-Child Nursing and Midwifery, Faculty of Nursing, Srinakharinwirot University, Nakhonnayok, Thailand
| | - Wannee Deoisres
- Faculty of Nursing, Rambhai Barni Rajabhat University, Chanthaburi, Thailand
| | - Pornpat Hengudomsub
- Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, Burapha University, Chon Buri, Thailand
| | - Nucharee Sangsawang
- Department of Maternal-Child Nursing and Midwifery, Faculty of Nursing, Srinakharinwirot University, Nakhonnayok, Thailand
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Anderson CA, Ruiz J. Depressive Symptoms Among Hispanic Adolescents and Effect on Neonatal Outcomes. HISPANIC HEALTH CARE INTERNATIONAL 2021; 20:25-32. [PMID: 33813920 DOI: 10.1177/15404153211003223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Hispanics have the highest birth rate among adolescents and may be vulnerable to experience depression. The purpose of this study was to explore the prevalence of perinatal depression and effects upon neonatal outcomes among Hispanic adolescents 13-19 years old. METHODS Available data from a previously conducted study examining the prevalence of adolescent depression and post-traumatic stress were used for the current secondary analysis. Perinatal data reflected a rating of prenatal depression and scores from the Edinburgh Postpartum Depression Scale (EPDS). Adverse infant outcomes included preterm birth, low birth weight, and neonatal complications. RESULTS Over 20% of adolescents reported an adverse infant outcome. About one third of adolescents reported perinatal depression: prenatally (14%) and postnatally (14% minor depression/12.7% major depression). Significant associations were found between EPDS scores, gestational age, and feelings during pregnancy; however, perinatal depression was not found to predict adverse infant outcomes. CONCLUSION Prenatally depressed adolescents are vulnerable to postpartum depression and if experience an adverse infant outcome, postpartum depression may be more likely reported. Therefore, prenatal- and afterbirth-focused assessments and care, including plans for follow-up, are essential.
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Affiliation(s)
- Cheryl Ann Anderson
- College of Nursing and Health Innovation, 12329The University of Texas at Arlington, TX, USA
| | - Jocelyn Ruiz
- The 12329TUniversity of Texas at Arlington, TX, USA
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Vanderkruik R, Gonsalves L, Kapustianyk G, Allen T, Say L. Mental health of adolescents associated with sexual and reproductive outcomes: a systematic review. Bull World Health Organ 2021; 99:359-373K. [PMID: 33958824 PMCID: PMC8061667 DOI: 10.2471/blt.20.254144] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 12/03/2020] [Accepted: 12/06/2020] [Indexed: 11/27/2022] Open
Abstract
Objective To systematically review the literature on the mental health of adolescents associated with sexual and reproductive outcomes, and compare the mental health outcomes with that of other age groups. Methods We searched seven databases for relevant peer-reviewed articles published between 1 January 2010 and 25 April 2019. Our inclusion criteria required that the study included age-disaggregated data on adolescents, and focused and assessed mental health outcomes associated with pregnancy or sexually transmitted infections. We extracted data on the specific health event, the mental health outcome and the method of measuring this, and comparisons with other age groups. Findings After initially screening 10 818 articles by title and abstract, we included 96 articles in our review. We observed that a wide-ranging prevalence of mental ill-health has been reported for adolescents. However, most studies of mental health during pregnancy did not identify an increased risk of depression or other mental disorders among adolescents compared with other age groups. In contrast, the majority of studies conducted during the postpartum period identified an increased risk of depression in adolescents compared with other age groups. Three studies reported on mental health outcomes following abortion, with varying results. We found no studies of the effect of sexually transmitted infections on mental health among adolescents. Conclusion We recommend that sexual and reproductive health services should be accessible to adolescents to address their needs and help to prevent any adverse mental health outcomes.
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Affiliation(s)
- Rachel Vanderkruik
- Massachusetts General Hospital, 185 Cambridge Street, Boston, MA 02114, United States of America
| | - Lianne Gonsalves
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | | | - Tomas Allen
- Department of Quality, Norms and Standards, World Health Organization, Geneva, Switzerland
| | - Lale Say
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Hou J, Yu Q, Lan X. COVID-19 Infection Risk and Depressive Symptoms Among Young Adults During Quarantine: The Moderating Role of Grit and Social Support. Front Psychol 2021; 11:577942. [PMID: 33488448 PMCID: PMC7820677 DOI: 10.3389/fpsyg.2020.577942] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 11/25/2020] [Indexed: 12/27/2022] Open
Abstract
Prior research has demonstrated that the adverse consequences of the coronavirus disease 2019 (COVID-19) pandemic may go beyond its economic hardships and physical health concerns, having a significant influence on psychological distress for individuals under quarantine. Nevertheless, relatively little attention has been paid to exploring the risk and protective factors in the link between COVID-19 infection risk and psychological distress among young adults. Following a socioecological framework, the current study examines the moderating role of grit (perseverance and consistency) and social support in the association between COVID-19 infection risk and depressive symptoms. A sample of 1,251 young adults under home quarantine (62.6% female; M age = 20.92 years, SD = 1.47; age ranged from 18 to 25 years) was involved in this study, and they were asked to complete a set of self-reported questionnaires online. Results of a linear regression analysis exhibited that COVID-19 infection risk was positively associated with depressive symptoms in young adults in quarantine. Moreover, moderation analyses showed that this association was moderated by perseverance and social support. To be specific, for those reporting higher levels of social support, this linkage was not significantly positive; in contrast, for those reporting lower levels of social support, perseverance was a significant protective factor for depressive symptoms when young adults were exposed to a high infection risk of COVID-19. The current study suggests that greater social support is essential to helping young adults deal with possible negative emotions in the context of the COVID-19 pandemic. Moreover, university-based counseling services should pay specific attention to those young adults with relatively insufficient social support resources and low levels of perseverance.
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Affiliation(s)
- Jie Hou
- College of General Aviation, Jingchu University of Technology, Jingmen, China
| | - Qingyun Yu
- Counseling Center for Mental Health Education, Jingchu University of Technology, Jingmen, China
| | - Xiaoyu Lan
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
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de Espíndola MI, Bedendo A, da Silva EA, Noto AR. Interpersonal relationships and drug use over time among homeless people: a qualitative study. BMC Public Health 2020; 20:1746. [PMID: 33213421 PMCID: PMC7678275 DOI: 10.1186/s12889-020-09880-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 11/11/2020] [Indexed: 05/30/2023] Open
Abstract
Background Homelessness is one of the most severe forms of social exclusion and is an important public health issue. It is characterized by processes of weakening of interpersonal bonds. The objective of this study was, therefore, to elucidate how interpersonal relationships change over the life cycle of homeless drug and alcohol users. Method We used a qualitative methodology. The participants were adults who had a history of homelessness and use of alcohol and other drugs. The interviews were semi structured and used a timeline instrument. All interview were audio recorded, transcribed, and submitted to thematic analysis. Results Twenty individuals participated in the study. Reports on social exclusion over time stood out in respect of four main themes and their respective subthemes: Theme 1 – Childhood: instability upbringing, abuse, violence, and an absent or not very present father figure; Theme 2 – Adolescence: school dropout and failure; acceptance of gender and sexual orientation; birth of first child, living with a partner or getting married: Theme 3 – Adulthood: estrangement or conflicting relationship with family; health problems; drug trafficking and prostitution; Theme 4 – Cross-cutting factors: death of relatives and substance use. Conclusion The results suggest that interpersonal relationships are permeated by successive breakups, conflicts and other events that start in childhood and can have a cumulative effect in later stages of life, and cross the subsequent phases. Substance abuse and dependence are mentioned as cross-cutting factors that intensify social exclusion in all stages of life. Supplementary Information Supplementary information accompanies this paper at 10.1186/s12889-020-09880-2.
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Affiliation(s)
- Marília Ignácio de Espíndola
- NEPSIS - Research Center on Health and Substance Use, Sao Paulo, Brazil. .,Department of Psychobiology, Universidade Federal de São Paulo - UNIFESP, Rua Botucatu, 862 - 1° Andar, Vila Clementino, SP, 04023062, Sao Paulo, Brazil.
| | - André Bedendo
- NEPSIS - Research Center on Health and Substance Use, Sao Paulo, Brazil.,Department of Psychobiology, Universidade Federal de São Paulo - UNIFESP, Rua Botucatu, 862 - 1° Andar, Vila Clementino, SP, 04023062, Sao Paulo, Brazil
| | - Eroy Aparecida da Silva
- NEPSIS - Research Center on Health and Substance Use, Sao Paulo, Brazil.,Department of Psychobiology, Universidade Federal de São Paulo - UNIFESP, Rua Botucatu, 862 - 1° Andar, Vila Clementino, SP, 04023062, Sao Paulo, Brazil
| | - Ana Regina Noto
- NEPSIS - Research Center on Health and Substance Use, Sao Paulo, Brazil.,Department of Psychobiology, Universidade Federal de São Paulo - UNIFESP, Rua Botucatu, 862 - 1° Andar, Vila Clementino, SP, 04023062, Sao Paulo, Brazil
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Anderson CA, Ghirmazion E. The Adolescent Birth Experience: A Comparison of Three Diverse Groups. J Perinat Educ 2020; 29:197-207. [PMID: 33223793 PMCID: PMC7662166 DOI: 10.1891/j-pe-d-19-00027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Recognized risk factors influencing the birth experience and subsequent poor mental health are not addressed among childbearing adolescents, especially minority teens. Our study purpose was to compare birth experiences of three adolescent groups by prevalence and influence of selected risk factors as moderated by racial/ethnic background. Using a birth rating scale and the Impact of Event Scale, birth perception and stress were examined among an equal number of Black, White, and Hispanic adolescents. Surveys completed at 72 hours postpartum showed Black adolescents most at risk for a negative birth experience. Contributing risk factors included depression, trauma, parity, and operative childbirth. Risk factors occur before and after birth; therefore, childbirth educators can promote a positive birth experience via perinatal assessments and interventions.
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Van Lieshout RJ, Savoy CD, Boyle MH, Georgiades K, Jack SM, Niccols A, Whitty H, Lipman EL. The Mental Health of Young Canadian Mothers. J Adolesc Health 2020; 66:464-469. [PMID: 32057608 DOI: 10.1016/j.jadohealth.2019.10.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 10/15/2019] [Accepted: 10/16/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Although many young mothers (aged <21 years) are exposed to multiple adversities that increase their risk for mental illness, prevalence data are largely limited self-report questionnaires estimating only the prevalence of postpartum depression. Gaining a greater understanding of the burden of a broader range of common mental illnesses affecting these young women has the potential to improve their health as well as the development and functioning of their children. METHODS The Young Mothers Health Study recruited 450 mothers aged <21 years and 100 comparison mothers (aged >20 years old at first delivery) living in urban and rural central-west Ontario. Age-matched young mothers were also compared with 15- to 17-year-old women without children (N = 630) from the 2014 Ontario Child Health Study. The prevalence of current mental disorders was assessed using the Mini-International Neuropsychiatric Interview for Children and Adolescents. RESULTS Nearly 2 of 3 young mothers reported at least one mental health problem, and almost 40% had more than one. Young mothers were 2 to 4 times as likely to have an anxiety disorder (generalized anxiety disorder, separation anxiety disorder, social phobia, and specific phobia), attention-deficit/hyperactivity disorder, oppositional defiant disorder, or conduct disorder and were 2 to 4 times more likely to have more than one psychiatric problem than older comparison mothers or women aged 15-17 years. CONCLUSIONS Given the high rates of mental health problems and complex needs of young mothers in Canada and the possible adverse effects of maternal psychopathology on their children, further efforts should be directed at engaging and treating this high-risk group.
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Affiliation(s)
- Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Calan D Savoy
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
| | - Michael H Boyle
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Susan M Jack
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Alison Niccols
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Heather Whitty
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Ellen L Lipman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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McDaid F, Underwood L, Fa Alili-Fidow J, Waldie KE, Peterson ER, Bird A, D Souza S, Morton S. Antenatal depression symptoms in Pacific women: evidence from Growing Up in New Zealand. J Prim Health Care 2020; 11:96-108. [PMID: 32171352 DOI: 10.1071/hc18102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 05/23/2019] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Pacific women in New Zealand (NZ) have higher rates of antenatal depression than women from other ethnic groups. AIM To identify factors that are significantly associated with depression symptoms in pregnant Pacific women living in NZ. METHODS Data were collected from 5657 pregnant women, 727 of whom identified their ethnicity as Pacific Island. Antenatal depression symptoms were measured using the Edinburgh Depression Scale with scores above 12 indicating elevated antenatal depression symptoms (ADS). RESULTS Pacific women had significantly higher rates of ADS than non-Pacific women, with 23% of pregnant Pacific women experiencing ADS. Factors associated with ADS for Pacific women included age <25 years, moderate to severe nausea during pregnancy, perceived stress, family stress and relationship conflict. Not seeing the importance of maintaining one's Pacific culture and traditions and negative feelings towards NZ culture were also significantly associated with ADS in Pacific women. One in three Pacific women aged <25 years experienced ADS. Pregnant Pacific women without a family general practitioner (GP) before their pregnancy were 4.5-fold more likely to experience ADS than non-Pacific women with a regular GP. DISCUSSION Further attention is required to providing appropriate primary health care for Pacific women of child-bearing age in NZ. Better screening processes and a greater understanding of effective antenatal support for Pacific women is recommended to respond to the multiple risk factors for antenatal depression among Pacific women.
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Affiliation(s)
- Frances McDaid
- Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Auckland, New Zealand
| | - Lisa Underwood
- School of Population Health, University of Auckland, PO Box 18288, Auckland, 1743, New Zealand; and Corresponding author.
| | - Jacinta Fa Alili-Fidow
- Centre for Longitudinal Research, University of Auckland, PO Box 18288, Auckland 1743, New Zealand
| | - Karen E Waldie
- School of Psychology, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Elizabeth R Peterson
- School of Psychology, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Amy Bird
- School of Psychology, University of Wollongong, Northfields Ave, NSW 2522, Australia
| | - Stephanie D Souza
- COMPASS Research Centre, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Susan Morton
- School of Population Health, University of Auckland, PO Box 18288, Auckland, 1743, New Zealand; and Centre for Longitudinal Research, University of Auckland, PO Box 18288, Auckland 1743, New Zealand
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Sezgin AU, Punamäki RL. Impacts of early marriage and adolescent pregnancy on mental and somatic health: the role of partner violence. Arch Womens Ment Health 2020; 23:155-166. [PMID: 30955087 PMCID: PMC7183488 DOI: 10.1007/s00737-019-00960-w] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 03/18/2019] [Indexed: 11/26/2022]
Abstract
Researchers agree that early marriage (EM) and adolescent pregnancy (AP) can form severe risks for women's somatic, mental, and reproductive health, as well as on educational and social status. Yet, less is known about factors that may moderate or mediate these associations. This study examined, first, retrospectively the impacts of EM and AP on self-reported mental and somatic health among multicultural group of women living in Eastern Anatolia, Turkey. Second task was to analyze whether and how the partner violence would mediate and/or moderate between EM and AP and mental health problems. The participants were 1569 women (16-72 years of age), who reported their age of being married, first pregnancy, and demographic characteristics. They described their mental health status through General Health Questionnaire (GHQ-28: depressive, anxiety, social dysfunction, and somatization symptoms) and symptoms of posttraumatic stress disorder (PTSD; DSM-5). Women's reports of somatic illnesses were classified according to WHO-ICD-10. The revised conflict tactics scale, short form was used as a proxy to partner violence. Women who gave birth at 13-19 years of age reported more anxiety and somatization symptoms than later delivered, and those married younger than 25 showed a higher level of depressive symptoms than later married. Both AP and EM formed a heightened risk for somatic illnesses. The partner violence functioned as a moderator; AP was associated with especially high levels of depressive and anxiety symptoms among women exposed to sexual coercion in their marriage. Non-significant mediation analysis indicates that partner violence did not explain the severe impacts of the AP and EM on women's mental health. Yet, the AP and EM were associated with heightened level of partner violence. Adolescent pregnancy forms a comprehensive mental health risk, and both AP and EM were risks for somatic illnesses, such as cardiovascular problems. The mental health risk of AP further intensified if women experienced sexual coercion in their partnership. Our fundamental work is to abolish these patriarchal phenomena.
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Affiliation(s)
- Aysen Ufuk Sezgin
- Istanbul University, Istanbul Medical Faculty, Forensic Medicine Department, Istanbul, Turkey
| | - Raija-Leena Punamäki
- Faculty of Social Sciences/Psychology, Tampere University, Kalevankatu 5, Linna 4krs, FIM-33014, Tampere, Finland.
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"…Society is, at the end of the day, still going to stigmatize you no matter which way": A qualitative study of the impact of stigma on social support during unintended pregnancy in early adulthood. PLoS One 2019; 14:e0217308. [PMID: 31120984 PMCID: PMC6532899 DOI: 10.1371/journal.pone.0217308] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 05/08/2019] [Indexed: 11/19/2022] Open
Abstract
Unintended pregnancy in adolescence and early adulthood is stigmatized in the United States because it deviates from social norms that consider young people’s sexuality as a social problem. While limited, prior research has found that this stigma prevents young people from telling people in their lives about their pregnancies, for fear of judgment or negative reactions. We hypothesized that this selective disclosure of unintended pregnancy due to stigma would reduce the social support available to young pregnant people at a particularly vulnerable time—social support that we know is important for optimal physical and mental health of the young person, and the pregnancy (should they choose to carry to term). To explore this hypothesis, we conducted a qualitative study among young people to understand if and how they experienced stigma in relation to an unintended pregnancy, how this stigma shaped patterns of pregnancy disclosure, the implications for received social support, and participant thoughts on how to alleviate the influence of this stigma on their lives. In in-depth interviews with 25 young people in the San Francisco Bay area who had experienced at least one unintended pregnancy, using a thematic analysis approach, we found that the stigma of unintended pregnancy led participants to selectively disclose the pregnancy to limited people, which in turn cut them off from needed sources of social support. Black and Hispanic women disproportionately described this experience. Participants expressed a desire for programs that would connect young people who had experienced unplanned pregnancy to each other–either via the internet, organized groups through clinical care sites, college or high school campuses, or other forums—as a way to alleviate stigma, share perspectives and lessons learned, and otherwise build emotional and informational support networks for themselves where their usual support had fallen away.
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Shamblaw AL, Cardy RE, Prost E, Harkness KL. Abuse as a risk factor for prenatal depressive symptoms: a meta-analysis. Arch Womens Ment Health 2019; 22:199-213. [PMID: 30196369 DOI: 10.1007/s00737-018-0900-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 08/08/2018] [Indexed: 10/28/2022]
Abstract
Depression is the most common mental disorder in pregnancy. An important risk factor in the development of prenatal depression is lifetime history of abuse. The current review quantitatively synthesized research on the association between history of abuse and prenatal depressive symptoms using a meta-analytic technique. A total of 3322 articles were identified through electronic searches of the following databases: PsycINFO, PubMed, CINAHL, and EMBASE Cochrane Collaboration databases between the years of 1980 and 2016. All were independently screened against the following inclusion criteria: articles reporting on original data that included measures of prenatal depression and abuse. Data were extracted by the first and second authors. Descriptive analyses were conducted using Excel version 15.32, and all analyses involving effect sizes were conducted using comprehensive meta-analysis (CMA) version 3.0. Seventy articles met the inclusion criteria and were included in the meta-analyses. Meta-bias detected no publication bias. Abuse had a significant positive relation with prenatal depressive symptoms, with effect sizes in the moderate range for any abuse ([Formula: see text] = 0.287), physical abuse ([Formula: see text] = 0.271), sexual abuse ([Formula: see text] = 0.259), and emotional abuse ([Formula: see text] = 0.340; Cohen 1969. Statistical power analysis for the behavioral sciences. Academic Press, New York). The meta-analyses found a robust relation between abuse and prenatal depressive symptoms holding across a variety of demographic and study design characteristics. These results reinforce the established association between trauma victimization and subsequent psychopathology, extending current knowledge to specifically address the under-studied area of prenatal depression. These findings highlight the need for women who have survived child or adulthood abuse to receive appropriate referral and psychological treatment to mitigate their risk for prenatal depression.
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Affiliation(s)
- Amanda L Shamblaw
- Department of Psychology, Queen's University, Kingston, Ontario, Canada.
| | - Robyn E Cardy
- Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Eric Prost
- Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Kate L Harkness
- Department of Psychology, Queen's University, Kingston, Ontario, Canada
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16
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A Primary Care Intervention to Prevent Repeat Pregnancy Among Teen Mothers. Am J Prev Med 2019; 56:404-410. [PMID: 30777159 DOI: 10.1016/j.amepre.2018.10.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 10/02/2018] [Accepted: 10/03/2018] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The purpose of this study is to determine the effectiveness of a patient-centered medical home intervention for teen parent families in reducing rates of unintended repeat pregnancy in the first 2 years postpartum. METHODS A prospective quasi-experimental evaluation was conducted with 98 African American, low-income, teen mother (aged <20 years) participants who received either the intervention or standard pediatric primary care. All participants completed structured interviews at baseline (child aged 2 months) and at follow-ups 12 and 24 months later. Data were collected from 2011 to 2015. Participants reported number of pregnancies, contraception used at last intercourse, depressive symptoms, and romantic status of the relationship with the baby's father. Analyses were conducted from 2015 to 2017. RESULTS Logistic regression showed that mothers in the intervention group were half as likely as mothers who received standard pediatric primary care to have a repeat pregnancy within 2 years (OR=0.55, p=0.16). The main effect of the intervention on lower rates of repeat pregnancy was mediated by higher rates of contraceptive use. Depression was associated with higher odds of repeat pregnancy, but did not appear to mediate the intervention effect. CONCLUSIONS This comprehensive and integrated model of care for teen parents may be an effective method to prevent rapid repeat pregnancies in this vulnerable population.
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Cluxton-Keller F, Buteau J, Williams M, Stolte P, Monroe-Cassel M, Bruce ML. Engaging rural young mothers in a technology-based intervention for depression. CHILD & YOUTH SERVICES 2019; 40:158-183. [PMID: 31274940 PMCID: PMC6608730 DOI: 10.1080/0145935x.2018.1561264] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Peripartum depression is prevalent among young mothers (ages 25 and younger), and low family support can exacerbate depressive symptoms. The current study explores an innovative method for engaging young mothers in a family-based intervention to help reduce peripartum depressive symptoms. This descriptive study includes details on the baseline characteristics of participants, integrative support teams, and a service delivery method to engage families living rural communities. In conclusion, engaging depressed young mothers living in rural communities requires a multifaceted approach. Our approach has demonstrated promise in engaging this hard-to-reach population. Implications for clinical practice and future research are addressed.
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Affiliation(s)
- Fallon Cluxton-Keller
- Department of Psychiatry, Dartmouth College, Geisel School of Medicine, Lebanon, NH, USA
| | | | | | | | | | - Martha L. Bruce
- Department of Psychiatry, Dartmouth College, Geisel School of Medicine, Lebanon, NH, USA
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Jo S, Park S, Youn JH, Sohn BK, Choi HJ, Lee JY, Lee JY, Lee JY. The Mental Health Status and Intellectual Ability of Unwed Mothers Dwelling in Korean Shelter Homes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040637. [PMID: 29601524 PMCID: PMC5923679 DOI: 10.3390/ijerph15040637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 03/26/2018] [Accepted: 03/27/2018] [Indexed: 11/16/2022]
Abstract
Although many unwed mothers have issues concerning mental health and intellectual ability, little research has focused on their mental and cognitive status. Due to the public stigma attached to unwed mothers in South Korea, they tend to conceal their status and are less likely to seek psychiatric and psychological help. In this context, this study aims to assess the current status of their mental health and intellectual characteristics. A total of 48 unwed mothers from two shelter homes in South Korea agreed to participate in the study. We compared the mental health status of these unwed mothers with that of the general female population. Unwed mothers were more likely than those of the general female population to have mood disorders, post traumatic stress disorder (PTSD), alcohol and nicotine use disorders, and attention-deficit hyperactivity disorder (ADHD). Among the 48 unwed mothers, 20 (41.7%) had an IQ of less than 70, and the mean IQ (78.31) was significantly lower than the normalized mean IQ of the general female population. This study confirmed that unwed mothers dwelling in Korean shelter homes are more likely than the general female population to have mental disorders.
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Affiliation(s)
- Suyeon Jo
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Korea.
| | - Soowon Park
- Department of Education, Sejong University, Seoul 05006, Korea.
| | - Jung Hae Youn
- Department of Art Therapy & Counseling Psychology, Cha University, Gyeonggi-do 11160, Korea.
| | - Bo Kyung Sohn
- Department of Psychiatry, Inje University Sanggye Paik Hospital, Seoul 01757, Korea.
| | - Hyo Jung Choi
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Korea.
| | - Ji Yeon Lee
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Korea.
| | - Jin Yong Lee
- Public Health Medical Service, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Korea.
| | - Jun-Young Lee
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Korea.
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An implementation-effectiveness hybrid trial of video-based family therapy for peripartum depression in home visited mothers: a protocol for a pilot trial. Pilot Feasibility Stud 2017; 3:55. [PMID: 29158913 PMCID: PMC5683555 DOI: 10.1186/s40814-017-0203-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 10/30/2017] [Indexed: 11/10/2022] Open
Abstract
Background The Federal Maternal, Infant, and Early Childhood Home Visiting (HV) Program serves over 100,000 vulnerable families at risk for child abuse in the USA and aims to improve many outcomes, including maternal mental health (HRSA’s Federal Home Visiting Program: partnering with parents to help children succeed, 2017). Most clients are insured by Medicaid, and about 40% are adolescent mothers (pregnant and post-delivery) (The mother and infant home visiting program evaluation: early findings on the Maternal, Infant, and Early Childhood Home Visiting Program, 2015). Over a third of home-visited clients report peripartum depressive symptoms (The mother and infant home visiting program evaluation: early findings on the Maternal, Infant, and Early Childhood Home Visiting Program, 2015). Family conflict increases rates of peripartum depression in adolescent mothers (J Ped Health Care 21:289–98, 2007; J Emot Behav Disord 5:173–83, 1997; Fam Relat 47:395–402, 1998; Arch Ped Adolesc Med 150:64–9, 1996; Obstet Gynecol 110:134–40, 2007; Am Fam Physician 93:852–58, 2016). Although home visitors screen for depression and refer those with positive screens for treatment (The mother and infant home visiting program evaluation: early findings on the Maternal, Infant, and Early Childhood Home Visiting Program, 2015), home-visited mothers infrequently obtain treatment or do not complete it if they do obtain it (Curr Probl Ped Adolesc Health Care 46:124–9, 2016; Making a difference in the lives of children and families: the impacts of Early Head Start Programs on infants and toddlers and their families, 2002; Depression and low-income women: challenges for TANF and welfare-to-work policies and programs, 2001; Aggress Violent Behav 15:191–200, 2010) due to many barriers (e.g., lack of child care, lack of transportation, geographical distance) (Arch Gen Psychiatry 68:627–36, 2011). There is a need for a video-based, family-oriented treatment for peripartum depression that is integrated into home visiting and would bypass these barriers. This article outlines a protocol for a pilot study that will explore the feasibility and acceptability of implementing a family-based treatment, using HIPAA-compliant video-based communication technology, for adolescents with peripartum depressive symptoms within the context of home visiting. Methods This study protocol includes a description of an implementation-effectiveness hybrid trial design that will include 12 depressed adolescent mothers and their family members and a historical comparison group of 12 previously enrolled adolescent mothers. Discussion The study results will provide a clearer understanding of whether or not video-based, family-oriented treatment is feasible and acceptable to implement within the context of home visiting and with home-visited adolescents with peripartum depressive symptoms. The findings from this pilot study could serve as a catalyst for future research that influences mental health practices and policies. Trial registration NCT03282448, ClinicalTrials.gov date of registration 09/21/2017.
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Recto P, Champion JD. Psychosocial Risk Factors for Perinatal Depression among Female Adolescents: A Systematic Review. Issues Ment Health Nurs 2017. [PMID: 28650677 DOI: 10.1080/01612840.2017.1330908] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Perinatal depression is a health concern among pregnant and postpartum adolescents as it may negatively impact fetal development and result in complications such as preterm delivery, low infant birth weight, and poor maternal-infant attachment. The purpose of this systematic review is to examine psychosocial risk factors for depression among adolescents during pregnancy and postpartum. A literature search was conducted from five databases from 1995 to 2016. A total of 17 studies matched the inclusion criteria. Lack of social support, perceived stress, prior history of depression, and a history of sexual or physical violence were most frequently identified as potential risk factors for perinatal depression. Additional risk factors include the adolescent's perception of her pregnancy, family criticism, self-efficacy, self-esteem, substance use, parental stress, community violence, anxiety, and African-American ethnicity. Research and clinical implications are indicated for adolescents at risk for perinatal depression.
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Affiliation(s)
- Pamela Recto
- a School of Nursing , University of Texas at Austin , Austin , Texas , USA
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Hughes LP, Austin-Ketch T, Volpe EM, Campbell-Heider N. Identification and Treatment of Adolescents With Perinatal Anxiety and Depression. J Psychosoc Nurs Ment Health Serv 2017; 55:23-29. [PMID: 28585664 DOI: 10.3928/02793695-20170519-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 04/04/2017] [Indexed: 11/20/2022]
Abstract
Perinatal mood and anxiety disorders (PMAD) are the most common, yet under-diagnosed and undertreated complication of pregnancy, affecting up to 50% of pregnant and parenting teens. PMAD are a global health issue that can have devastating effects on the mental, physical, emotional, developmental health, and social life of the mother, infant, and family. Adolescents present with similar symptoms of PMAD as their adult counterparts, but also experience isolation from their peer group and lack of resources and coping strategies, as well as difficulty sleeping and lack of concentration and ability to focus. Nurses and nurse practitioners are in an ideal position to assess preexisting risk factors for PMAD. The current applied evidence-based article addresses the diagnosis of PMAD, provides a conceptual framework for understanding the intra- and interpersonal dynamics affecting teens with PMAD, and suggests a new screening tool to guide diagnosis. An easy to recall mnemonic for diagnosis and referral (SAIL AHEAD) is proposed. By using the SAIL AHEAD mnemonic, providers will impact adolescents' parenting success and resiliency, thereby enhancing their future success in life. [Journal of Psychosocial Nursing and Mental Health Services, 55(6), 23-29.].
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Underwood L, Waldie KE, Peterson E, D’Souza S, Verbiest M, McDaid F, Morton S. Paternal Depression Symptoms During Pregnancy and After Childbirth Among Participants in the Growing Up in New Zealand Study. JAMA Psychiatry 2017; 74:360-369. [PMID: 28199455 PMCID: PMC5470399 DOI: 10.1001/jamapsychiatry.2016.4234] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
IMPORTANCE Antenatal and postnatal depression are known to be common and associated with poor outcomes for women and their children. There is little evidence on depression symptoms among men during the perinatal period. OBJECTIVE To identify characteristics associated with depression symptoms among men whose partners were pregnant and subsequently gave birth. DESIGN, SETTING, AND PARTICIPANTS A longitudinal cohort study provided data from a demographically diverse sample of 3523 New Zealand men who completed interviews during their partner's pregnancy and 9 months after the birth of their child. Participants were drawn from a cohort whose partners were pregnant women with a due date between April 25, 2009, and March 25, 2010, who were enrolled in the Growing Up in New Zealand study. Data analysis was conducted from September 1, 2015, to January 8, 2016. MAIN OUTCOMES AND MEASURES Depression symptoms were measured using the Edinburgh Postnatal Depression Scale and the 9-item Patient Health Questionnaire; elevated depression symptoms were defined as scores higher than 12 and 9, respectively. RESULTS The mean (SD) age of the participants at the antenatal interview was 33.20 (6.25) years (range, 16-63 years). Elevated antenatal paternal depression symptoms affected 82 fathers (2.3%) and were associated with perceived stress (odds ratio [OR], 1.38; 95% CI, 1.30-1.47) and fair to poor health during their partner's pregnancy (OR, 2.06; 95% CI, 1.18-3.61). Elevated postnatal paternal depression symptoms affected 153 (4.3%) of fathers and were associated with perceived stress in pregnancy (OR, 1.12; 95% CI, 1.08-1.17), no longer being in a relationship with the mother 9 months after childbirth (OR, 6.36; 95% CI, 2.28-17.78), having fair to poor health at 9 months (OR, 3.29; 95% CI, 2.10-5.16), being unemployed at 9 months (OR, 1.86; 95% CI, 1.11-3.10), and a history of depression (OR, 2.84; 95% CI, 1.69-4.78). CONCLUSIONS AND RELEVANCE Expectant fathers were at risk of depression symptoms if they felt stressed or were in poor health. Rates of elevated depression symptoms were higher during the postpartum period and were associated with adverse social and relationship factors. Identifying fathers most at risk of depressive symptoms and when best to target interventions (antenatal or postnatal) may be beneficial to men and their families.
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Affiliation(s)
- Lisa Underwood
- Growing Up in New Zealand, University of Auckland, Auckland, New Zealand,Center for Longitudinal Research–He Ara ki Mua, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Karen E. Waldie
- Growing Up in New Zealand, University of Auckland, Auckland, New Zealand,School of Psychology, University of Auckland, Auckland, New Zealand
| | - Elizabeth Peterson
- Growing Up in New Zealand, University of Auckland, Auckland, New Zealand,School of Psychology, University of Auckland, Auckland, New Zealand
| | - Stephanie D’Souza
- Center for Longitudinal Research–He Ara ki Mua, School of Population Health, University of Auckland, Auckland, New Zealand,School of Psychology, University of Auckland, Auckland, New Zealand
| | - Marjolein Verbiest
- Growing Up in New Zealand, University of Auckland, Auckland, New Zealand,National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Frances McDaid
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Susan Morton
- Growing Up in New Zealand, University of Auckland, Auckland, New Zealand,Center for Longitudinal Research–He Ara ki Mua, School of Population Health, University of Auckland, Auckland, New Zealand
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Mokwena JP, Govender S, Setwaba MB. Health and well-being among teenage mothers in a rural South African community. JOURNAL OF PSYCHOLOGY IN AFRICA 2016. [DOI: 10.1080/14330237.2016.1219539] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Stress in the City: Influence of Urban Social Stress and Violence on Pregnancy and Postpartum Quality of Life among Adolescent and Young Mothers. J Urban Health 2016; 93:19-35. [PMID: 26791234 PMCID: PMC4794454 DOI: 10.1007/s11524-015-0021-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Adolescent and young mothers transitioning from pregnancy to postpartum need to maintain an optimal quality of life. Stress and exposure to violence (e.g., intimate partner violence (IPV), nonpartner violence) are predictors of poor quality of life for adult women; however, these associations remain understudied among adolescent and young mothers in urban areas. Guided by the social ecological model, the current study created a latent variable, urban social stress, to examine the impact of the urban social environment (i.e., stressful life events, discrimination, family stress, and neighborhood problems) on the quality of life of adolescent and young mothers during both pregnancy and postpartum. The current study is a secondary data analysis of a prospective cohort study of 296 expectant young mothers recruited at obstetrics and gynecology clinics. Results from structural equation and multigroup models found that higher urban social stress predicted lower mental and physical quality of life during pregnancy, but these associations were significantly stronger for IPV-exposed and nonpartner violence-exposed mothers. In the postpartum period, higher urban social stress predicted lower mental and physical quality of life, but these associations were significantly stronger for IPV-unexposed and nonpartner violence-exposed mothers. Stress reduction programs need to help adolescent and young mothers in urban areas develop stress management skills specific to urban social stress. Pregnancy and parenting programs need to be tailored to the specific needs of young mothers in urban areas by becoming sensitive to the role of IPV and nonpartner violence in these young women's lives.
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