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Qi L, Fu Q, Li W, Wu J, Li J, Ni S. Analysis of job satisfaction among clinical research coordinators. Work 2024:WOR230732. [PMID: 38875070 DOI: 10.3233/wor-230732] [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: 06/16/2024] Open
Abstract
BACKGROUND While CRCs play a crucial role in clinical trials, their job satisfaction has not received enough attention. OBJECTIVE To assess the job satisfaction of CRCs and to explore the relevant factors. METHODS The survey was programmed into an online questionnaire platform and distributed to CRCs in China for self-evaluation. The Minnesota Satisfaction Questionnaire (MSQ) was used to assess job satisfaction, and data on demographic characteristics, working situations, burnout and social support also were collected to identify factors associated with job satisfaction. Data analysis was performed using the R software program. Factors associated with job satisfaction were explored using ordinal logistic regression models. RESULTS 2,840 participants were included in this survey, and the mean value of overall job satisfaction was characterized as "moderate to not fully satisfied". Additionally, both burnout and overall social support were reported at moderate levels. Ordinal logistic regression analysis revealed that age, monthly income, sleep duration per day, weekly working time, a fixed workplace, subjective support, utilization of support, emotional exhaustion, depersonalization and reduced personal accomplishment were significantly associated with all types of job satisfaction (p < 0.05). Among all the factors, a fixed workplace was more strongly associated with job satisfaction than the other factors (OR = 0.596, p < 0.001). CONCLUSIONS Implementing the fixed-point CRC mode to promote the provision of a fixed workplace, improving the CRC career development path, increasing income, subjective support and utilization of support, reducing weekly working time, job burnout will help to predict job satisfaction in CRCs.
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Affiliation(s)
- Linyan Qi
- Department of Clinical Trial Institution Office, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejaing, China
| | - Qibo Fu
- Department of Clinical Trial Institution Office, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejaing, China
| | - Wenchang Li
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jiheng Wu
- Department of Clinical Trial Institution Office, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejaing, China
| | - Ji Li
- Department of Clinical Trial Institution Office, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejaing, China
| | - Shaoqing Ni
- Department of Clinical Trial Institution Office, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejaing, China
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Johnson NL, Brann M, Scott SF, Bute JJ. "I'm Not Comfortable With COVID, But …": Dilemmas and Decision-Making to Mitigate Risks Among Mothers Who Gave Birth During the COVID-19 Pandemic. QUALITATIVE HEALTH RESEARCH 2024; 34:517-527. [PMID: 38073522 DOI: 10.1177/10497323231217594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2024]
Abstract
Individuals have faced unprecedented uncertainty and risk surrounding the COVID-19 pandemic, and decision-making dilemmas have been complicated by quickly evolving and often contradictory recommendations for staying healthy. Using tenets of problematic integration theory and risk orders theory, we analyzed interview data from 50 mothers who gave birth during the pandemic to understand how uncertainty and risk perceptions shaped their decision-making about keeping themselves and their infants healthy in the first year after birth. Results describe how some mothers in our sample made sense of their decision-making to prioritize first-order risks to their own and their family's physical health, and other mothers prioritized second-order risks to their relationships and identities. We also discuss the social nature of mitigating risk during the COVID-19 pandemic and the catalysts for shifting risk perceptions. Theoretical and practical implications include improving public health messaging and clinical conversations to enable individuals to effectively manage social and identity needs alongside serious threats to physical health.
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Affiliation(s)
- Nicole L Johnson
- Center for Access & Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, IA, USA
| | - Maria Brann
- Department of Communication Studies, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Susanna F Scott
- College of Pharmacy and Health Sciences, Butler University, Indianapolis, IN, USA
| | - Jennifer J Bute
- Department of Communication Studies, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
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3
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Farewell C, Tong S, Sehrt M, Siegart J, Nicklas J. Factors associated with postpartum depression among high-risk women during the COVID-19 pandemic. Women Health 2024; 64:224-234. [PMID: 38287691 DOI: 10.1080/03630242.2024.2310047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 01/18/2024] [Indexed: 01/31/2024]
Abstract
The purpose of this study was to investigate the impacts of the COVID-19 pandemic on multi-level factors associated with depression among a high-risk sample of postpartum women using longitudinal data collected at two timepoints. High-risk postpartum participants in the United States were recruited to participate in a parent study focused on mitigating risk of cardiometabolic disease in postpartum women. Individuals completed a baseline survey which included the Edinburgh Postpartum Depression Scale (EPDS) at 6-weeks postpartum between 2017 through 2019. A modified survey with the inclusion of selected questions from the Coronavirus Health Impact Survey (CRISIS) questionnaire was administered again during the first 6-months of the COVID-19 pandemic and individuals who completed both the baseline assessment and the COVID-19 assessment were included for analyses (n = 46). Multivariate models were run to investigate the impacts of individual-, interpersonal-, and structural-level factors on change in EPDS scores across the postpartum period. Findings suggest that losing contact with social supports (β = 4.5, SE = 1.9, p = .02) and individuals who reported a total household income of less than $75,000 (β = 3.4, SE = 1.7, p = .05) were more likely to report significantly worsening postpartum depression scores compared to others. Recommendations to mitigate the stressors that have been amplified by the COVID-19 pandemic and resulting mental health disparities include screening all high-risk postpartum women for depression and anxiety during both postpartum and pediatric healthcare visits, providing informational flyers with tips related to healthy coping behaviors and free/affordable community resources, and linking individuals to peer-led support groups.
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Affiliation(s)
- Charlotte Farewell
- Colorado School of Public Health, University of Colorado Anschutz Campus, Aurora, Colorado, USA
| | - Suhong Tong
- Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Madeleine Sehrt
- Colorado School of Public Health, University of Colorado Anschutz Campus, Aurora, Colorado, USA
| | - Jamie Siegart
- Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Jacinda Nicklas
- Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
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Melnick EM, Doom JR. "Associations between maternal perceptions of social support and adolescent weight status: A longitudinal analysis". SSM Popul Health 2024; 25:101647. [PMID: 38495803 PMCID: PMC10943960 DOI: 10.1016/j.ssmph.2024.101647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/12/2024] [Accepted: 02/27/2024] [Indexed: 03/19/2024] Open
Abstract
Social support is a well-established predictor of improved physical health outcomes among adults. Establishing whether maternal social support may have an inter-generational positive impact on their child's physical health will provide important information for developing potential interventions and policies. Elevated body mass index (BMI) is one indicator of child health that is linked to increased risk for cardiovascular disease and other morbidities later in life. There is some evidence that maternal social support is associated with improved child and adolescent weight status; however, no studies have examined whether specific aspects of social support are more impactful than others or whether support availability is differentially impactful across developmental stages. The present study examined whether maternal perceptions of specific types of social support (i.e., financial support, non-monetary instrumental support, partner emotional support, and having a close supportive contact) were associated with lower adolescent BMI z-scores using longitudinal data collected over a 15-year period from the Future of Families and Child Wellbeing Study (n = 3146), which includes a high proportion of families experiencing socioeconomic disadvantage. Findings from linear regression models using specific types of social support measured across six waves of data collected over a 15-year period indicated that maternal perceptions of greater financial support were associated with lower adolescent BMI z-scores at 15 years (B = -0.05, 95% CI: -0.10, -0.004, P = 0.04), while the other types of support were not. Additional timing analyses demonstrated that perceived financial support during late childhood to adolescence was associated with lower adolescent BMI z-scores (B = -0.06, 95% CI: -0.11, -0.01, P = 0.01), whereas associations between support during infancy and early childhood were not detected. Study findings provide important insights for developing interventions and policies that improve maternal social supports to benefit child health.
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Affiliation(s)
- Emily M. Melnick
- Department of Psychiatry, University of Colorado Anschutz, 13001 E 17th Pl, Aurora, CO, 80045, USA
- Department of Psychology, University of Denver, 2155 S. Race St., Denver, CO, 80210, USA
| | - Jenalee R. Doom
- Department of Psychology, University of Denver, 2155 S. Race St., Denver, CO, 80210, USA
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5
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Julian M, Somers JA, Dunkel Schetter C, Guardino CM. Resilience resources, life stressors, and postpartum depressive symptoms in a community sample of low and middle-income Black, Latina, and White mothers. Stress Health 2024; 40:e3275. [PMID: 37220227 PMCID: PMC10665547 DOI: 10.1002/smi.3275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 04/25/2023] [Accepted: 05/06/2023] [Indexed: 05/25/2023]
Abstract
Resilience resources refer to factors that protect against the physical and mental health effects of stress exposure. This study used a cross-sectional design to test whether three individual-level resilience resources-mastery, self-esteem, and perceived social support-moderated associations between prenatal major life stressors and postpartum depressive symptoms at approximately 8 weeks postpartum. Participants were 2510 low- and middle-income women enrolled after the birth of a baby in a multi-site study of five communities in the United States. At approximately 8 weeks postpartum, participants were interviewed in their homes to assess the three resilience resources, symptoms of depression, and major life stressors that had occurred during the pregnancy. The results of path analyses revealed that mastery and self-esteem moderated the positive association between prenatal life stressors and postpartum depressive symptoms adjusting for race/ethnicity, partner status, years of education, and household income. Perceived social support was associated with fewer postpartum depressive symptoms but did not moderate the association between life stressors and depressive symptoms. Higher levels of two personal resilience resources, mastery and self-esteem, attenuated the association between prenatal life stressors and early postpartum depressive symptoms in a large, predominantly low-income multi-site community sample. These findings highlight the protective nature of individual-level resilience resources in the early postpartum period when maternal adjustment shapes parent and child health outcomes.
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Affiliation(s)
- Melissa Julian
- Department of Psychological and Brain Sciences, George Washington University
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Jackson L, Fallon V, Harrold JA, De Pascalis L. Psychosocial predictors of post-natal anxiety and depression: Using Structural Equation Modelling to investigate the relationship between pressure to breastfeed, health care professional support, post-natal guilt and shame, and post-natal anxiety and depression within an infant feeding context. MATERNAL & CHILD NUTRITION 2024; 20:e13558. [PMID: 37752680 PMCID: PMC10750005 DOI: 10.1111/mcn.13558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 06/30/2023] [Accepted: 08/03/2023] [Indexed: 09/28/2023]
Abstract
High perceived pressure to breastfeed and poor perceived quality of health care professional support have been associated with early breastfeeding cessation, guilt, and shame. This is problematic because guilt and shame significantly predict post-natal anxiety and depression. No previous attempts have been made to provide quantitative evidence for relationships mapped between the post-natal social context, infant feeding method and post-natal emotional well-being. The current study aimed to empirically investigate aforementioned pathways. Structural equation modelling was applied to survey data provided online by 876 mothers. Guilt and shame both significantly predicted anxiety and depression. Poor health care professional support and high pressure to breastfeed increased anxiety and depression, and these effects were explained by indirect pathways through increases in guilt and shame. Formula feeding exclusivity was negatively correlated with post-natal anxiety symptoms. This finding may be explained by feelings of relief associated with observed infant weight gain and being able to share infant feeding responsibilities others e.g., with one's partner. This relationship was counterbalanced by an indirect pathway where greater formula feeding exclusivity positively predicted guilt, which increased post-natal anxiety score. While guilt acted as mediator of infant feeding method to increase post-natal depression and anxiety, shame acted independently of infant feeding method. These identified differences provide empirical support for the transferability of general definitions of guilt (i.e., as remorse for having committed a moral transgression) and shame (i.e., internalisation of transgressive remorse to the self), to an infant feeding context. Recommendations for health care practitioners and the maternal social support network are discussed.
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Affiliation(s)
- Leanne Jackson
- Department of Psychological SciencesUniversity of LiverpoolLiverpoolMerseysideUK
| | - Vicky Fallon
- Department of Psychological SciencesUniversity of LiverpoolLiverpoolMerseysideUK
| | - Joanne A. Harrold
- Department of Psychological SciencesUniversity of LiverpoolLiverpoolMerseysideUK
| | - Leonardo De Pascalis
- Department of Psychological SciencesUniversity of LiverpoolLiverpoolMerseysideUK
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7
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Sun Y, Chia SC, Shi Y. How Exposure to Online Parenting Content Relates to Mothers' Self-Discrepancy and Postpartum Mental Health. HEALTH COMMUNICATION 2023; 38:2782-2794. [PMID: 36127777 DOI: 10.1080/10410236.2022.2114769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Postpartum mental health problems are common and have deleterious effects on new mothers and their babies. This study developed a theoretically informed model of the relationship between exposure to images of motherhood in online parenting content and mothers' postpartum mental health. The model was tested using survey data collected from 509 Chinese mothers during their 12-month postpartum period. The results revealed that greater exposure to online public parenting content was indirectly related to lower levels of shame among new mothers via two mediators: the presumed influence of parenting media content on their partners, and the mothers' perceptions of the discrepancy between their actual selves as mothers and their partners' expectations of an ideal mother (i.e. actual/own - ideal/partner self-discrepancy). In contrast, increased exposure to online private parenting content shared by peers was indirectly related to increased levels of shame among new mothers via the mediation of social comparison with parenting media images, and of the mothers' perceptions of the discrepancy between their actual selves as mothers and their own expectations of an ideal mother (i.e. actual/own - ideal/own self-discrepancy). Additionally, new mothers were more likely to experience depressive symptoms and shame if they felt that they fell short of their partners' expectations of an ideal mother. However, increased social support reduced the anxiety and shame that stemmed from this belief.
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Affiliation(s)
- Yanqing Sun
- School of Journalism and Communication, Hunan University
| | - Stella C Chia
- Department of Media and Communication, City University of Hong Kong
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8
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Katzow MW, Messito MJ, Mendelsohn AL, Scott MA, Gross RS. Protective Effect of Prenatal Social Support on the Intergenerational Transmission of Obesity in Low-Income Hispanic Families. Child Obes 2023; 19:382-390. [PMID: 36112108 PMCID: PMC10468550 DOI: 10.1089/chi.2021.0306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Prepregnancy overweight/obesity (OW/OB) is a strong risk factor for child obesity. Few studies have identified modifiable factors that mitigate this risk. Objective: The objective of this study was to determine if prenatal social support buffers the effect of prepregnancy OW/OB on child birth weight z-score (BWz) and weight-for-age z-score (WFAz) trajectory. Methods: We performed a longitudinal secondary analysis of 524 mother-infant pairs enrolled in a randomized controlled trial of the Starting Early Program, a child obesity prevention program for Hispanic families with low income. Social support was assessed in the third trimester of pregnancy; maternal prepregnancy OW/OB and child WFAz from birth to age 3 years were obtained from medical records. Linear regression and multilevel modeling tested the effects of maternal prepregnancy OW/OB on child weight outcomes, and whether prenatal social support moderated these effects. Results: Prepregnancy OW/OB was associated with significantly higher child BWz (B = 0.23, p = 0.01) and WFAz trajectories (B = 0.19, 0.01). The interaction between social support and prepregnancy OW/OB was negatively related to child BWz (B = -0.26, p = 0.02) and WFAz trajectory (B = -0.40, p = 0.047). Conclusions: Prenatal social support may be protective against the intergenerational transmission of obesity risk. Interventions for the prevention of child obesity should consider incorporating social support into their design. Clinical Trial Registration Number: NCT01541761.
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Affiliation(s)
- Michelle W. Katzow
- Division of General Pediatrics, Department of Pediatrics, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Mary Jo Messito
- Division of General Pediatrics, Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
| | - Alan L. Mendelsohn
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
| | - Marc A. Scott
- Department of Applied Statistics, Social Science, and Humanities, New York University Steinhardt School of Culture, Education, and Human Development, New York, NY, USA
| | - Rachel S. Gross
- Division of General Pediatrics, Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
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Abuhammad S, Hamaideh S, Gharaibeh M, Assaf EA, Al-Qasem H, Eldeirawi K. Depression among Jordanian women during pregnancy in COVID-19: Role of social support. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2023. [DOI: 10.29333/ejgm/13093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
Abstract
<b>Aims:</b> To describe the level of depression and social support experienced by pregnant Jordanian women and assess the role of support and other factors on depression level among a sample of Jordanian women during pregnancy during the COVID-19 pandemic.<br />
<b>Method</b>: The study invitation and link to an online survey were shared during November 2021 via social media and through word of mouth. A convenience sample of 434 pregnant women completed the study questionnaire, which included questions on their COVID-19 status, demographics, depression, and social. Depression was assessed using the Center for Epidemiologic Studies Depressive Scale (CES-D).<br />
<b>Results</b>: The prevalence of depression among women during pregnancy was 28.3%. The mean of depression score among women during pregnancy was 24.3±4.4. The prevalence of social support among women during pregnancy were (63%). The mean social support score among the participants was 39.3±9.1. Factors associated with a higher depression score included not get influenza vaccination, not having insurance, described life as poor, having pressure, and not having social support.<br />
<b>Conclusion:</b> This is a national study among women during pregnancy in Jordan. The study found that people who took influenza vaccination, having insurance, described life as poor, and having pressure, they experience more depression than other people. Moreover, our study found as social support increased, the depression decreased.
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Affiliation(s)
- Sawsan Abuhammad
- Department of Maternal and Child Health, Jordan University of Science and Technology, Irbid, JORDAN
| | - Shaher Hamaideh
- Department of Community and Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, JORDAN
| | - Muntaha Gharaibeh
- Faculty of Nursing, Al-Ahliyya Amman University, Amman, JORDAN
- Department of Maternal and Child Health, Jordan University of Science and Technology, Irbid, JORDAN
| | - Enas A Assaf
- Faculty of Nursing, Applied Science Private University, Amman, JORDAN
| | | | - Kamal Eldeirawi
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
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10
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Fox MM, Knorr DA, Kwon D, Wiley KS, Parrish MH. How prenatal cortisol levels relate to grandmother-mother relationships among a cohort of Latina women. Am J Hum Biol 2023; 35:e23883. [PMID: 36862026 PMCID: PMC10474942 DOI: 10.1002/ajhb.23883] [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: 09/17/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 03/03/2023] Open
Abstract
INTRODUCTION As part of the human reproductive strategy, mothers receive childcare assistance from others. For kin, allomothers are adaptively incentivized to provide assistance due to inclusive fitness benefits. Previous studies across a broad range of populations identify grandmothers as particularly consistent allomothers. Minimal attention has been paid to the possibility that allomothers may begin investing in offspring quality during the prenatal stage of life. Here, we innovate within the area of grandmother allocare research by examining the prenatal stage of life and biopsychosocial mechanisms by which prenatal grandmother effects may be enacted. METHODS Data derive from the Mothers' Cultural Experiences study, a cohort of 107 pregnant Latina women in Southern California. At <16 weeks' gestation, we administered questionnaires, collected morning urine samples, and measured cortisol by enzyme-linked immunosorbent assay, correcting for specific gravity. We measured the soon-to-be maternal and paternal grandmothers' relationship quality, social support, frequency of seeing each other, communicating, and geographic proximity to pregnant mothers, that is, their daughters and daughters-in-law. These measures were self-reported by the pregnant mothers. We assessed how grandmother constructs related to the pregnant women's depression, stress, anxiety, and cortisol levels. RESULTS We observed benefits conferred by maternal grandmothers for mothers' prenatal mental health and lower cortisol levels. Paternal grandmothers also conferred mental health benefits to pregnant daughters-in-law, but higher cortisol levels. CONCLUSION Our results suggest that grandmothers, especially maternal grandmothers, are able to improve their inclusive fitness by caring for pregnant daughters, and allomother support may positively impact prenatal health. This work extends the traditional cooperative breeding model by identifying a prenatal grandmother effect, and, by examining a maternal biomarker.
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Affiliation(s)
- Molly M. Fox
- Department of Anthropology, University of California, Los Angeles, Los Angeles, CA, 90095 USA
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, 90095 USA
| | - Delaney A. Knorr
- Department of Anthropology, University of California, Los Angeles, Los Angeles, CA, 90095 USA
| | - Dayoon Kwon
- Department of Epidemiology, UCLA Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, 90095 USA
| | - Kyle S. Wiley
- Department of Anthropology, University of California, Los Angeles, Los Angeles, CA, 90095 USA
| | - Michael H. Parrish
- Department of Psychology, University of California, Los Angeles, CA 90095 USA
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11
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Huang W, Li G, Wang D, Qu H, Tian M, Wang Y. Postpartum depression literacy in Chinese perinatal women: a cross-sectional study. Front Psychiatry 2023; 14:1117332. [PMID: 37389174 PMCID: PMC10306307 DOI: 10.3389/fpsyt.2023.1117332] [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: 12/06/2022] [Accepted: 05/17/2023] [Indexed: 07/01/2023] Open
Abstract
Background Postpartum depression literacy is a specific mental health literacy that can help perinatal women identify, manage, and prevent postpartum depression. However, the current status and associated factors of postpartum depression literacy among Chinese perinatal women are still unclear. This study investigated postpartum depression literacy and its associated factors among this group. Methods A cross-sectional survey was conducted involving 386 cases of perinatal women using the convenience sampling method. Participants completed four questionnaires to evaluate their general characteristics, postpartum depression literacy, perceived social support, and general self-efficacy. The SPSS 24.0 software was used for descriptive statistical analysis, univariate analysis, and multivariate analysis. Results The total PoDLiS score was (3.56 ± 0.32). The factors that composed the final multiple regression equation included planned pregnancy condition (β = -0.137, p = 0.003), education (β = 0.127, p < 0.001), history of depression (β = -0.271, p < 0.001), social support (β = 0.0012, p < 0.001), self-efficacy (β = 0.030, p < 0.001), and complications (β = -0.0191, p = 0.0019). They accounted for 32.8% of the total postpartum depression literacy variation (R2 = 0.328, F = 24.518, p < 0.001). Conclusion The findings of this study improved our understanding of perinatal women's postpartum depression literacy and its associated factors. Women with low postpartum depression literacy urgently need to be identified. Comprehensive nursing intervention measures should be taken from six dimensions of mental health literacy, social support, and self-efficacy to improve the postpartum depression literacy of perinatal women.
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Affiliation(s)
- Weijian Huang
- Eastern Operating Room, Yantai Yuhuangding Hospital, Yantai, China
| | - Guiqin Li
- Obstetrics Department, Yantai Yuhuangding Hospital, Yantai, China
| | - Dongmei Wang
- Obstetrics Department, Yantai Hospital of Traditional Chinese Medicine, Yantai, China
| | - Hua Qu
- Obstetrics Department, Yantai Yuhuangding Hospital, Yantai, China
| | - Maozhou Tian
- Department of Cardiac Surgery, Yantai Yuhuangding Hospital, Yantai, China
| | - Yanmei Wang
- Hemodialysis Department, Yantai Yuhuangding Hospital, Yantai, China
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12
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Perkins R, Spiro N, Waddell G. Online songwriting reduces loneliness and postnatal depression and enhances social connectedness in women with young babies: randomised controlled trial. Public Health 2023; 220:72-79. [PMID: 37270855 DOI: 10.1016/j.puhe.2023.04.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 04/12/2023] [Accepted: 04/21/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Loneliness is a public health challenge associated with postnatal depression (PND). This study developed and tested an online songwriting intervention, with the aim of reducing loneliness and symptoms of PND and enhancing social connectedness among women with young babies. STUDY DESIGN This was a two-armed non-blinded randomised controlled trial (RCT, ISRCTN17647261). METHODS Randomisation was conducted in Excel using a 1:1 allocation, with participants (N = 89) allocated to an online 6-week songwriting intervention (Songs from Home) or to waitlist control. Inclusion criteria were women aged ≥18 years, with a baby ≤9 months old, reporting loneliness (4+ on UCLA 3-Item Loneliness Scale) and symptoms of PND (10+ on Edinburgh Postnatal Depression Scale [EPDS]). Loneliness (UCLA-3) was measured at baseline, after each intervention session and at 4-week follow-up. The secondary measures of PND (EPDS) and social connectedness (Social Connectedness Revised 15-item Scale [SC-15]) were measured at baseline, postintervention and at 4-week follow-up (Week 10). Factorial mixed analyses of variance with planned custom contrasts were conducted for each outcome variable comparing the intervention and control groups over time and across baseline, Weeks 1-6 and the follow-up at Week 10 for each outcome variable. RESULTS Compared with waitlist control, the intervention group reported significantly lower scores postintervention and at follow-up for loneliness (P < 0.001, η2P = 0.098) and PND (P < 0.001, η2P = 0.174) and significantly higher scores at follow-up for social connectedness (P < 0.001, η2P = 0.173). CONCLUSIONS A 6-week online songwriting intervention for women with young babies can reduce loneliness and symptoms of PND and increase social connectedness.
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Affiliation(s)
- R Perkins
- Centre for Performance Science, Royal College of Music, Prince Consort Road, London SW7 2BS, UK; Faculty of Medicine, Imperial College London, South Kensington Campus, London SW7 2AZ, UK.
| | - N Spiro
- Centre for Performance Science, Royal College of Music, Prince Consort Road, London SW7 2BS, UK; Faculty of Medicine, Imperial College London, South Kensington Campus, London SW7 2AZ, UK
| | - G Waddell
- Centre for Performance Science, Royal College of Music, Prince Consort Road, London SW7 2BS, UK; Faculty of Medicine, Imperial College London, South Kensington Campus, London SW7 2AZ, UK
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13
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Prenatal maternal stress during the COVID-19 pandemic and infant regulatory capacity at 3 months: A longitudinal study. Dev Psychopathol 2023; 35:35-43. [PMID: 34210369 DOI: 10.1017/s0954579421000766] [Citation(s) in RCA: 59] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The COVID-19 pandemic is a global traumatic experience for citizens, especially during sensitive time windows of heightened plasticity such as pregnancy and neonatal life. Pandemic-related stress experienced by mothers during pregnancy may act as an early risk factor for infants' regulatory capacity development by altering maternal psychosocial well-being (e.g., increased anxiety, reduced social support) and caregiving environment (e.g., greater parenting stress, impaired mother-infant bonding). The aim of the present longitudinal study was to assess the consequences of pandemic-related prenatal stress on infants' regulatory capacity. A sample of 163 mother-infant dyads was enrolled at eight maternity units in northern Italy. They provided complete data about prenatal stress, perceived social support, postnatal anxiety symptoms, parenting stress, mother-infant bonding, and infants' regulatory capacity at 3 months of age. Women who experienced emotional stress and received partial social support during pregnancy reported higher anxious symptoms. Moreover, maternal postnatal anxiety was indirectly linked to the infants' regulatory capacity at 3 months, mediated by parenting stress and mother-infant bonding. Dedicated preventive interventions should be delivered to mothers and should be focused on protecting the mother-infant dyad from the detrimental effects of pandemic-related stress during the COVID-19 healthcare emergency.
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Zuo S, Lin L, Chen S, Wang Z, Tian L, Li H, Xu Y. Influencing factors of loneliness among older adults in China: a systematic review and meta-analysis. Psychogeriatrics 2023; 23:164-176. [PMID: 36270596 DOI: 10.1111/psyg.12897] [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: 06/30/2022] [Revised: 08/30/2022] [Accepted: 09/25/2022] [Indexed: 01/05/2023]
Abstract
China has a large and rapidly growing older population. Loneliness is associated with a range of negative health outcomes in older adults. However, to date, there is still a lack of comprehensive and systematic evidence on the factors influencing loneliness among older adults in China. Nine Chinese and English databases were searched by computer from inception to March 2022: China Knowledge Network, WanFang Data, Chinese Scientific Journal Database, SinoMed, PubMed, Embase, Web of Science, PsycINFO, and Cochrane Library. Studies on factors influencing loneliness among older adults in China were included. Two reviewers independently completed the literature screening, quality evaluation, and data extraction, and statistical analyses were performed using Review Manager 5.4 software. A total of 15 studies were included in the review, with 47 066 participants in total. Fifty-nine influencing factors of loneliness in older Chinese were involved. Twenty factors with a total of 30 subfactors that were involved in two or more studies and with extractable data were included in the data synthesis. Eleven subfactors were not statistically significantly associated with loneliness, namely, male, female, lower age, higher education level, health status-fair, health status-poor, social support-none/low, no health insurance, smoking, alcohol consumption, and body mass index-overweight and above (all P > 0.05), while the remaining 19 subfactors (concerning 15 factors) were significantly associated with loneliness in older adults in China (all P < 0.05). This study suggested that age, education level, marital status, living arrangement, having (no) children, receiving family support, relationship with family members, being with or without chronic diseases, health status, activities of daily living, social support, social activities, financial status, satisfaction with housing conditions, and the decision-making right for major household expenditures were the main influencing factors of loneliness among older adults in China.
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Affiliation(s)
- Shufang Zuo
- School of Nursing, Suzhou Medical College of Soochow University, Suzhou, China.,The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Lu Lin
- School of Nursing, Suzhou Medical College of Soochow University, Suzhou, China.,The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Si Chen
- School of Nursing, Suzhou Medical College of Soochow University, Suzhou, China
| | - Ziyu Wang
- School of Nursing, Suzhou Medical College of Soochow University, Suzhou, China
| | - Li Tian
- School of Nursing, Suzhou Medical College of Soochow University, Suzhou, China.,The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Huilling Li
- School of Nursing, Suzhou Medical College of Soochow University, Suzhou, China.,The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yong Xu
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
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15
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Zhong R, Zhang H, Han Y, Guo X, Lin W. Social support for and features of Chinese adults with epilepsy. ACTA EPILEPTOLOGICA 2022. [DOI: 10.1186/s42494-022-00087-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The lack of social support for adults with epilepsy (AWEs) is receiving increased attention, as it may result in low quality of life. This study was aimed to confirm the demographic characteristics of and clinical factors associated with social support for AWEs.
Methods
AWEs were consecutively recruited from our hospital. The 10-term Social Support Rating Scale (SSRS) was used to measure social support. A linear regression analysis with stepwise selection was performed to analyze the independent variables associated with social support for AWEs.
Results
In total, 165 AWEs were consecutively included in the present study. Linear regression analysis showed that the marital status (t = -3.550, β = -0.272, P = 0.001), the age at onset (t = 2.545, β = 0.192, P = 0.012), and the QOLIE-31 score (t = 3.144, β = 0.221, P = 0.002) were independent variables associated with social support for AWEs.
Conclusions
Our findings suggest that the poor social support is associated with childhood onset of epilepsy and the unmarried status. This study also confirmed a negative influence of low social support on quality of life in AWEs.
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Liu C, Chen H, Zhou F, Long Q, Wu K, Lo LM, Hung TH, Liu CY, Chiou WK. Positive intervention effect of mobile health application based on mindfulness and social support theory on postpartum depression symptoms of puerperae. BMC Womens Health 2022; 22:413. [PMID: 36217135 PMCID: PMC9549653 DOI: 10.1186/s12905-022-01996-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 09/26/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE This study investigated the effects of mobile health application designed based on mindfulness and social support theory on parenting self-efficacy and postpartum depression symptoms of puerperae. METHODS We recruited 130 puerperae from a hospital in China and randomized them to an App use group (n = 65) and a waiting control group (n = 65). The App group underwent an 8-week app use intervention while the control group underwent no intervention. We measured four main variables (mindfulness, perceived social support, maternal parental self-efficacy and postpartum depressive symptoms) before and after the App use intervention. RESULTS In the App group, perceived social support, maternal parental self-efficacy were significantly higher and postpartum depressive symptoms was significantly lower. In the control group, there were no significant differences in any of the four variables between the pre-test and post-test. CONCLUSIONS Our findings indicated that the mobile health application may help to improve perceived social support, maternal self-efficacy and reduce postpartum depressive symptoms. The finding of the mobile health application's effect extends our understanding of integrative effects of mindfulness and perceived social support on reduction of postpartum depressive symptoms and suggests clinical potentials in the treatment of postpartum depressive symptoms.
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Affiliation(s)
- Chao Liu
- grid.495500.d0000 0004 1762 5592School of Journalism and Communication, Hua Qiao University, School of Film and Communication, Xiamen University of Technology, Department of Economic and Management, Suzhou Vocational Institute of Industrial Technology, Xiamen, 361021 China ,grid.145695.a0000 0004 1798 0922Director of Business Analytics Research Center, Chang Gung University, Taoyuan, 33302 Taiwan
| | - Hao Chen
- grid.495500.d0000 0004 1762 5592School of Journalism and Communication, Hua Qiao University, School of Film and Communication, Xiamen University of Technology, Department of Economic and Management, Suzhou Vocational Institute of Industrial Technology, Xiamen, 361021 China ,grid.145695.a0000 0004 1798 0922Director of Business Analytics Research Center, Chang Gung University, Taoyuan, 33302 Taiwan
| | - Fang Zhou
- grid.495500.d0000 0004 1762 5592School of Journalism and Communication, Hua Qiao University, School of Film and Communication, Xiamen University of Technology, Department of Economic and Management, Suzhou Vocational Institute of Industrial Technology, Xiamen, 361021 China
| | - Qiqi Long
- grid.8547.e0000 0001 0125 2443Shanghai Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200090 China
| | - Kan Wu
- grid.145695.a0000 0004 1798 0922Director of Business Analytics Research Center, Chang Gung University, Taoyuan, 33302 Taiwan ,grid.413801.f0000 0001 0711 0593Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Taoyuan, 33302 Taiwan
| | - Liang-Ming Lo
- grid.145695.a0000 0004 1798 0922Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Tai-Ho Hung
- grid.145695.a0000 0004 1798 0922Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Chia-Yih Liu
- grid.413801.f0000 0001 0711 0593Department of Psychiatry, Chang Gung Memorial Hospital, Taipei, 10507 Taiwan
| | - Wen-Ko Chiou
- grid.413801.f0000 0001 0711 0593Department of Psychiatry, Chang Gung Memorial Hospital, Taipei, 10507 Taiwan ,grid.145695.a0000 0004 1798 0922Department of Industrial Design, Chang Gung University, Taoyuan, 33302 Taiwan ,grid.440372.60000 0004 1798 0973Department of Industrial Engineering and Management, Ming Chi University of Technology, New Taipei, 24301 Taiwan
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Zhang D, Luo H, Xiao L, Zhang Z, Huang J, Li X, Zhu H, Lai C. Depression and Insomnia of Front-Line Medical Staff During the COVID-19 Outbreak in China: An On-Line Cross-Sectional Study. Front Psychol 2022; 13:897896. [PMID: 35846703 PMCID: PMC9277440 DOI: 10.3389/fpsyg.2022.897896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/20/2022] [Indexed: 01/19/2023] Open
Abstract
PurposeDuring the COVID-19 outbreak, medical staff working in high-risk workplaces had a higher rate of epidemic infection. They also faced heavy workloads and pressure, which means they are more likely to suffer from psychological problems than others. To understand the mental health of medical staff during the epidemic, we explore the characteristics of medical staff susceptible to negative psychological emotions during the outbreak of public safety and health events. At the same time, we provide corresponding prevention and intervention measures to help them relieve negative emotions, this study compared the psychological symptoms of front-line and non-front-line medical staff, then explored its influencing factors.MethodsThis research investigated 5,924 medical staff in Guangdong, Beijing, Hubei, Hainan, Jiangxi, and Henan in China. The questionnaires were released online by Questionnaire Star, and levels of depression, anxiety, insomnia, and social support were measured by Patients' Health Questionnaire Depression Scale-9 item (PHQ-9), Generalized Anxiety Disorder 7-item Scale (GAD-7), Insomnia Severity Index (ISI) and Social Support Rating Scale (SSRS).ResultsThe depressive, anxious, and insomniac scores of front-line medical staff during the COVID-19 epidemic period were higher than those of non-front-line with significant differences (P < 0.001). In addition, front-line nurses went through the most serious psychological problems. Age, education, and anxiety level were the influencing factors of depression and insomnia in front-line medical staff. Among them, age was a protective factor for depression (OR = 0.71 <1, P = 0.001 <0.05, Beta = −0.34), while educational level was a risk factor for insomnia (OR = 1.27, P = 0.02 <0.05, Beta = 0.24).ConclusionsDuring the epidemic, front-line medical staff would experience more serious psychological problems, especially those who were younger, less experienced, and insufficiently educated. Attention should be paid to giving them psychological assistance and psychological interventions in the future.
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Affiliation(s)
- Donglin Zhang
- Department of Emergency Medicine, Meizhou People's Hospital, Meizhou, China
| | - Hailong Luo
- Department of Rehabilitation Medicine, Meizhou People's Hospital, Meizhou, China
| | - Litian Xiao
- Department of Rehabilitation Medicine, Meizhou People's Hospital, Meizhou, China
| | - Zhun Zhang
- Department of Rehabilitation Medicine, Meizhou People's Hospital, Meizhou, China
| | - Jianqing Huang
- Department of Rehabilitation Medicine, Meizhou People's Hospital, Meizhou, China
| | - Xiaoqin Li
- Department of Rehabilitation Medicine, Meizhou People's Hospital, Meizhou, China
| | - Hongke Zhu
- College of Education, Guangzhou University, Guangzhou, China
- *Correspondence: Hongke Zhu
| | - Cuiwei Lai
- Nursing Department, Meizhou People's Hospital, Meizhou, China
- Cuiwei Lai
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18
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In her shoes: Partner reflective functioning promotes family-level resilience to maternal depression. Dev Psychopathol 2022; 35:958-971. [PMID: 35314013 DOI: 10.1017/s0954579422000189] [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: 11/06/2022]
Abstract
Parental depression has significant implications for family functioning, yet much of the literature does not consider family-level dynamics in investigating individual, parenting and child outcomes. In the current study we apply a new index of couple-level support, partner reflective functioning (RF), or the romantic partner's ability to consider how the partner's mental states can guide behavior, to study familial resiliency in the face of prenatal parental depression among first-time parents. We investigate how partner RF buffers the association between prenatal parental depression and outcomes of postnatal parental depression, parenting style, and child effortful control. Maternal and paternal depression were measured in 91 primiparous couples during the sixth month of pregnancy and parental depression, partner RF, parental RF at 6 months postnatally. Outcomes of parental depression, permissive parenting, and children's effortful control were assessed 24 months postnatally. Results indicate that average and high levels of paternal partner (not parental) RF attenuate risk for maternal postnatal depression, maternal permissive parenting, and deficits in child effortful control. Implications are discussed from a family systems approach.
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19
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PAMUK G, GÜÇLÜ YA. Prevalence and accompanying factors for postpartum depression symptoms. FAMILY PRACTICE AND PALLIATIVE CARE 2022. [DOI: 10.22391/fppc.1024922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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20
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Matsumura K, Hamazaki K, Tsuchida A, Kasamatsu H, Inadera H. Causal model of the association of social support during pregnancy with a perinatal and postpartum depressive state: A nationwide birth cohort - the Japan Environment and Children's Study. J Affect Disord 2022; 300:540-550. [PMID: 34979183 DOI: 10.1016/j.jad.2021.12.117] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 12/03/2021] [Accepted: 12/30/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Despite many epidemiological studies on the relationship between social support during pregnancy and perinatal/postpartum depression, its impact remains unclear. Therefore, this study examined this association using a causal model of risk based on various levels of social support. METHODS Participants were 88,711 mothers in an ongoing nationwide birth cohort study in Japan. Social support during pregnancy was set at four treatment levels. Depressive state was identified twice, with the Kessler Psychological Distress Scale (K6; score ≥ 5) and the Edinburgh Postnatal Depression Scale (EPDS; score ≥ 9). With the highest level of social support set as reference, marginal structural models were fitted to derive counterfactual risk ratios (cRRs). RESULTS cRRs (95% CIs) for EPDS cases increased as the level of social support decreased, with values of 1.06 (0.99-1.13) for upper-middle, 1.30 (1.23-1.39) for lower-middle, and 1.61 (1.52-1.71) for low. Also, cRRs (95% CIs) at the second measurement (interaction) tended to increase as social support decreased, with values of 1.05 (0.97-1.13) for upper-middle, 1.05 (0.98-1.13) for lower-middle, and 1.10 (1.03-1.18) for low. The same tendency was observed in K6 cases. LIMITATION Depressive state was identified by self-administered questionnaire. CONCLUSIONS Lower social support during pregnancy is associated with increased counterfactual risk of perinatal/postpartum depressive state and worsened counterfactual spontaneous recovery over time. These findings highlight the importance of sufficient social support for preventing perinatal/postpartum depression and promoting recovery. TRIAL REGISTRATION UMIN000030786.
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Affiliation(s)
- Kenta Matsumura
- Department of Public Health, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Japan; Toyama Regional Center for JECS, University of Toyama, Toyama, Japan.
| | - Kei Hamazaki
- Department of Public Health, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Japan; Toyama Regional Center for JECS, University of Toyama, Toyama, Japan; Department of Public Health, Gunma University Graduate school of Medicine, Gunma, Japan
| | - Akiko Tsuchida
- Department of Public Health, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Japan; Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
| | - Haruka Kasamatsu
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
| | - Hidekuni Inadera
- Department of Public Health, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Japan; Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
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21
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Hong L, Le T, Lu Y, Shi X, Xiang L, Liu M, Zhang W, Zhou M, Wang J, Xu D, Yu X, Zhao K. Distinct trajectories of perinatal depression in Chinese women: application of latent growth mixture modelling. BMC Pregnancy Childbirth 2022; 22:24. [PMID: 35012496 PMCID: PMC8751241 DOI: 10.1186/s12884-021-04316-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 12/03/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Current research on perinatal depression rarely pays attention to the continuity and volatility of depression symptoms over time, which is very important for the early prediction and prognostic evaluation of perinatal depression. This study investigated the trajectories of perinatal depression symptoms and aimed to explore the factors related to these trajectories. METHODS The study recruited 550 women during late pregnancy (32 ± 4 weeks of gestation) and followed them up 1 and 6 weeks postpartum. Depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS). Latent growth mixture modelling (LGMM) was used to identify trajectories of depressive symptoms during pregnancy. RESULTS Two trajectories of perinatal depressive symptoms were identified: "decreasing" (n = 524, 95.3%) and "increasing" (n = 26, 4.7%). History of smoking, alcohol use and gestational hypertension increased the chance of belonging to the increasing trajectories, and a high level of social support was a protective factor for maintaining a decreasing trajectory. CONCLUSIONS This study identified two trajectories of perinatal depression and the factors associated with each trajectory. Paying attention to these factors and providing necessary psychological support services during pregnancy would effectively reduce the incidence of perinatal depression and improve patient prognosis.
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Affiliation(s)
- Lan Hong
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Tao Le
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Yinping Lu
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Xiang Shi
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Ludan Xiang
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Meng Liu
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Wenmiao Zhang
- Department of Obstetrics, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Meixi Zhou
- Department of Obstetrics, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jiangling Wang
- Department of Obstetrics, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Dongwu Xu
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China.
| | - Xin Yu
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China.
| | - Ke Zhao
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China.
- The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, 325035, China.
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22
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Sheng Q, Cai C, Li P, Chen L, Zhang X, Wang X, Gong Y. Development and Validation of a Nomogram for Predicting the Unresolved Risk of Parents of Adolescents With Psychiatric Diagnoses. Front Psychiatry 2022; 13:796384. [PMID: 35432017 PMCID: PMC9010732 DOI: 10.3389/fpsyt.2022.796384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 02/01/2022] [Indexed: 12/29/2022] Open
Abstract
Evaluating the resolution of parents of ill children can help in taking measures to alleviate their distress in a timely manner and promote children's rehabilitation. This study aims to develop and validate a nomogram for predicting the unresolved risk of parents of adolescents with psychiatric diagnoses. The data for 130 parents (modeling dataset = 90; validation dataset = 40) were collected. A nomogram was first developed to predict the unresolved risk for parents based on the logistic regression analysis in the modeling dataset. The internal and external validation then were conducted through quantifying the performance of the nomogram with respect to discrimination and calibration, respectively, in the modeling and validation datasets. Finally, the clinical use was evaluated through decision curve analyses (DCA) in the overall dataset. In the results, the nomogram consisted of six risk factors and provided a good discrimination with areas under the curve of 0.920 (95% CI, 0.862-0.978) in internal validation and 0.886 (95% CI, 0.786-0.986) in external validation. The calibration with good consistency between the observed probability and predicted probability was also found in both internal and external validation. DCA showed that the nomogram had a good clinical utility. In conclusion, the proposed nomogram exhibited a favorable performance with regard to its predictive accuracy, discrimination capability, and clinical utility, and, thus, can be used as a convenient and reliable tool for predicting the unresolved risk of parents of children with psychiatric diagnoses.
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Affiliation(s)
- Qingqing Sheng
- Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chunfeng Cai
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Pingdong Li
- Nursing Department, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lihua Chen
- Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xi Zhang
- The First Clinical Medical College, Anhui Medical University, Hefei, China
| | - Xinyu Wang
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Yucui Gong
- Nursing Department, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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23
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Yang X, Gao L, Zhang S, Zhang L, Zhang L, Zhou S, Qi M, Chen J. The Professional Identity and Career Attitude of Chinese Medical Students During the COVID-19 Pandemic: A Cross-Sectional Survey in China. Front Psychiatry 2022; 13:774467. [PMID: 35242061 PMCID: PMC8886109 DOI: 10.3389/fpsyt.2022.774467] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 01/10/2022] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Although professional identity is a strong predictor of career choice, only a few studies have reported on medical students' career attitude during a public health emergency. This study investigates the changes in medical students' professional identity and career attitude during the COVID-19 pandemic, evaluates their mental health and social support system under stress, and explores the relationship between their career attitude and other factors. METHODS An online survey of 6,226 Chinese medical students was conducted to collect information on demographics, professional identity, and career attitude. The collected data were assessed using the Patient Health Questionnaire, the Generalized Anxiety Disorder Scale, and the Social Support Rating Scale. RESULTS The results revealed that most (80.8%) of the participants did not change their career attitude and the professional identity of most participants strengthened, and they preferred to participate on the frontline during the COVID-19 pandemic. The prevalence of depression and anxiety among medical students was 22.86% and 35.43%. Low social support, depressive symptoms, male gender, and higher grades were factors that negatively affected career attitude. CONCLUSIONS After the outbreak of the pandemic, it was necessary to conduct diversified professional identity research to support medical students, especially those with low social support and depressive symptoms.
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Affiliation(s)
- Xingjie Yang
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Lan Gao
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Suoyuan Zhang
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Libin Zhang
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, China
| | - Ligang Zhang
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Shuangjiang Zhou
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Meng Qi
- Department of Applied Psychology, Chengde Medical College, Chengde, China
| | - Jingxu Chen
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
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24
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Morse RB, Bretzin AC, Canelón SP, D'Alonzo BA, Schneider ALC, Boland MR. Design and Evaluation of a Postpartum Depression Ontology. Appl Clin Inform 2022; 13:287-300. [PMID: 35263799 PMCID: PMC8906993 DOI: 10.1055/s-0042-1743240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 01/04/2022] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVE Postpartum depression (PPD) remains an understudied research area despite its high prevalence. The goal of this study is to develop an ontology to aid in the identification of patients with PPD and to enable future analyses with electronic health record (EHR) data. METHODS We used Protégé-OWL to construct a postpartum depression ontology (PDO) of relevant comorbidities, symptoms, treatments, and other items pertinent to the study and treatment of PPD. RESULTS The PDO identifies and visualizes the risk factor status of variables for PPD, including comorbidities, confounders, symptoms, and treatments. The PDO includes 734 classes, 13 object properties, and 4,844 individuals. We also linked known and potential risk factors to their respective codes in the International Classification of Diseases versions 9 and 10 that would be useful in structured EHR data analyses. The representation and usefulness of the PDO was assessed using a task-based patient case study approach, involving 10 PPD case studies. Final evaluation of the ontology yielded 86.4% coverage of PPD symptoms, treatments, and risk factors. This demonstrates strong coverage of the PDO for the PPD domain. CONCLUSION The PDO will enable future researchers to study PPD using EHR data as it contains important information with regard to structured (e.g., billing codes) and unstructured data (e.g., synonyms of symptoms not coded in EHRs). The PDO is publicly available through the National Center for Biomedical Ontology (NCBO) BioPortal ( https://bioportal.bioontology.org/ontologies/PARTUMDO ) which will enable other informaticists to utilize the PDO to study PPD in other populations.
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Affiliation(s)
- Rebecca B. Morse
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Abigail C. Bretzin
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Silvia P. Canelón
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Bernadette A. D'Alonzo
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Andrea L. C. Schneider
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Mary R. Boland
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
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Stirling Cameron E, Ramos H, Aston M, Kuri M, Jackson L. "COVID affected us all:" the birth and postnatal health experiences of resettled Syrian refugee women during COVID-19 in Canada. Reprod Health 2021; 18:256. [PMID: 34952615 PMCID: PMC8709538 DOI: 10.1186/s12978-021-01309-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 12/11/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Prior to COVID-19, postnatal resettled refugee women in Canada reported barriers to healthcare and low levels of social support, contributing to maternal health morbidities. The COVID-19 pandemic appears to be further exacerbating health inequities for marginalized populations. The experiences of resettled refugee women are not fully known. AIM To understand Syrian refugee women's experiences accessing postnatal healthcare services and supports during the COVID-19 pandemic. METHODS Semi-structured, virtual interviews were conducted with eight resettled Syrian refugee women living in Nova Scotia (Canada) who were postnatal between March and August 2020. Data analysis was informed by constructivist grounded theory. FINDINGS Three themes emerged: "the impacts of COVID-19 on postnatal healthcare;" "loss of informal support;" and "grief and anxiety." Women experienced difficult healthcare interactions, including socially and physically isolated deliveries, challenges accessing in-person interpreters, and cancelled or unavailable in-home services (e.g., public health nurse and doula visits). Increased childcare responsibilities and limited informal supports due to pandemic restrictions left women feeling overwhelmed and exhausted. Stay-at-home orders resulted in some women reporting feelings of isolation and loss, as they were unable to share in person postnatal moments with friends and family, ultimately impacting their mental wellness. CONCLUSIONS COVID-19 and associated public health restrictions had significant impacts on postnatal Syrian refugee women. Data presented in this study demonstrated the ways in which the pandemic environment and related restrictions amplified pre-existing barriers to care and postnatal health inequalities for resettled refugee women-particularly a lack of postnatal informal supports and systemic barriers to care.
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Affiliation(s)
- Emma Stirling Cameron
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada.
- School of Nursing, Dalhousie University, Halifax, NS, Canada.
| | - Howard Ramos
- Department of Sociology, University of Western Ontario, London, ON, Canada
| | - Megan Aston
- School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Marwa Kuri
- School of Social Work, Dalhousie University, Halifax, NS, Canada
| | - Lois Jackson
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
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26
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Zhou J, Havens KL, Starnes CP, Pickering TA, Brito NH, Hendrix CL, Thomason ME, Vatalaro TC, Smith BA. Changes in social support of pregnant and postnatal mothers during the COVID-19 pandemic. Midwifery 2021; 103:103162. [PMID: 34649034 PMCID: PMC8485715 DOI: 10.1016/j.midw.2021.103162] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 09/04/2021] [Accepted: 09/27/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Our objectives were to assess in perinatal women: the most effective methods used to meet social support needs during COVID-19, the impact of COVID-19 on self-reported social support levels, and how perceived change in social support related to distress, depression, and mental health. DESIGN One-time survey administered from April to August 2020 SETTING: Online PARTICIPANTS: Pregnant and postpartum women with infants less than 6 months of age MEASUREMENT AND FINDINGS: Participants indicated the methods they used to meet social support needs during COVID-19. They self-rated their social support level pre- and during pandemic and their distress, depressive symptoms, and mental health changes on a Likert scale. Out of 1142 participants, the most effective methods for obtaining social support during the pandemic were virtual means (e.g. video call) and interaction with friends. There was a significant difference in distribution of self-reported levels of social support before and during the pandemic, with more respondents reporting a decrease in support. Decreases in social support were associated with higher distress levels, higher levels of depressive symptoms, and poorer mental health. KEY CONCLUSIONS Perinatal women reported decreased social support during the COVID-19 pandemic which was associated with poorer mental health. Using virtual means of social support and support provided by friends had the largest positive effect on perceived social support levels. IMPLICATIONS FOR PRACTICE Interventions using virtual support means from friends may be helpful to improve social support and mental health in this population.
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Affiliation(s)
- Judy Zhou
- Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, 1540 Alcazar St, CHP 155, Los Angeles, CA, 90033, United States.
| | - Kathryn L Havens
- Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, 1540 Alcazar St, CHP 155, Los Angeles, CA, 90033, United States
| | | | - Trevor A Pickering
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N. Soto St., Los Angeles, CA, 90033, United States
| | - Natalie H Brito
- Department of Applied Psychology, New York University, 246 Greene Street, 8th Floor, New York, NY, 10003, United States
| | - Cassandra L Hendrix
- Department of Child and Adolescent Psychiatry, New York University Langone Health, 1 Park Avenue, 7th Floor, New York, New York, 10016, United States
| | - Moriah E Thomason
- Department of Child and Adolescent Psychiatry, New York University Langone Health, 1 Park Avenue, 7th Floor, New York, New York, 10016, United States; Department of Population Health, New York University Langone Health, 550 First Avenue New York, New York, 10016, United States
| | - Tessa C Vatalaro
- Department of Child and Adolescent Psychiatry, New York University Langone Health, 1 Park Avenue, 7th Floor, New York, New York, 10016, United States
| | - Beth A Smith
- Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, 1540 Alcazar St, CHP 155, Los Angeles, CA, 90033, United States; Department of Pediatrics, Keck School of Medicine, University of Southern California, 1975 Zonal Ave Los Angeles, California, 90033, United States; Division of Research on Children, Youth, and Families, Children's Hospital Los Angeles, 4650 Sunset Blvd Los Angeles, CA, 90027, United States; Developmental Neuroscience and Neurogenetics Program, The Saban Research Institute, Children's Hospital Los Angeles, 4650 Sunset Blvd Los Angeles, California, 90027, United States
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27
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Rosinger ZJ, Mayer HS, Geyfen JI, Orser MK, Stolzenberg DS. Ethologically relevant repeated acute social stress induces maternal neglect in the lactating female mouse. Dev Psychobiol 2021; 63:e22173. [PMID: 34674243 PMCID: PMC10631567 DOI: 10.1002/dev.22173] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 06/23/2021] [Accepted: 06/26/2021] [Indexed: 12/27/2022]
Abstract
Psychosocial stress is a top predictor of peripartum mood disorders in human mothers. In the present study, we developed a novel paradigm testing the effects of direct and vicarious social stress on maternal and mood-related behaviors in B6 mice. Using a novel housing paradigm, we examined the extent to which postpartum dams withdrew from litters following psychosocial stress. Repeated acute direct social stress involved exposing dams to a virgin male mouse for 7 min/day on postpartum days 5-7 during a brief (15-min) mother-pup separation. To remove the effects of direct stress, the vicarious social stress dams were housed in the same vivarium as direct social stressed dams, but without direct exposure to intruders. Control dams were given mock intruder exposure and housed in a separate vivarium room containing breeding mice. All dams experienced pup separation, and maternal care was investigated upon reunion. Direct and vicarious social stress induced significant deficits in maternal care and increased maternal anxiety relative to controls. Although vicarious stress effects were more likely to occur on days when there was acute stress exposure, direct stress sustained maternal deficits 24 h after the final stressor. Together, these data suggest psychosocial stress induces aberrant maternal phenotypes in mice.
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Affiliation(s)
- Zachary J Rosinger
- Department of Psychology, University of California, Davis, California, USA
| | - Heather S Mayer
- Department of Psychology, University of California, Davis, California, USA
| | | | - Mable K Orser
- Department of Psychology, University of California, Davis, California, USA
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28
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Stirling Cameron E, Aston M, Ramos H, Kuri M, Jackson L. The postnatal experiences of resettled Syrian refugee women: Access to healthcare and social support in Nova Scotia, Canada. Midwifery 2021; 104:103171. [PMID: 34736018 DOI: 10.1016/j.midw.2021.103171] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 09/18/2021] [Accepted: 10/15/2021] [Indexed: 10/20/2022]
Abstract
AIM The purpose of this qualitative study was to understand Syrian refugee women's perceptions and experiences of access to formal health services and informal supports during the postpartum period in Nova Scotia, Canada and to identify valued and missing services and supports in the community. BACKGROUND The postnatal period is a critical time when mothers may need access to health services (e.g., family physicians, psychologists) and informal supports (e.g., friends, family) to support their positive mental and physical health after birth. Resettled refugee women commonly encounter barriers when accessing care during the postnatal period and often have limited social supports. METHODS Semi-structured, telephone or virtual interviews were conducted with 11 resettled Syrian refugee women who gave birth in Nova Scotia, Canada within the past five years. Data were collected in the summer of 2020. This study was conducted using elements of constructivist grounded theory. FINDINGS Four key themes were identified from women's experiences: (i) postpartum social support was critical, but often lacking, (ii) structural barriers (e.g., irregular interpreter services, limited childcare options) impeded women's access to healthcare, (iii) paternalistic healthcare providers limited women's decision-making autonomy, and (iv) the value and need for culturally competent, integrated care (e.g., newcomer specific healthcare centres), in-home services, and family support. CONCLUSION Resettled Syrian refugee women in Nova Scotia, Canada experience a range of barriers that limits their access to postnatal healthcare. Policy change, program development, and/or interventions are needed to improve access to postnatal services and supports for resettled Syrian women in Canada.
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Affiliation(s)
- Emma Stirling Cameron
- Dalhousie University, School of Health and Human Performance, Halifax, Nova Scotia, Canada.
| | - Megan Aston
- Dalhousie University, School of Nursing, Halifax, Nova Scotia, Canada
| | - Howard Ramos
- University of Western Ontario, Department of Sociology, London, Ontario, Canada
| | - Marwa Kuri
- Dalhousie University, School of Social Work, Halifax, Nova Scotia, Canada
| | - Lois Jackson
- Dalhousie University, School of Health and Human Performance, Halifax, Nova Scotia, Canada
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29
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Hagaman A, LeMasters K, Zivich PN, Sikander S, Bates LM, Bhalotra S, Chung EO, Zaidi A, Maselko J. Longitudinal effects of perinatal social support on maternal depression: a marginal structural modelling approach. J Epidemiol Community Health 2021; 75:936-943. [PMID: 33712512 PMCID: PMC8434957 DOI: 10.1136/jech-2020-215836] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/22/2021] [Accepted: 03/02/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Depression in the perinatal period, during pregnancy or within 1 year of childbirth, imposes a high burden on women with rippling effects through her and her child's life course. Social support may be an important protective factor, but the complex bidirectional relationship with depression, alongside a paucity of longitudinal explorations, leaves much unknown about critical windows of social support exposure across the perinatal period and causal impacts on future depressive episodes. METHODS This study leverages marginal structural models to evaluate associations between longitudinal patterns of perinatal social support and subsequent maternal depression at 6 and 12 months postpartum. In a cohort of women in rural Pakistan (n=780), recruited in the third trimester of pregnancy and followed up at 3, 6 and 12 months postpartum, we assessed social support using two well-validated measures: the Multidimensional Scale of Perceived Social Support (MSPSS) and the Maternal Social Support Index (MSSI). Major depressive disorder was assessed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM IV). RESULTS High and sustained scores on the MSPSS through the perinatal period were associated with a decreased risk of depression at 12 months postpartum (0.35, 95% CI: 0.19 to 0.63). Evidence suggests the recency of support also matters, but estimates are imprecise. We did not find evidence of a protective effect for support based on the MSSI. CONCLUSIONS This study highlights the protective effect of sustained social support, particularly emotional support, on perinatal depression. Interventions targeting, leveraging and maintaining this type of support may be particularly important for reducing postpartum depression.
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Affiliation(s)
- Ashley Hagaman
- Social Behavioral Sciences, Yale University School of Public Health, New Haven, Connecticut, USA
- Center for Methods in Implementation and Prevention Science, Yale University, New Haven, Connecticut, USA
| | - Katherine LeMasters
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Paul N Zivich
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Siham Sikander
- Human Development Research Foundation, Islamabad, Pakistan
- Global Health Department, Health Services Academy, Islamabad, Pakistan
| | - Lisa M Bates
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Sonia Bhalotra
- Department of Economics, University of Warwick, UK, Coventry, Warwickshire, UK
| | - Esther O Chung
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ahmed Zaidi
- Human Development Research Foundation, Islamabad, Pakistan
| | - Joanna Maselko
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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30
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Grumi S, Provenzi L, Accorsi P, Biasucci G, Cavallini A, Decembrino L, Falcone R, Fazzi EM, Gardella B, Giacchero R, Guerini P, Grossi E, Magnani ML, Mariani EM, Nacinovich R, Pantaleo D, Pisoni C, Prefumo F, Sabatini C, Scelsa B, Spartà MV, Spinillo A, Giorda R, Orcesi S, Borgatti R. Depression and Anxiety in Mothers Who Were Pregnant During the COVID-19 Outbreak in Northern Italy: The Role of Pandemic-Related Emotional Stress and Perceived Social Support. Front Psychiatry 2021; 12:716488. [PMID: 34539466 PMCID: PMC8446509 DOI: 10.3389/fpsyt.2021.716488] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/09/2021] [Indexed: 12/28/2022] Open
Abstract
The COVID-19 pandemic is a collective trauma that is threatening citizens' mental health resulting in increased emotional stress, reduced social support, and heightened risk for affective symptoms. The present study aimed to investigate the effects of antenatal pandemic-related emotional stress and perceived social support on the symptoms of depression and anxiety of mothers who were pregnant during the initial COVID-19 outbreak in northern Italy. A sample of 281 mothers was enrolled at eight maternity units in the first hotspot region of the COVID-19 outbreak in northern Italy. Participants filled out online questionnaires assessing the direct or indirect exposure to the SARS-CoV-2 virus, pandemic-related stress, perceived social support, as well as symptoms of depression and anxiety. Depressive and anxious symptomatology was above clinical concern, respectively, in 26 and 32% of the respondents. Mothers who reported no exposure to SARS-CoV-2 during pregnancy and those who reported at least one direct or indirect exposure did not differ in terms of affective symptoms. Continuous scores and risk for severe depression and anxiety were positively associated with prenatal pandemic-related emotional stress and negatively linked with perceived social support during pregnancy. Women who become mothers during the COVID-19 emergency may be at high risk for affective problems. Dedicated preventive programs are needed to provide adequate preventive support and care for maternal mental health during and after the COVID-19 pandemic.
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Affiliation(s)
- Serena Grumi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Livio Provenzi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Patrizia Accorsi
- Unit of Child and Adolescence Neuropsychiatry, ASST Spedali Civili, Brescia, Italy
| | - Giacomo Biasucci
- Pediatrics & Neonatology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Anna Cavallini
- Child and Adolescent Mental Health, San Gerardo Hospital, Monza, Italy
| | | | | | - Elisa Maria Fazzi
- Unit of Child and Adolescence Neuropsychiatry, ASST Spedali Civili, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Barbara Gardella
- Department of Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | | | - Paola Guerini
- Pediatric Unit and Neonatal Unit, ASST Pavia, Pavia, Italy
| | - Elena Grossi
- Pediatrics & Neonatology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | | | | | - Renata Nacinovich
- Child and Adolescent Mental Health, San Gerardo Hospital, Monza, Italy
- School of Medicine and Surgery and Milan Center for Neuroscience, Università Bicocca, Milan, Italy
| | - Dario Pantaleo
- Pediatric Unit and Neonatal Unit, ASST Pavia, Pavia, Italy
| | - Camilla Pisoni
- Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Federico Prefumo
- Unit of Child and Adolescence Neuropsychiatry, ASST Spedali Civili, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | | | - Barbara Scelsa
- Pediatric Neurology Unit, V. Buzzi Children's Hospital, Milan, Italy
| | | | - Arsenio Spinillo
- Department of Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Roberto Giorda
- Biology Lab, Scientific Institute IRCCS E. Medea, Bosisio Parini, Italy
| | - Simona Orcesi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Renato Borgatti
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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31
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Gustafsson HC, Young AS, Doyle O, Nagel BJ, Mackiewicz Seghete K, Nigg JT, Sullivan EL, Graham AM. Trajectories of perinatal depressive symptoms in the context of the COVID-19 pandemic. Child Dev 2021; 92:e749-e763. [PMID: 34448493 PMCID: PMC8652588 DOI: 10.1111/cdev.13656] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This study sought to advance understanding of the potential long‐term consequences of the COVID‐19 pandemic for child development by characterizing trajectories of maternal perinatal depression, a common and significant risk factor for adverse child outcomes. Data came from 393 women (86% White, 8% Latina; mean age = 33.51 years) recruited during pregnancy (n = 247; mean gestational age = 22.94 weeks) or during the first year postpartum (n = 146; mean child age = 4.50 months; 55% female). Rates of depression appear elevated, relative to published reports and to a pre‐pandemic comparison group (N = 155). This study also provides evidence for subgroups of individuals who differ in their depressive symptom trajectories over the perinatal period. Subgroup membership was related to differences in maternal social support, but not to child birth outcomes.
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Affiliation(s)
| | - Anna S Young
- Oregon Health & Science University, Portland, Oregon, USA
| | - Olivia Doyle
- Oregon Health & Science University, Portland, Oregon, USA
| | - Bonnie J Nagel
- Oregon Health & Science University, Portland, Oregon, USA
| | | | - Joel T Nigg
- Oregon Health & Science University, Portland, Oregon, USA
| | - Elinor L Sullivan
- Oregon Health & Science University, Portland, Oregon, USA.,Oregon National Primate Research Center, Beaverton, Oregon, USA
| | - Alice M Graham
- Oregon Health & Science University, Portland, Oregon, USA
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32
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Matsumura K, Morozumi R, Hamazaki K, Tsuchida A, Inadera H. Effect estimate of time-varying social support and trust on the physical and mental health of mothers at 2.5 years postpartum: The Japan Environment and Children's Study (JECS). J Epidemiol 2021; 33:177-185. [PMID: 34373419 PMCID: PMC9939921 DOI: 10.2188/jea.je20210134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Many epidemiological studies have reported the association between various social factors and health status in mothers during and after pregnancy. However, little is known about their joint and longitudinal impact. We therefore examined the association of lack of social support and trust during pregnancy and at 2.5 years postpartum with health status in mothers. METHODS To adequately address time-varying exposure, marginal structural models were fitted to a pseudopopulation constructed by inverse probability weighting. The model included records of 90,071 mothers participating in the Japan Environment and Children's Study. Social support and trust were measured using a 9-item questionnaire (Q1-9). Mental and physical health were measured using Mental and Physical Component Summary scores from the 8-item Short-Form Health Survey. RESULTS For the Mental Component Summary, the magnitude of the effect estimate was largest when participants lacked close friends/neighbors (Q4) at only 2.5 years postpartum (= -6.23), followed by a lack in emotional support (Q2) at the same time point (= -4.94). For the Physical Component Summary, effect estimates were negligible. The magnitude of the effect estimates of lack of social support and trust tended to be larger when there was a lack at only 2.5 years postpartum than at both time points. CONCLUSIONS These findings suggest that, after childbirth, a loss in social support, particularly in a concrete or instrumental aspect, carries high risk, especially for mental health. Our results highlight the importance of supporting mothers for more than a few years after pregnancy.
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Affiliation(s)
| | | | - Kei Hamazaki
- Toyama Regional Center for JECS, University of Toyama.,Department of Public Health, Faculty of Medicine, University of Toyama.,Department of Public Health, Graduate School of Medicine, Gunma University
| | - Akiko Tsuchida
- Toyama Regional Center for JECS, University of Toyama.,Department of Public Health, Faculty of Medicine, University of Toyama
| | - Hidekuni Inadera
- Toyama Regional Center for JECS, University of Toyama.,Department of Public Health, Faculty of Medicine, University of Toyama
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33
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Ando H, Shen J, Morishige KI, Suto S, Nakashima T, Furui T, Kawasaki Y, Watanabe H, Saijo T. Association between postpartum depression and social support satisfaction levels at four months after childbirth. Arch Psychiatr Nurs 2021; 35:341-346. [PMID: 34176574 DOI: 10.1016/j.apnu.2021.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 03/09/2021] [Accepted: 03/28/2021] [Indexed: 02/01/2023]
Abstract
This study clarifies the association between postpartum depression (PPD) and satisfaction with social support after childbirth through an anonymous survey of 427 postpartum mothers. Mothers' PPD was found to be significantly associated with satisfaction levels regarding formal-instrumental support (OR: 0.32, 95% CI: 0.162-0.632), informal-instrumental support (OR: 0.547, 95% CI: 0.313-0.955), and informal-psychological support (OR: 0.591, 95% CI: 0.384-0.912) in a multivariate logistic regression analysis. To prevent PPD, specialists as formal support providers must provide qualified care based on comprehensive judgments, and families as informal support providers should help with childcare, housework, and mental support.
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Affiliation(s)
- Hitomi Ando
- Department of Human Nursing, Faculty of Human Health, Sonoda Women's University, Japan; Division of Health Sciences, Graduate School of Medicine, Osaka University, Japan.
| | - Junyi Shen
- Research Institute for Economics and Business Administration, Kobe University, Japan
| | - Ken-Ichirou Morishige
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Gifu University, Japan
| | - Shunji Suto
- Department of Community Medicine, Nara Medical University, Japan
| | - Takako Nakashima
- Faculty of Economics, University of Marketing and Distribution Sciences, Japan
| | - Tatsuro Furui
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Gifu University, Japan
| | - Yuki Kawasaki
- Faculty of Nursing, Graduate School of Nursing, Kansai Medical University, Japan
| | - Hiroko Watanabe
- Division of Health Sciences, Graduate School of Medicine, Osaka University, Japan
| | - Tatsuyoshi Saijo
- Research Institute for Humanity and Nature, Research Institute for Future Design at Kochitech, Japan
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34
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Chen Y, Ismail F, Xiong Z, Li M, Chen I, Wen SW, Xie RH. Association between perceived birth trauma and postpartum depression: A prospective cohort study in China. Int J Gynaecol Obstet 2021; 157:598-603. [PMID: 34324705 DOI: 10.1002/ijgo.13845] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 07/26/2021] [Accepted: 07/28/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To assess the association between women's perceived birth trauma and risk of postpartum depression (PPD). METHODS We conducted a prospective cohort study in China between December 2018 and November 2019. Women aged 18-45 years who had a singleton live birth at a university teaching hospital were enrolled after written consent was obtained. PPD was defined as a score of 13 or more on the Chinese version of the Edinburgh Postnatal Depression Scale. We used multiple log-binomial regression analysis to estimate the independent association between perceived birth trauma and PPD. RESULTS A total of 650 eligible women were included in the final analysis. Of them, 245 (37.69%) had self-reported perceived birth trauma and 188 (28.92%) developed PPD. The PPD rate was 42.04% in women with perceived birth trauma, compared with 20.99% in women without perceived birth trauma (crude relative risk [RR] 2.46, 95% confidence interval [CI] 1.48-3.72). The increased risk of PPD for women with perceived birth trauma remained after adjustment for sociodemographic and obstetric factors (adjusted RR 2.13, 95% CI 1.69-3.28). CONCLUSION Perceived birth trauma may be an important risk factor for PPD in Chinese women. Supportive care for women who perceived childbirth as a trauma may help to reduce the risk of PPD.
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Affiliation(s)
- Yanfang Chen
- Department of Nursing, The Seventh Affiliated Hospital of Southern Medical University, Foshan, Guangdong, China
| | - Faeeha Ismail
- Department of Nursing, The Seventh Affiliated Hospital of Southern Medical University, Foshan, Guangdong, China
| | - Ziyu Xiong
- Department of Nursing, The Seventh Affiliated Hospital of Southern Medical University, Foshan, Guangdong, China
| | - Meng Li
- Department of Obstetrics, The Seventh Affiliated Hospital of Southern Medical University, Foshan, Guangdong, China
| | - Innie Chen
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Department of Obstetrics & Gynecology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - Shi Wu Wen
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Department of Obstetrics & Gynecology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - Ri-Hua Xie
- Department of Nursing, The Seventh Affiliated Hospital of Southern Medical University, Foshan, Guangdong, China
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Ahmed GK, Elbeh K, Shams RM, Malek MAA, Ibrahim AK. Prevalence and predictors of postpartum depression in Upper Egypt: A multicenter primary health care study. J Affect Disord 2021; 290:211-218. [PMID: 34004403 DOI: 10.1016/j.jad.2021.04.046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/23/2021] [Accepted: 04/25/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Postpartum depression (PPD) is highly prevalent with a major impact on the mother and child health. We aimed to determine the prevalence of PPD in primary health care centres which provide vaccinations services to infants in Assiut city and to evaluate the possible risk factors associated with PPD. METHODS In this multicentre study, 257 mothers attended three primary health care centres for immunization of their babies were recruited from January 2019 to January 2020. All participants were evaluated for socio-demographic features, Family affluence scale (FAS), Edinburgh Postnatal Depression Scale (EPDS) and associated risk factors. RESULTS The mean age of the participants was 27.98 ± 4.7. About half of the mothers and their husbands had low education level. Most of the families (89%) have low socioeconomic scale (SES). About (33.5%) women were found to have possible PPD. In the logistic regression analysis, SES, history of depression, history of PPD, history of stressful conditions, familial support, unwanted pregnancy, and male preference were significant statistical in PPD (p < 0.05). LIMITATIONS We did not investigate the medical and psychological problems during antenatal care. Also, we did not assess relation of the type of delivery and medical problems during delivery on the postnatal care. CONCLUSIONS PPD was prevalent in 33.5% The possible risk factors of PPD were low SES, history of depression, history of PPD, history of stressful conditions, familial support, unwanted pregnancy, and male preference.
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Affiliation(s)
- Gellan K Ahmed
- Department of Neurology and Psychiatry, Assiut University, 71516 Assiut, Egypt; Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK.
| | - Khaled Elbeh
- Department of Neurology and Psychiatry, Assiut University, 71516 Assiut, Egypt
| | - Randa M Shams
- Department of Public Health, Faculty of Medicine, Assiut University, Assiut, Egypt
| | | | - Ahmed K Ibrahim
- Department of Public Health, Faculty of Medicine, Assiut University, Assiut, Egypt
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Stojanov J, Stankovic M, Zikic O, Stankovic M, Stojanov A. The risk for nonpsychotic postpartum mood and anxiety disorders during the COVID-19 pandemic. Int J Psychiatry Med 2021; 56:228-239. [PMID: 33322982 PMCID: PMC8191144 DOI: 10.1177/0091217420981533] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The coronavirus disease 2019 (COVID-19) appears to be the largest pandemic of our times. The aim was to recognize the risk factors for nonpsychotic postpartum mood and anxiety disorders (NPMADs) in women during the pandemic and state of emergency police lockdown in Serbia. METHODS We assessed 108 postpartum women who completed the Edinburgh Postnatal Depression Scale (EPDS) and an additional survey constructed for this study. We also used the additional, previously mentioned survey, in 67 healthy age-matched women with children who were ≥2 years of age. The additional survey allowed us to gain insight into the impact of the pandemic as well as postpartum period on the risk of NPMADs. RESULTS In 16 (14.8%) subjects we found a score ≥10 on EPDS. Higher rates on the EPDS were noticed in elderly, single, and unemployed, women who lost their jobs due to the pandemic, or women who were dissatisfied with their household income (p < 0.05). The risk of NPMADs was linked significantly to quarantine, and social isolation, the absence of social support, as well as having emotional problems. Postpartum women, compared to non-postpartum women, were more anxious and had feelings of helplessness during social isolation. CONCLUSION Understanding the factors that increase the risk of NPMADs during the pandemic could help prevent mental disorders during a possible future pandemic.
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Affiliation(s)
- Jelena Stojanov
- Special Hospital for Psychiatric Disorders, Gornja Toponica, Serbia
| | - Miodrag Stankovic
- Faculty of Medicine, University of Nis, Nis, Serbia,Center of Mental Health Protection, Clinical Centre Nis, Nis, Serbia
| | - Olivera Zikic
- Faculty of Medicine, University of Nis, Nis, Serbia,Center of Mental Health Protection, Clinical Centre Nis, Nis, Serbia
| | | | - Aleksandar Stojanov
- Clinic of Neurology, Clinical Center Nis, Nis, Serbia,Aleksandar Stojanov, Ozrenska 32, 18000 Nis, Serbia.
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Minckas N, Gram L, Smith C, Mannell J. Disrespect and abuse as a predictor of postnatal care utilisation and maternal-newborn well-being: a mixed-methods systematic review. BMJ Glob Health 2021; 6:bmjgh-2020-004698. [PMID: 33883187 PMCID: PMC8061800 DOI: 10.1136/bmjgh-2020-004698] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction Globally, a substantial number of women experience abusive and disrespectful care from health providers during childbirth. As evidence mounts on the nature and frequency of disrespect and abuse (D&A), little is known about the consequences of a negative experience of care on health and well-being of women and newborns. This review summarises available evidence on the associations of D&A of mother and newborns during childbirth and the immediate postnatal period (understood as the first 24 hours from birth) with maternal and neonatal postnatal care (PNC) utilisation, newborn feeding practices, newborn weight gain and maternal mental health. Methods We conducted a systematic review of all published qualitative, quantitative and mixed-methods studies on D&A and its postnatal consequences across all countries. Pubmed, Embase, Web of Science, LILACS and Scopus were searched using predetermined search terms. Quantitative and qualitative data were analysed and presented separately. Thematic analysis was used to synthesise the qualitative evidence. Results A total of 4 quantitative, 1 mixed-methods and 16 qualitative studies were included. Quantitative studies suggested associations between several domains of D&A and use of PNC as well as maternal mental health. Different definitions of exposure meant formal meta-analysis was not possible. Three main themes emerged from the qualitative findings associated with PNC utilisation: (1) women’s direct experiences; (2) women’s expectations and (3) women’s agency. Conclusion This review is the first to examine the postnatal effect of D&A of women and newborns during childbirth. We highlight gaps in research that could help improve health outcomes and protect women and newborns during childbirth. Understanding the health and access consequences of a negative birth experience can help progress the respectful care agenda.
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Affiliation(s)
- Nicole Minckas
- Institute for Global Health, University College London, London, UK
| | - Lu Gram
- Institute for Global Health, University College London, London, UK
| | - Colette Smith
- Institute for Global Health, University College London, London, UK
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Collins HN, Oza-Frank R, Marshall C. Perceived social support and postpartum depression symptoms across geographical contexts: Findings from the 2016 Ohio Pregnancy Assessment survey. Birth 2021; 48:257-264. [PMID: 33570210 DOI: 10.1111/birt.12536] [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: 08/24/2020] [Revised: 12/23/2020] [Accepted: 01/19/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The purpose of this study was to examine the association between perceived social support and postpartum depression symptoms (PDS) and to understand how this association may differ for urban, suburban, rural Appalachian, and rural non-Appalachian women in Ohio. METHODS Data were obtained via the 2016 Ohio Pregnancy Assessment Survey (n = 3382), a representative sample of postpartum women in Ohio. We conducted bivariate analyses to assess the associations between self-perceived social support and PDS, and covariates. Univariate and multivariate logistic regressions were conducted using a modified Poisson distribution to estimate the association between social support and PDS, adjusting for sociodemographic characteristics. We also examined geographical context as an independent predictor of PDS and as an effect modifier for the association between social support and PDS. RESULTS 15.6% of survey respondents experienced PDS. Women with low levels of social support had slightly higher prevalence (aPR: 1.4, 95% CI: 1.0-2.1) of PDS compared to women with high social support. Geographic context was an independent predictor of PDS; women in rural Appalachia had significantly lower prevalence (aPR: 0.5, 95% CI: 0.2-0.9) of PDS compared to women in urban areas. We did not find that geographical context modified the relationship between social support and PDS (Wald P = .5). CONCLUSIONS Low social support was associated with increased PDS but did not reach statistical significance. Women living in rural Appalachia had a lower prevalence of PDS. Future studies should explore the reasons for lower rates of PDS in rural Appalachia.
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Peng K, Zhou L, Liu X, Ouyang M, Gong J, Wang Y, Shi Y, Chen J, Li Y, Sun M, Wang Y, Lin W, Yuan S, Wu B, Si L. Who is the main caregiver of the mother during the doing-the-month: is there an association with postpartum depression? BMC Psychiatry 2021; 21:270. [PMID: 34034695 PMCID: PMC8147344 DOI: 10.1186/s12888-021-03203-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/31/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To examine the relationship between the main caregiver during the "doing-the-month" (a traditional Chinese practice which a mother is confined at home for 1 month after giving birth) and the risk of postpartum depression (PPD) in postnatal women. METHODS Participants were postnatal women stayed in hospital and women who attended the hospital for postpartum examination, at 14-60 days after delivery from November 1, 2013 to December 30, 2013. Postpartum depression status was assessed using the Edinburgh Postnatal Depression Scale. Univariate and multivariable logistic regressions were used to identify the associations between the main caregiver during "doing-the-month" and the risk of PPD in postnatal women. RESULTS One thousand three hundred twenty-five postnatal women with a mean (SD) age of 28 (4.58) years were included in the analyses. The median score (IQR) of PPD was 6.0 (2, 10) and the prevalence of PPD was 27%. Of these postnatal women, 44.5% were cared by their mother-in-law in the first month after delivery, 36.3% cared by own mother, 11.1% by "yuesao" or "maternity matron" and 8.1% by other relatives. No association was found between the main caregivers and the risk of PPD after multiple adjustments. CONCLUSIONS Although no association between the main caregivers and the risk of PPD during doing-the-month was identified, considering the increasing prevalence of PPD in Chinese women, and the contradictions between traditional culture and latest scientific evidence for some of the doing-the-month practices, public health interventions aim to increase the awareness of PPD among caregivers and family members are warranted.
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Affiliation(s)
- Ke Peng
- National Clinical Research Center for Cardiovascular Diseases, Shenzhen, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Shenzhen, China ,grid.284723.80000 0000 8877 7471Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Lin Zhou
- Shenzhen Centre for Disease Control and Prevention, Shenzhen, China
| | - Xiaoying Liu
- grid.1013.30000 0004 1936 834XSchool of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Menglu Ouyang
- grid.1005.40000 0004 4902 0432The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Jessica Gong
- grid.1005.40000 0004 4902 0432The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Yuanyuan Wang
- grid.48815.300000 0001 2153 2936Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Yu Shi
- National Clinical Research Center for Cardiovascular Diseases, Shenzhen, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Shenzhen, China
| | - Jiani Chen
- grid.259384.10000 0000 8945 4455University International College, Macau University of Science and Technology, Macau, China
| | - Yichong Li
- National Clinical Research Center for Cardiovascular Diseases, Shenzhen, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Shenzhen, China
| | - Mingfan Sun
- National Clinical Research Center for Cardiovascular Diseases, Shenzhen, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Shenzhen, China
| | - Yueyun Wang
- Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China.
| | - Wei Lin
- grid.284723.80000 0000 8877 7471Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Shixin Yuan
- grid.284723.80000 0000 8877 7471Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Bo Wu
- grid.284723.80000 0000 8877 7471Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Lei Si
- grid.1005.40000 0004 4902 0432The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia ,grid.89957.3a0000 0000 9255 8984School of Health Policy & Management, Nanjing Medical University, Nanjing, China
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Farewell CV, Melnick E, Leiferman J. Maternal mental health and early childhood development: Exploring critical periods and unique sources of support. Infant Ment Health J 2021; 42:603-615. [PMID: 33998003 DOI: 10.1002/imhj.21925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The objective of this study was to explore associations between maternal depression and anxiety during early sensitive periods, child social-emotional and behavioral problems and the moderating roles of financial, instrumental, and partner emotional support. METHODS Analyses was conducted using data from the Fragile Families and Child Wellbeing Study. Hierarchical linear regression modeling was used to explore associations between maternal depression and anxiety at 1- and 3-years postpartum, three unique types of social support, and childhood behavioral problems at 5-years of age (n = 2,827). RESULTS Mothers who were depressed at one or both timepoints, compared to nondepressed mothers, reported higher externalizing behavioral problems scores of 1.96 and 2.90, and internalizing behavioral problems scores of 1.16 and 2.20, respectively, at 5-years of age (both p < .01), after controlling for covariates. Financial, instrumental, and partner emotional support were independently and inversely associated with behavioral problems (p < .05); however, none of these types of support moderated the relationship between maternal depression and behavioral problems, after controlling for covariates. IMPLICATIONS Promoting maternal mental health as well as different sources of support throughout the first five years of life, instead of one critical period, may help to reduce the burden of chronic disease in the next generation.
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Affiliation(s)
- Charlotte V Farewell
- Rocky Mountain Prevention Research Center, Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado, 80045, USA
| | - Emily Melnick
- Rocky Mountain Prevention Research Center, Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado, 80045, USA
| | - Jenn Leiferman
- Rocky Mountain Prevention Research Center, Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado, 80045, USA
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Huang Y, Liu Y, Wang Y, Liu D. Family function fully mediates the relationship between social support and perinatal depression in rural Southwest China. BMC Psychiatry 2021; 21:151. [PMID: 33711987 PMCID: PMC7953569 DOI: 10.1186/s12888-021-03155-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 03/08/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Perinatal depression is the most common complication of gestation and childbearing affecting women and their families, and good social support and family function are considered protective and modifiable factors. This study aimed to investigate depression status and explore inter-relationships between social support and perinatal depression considering the influence of family function in rural areas of Southwest China. METHODS This is a cross-sectional study. The following instruments were used: the Edinburgh Postpartum Depression Scale, the APGAR Family Care Index Scale, and the Social Support Rate Scale. A structural equation modelling was used to test the hypothesis relationships among the variables. RESULTS A total of 490 rural antenatal (N = 249) and postpartum (N = 241) women (mean age (standard deviation), 28.17 ± 5.12) participated. We found that the prevalence of depression symptoms was 10.4%. Path analysis showed that family function had a direct negative correlation with depression (β = - 0.251, 95%CI: - 0.382 to - 0.118). Social support had a direct positive correlation with family function (β =0.293, 95%CI: 0.147 to 0.434) and had an indirect negative correlation with depression (β = - 0.074, 95%CI: - 0.139 to - 0.032), family function fully mediated the relationship between social support and depression. CONCLUSIONS Findings of this study highlight that family function should be considered as the key target for interventions aiming to lower the prevalence of perinatal depression. Family members interventions are critical to reduce depression among antenatal and postpartum women.
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Affiliation(s)
- Yilin Huang
- grid.13291.380000 0001 0807 1581West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041 China
| | - Yan Liu
- grid.13291.380000 0001 0807 1581West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041 China
| | - Yu Wang
- grid.506261.60000 0001 0706 7839Department of Radiation Oncology, National Cancer Center and Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Danping Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China.
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Factors Influencing the Quality of Life of Empty Nesters: Empirical Evidence from Southwest China. SUSTAINABILITY 2021. [DOI: 10.3390/su13052662] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Quality of life is a widely accepted concept based on the notion that people’s lives have been subject to rapid development and industrialization. This study aims to explore the impact of different factors on the quality of life of empty nesters in Southwest China. The main factors explored are resilience and social supports (SS), highlighted here from different perspectives. Moreover, the correlations between other variables and quality of life are shown here. This study experimented with a hierarchical multiple regression model from survey data with 3583 valid responses. It argued that both resilience and social supports, including family members and friends, are significantly correlated with the Chinese empty nesters’ quality of life. Family support and friend support play a significant mediating role in the association between resilience and quality of life. However, neither government nor nongovernmental support significantly influences the quality of life. Therefore, the hypothetical recommendations of this study have been partially confirmed. The findings of this study provide a more comprehensive understanding of the overall mental and physical health of Chinese empty nesters.
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Cheng B, Meng Y, Zhou Y, Li J, Zeng J, Tan X, Zhang K, Luo Y, Zhang Y. Cerebral Regional Homogeneity Alternation of Pregnant Women With Antenatal Depression During the Pandemic. Front Psychiatry 2021; 12:627871. [PMID: 33959047 PMCID: PMC8093433 DOI: 10.3389/fpsyt.2021.627871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/22/2021] [Indexed: 02/05/2023] Open
Abstract
Purpose: The COVID-19 epidemic has been a threat to the health of people all over the world. Various precautions during COVID-19 in China have kept a large number of people in isolation, and this has inconvenienced and placed enormous stress on pregnant women. Pregnant women are more likely to suffer from antenatal depression (ANDP) with social isolation or low social support. This research aims to investigate the neurobiological mechanisms underlying ANDP, which impedes early detection and intervention in this disorder. Methods: A total of 43 singleton pregnant women who experienced isolation were recruited, including 21 treatment-naïve ANDP patients and 22 healthy pregnant women (HPW). To explore the intrinsic cerebral activity alternations in ANDP using resting-state functional MRI (rsfMRI), we assessed the local regional homogeneity (ReHo) differences in two groups using the voxel-based whole-brain analysis. The correlation between the regional functional abnormalities and clinical variables in ANDP patients was also examined. Results: Compared with HPW, ANDP patients showed decreased ReHo in the left dorsolateral prefrontal cortex, right insular and the cluster coving the right ventral temporal cortex (VTC), amygdala (AMG), and hippocampus (HIP). The Edinburgh Postnatal Depression Scale (EPDS) scores of ANDP patients negatively correlated with the ReHo in the right VTC, AMG, and HIP. Conclusion: Elucidating the neurobiological features of ANDP patients during COVID-19 is crucial for evolving adequate methods for early diagnosis, precaution, and intervention in a future epidemic.
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Affiliation(s)
- Bochao Cheng
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Yajing Meng
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
| | - Yushan Zhou
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Jinrong Li
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Jianguang Zeng
- School of Economics and Business Administration, Chongqing University, Chongqing, China
| | - Xi Tan
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Kaiyou Zhang
- Department of Clinical Laboratory, West China Second Hospital, Sichuan University, Chengdu, China
| | - Ya Luo
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
| | - Yan Zhang
- Department of Gynecology and Obstetrics, Wuxi Maternal and Child Health Hospital, The Affiliated Hospital of Nanjing Medical University, Wuxi, China
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Hou F, Liu H, Peng X, You L, Zhou Z, Xie H, Liu T. Gender disparities in depressive and anxiety symptoms among internal migrant workers in Shenzhen: a cross-sectional study. BMJ Open 2020; 10:e041446. [PMID: 33268428 PMCID: PMC7713212 DOI: 10.1136/bmjopen-2020-041446] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To investigate the gender disparities in the prevalence and severity of depressive and anxiety symptoms and associated factors among internal migrant workers in Shenzhen. DESIGN Cross-sectional study. SETTING Labour intensive factories in Shenzhen, Guangdong, China. PARTICIPANTS We recruited 3200 internal migrant workers who aged over 18 years old and above and did not register in Shenzhen's household registration system. There were 3095 participants eligible for this study. METHODS Participants completed sociodemographic questionnaire, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, the UCLA Loneliness Scale, the Barratt Impulsiveness Scale, the Social Support Rating Scale, the Simplified Coping Style Questionnaire and Meaning in Life Questionnaire. We applied χ2 test, analysis of variance, Wilcoxon rank test, Fisher's exact test and univariate and multivariate multilevel linear regression analysis. RESULTS The overall prevalence of depressive and anxiety symptoms was 27.85% and 19.26% among internal migrant workers. We reported gender disparities of depressive and anxiety symptoms among participants that the prevalence of depressive and anxiety symptoms was higher in women (30.57% vs 26.43% and 22.67% vs 17.47%), and the symptoms were more severe among women. Female migrant workers were more likely to be singled, have lower prevalence of smoking and drinking, receive less education and monthly income, have higher level of impulsiveness and social support and lower level of meaning in life. We found age, marriage, income, adaption to living in Shenzhen, being discriminated, drinking, loneliness, impulsiveness, social support, coping strategies and meaning of life were associated with the severity of depressive and anxiety symptoms among internal migrant workers in Shenzhen. CONCLUSION Gender inequality may be the institutional factor leading to disparities in depressive and anxiety symptoms among internal migrant workers. Interventions should be embedded with strategies improving gender equality.
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Affiliation(s)
- Fengsu Hou
- Department of Public Health, Shenzhen Kangning Hospital/Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Huiming Liu
- Department of Public Health, Shenzhen Kangning Hospital/Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Xiaodong Peng
- Department of Public Health, Shenzhen Kangning Hospital/Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Liqin You
- Department of Public Health, Shenzhen Kangning Hospital/Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Zhijian Zhou
- Department of Public Health, Shenzhen Kangning Hospital/Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Haiyan Xie
- Department of Public Health, Shenzhen Kangning Hospital/Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Tiebang Liu
- Shenzhen Kangning Hospital/Shenzhen Mental Healch Center, Shenzhen, Guangdong, China
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Nisar A, Yin J, Waqas A, Bai X, Wang D, Rahman A, Li X. Prevalence of perinatal depression and its determinants in Mainland China: A systematic review and meta-analysis. J Affect Disord 2020; 277:1022-1037. [PMID: 33065811 DOI: 10.1016/j.jad.2020.07.046] [Citation(s) in RCA: 100] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 05/16/2020] [Accepted: 07/05/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND Perinatal depression is a maternal mental health condition that is associated with various adverse health outcomes both for the mothers and the babies. The study aim was to estimate the prevalence of perinatal depression and its risks and determinants in Mainland China. METHODS Systematic searches were conducted in 10 major databases and random effect meta-analysis was performed to achieve the pooled variance of perinatal depression. Subgroup analyses were conducted based on region, scale, methods of diagnosis and study design. Meta-regression was performed with the variables such as age, quality assessment score and gross domestic product (GDP) of the province. RESULTS Pooled prevalence of perinatal depression was 16.3% (CI=95%; 14.7% to 18.2%, P < 0.001), with antenatal depression 19.7% (CI=95%; 15.8% to 24.2%, P < 0.001) and postnatal depression 14.8% (CI=95%; 13.1% to 16.6%, P < 0.001). Significant publication bias was found and heterogeneity was I2= 98.13%. Lower socioeconomic status, poor physical health, anxiety about pregnancy and reduced social support were major risk factors while better living conditions and higher level of education were protective factors. The prevalence of perinatal depression showed a significant increasing trend in the last decade. LIMITATIONS The review does not include studies with small sample size (n <250). Moreover a narrative review of risk and protective factors was done, these were not included in meta-analysis. CONCLUSION The prevalence of perinatal depression in China is similar to low and middle-income countries. Urgent attention is needed to address this public health priority in China.
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Affiliation(s)
| | - Juan Yin
- Xi'an Jiaotong University, Xi'an, China
| | - Ahmed Waqas
- University of Liverpool, Liverpool, United Kingdom; Human Development Research Foundation, Islamabad, Pakistan
| | - Xue Bai
- Xi'an Jiaotong University, Xi'an, China
| | - Duolao Wang
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Atif Rahman
- University of Liverpool, Liverpool, United Kingdom
| | - Xiaomei Li
- Xi'an Jiaotong University, Xi'an, China.
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Schwank SE, Chung HF, Hsu M, Fu SC, Du L, Zhu L, Huang HY, Andersson E, Acharya G. Mental health of Urban Mothers (MUM) study: a multicentre randomised controlled trial, study protocol. BMJ Open 2020; 10:e041133. [PMID: 33247023 PMCID: PMC7703424 DOI: 10.1136/bmjopen-2020-041133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 10/27/2020] [Accepted: 11/07/2020] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Mental health disorders are common during pregnancy and the postnatal period and can have serious adverse effects on women and their children. The consequences for global mental health due to COVID-19 are likely to be significant and may have a long-term impact on the global burden of disease. Besides physical vulnerability, pregnant women are at increased risk of mental health problems such as anxiety, depression and post-traumatic stress disorder due to the consequences of social distancing. It can result in altered healthcare routines, less support from the family and friends, and in some cases, partners not being allowed to be present during prenatal visits, labour and delivery. Higher than expected, rates of perinatal anxiety and depression have been already reported during the pandemic. Pregnant women may also feel insecure and worried about the effects of COVID-19 on their unborn child if they get infected during pregnancy. Today, young urban women are used to using internet services frequently and efficiently. Therefore, providing mental health support to pregnant women via internet may be effective in ameliorating their anxiety/depression, reducing the risk of serious mental health disorders, and lead to improved maternal and perinatal outcomes. OVERARCHING AIM Our aim is to explore the effectiveness of a web-based psychosocial peer-to-peer support intervention in reducing the risk and severity of perinatal mental health disorders and preventing adverse pregnancy outcomes among pregnant women living in metropolitan urban settings. METHODS AND ANALYSIS We plan to conduct a multicentre prospective randomised controlled trial, Mental health of Urban Mothers trial. Pregnant women living in large metropolitan cities will be recruited using internet-based application through non-profit organisations' websites. The women who consent will be randomised to receive a web-based peer-to-peer support intervention or usual care. Data will be analysed to identify the effects of intervention on Edinburgh Postnatal Depression Score and Generalised Anxiety Disorder 7 scores as well as pregnancy outcomes. The impact of COVID-19 pandemic on maternal stress will be assesed using Impact Event Scale-R. Any differences in outcomes between cities will be addressed in subgroup analyses. ETHICS AND DISSEMINATION The study will be conducted according to the principles of Good Clinical Practice and will follow the ethical principles of the Declaration of Helsinki. The study protocol has been approved by the ethical review board of Chinese University of Hong Kong (IRB number 2019-8170) and Shanghai Center for Women's and Children's Health (international review board (IRB) number 2020-F001-12). The results will be disseminated at national and international scientific conferences, published in peer-reviewed medical journals and spread to the public through social media, news outlets and podcasts. TRIAL REGISTRATION NUMBER NCT04363177; Trial sponsor Karolinska Institute, CLINTEC, Stockholm, Sweden.
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Affiliation(s)
- Simone Eliane Schwank
- CLINTEC, Karolinska Institute, Stockholm, Sweden
- Women's Health and Perinatology Research Group, Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
| | - Ho-Fung Chung
- Psychiatry, The University of Hong Kong, Hong Kong, Hong Kong
| | - Mandy Hsu
- Psychological and Brain Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Shih-Chien Fu
- Counseling Psychology, National Taipei University of Education, Taipei, Taiwan
| | - Li Du
- Department of Research and Education, Tongji University, Shanghai, Shanghai, China
| | - Liping Zhu
- Department of Research and Education, Tongji University, Shanghai, Shanghai, China
| | - Hsuan-Ying Huang
- Anthropology, The Chinese University Hong Kong, Hong Kong, Hong Kong
| | - Ewa Andersson
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Ganesh Acharya
- Women's Health and Perinatology Research Group, Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
- CLINTEC Department of Clinical Technology, Karolinska Institutet, Stockholm, Sweden
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Machine Learning-Based Predictive Modeling of Postpartum Depression. J Clin Med 2020; 9:jcm9092899. [PMID: 32911726 PMCID: PMC7564708 DOI: 10.3390/jcm9092899] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 09/06/2020] [Accepted: 09/07/2020] [Indexed: 12/03/2022] Open
Abstract
Postpartum depression is a serious health issue beyond the mental health problems that affect mothers after childbirth. There are no predictive tools available to screen postpartum depression that also allow early interventions. We aimed to develop predictive models for postpartum depression using machine learning (ML) approaches. We performed a retrospective cohort study using data from the Pregnancy Risk Assessment Monitoring System 2012–2013 with 28,755 records (3339 postpartum depression and 25,416 normal cases). The imbalance between the two groups was addressed by a balanced resampling using both random down-sampling and the synthetic minority over-sampling technique. Nine different ML algorithms, including random forest (RF), stochastic gradient boosting, support vector machines (SVM), recursive partitioning and regression trees, naïve Bayes, k-nearest neighbor (kNN), logistic regression, and neural network, were employed with 10-fold cross-validation to evaluate the models. The overall classification accuracies of the nine models ranged from 0.650 (kNN) to 0.791 (RF). The RF method achieved the highest area under the receiver-operating-characteristic curve (AUC) value of 0.884, followed by SVM, which achieved the second-best performance with an AUC value of 0.864. Predictive modeling developed using ML-approaches may thus be used as a prediction (screening) tool for postpartum depression in future studies.
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Sense of Coherence Mediates the Links between Job Status Prior to Birth and Postpartum Depression: A Structured Equation Modeling Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176189. [PMID: 32858960 PMCID: PMC7504177 DOI: 10.3390/ijerph17176189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/20/2020] [Accepted: 08/23/2020] [Indexed: 11/17/2022]
Abstract
Postpartum depression (PPD) has detrimental effects on the health of the mother, child and family. Socio-demographic variables can influence PPD. Sense of coherence (SOC) is a personal resource that mitigates the experience of stressful events. We hypothesized that SOC would have a protective effect against PPD over time. The aim was to investigate the effects of socio-demographic factors and SOC on PPD at birth (T1) and nine months postpartum (T2). A longitudinal study of primiparous women (n = 114; age range 18-47 years) measured PPD, SOC and socio-demographics at T1 and T2. The majority were married, had no economic difficulties and were employed before birth. Results showed that PPD at T1 (15.8%) declined to 6.2% (T2). Job status was positively associated with SOC at T1. The structured equation model accounted for 27% of the variance in PPD (T2). In the first pathway, job status was linked to PPD (T2) via SOC at T1 and T2. In the second, SOC and PPD (T1) and SOC (T2) mediated the link between job status and PPD (T2). Results and clinical implications are discussed in the context of the theory of conservation of resources. An intervention for enhancing SOC is recommended for woman at risk of PPD.
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Nyman T, Pegg S, Kiel EJ, Mistry-Patel S, Becker-Schmall LJ, Brooker RJ. Perceived social support moderates neural reactivity to emotionally valenced stimuli during pregnancy. Psychophysiology 2020; 57:e13647. [PMID: 32715514 DOI: 10.1111/psyp.13647] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 05/28/2020] [Accepted: 06/24/2020] [Indexed: 01/17/2023]
Abstract
Reactivity to emotional information, measurable at the level of neural activity using event-related potentials, is linked to symptoms of affective disorders. Behavioral evidence suggests that contextual factors, such as social support, can alter emotional reactivity such that affective responding is normalized when social support is high. This possibility remains largely untested at the neural level, specifically through approaches that can offer insight into the mechanistic processes contributing to individual differences in emotional reactivity. Yet, such knowledge could be useful for prevention and intervention efforts, particularly with groups at risk for increased emotional reactivity, such as pregnant mothers for whom emotional distress predicts both maternal and child outcomes. Expectant mothers took part in a longitudinal study that tested whether the late positive potential (LPP), a neural index of reactivity to emotional information, was moderated by maternal perceptions of social support. In the third trimester of pregnancy, lower perceived social support was associated with an absence of a traditional LPP effect, which differentiates valenced from neutral stimuli. Findings suggest that perceptions of social support may normalize emotional processing at the neural level and highlight the potential importance of social support modulation of emotional reactivity during times of known biological change.
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Affiliation(s)
- Tristin Nyman
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA
| | - Samantha Pegg
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | | | - Sejal Mistry-Patel
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA
| | - Lisa J Becker-Schmall
- Department of Physical Therapy and Rehabilitation Science, The University of Iowa, Iowa City, IA, USA
| | - Rebecca J Brooker
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA
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SİS ÇELİK A, ATASEVER İ. GEBELERDE ALGILANAN STRES DÜZEYLERİNİN VE ETKİLEYEN FAKTÖRLERİN BELİRLENMESİ. JOURNAL OF ANATOLIA NURSING AND HEALTH SCIENCES 2020. [DOI: 10.17049/ataunihem.622304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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