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Zhang Y, Liu X, Liu M, Li M, Chen P, Yan G, Ma Q, Li Y, You D. Multidimensional influencing factors of postpartum depression based on the perspective of the entire reproductive cycle: evidence from western province of China. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02686-2. [PMID: 38789557 DOI: 10.1007/s00127-024-02686-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 05/03/2024] [Indexed: 05/26/2024]
Abstract
OBJECTIVE China has a serious burden of Postpartum depression (PPD). In order to improve the current situation of high burden of PPD, this study explores the factors affecting PPD from the multidimensional perspectives with physiology, family support and social support covering the full-time chain of pre-pregnancy-pregnancy-postpartum. METHODS A follow-up survey was conducted in the Qujing First People's Hospital of Yunnan Province from 2020 to 2022, and a total of 4838 pregnant women who underwent antenatal checkups in the hospital were enrolled as study subjects. Mothers were assessed for PPD using the Edinburgh Postnatal Depression Scale (EPDS), and logistic regression was used to analyse the level of mothers' postnatal depression and identify vulnerability characteristics. RESULTS The prevalence of mothers' PPD was 46.05%, with a higher prevalence among those who had poor pre-pregnancy health, had sleep problems during pregnancy, and only had a single female fetus. In the family support dimension, only family care (OR = 0.52, 95% CI 0.42-0.64) and only other people care(OR = 0.78, 95% CI 0.64-0.96) were the protective factors of PPD. The experience risk of PPD was higher among mothers who did not work or use internet. CONCLUSION The PPD level in Yunnan Province was significantly higher than the global and Chinese average levels. Factors affecting mothers' PPD exist in all time stages throughout pregnancy, and the influence of family support and social support on PPD shouldn't be ignored. There is an urgent need to extend the time chain of PPD, move its prevention and treatment forward and broaden the dimensions of its intervention.
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Affiliation(s)
- Yiyun Zhang
- School of Ethnology and Sociology, Yunnan University, Kunming, 650091, Yunnan, China
| | - Xinwei Liu
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, 150086, Heilongjiang, China
| | - Mengmei Liu
- School of Public Health, Kunming Medical University, Kunming, 650500, Yunnan, China
| | - Min Li
- School of Public Health, Kunming Medical University, Kunming, 650500, Yunnan, China
| | - Ping Chen
- School of Public Health, Kunming Medical University, Kunming, 650500, Yunnan, China
| | - Guanghong Yan
- School of Public Health, Kunming Medical University, Kunming, 650500, Yunnan, China
| | - Qingyan Ma
- School of Public Health, Kunming Medical University, Kunming, 650500, Yunnan, China
| | - Ye Li
- School of Public Health, Hangzhou Normal University, Hangzhou, 311121, Zhejiang, China.
| | - Dingyun You
- Yunnan Provincial Key Laboratory of Public Health and Biosafety & School of Public Health, Kunming Medical University, Kunming, 650500, Yunnan, China.
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Kakasci CG, Durmaz A. Does individualized care make a difference in postpartum discharge?: A block randomized controlled trial. Health Care Women Int 2023; 44:1481-1499. [PMID: 35616352 DOI: 10.1080/07399332.2022.2046752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 02/22/2022] [Indexed: 10/18/2022]
Abstract
With this study, we aimed to determine the severity of physical symptoms displayed by mothers who received individualized care during the early postpartum period and their level of perceived readiness for discharge after birth. We conducted the study as a single-blind randomized controlled trial, assigning the mothers to the experimental (EG = 60) and control (CG = 60) groups using the permuted block randomization method. We administered the EG individualized care and the CG a routine care. Both groups received Postpartum Physical Symptom Severity Scale and Readiness for Hospital Discharge Scale-New Mother Form. The mean posttest scores the groups obtained from Postpartum Physical Symptom Severity Scale and Readiness for Hospital Discharge Scale-New Mother Form were significant in favor of the EG (p < 0.05). It is fair to state that individualized care is effective in reducing the physical complaints increasing the maternal health and improving the general health.
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Affiliation(s)
- Cigdem Gun Kakasci
- Faculty of Health Sciences, Department of Midwifery, Suleyman Demirel University, Isparta, Turkey
| | - Aysegul Durmaz
- Faculty of Health Sciences, Department of Midwifery, Kutahya Health Sciences University, Kutahya, Turkey
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Diagnosis and Management of Perinatal Depression. Nurs Womens Health 2022; 26:318-330. [PMID: 35714763 DOI: 10.1016/j.nwh.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 04/27/2022] [Accepted: 05/19/2022] [Indexed: 11/23/2022]
Abstract
Perinatal depression is a mood disorder that may occur during pregnancy or within a year after childbirth. It can be disabling for the birthing parent and cause attachment and developmental problems for the infant. A host of risk factors, including genetics, reproductive history, and life experiences, are associated with perinatal depression. With validated screening tools, health care providers can assess individuals, initiate treatment, and/or refer as appropriate. Successful treatment, which may include modalities such as cognitive behavioral therapy and/or pharmacologic therapies, helps individuals maintain a sense of control, develop self-confidence, take control of their thinking, and learn coping skills. Integrative therapies and lifestyle changes have some success but may not be adequate for many individuals. Patients may benefit from providers learning and initiating cognitive behavioral therapy techniques while awaiting therapy.
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Rossi MA, Vermeir E, Brooks M, Pierce M, Pukall CF, Rosen NO. Comparing Self-Reported Pain During Intercourse and Pain During a Standardized Gynecological Exam at 12- and 24-Month Postpartum. J Sex Med 2022; 19:116-131. [PMID: 36963976 DOI: 10.1016/j.jsxm.2021.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 10/26/2021] [Accepted: 11/01/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND There is limited information about the physical indicators and biopsychosocial predictors of self-reported pain during intercourse and pain during a gynecological examination at 12- and 24-month following childbirth. AIM This longitudinal study aimed to (i) Compare the findings from gynecological exams at 12- and 24-month postpartum for women with minimal vs clinically significant pain during intercourse; (ii) Assess the biomedical and psychosocial correlates of self-reported pain during intercourse and the vestibular pain index (VPI) from the cotton-swab test at 12- and 24-month postpartum; (iii) Establish the relationship between self-reported pain during intercourse and the cotton-swab test. METHODS Women (N = 97 at 12 months postpartum and N = 44 at 24-month postpartum) recruited from a local women's hospital completed online surveys in their first trimester of pregnancy and at 12- and 24-month postpartum to assess pain during intercourse and biopsychosocial variables. Those with clinically significant (pain ≥4/10 on a visual analogue scale) were matched with those reporting minimal pain (pain <3/10) and underwent a gynecological exam including a cotton-swab test. Descriptive analyses, multiple regressions, and bivariate correlations were conducted to address each of the study aims, respectively. MAIN OUTCOME MEASURES (i) Findings from the gynecological examination (ii) Numerical rating scale for the VPI; (iii) Visual analogue scale of pain during intercourse. RESULTS The majority of women in both pain groups had normal physical findings in the gynecological exam. Greater sexual distress and pain catastrophizing at 12- and 24-month postpartum were significantly associated with greater pain during intercourse at each time-point, respectively. Greater pain catastrophizing at 12 months postpartum was significantly associated with greater pain during the cotton-swab test at that time-point. Lower relationship satisfaction at 12 months postpartum was associated with greater VPI ratings at 24 months postpartum. Pain during intercourse and the VPI were moderately and positively correlated. CLINICAL IMPLICATIONS Addressing psychosocial variables may interrupt the maintenance of postpartum pain. Following an initial assessment, self-reported pain intensity may be a suitable proxy for repeated examinations. STRENGTHS & LIMITATIONS This study is the first to describe the physical findings and psychosocial predictors of pain during intercourse and the VPI at 12- and 24-month postpartum. The homogenous and small sample may limit generalizability. CONCLUSION There were no observable physical indicators of clinically significant postpartum pain during intercourse. Psychosocial variables were linked to women's greater postpartum pain during intercourse and VPI ratings.
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Affiliation(s)
- Meghan A Rossi
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Ella Vermeir
- Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Melissa Brooks
- Department of Obstetrics and Gynaecology, IWK Health Centre, Halifax, NS, Canada
| | - Marianne Pierce
- Department of Obstetrics and Gynaecology, IWK Health Centre, Halifax, NS, Canada
| | | | - Natalie O Rosen
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
- Department of Obstetrics and Gynaecology, IWK Health Centre, Halifax, NS, Canada
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Eslahi Z, Alimoradi Z, Bahrami N, Lin CY, Griffiths MD, Pakpour AH. Psychometric properties of Postpartum Partner Support Scale-Persian version. Nurs Open 2021; 8:1688-1695. [PMID: 33608977 PMCID: PMC8186706 DOI: 10.1002/nop2.806] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/30/2020] [Accepted: 01/29/2021] [Indexed: 11/18/2022] Open
Abstract
Aim The aim of the present study was to translate the Postpartum Partner Support Scale (PPSS) into Persian and evaluate its psychometric properties among postpartum women. Design A total of 248 women aged 18–39 years participated in this psychometric study. The PPSS was translated into Persian using a forward‐backward method. Confirmatory factor analysis (CFA) and Rasch model analysis were used to assess the psychometric properties of the PPSS. In addition, the Edinburgh Postpartum Depression Scale (EPDS) was completed simultaneously to assess the construct validity. Internal consistency of the questionnaire was assessed by calculating the Cronbach's alpha coefficient and corrected item‐total correlation. Results The unidimensionality of the PPSS was supported in both CFA and Rasch analysis. The PPSS had a significant negative association with EPDS (r = −0.39 p < .001). The scale had excellent internal consistency (Cronbach's alpha = 0.94) and the correlation between items and total score was satisfactory. Conclusion The Persian version of PPSS with 20 items is a valid and reliable scale to assess postpartum support.
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Affiliation(s)
- Zahra Eslahi
- Students Research Committee, School of Nursing & Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Zainab Alimoradi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Nasim Bahrami
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Chung-Ying Lin
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, Hong Kong.,Institute of Allied Health Sciences and Departments of Occupational Therapy and Public Health, National Cheng Kung University Hospital, College of Medicine Taiwan, National Cheng Kung University, Tainan, Taiwan
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.,Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Gómez-Pérez L, Cumsille P, Román C. Bidirectional relationship between physical health symptoms and depressive symptoms in the pre- and postpartum period. J Psychosom Res 2020; 139:110280. [PMID: 33130484 DOI: 10.1016/j.jpsychores.2020.110280] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 10/01/2020] [Accepted: 10/09/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To test the bidirectional relationships between physical health symptoms (PHS) and depressive symptoms (DS) as well as between the intensity of 'any pain' and DS in the pre- and postpartum period METHOD: Women (N = 615) completed the Edinburgh Postnatal Depression Scale, the Patients Health Questionnaire-15, and numerical pain rating scales when they were between 32 and 37 weeks of gestation, and subsequently one, three, and six months postpartum. We conducted two random intercept cross-lagged panel models (RI-CLPM) RESULTS: Both models presented excellent fits. The relationship between PHS and DS was bidirectional across all the data waves (χ2(9) = 6.610, p = .678, CFI = 1, TLI = 1, RMSEA = 0). The magnitude of the standardized cross-lagged regression coefficient was relatively similar from DS to PHS (raging between 0.081 and 0.171); and from PHS to DS (raging between 0.121 and 0.138). The relationship between 'any pain' intensity and DS was also bidirectional, but only during the postnatal period (χ2(9) =11.765, p = .227, CFI = 0.99, TLI = 0.98, RMSEA = 0.022). The magnitude of the standardized cross-lagged regression coefficient was higher from DS to 'any pain' intensity (raging between 0.214 and 0.216); than from 'any pain' intensity to DS (raging between 0.092 and 0.097). CONCLUSIONS Concurrently intervening over physical and mental health symptoms could promote women's perinatal health.
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Affiliation(s)
- Lydia Gómez-Pérez
- Escuela de Psicología, Facultad de Ciencias Sociales, Pontificia Universidad Católica de Chile, Chile.
| | - Patricio Cumsille
- Escuela de Psicología, Facultad de Ciencias Sociales, Pontificia Universidad Católica de Chile, Chile
| | - Camila Román
- Escuela de Psicología, Facultad de Ciencias Sociales, Pontificia Universidad Católica de Chile, Chile
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Wadephul F, Glover L, Jomeen J. Conceptualising women's perinatal well-being: A systematic review of theoretical discussions. Midwifery 2020; 81:102598. [DOI: 10.1016/j.midw.2019.102598] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 10/15/2019] [Accepted: 12/02/2019] [Indexed: 10/25/2022]
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Lowenhoff C, Davison-Fischer J, Pike N, Appleton JV. Using the TIDieR checklist to describe health visitor support for mothers with mental health problems: Analysis of a cross-sectional survey. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:e824-e836. [PMID: 31293024 DOI: 10.1111/hsc.12790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 04/17/2019] [Accepted: 05/12/2019] [Indexed: 06/09/2023]
Abstract
At least half of the 20% of mothers who experience mental health problems (MHPs) during pregnancy or after birth are not receiving the help they need that will lead to recovery. In order to identify where improvements need to be made, it is necessary to describe exactly what is being done and the barriers and facilitators that compromise or enhance optimal care. The majority of mothers experience mild to moderate anxiety or depression. The expectation is that primary care professionals, such as health visitors (HVs), can provide the support they need that will lead to recovery. The aim of this study was to explore the views of HVs regarding the content and purpose of an intervention to support mothers with MHPs, described as 'listening visits' (LVs). A link to an online survey was offered to the members and champions of the Institute of Health Visiting (n = 9,474) March-May 2016. The survey was completed by 1,599 (17%) of the target population, of whom 85% were offering LVs. The Template for Intervention Description and Replication (TIDieR) checklist was used to provide a framework to describe commonalities and variations in practice. There appeared to be a shared understanding of the rationale for LVs but a lack of agreement about what the intervention should be called, the techniques that should be used and the duration, frequency and expected outcomes of the intervention. Contextual factors such as staff shortages; conflicting priorities; the needs and circumstances of mothers; the capability and motivation of HVs; inadequate training and supervision; and the absence of clear guidance contributed to variations in perceptions and practice. There are many ways in which the HV contribution to the assessment and management of mothers with MHPs could be improved. The intervention delivered by HVs needs to be more clearly articulated. The contextual factors influencing competent and consistent practice also need to be addressed.
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Affiliation(s)
- Catherine Lowenhoff
- Oxford Brookes University, Oxford, UK
- Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, UK
- European Academy of Nursing Studies, Brussels, Belgium
| | | | - Nick Pike
- Oxford Brookes University, Oxford, UK
| | - Jane V Appleton
- Oxford Brookes University, Oxford, UK
- Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, UK
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Catena RD, Campbell N, Wolcott WC, Rothwell SA. Anthropometry, standing posture, and body center of mass changes up to 28 weeks postpartum in Caucasians in the United States. Gait Posture 2019; 70:196-202. [PMID: 30897492 DOI: 10.1016/j.gaitpost.2019.03.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 02/13/2019] [Accepted: 03/11/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Anthropometric models are used when body center of mass motion is calculated for assessment of dynamic balance. It is currently unknown how body segments and posture change in the postpartum period. Therefore, this study was conducted to evaluate the longitudinal changes in anthropometry, center of mass, and standing posture postpartum. METHODS Seventeen pregnant women were tested at nine different times: 16-20 weeks and 36-40 weeks gestation, and then in 4-week intervals from childbirth to 28 weeks postpartum. Anthropometry was measured and then participants conducted a static standing and static laying trial. Force plate data and motion capture data were used in combination with anthropometry to calculate the masses of individual segments and the body center of mass. Change over time was determined through a linear mixed model analysis. RESULTS Anthropometric changes related to the abdomen or fluid retention during pregnancy immediately regress to early pregnancy levels following childbirth. However, other changes related to breast tissue and fat deposits persist postpartum. As such, masses of different segments affect an anthropometric model for center of mass calculation, and body center of mass changes in the lateral and anterior directions postpartum. Vertical body center of mass position was unaffected. SIGNIFICANCE Increased postpartum breast mass may be the cause of persistent lordotic curvature changes in the lumbar spine. There is potential that this affects postpartum back pain. Future research should explore how body center of mass changes postpartum for individuals that do not breast feed, and thus may not have significant breast mass postpartum.
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Affiliation(s)
- Robert D Catena
- Washington State University, 101 Physical Education Building, Pullman, WA, United States.
| | - Nigel Campbell
- Moscow/Pullman OBGYN, 1205 SE Professional Mall Blvd #102, Pullman, WA, United States
| | - W Connor Wolcott
- Washington State University, 101 Physical Education Building, Pullman, WA, United States
| | - Sarah A Rothwell
- Washington State University, 101 Physical Education Building, Pullman, WA, United States
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Tenfelde S, Tell D, Brincat C, Fitzgerald CM. Musculoskeletal Pelvic Pain and Sexual Function in the First Year After Childbirth. J Obstet Gynecol Neonatal Nurs 2018; 48:59-68. [PMID: 30503526 DOI: 10.1016/j.jogn.2018.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2018] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To characterize sexual function in women with and without musculoskeletal pelvic pain during the first year after childbirth. DESIGN Cross-sectional descriptive study. SETTING Outpatient women's health clinic in a Midwestern U.S. academic medical center. PARTICIPANTS Women who gave birth to singleton infants within the past year. METHODS Women were recruited from various outpatient settings. We obtained baseline demographic variables and used selected components from the Wilson and Cleary Health-Related Quality of Life model. Participants completed questionnaires related to sexual health, pain symptoms, and general quality of life. They were asked to indicate their pain on a pain diagram and to quantify it with the use of a numeric rating scale (NRS). Examiners used validated examination techniques to assess pelvic floor muscle tenderness, strength, and pelvic girdle pain. Participants who reported pelvic pain and had at least one positive physical examination finding were classified in the pain group. RESULTS Forty-five participants completed the study, and 20 participants were in the pain group. Most participants with pain had pelvic girdle pain (n = 15) and pelvic floor myofascial pain (n = 20). Participants with pain reported less sexual satisfaction (t[43] = 2.84, p = .007) and reduced quality of life (t[36] = 5.25, p < .001) compared with participants without pain. CONCLUSION Participants who experienced musculoskeletal pelvic pain in the first year after childbirth were significantly more likely to report problems with sexual function compared with their counterparts without pain.
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Séjourné N, De la Hammaide M, Moncassin A, O'Reilly A, Chabrol H. [Study of the relations between the pain of childbirth and postpartum, and depressive and traumatic symptoms]. ACTA ACUST UNITED AC 2018; 46:658-663. [PMID: 29933918 DOI: 10.1016/j.gofs.2018.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Indexed: 10/28/2022]
Abstract
OBJECTIVES This study aims to determine the incidence of pain in childbirth and postpartum on depressive and post-traumatic symptomatology 6weeks after delivery. METHODS One hundred and nine women who gave birth in maternity hospitals of type 2$participated in the study. Two to four days after delivery they have completed five self-administered questionnaires to assess pain of childbirth (QDSA), dramatization of pain (PCS-CF), satisfaction of childbirth (CEQ), peri-traumatic distress (IDP) and depressive symptoms (EPDS) and visual analogue scales to measure immediate postnatal pain. Six weeks after birth they have again completed questionnaires to measure pain (QDSA and visual analogue scales) and depressive symptoms (EPDS) and a scale measuring posttraumatic symptomatology (IES-R). RESULTS The pain of childbirth and immediate postpartum was associated with depressive (r=0.27 and r=0.31 respectively) and traumatic symptomatology (r=0.30 and r=0.34 respectively) in postpartum. Regression analysis, however, revealed that only the depressive symptomatology and the affective dimension of postpartum pain at six weeks post-partum was related to post-traumatic stress. CONCLUSION The results of this study highlight the importance to support the pain of childbirth but also the pain occurring in the postpartum period.
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Affiliation(s)
- N Séjourné
- Centre d'études et de recherches en psychopathologie et psychologie de la santé, université de Toulouse, UT2J, 31058 Toulouse, France.
| | - M De la Hammaide
- Centre d'études et de recherches en psychopathologie et psychologie de la santé, université de Toulouse, UT2J, 31058 Toulouse, France
| | - A Moncassin
- Centre d'études et de recherches en psychopathologie et psychologie de la santé, université de Toulouse, UT2J, 31058 Toulouse, France
| | - A O'Reilly
- Centre d'études et de recherches en psychopathologie et psychologie de la santé, université de Toulouse, UT2J, 31058 Toulouse, France
| | - H Chabrol
- Centre d'études et de recherches en psychopathologie et psychologie de la santé, université de Toulouse, UT2J, 31058 Toulouse, France
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