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Li Y, Yu H, Shen K, Long J. Women's mental health during late pregnancy: A survey conducted in Shandong Province, China. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2024. [PMID: 38959946 DOI: 10.1055/a-2337-4336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/05/2024]
Abstract
BACKGROUND The study aimed to investigate the general mental health status and its associated factors in women during late pregnancy. The objective was to provide a scientific basis for developing psychological interventions tailored to this specific population. METHODS The research was conducted from May 2021 to July 2022, involving the recruitment of 200 women attending maternal and child health clinics for their late-pregnancy checkups. Data collection was carried out using a comprehensive approach, involving several validated tools. The participants completed a general demographic and sociological questionnaire along with four standardized psychological assessment scales: the 12-item General Health Questionnaire (GHQ-12), the Athens Insomnia Scale (AIS-8), the Generalized Anxiety Disorder 7 (GAD-7), and the 9-question Patient Health Questionnaire (PHQ-9). A total of 200 valid questionnaires were collected for analysis. RESULTS The study revealed that the overall prevalence of positive detection of general mental health problems in women during late pregnancy was 11%. Significant differences were observed in the positive detection rate of general mental health status based on various factors such as the quality of relationships with husbands, pregnancy intentions, insomnia, anxiety, and depression (p<0.01). Furthermore, participants with general mental health problems displayed notably higher scores on the AIS-8, PHQ-9, and GAD-7 scales compared to those without such problems (p<0.01). Regression analysis indicated that pregnancy intention and PHQ-9 scores were influential factors affecting the general mental health of women during late pregnancy (p<0.05). CONCLUSION The study highlights high rates of general mental health problems during late pregnancy, with unplanned pregnancy and elevated depression scores as key risk factors. Regular mental health screening and targeted interventions are essential to support women during this critical period and enhance the well-being of both mothers and babies.
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Affiliation(s)
- Yijie Li
- Psychological Clinic, Tianjin Anding Hospital, Tianjin, China
| | - Huihui Yu
- Department of outpatient psychology, Tianjin Anding Hospital, Tianjin, China
| | - Kaifang Shen
- Department of Maternal Medicine, Linyi Maternal and Child Health Hospital, Linyi, China
| | - Jing Long
- Tianjin Anding Hospital, Tianjin, China
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Islam MI, Chaffey OA, Chadwick V, Martiniuk A. Mental health in children conceived by Assisted Reproductive Technologies (ARTs): Insights from a longitudinal study of Australian children. PLoS One 2024; 19:e0304213. [PMID: 38935695 PMCID: PMC11210819 DOI: 10.1371/journal.pone.0304213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 05/08/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND The mental health of children conceived using Assisted Reproductive Technologies (ARTs) such as In-Vitro-Fertilization (IVF) is a subject of significant controversy. Existing studies suggest children conceived through ART meet physical and cognitive developmental milestones at similar rates to their spontaneously conceived peers, however, a significant number of studies have connected ART conception with mental health conditions, particularly depression and attention-deficit hyperactivity disorder (ADHD) in adolescence. This study, therefore, aimed to determine whether maternal use of ARTs to achieve pregnancy is associated with an increased risk of mental disorders in these children, and whether these effects are sex-dependent or confounded by known covariates in the ART population. METHODS Secondary data analysis was performed using Growing Up in Australia: The Longitudinal Study of Australian Children (LSAC) data; a nationally representative population-based cross-sequential cohort study. Multivariate logistic regression models examined the impact of ART (including IVF and other fertility drugs, from LSAC wave-1 and wave-2 conducted in 2004 and 2006, respectively) on mental health outcomes (i.e., autism, ADHD, anxiety and/or depression, from LSAC waves 8 conducted in 2018) in Australian adolescents aged 18-19 years in 2018 (n = 1735). Known sociological and obstetric covariates including maternal age, birth weight, smoking and drinking alcohol during pregnancy, maternal gestational diabetes, postnatal depression, hypertension, and socioeconomic status were considered to generate an adjusted logistic model. Variables with a p-value of <0.05 in the regression models were considered statistically significant. RESULTS Of the 1735 mother-child dyads analysed, the maternal mean age was 35.6 years (Standard deviation = ±4.75), approximately 5% of mothers (n = 89) used ART to become pregnant, and 22% of adolescents (n = 384) had a mental disorder. Longitudinal analysis revealed no relationship between ART and children developing a mental disorder in the LSAC population. CONCLUSION These results should reassure parents considering ART that there is no increased risk of psychological or neurodevelopmental problems in their ART conceived offspring.
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Affiliation(s)
- Md. Irteja Islam
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Research, Innovation and Grants, Spreeha Bangladesh, Dhaka, Bangladesh
- Centre for Health Research, The University of Southern Queensland, Darling Heights, Queensland, Australia
| | - Oscar A. Chaffey
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Verity Chadwick
- Obstetrics and Gynaecology Department, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Alexandra Martiniuk
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- The George Institute for Global Health, Newtown, New South Wales, Australia
- Dalla Lana School of Public Health, The University of Toronto, Toronto, Ontario, Canada
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Gomà M, Arias-Pujol E, Prims E, Ferrer J, Lara S, Glover V, Martinez M, Llairó A, Nanzer N. Internet-based interdisciplinary therapeutic group (Grupo Interdisciplinar Online, GIO) for perinatal anxiety and depression-a randomized pilot study during COVID-19. Arch Womens Ment Health 2024; 27:405-415. [PMID: 38150150 PMCID: PMC11116180 DOI: 10.1007/s00737-023-01412-2] [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: 08/12/2023] [Accepted: 12/09/2023] [Indexed: 12/28/2023]
Abstract
Early interventions may promote reductions in mothers' anxiety-depression (AD) symptoms and improvements in their offspring. This longitudinal randomized research was conducted to assess the effects of interdisciplinary online therapeutic groups (GIO) in at-risk mothers and babies during the COVID-19 pandemic in a disadvantaged neighborhood in Barcelona (Spain). A total of 135 babies were born from March 2020 to June 2021 in a primary healthcare center of Barcelona (Spain). Pregnant woman and new mothers were screened for AD symptomatology through EPDS and STAI questionnaires. Seventy-two of them met high-risk criteria for AD and were included in the study. They were randomly assigned into the two groups of the study: 40 participants were assigned to GIO, the therapeutic group (TG), while 32 of them were assigned to the control group (CG) and received treatment as usual. The course of the mothers' symptomatology was assessed, as well as the baby's development at 6 months old in a blind pediatric follow-up. No differences were found in AD between both groups before the intervention. However, we obtained a significant decrease in AD symptomatology (EPDS p < .001; STAI state p = .015 and STAI trait p < .001at 6 months of life) after the intervention in the TG compared to the CG. Pediatric follow-up at 6 months demonstrated significant differences between groups in babies' development assessment (manipulation p = .003; language p < .001; sociability p < .001). The GIO helped to ensure healthy development of the baby and reduction of the mothers' depressive-anxiety symptomatology.
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Affiliation(s)
- M Gomà
- Faculty of Psychology, Education and Sports Sciences Blanquerna, Ramon Llull University (URL), Barcelona, Spain.
- Department of Perinatal Care, Bruc Salut Clinical Psychology Center, Barcelona, Spain.
| | - E Arias-Pujol
- Faculty of Psychology, Education and Sports Sciences Blanquerna, Ramon Llull University (URL), Barcelona, Spain
| | - E Prims
- Roquetes-Canteres Primary Care Center, Catalan Public Health, Barcelona, Spain
| | - J Ferrer
- Roquetes-Canteres Primary Care Center, Catalan Public Health, Barcelona, Spain
| | - S Lara
- Roquetes-Canteres Primary Care Center, Catalan Public Health, Barcelona, Spain
| | - V Glover
- Institute of Reproductive and Developmental Biology, Imperial College London, London, UK
| | - M Martinez
- Roquetes-Canteres Primary Care Center, Catalan Public Health, Barcelona, Spain
| | - A Llairó
- Faculty of Psychology, Education and Sports Sciences Blanquerna, Ramon Llull University (URL), Barcelona, Spain
- Department of Perinatal Care, Bruc Salut Clinical Psychology Center, Barcelona, Spain
| | - N Nanzer
- Child and Adolescent Psychiatry Service, Geneva University Hospitals, Geneva, Switzerland
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Radoš SN, Akik BK, Žutić M, Rodriguez-Muñoz MF, Uriko K, Motrico E, Moreno-Peral P, Apter G, den Berg MLV. Diagnosis of peripartum depression disorder: A state-of-the-art approach from the COST Action Riseup-PPD. Compr Psychiatry 2024; 130:152456. [PMID: 38306851 DOI: 10.1016/j.comppsych.2024.152456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/26/2023] [Accepted: 01/28/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Peripartum depression (PPD) is a major depression disorder (MDD) episode with onset during pregnancy or within four weeks after childbirth, as defined in DSM-5. However, research suggests that PPD may be a distinct diagnosis. The goal of this study was to summarize the similarities and differences between PPD and MDD by synthesizing the current research on PPD diagnosis concerning different clinical features and give directions for improving diagnosis of PPD in clinical practice. METHODS To lay the groundwork for this narrative review, several databases were searched using general search phrases on PPD and its components of clinical diagnosis. RESULTS When compared to MDD, peripartum depression exhibits several distinct characteristics. PPD manifests with a variety of symptoms, i.e., more anxiety, psychomotor symptoms, obsessive thoughts, impaired concentration, fatigue and loss of energy, but less sad mood and suicidal ideation, compared to MDD. Although PPD and MDD prevalence rates are comparable, there are greater cross-cultural variances for PPD. Additionally, PPD has some distinct risk factors and mechanisms such as distinct ovarian tissue expression, premenstrual syndrome, unintended pregnancy, and obstetric complications. CONCLUSION There is a need for more in-depth research comparing MDD with depression during pregnancy and the entire postpartum year. The diagnostic criteria should be modified, particularly with (i) addition of specific symptoms (i.e., anxiety), (ii) onset specifier extending to the first year following childbirth, (iii) and change the peripartum onset specifier to either "pregnancy onset" or "postpartum onset". Diagnostic criteria for PPD are further discussed.
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Affiliation(s)
- Sandra Nakić Radoš
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | | | - Maja Žutić
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | - Maria F Rodriguez-Muñoz
- Department of Psychology, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | - Kristiina Uriko
- Department of Psychology and Behavioural Sciences, Tallinn University, Tallinn, Estonia
| | - Emma Motrico
- Department of Psychology, Universidad Loyola Andalucia, Seville, Spain
| | - Patricia Moreno-Peral
- Department of Personality, Evaluation and Psychological Treatment, University of Málaga (UMA), Málaga, Spain
| | - Gisèle Apter
- Child and Perinatal Psychiatric Department, Le Havre University Hospital, University Rouen Normandie, Le Havre, France
| | - Mijke Lambregtse-van den Berg
- Departments of Psychiatry and Child & Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands.
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Nawab T, Akram A, Rafat D, Khan T. Antepartum Depression and Its Clinico-Social Correlates: A Cross Sectional Study in a Tertiary Hospital of North India. J Obstet Gynaecol India 2023; 73:247-254. [PMID: 38143973 PMCID: PMC10746677 DOI: 10.1007/s13224-023-01878-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/04/2023] [Indexed: 12/26/2023] Open
Abstract
Background Maternal depression, the second leading cause of disease burden in women worldwide is often under-diagnosed and untreated. It can have consequences for pregnancy outcomes and child health. Objectives (1) To estimate the prevalence of antepartum depression among females attending antenatal clinic of a tertiary hospital. (2) To determine its obstetric and clinico-social correlates. Methods A cross-sectional study was conducted in antenatal clinic by consecutive sampling of 300 pregnant women. We included those in third trimester, aged 18-40 years and giving informed consent and excluded those with pre-diagnosed mental disorders. Pre-tested structured questionnaire and Edinburgh postnatal depression scale used. Score ≥ 10 indicated possible antepartum depression (APD). Chi-square test and logistic regression analysis applied using IBM SPSS version 22.0. P < 0.05 was considered statistically significant. Results Prevalence of possible APD was 23.3%. It was higher among urban females (25.3%) than rural (17.7%) but the difference was not statistically significant. APD increased with increasing maternal age. Other socio-demographic and obstetric factors were not associated significantly with APD. History of recent stressful life event, domestic violence, marital conflict, lack of support from husband, and preference of male child were found to be the significant correlates. Conclusions More than one out of five antenatal females had possible antepartum depression, but none had sought treatment for the same. Antenatal women of higher age and those afflicted with social pathologies are more at risk. Screening for APD should be included in the maternal and child health care programme to address this hidden 'iceberg' disease.
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Affiliation(s)
- Tabassum Nawab
- Department of Community Medicine, J. N. Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh 202002 India
| | - Atia Akram
- Department of Community Medicine, J. N. Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh 202002 India
- Department of Obstetrics and Gynaecology, J. N. Medical College, Aligarh Muslim University, Aligarh, India
| | - Dalia Rafat
- Department of Obstetrics and Gynaecology, J. N. Medical College, Aligarh Muslim University, Aligarh, India
| | - Tamkin Khan
- Department of Obstetrics and Gynaecology, J. N. Medical College, Aligarh Muslim University, Aligarh, India
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Nishigori H, Nishigori T, Suzuki T, Mori M, Yamada M, Isogami H, Murata T, Kyozuka H, Ogata Y, Sato A, Metoki H, Shinoki K, Yasumura S, Hosoya M, Hashimoto K, Fujimori K. Maternal prenatal and postnatal psychological distress trajectories and impact on cognitive development in 4-year-old children: the Japan Environment and Children's Study. J Dev Orig Health Dis 2023; 14:781-794. [PMID: 38327072 DOI: 10.1017/s2040174424000011] [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] [Indexed: 02/09/2024]
Abstract
Maternal prenatal and postnatal psychological distress, including depression and anxiety, may affect children's cognitive development. However, the findings have been inconsistent. We aimed to use the dataset from the Japan Environment and Children's Study, a nationwide prospective birth cohort study, to examine this association. We evaluated the relationship between the maternal six-item version of the Kessler Psychological Distress Scale (K6) scores and cognitive development among children aged 4 years. K6 was administered twice during pregnancy (M-T1; first half of pregnancy, M-T2; second half of pregnancy) and 1 year postpartum (C-1y). Cognitive development was assessed by trained testers, using the Kyoto Scale of Psychological Development 2001. Multiple regression analysis was performed with the group with a K6 score ≤ 4 for both M-T1 and M-T2 and C-1y as a reference. Records from 1,630 boys and 1,657 girls were analyzed. In the group with K6 scores ≥ 5 in both M-T1 and M-T2 and C-1Y groups, boys had significantly lower developmental quotients (DQ) in the language-social developmental (L-S) area (partial regression coefficient: -4.09, 95% confidence interval: -6.88 - -1.31), while girls did not differ significantly in DQ for the L-S area. Among boys and girls, those with K6 scores ≤ 4 at any one or two periods during M-T1, M-T2, or C-1y did not have significantly lower DQ for the L-S area. Persistent maternal psychological distress from the first half of pregnancy to 1 year postpartum had a disadvantageous association with verbal cognitive development in boys, but not in girls aged 4 years.
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Affiliation(s)
- Hidekazu Nishigori
- Department of Development and Environmental Medicine, Fukushima Medical Center for Children and Women, Fukushima Medical University Graduate School of Medicine, Fukushima, Japan
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
| | - Toshie Nishigori
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Taeko Suzuki
- Department of Development and Environmental Medicine, Fukushima Medical Center for Children and Women, Fukushima Medical University Graduate School of Medicine, Fukushima, Japan
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
- Department of Midwifery and Maternal Nursing, Fukushima Medical University School of Nursing, Fukushima, Japan
| | - Miyuki Mori
- Department of Development and Environmental Medicine, Fukushima Medical Center for Children and Women, Fukushima Medical University Graduate School of Medicine, Fukushima, Japan
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
- Department of Midwifery and Maternal Nursing, Fukushima Medical University School of Nursing, Fukushima, Japan
| | - Mika Yamada
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hirotaka Isogami
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tsuyoshi Murata
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hyo Kyozuka
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yuka Ogata
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
| | - Akiko Sato
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
| | - Hirohito Metoki
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Kosei Shinoki
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
| | - Seiji Yasumura
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Mitsuaki Hosoya
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Koichi Hashimoto
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Keiya Fujimori
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
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O'Dea GA, Youssef GJ, Hagg LJ, Francis LM, Spry EA, Rossen L, Smith I, Teague SJ, Mansour K, Booth A, Davies S, Hutchinson D, Macdonald JA. Associations between maternal psychological distress and mother-infant bonding: a systematic review and meta-analysis. Arch Womens Ment Health 2023:10.1007/s00737-023-01332-1. [PMID: 37316760 DOI: 10.1007/s00737-023-01332-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 05/20/2023] [Indexed: 06/16/2023]
Abstract
PURPOSE Maternal psychological distress and mother-infant bonding problems each predict poorer offspring outcomes. They are also related to each other, yet the extensive literature reporting their association has not been meta-analysed. METHODS We searched MEDLINE, PsycINFO, CINAHL, Embase, ProQuest DTG, and OATD for English-language peer-reviewed and grey literature reporting an association between mother-infant bonding, and multiple indicators of maternal psychological distress. RESULTS We included 133 studies representing 118 samples; 99 samples (110,968 mothers) were eligible for meta-analysis. Results showed concurrent associations across a range of timepoints during the first year postpartum, between bonding problems and depression (r = .27 [95% CI 0.20, 0.35] to r = .47 [95% CI 0.41, 0.53]), anxiety (r = .27 [95% CI 0.24, 0.31] to r = .39 [95% CI 0.15, 0.59]), and stress (r = .46 [95% CI 0.40, 0.52]). Associations between antenatal distress and subsequent postpartum bonding problems were mostly weaker and with wider confidence intervals: depression (r = .20 [95% CI 0.14, 0.50] to r = .25 [95% CI 0.64, 0.85]), anxiety (r = .16 [95% CI 0.10, 0.22]), and stress (r = .15 [95% CI - 0.67, 0.80]). Pre-conception depression and anxiety were associated with postpartum bonding problems (r = - 0.17 [95% CI - 0.22, - 0.11]). CONCLUSION Maternal psychological distress is associated with postpartum mother-infant bonding problems. Co-occurrence of psychological distress and bonding problems is common, but should not be assumed. There may be benefit in augmenting existing perinatal screening programs with well-validated mother-infant bonding measures.
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Affiliation(s)
- Gypsy A O'Dea
- School of Psychology, Centre for Social and Emotional Early Development, Deakin University, Geelong, Australia.
| | - George J Youssef
- School of Psychology, Centre for Social and Emotional Early Development, Deakin University, Geelong, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
| | - Lauryn J Hagg
- School of Psychology, Centre for Social and Emotional Early Development, Deakin University, Geelong, Australia
| | - Lauren M Francis
- School of Psychology, Centre for Social and Emotional Early Development, Deakin University, Geelong, Australia
| | - Elizabeth A Spry
- School of Psychology, Centre for Social and Emotional Early Development, Deakin University, Geelong, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Larissa Rossen
- Counselling Psychology Department, Trinity Western University, Langley Township, BC, Canada
| | - Imogene Smith
- School of Psychology, Centre for Social and Emotional Early Development, Deakin University, Geelong, Australia
| | - Samantha J Teague
- School of Psychology, Centre for Social and Emotional Early Development, Deakin University, Geelong, Australia
- Division of Tropical Health and Medicine, Department of Psychology, College of Healthcare Sciences, James Cook University, Townsville, Australia
| | - Kayla Mansour
- School of Psychology, Centre for Social and Emotional Early Development, Deakin University, Geelong, Australia
| | - Anna Booth
- La Trobe University, School of Psychology and Public Health, The Bouverie Centre, Brunswick, Australia
| | - Sasha Davies
- School of Psychology, Centre for Social and Emotional Early Development, Deakin University, Geelong, Australia
- Faculty of Psychology, Counselling, and Psychotherapy, The Cairnmillar Institute, Hawthorn East, Australia
| | - Delyse Hutchinson
- School of Psychology, Centre for Social and Emotional Early Development, Deakin University, Geelong, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Jacqui A Macdonald
- School of Psychology, Centre for Social and Emotional Early Development, Deakin University, Geelong, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
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Westgate V, Manchanda T, Maxwell M. Women's experiences of care and treatment preferences for perinatal depression: a systematic review. Arch Womens Ment Health 2023; 26:311-319. [PMID: 37147447 DOI: 10.1007/s00737-023-01318-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 04/11/2023] [Indexed: 05/07/2023]
Abstract
Understanding women's experiences of care, and treatment preferences, is vital for delivering acceptable and useful services to women with perinatal depression. This systematic review synthesises evidence on care and treatment preferences of women with perinatal depression. This qualitative evidence synthesis uses systematic review methodology. Medline, PsychINFO, CINAHL and EMBASE were searched from January 2011 to October 2021. Search terms fell into five categories: depression, the perinatal period, treatment preferences, experiences of care and qualitative research. Study quality was assessed and thematic analysis was used to synthesise findings. Thirteen papers met the inclusion criteria. Quality of included papers was of moderate to high quality. Five key themes were identified: women prioritise family needs; perinatal-specific care; when care falls short; professional empathy; and tailored care. Clinicians need to enable mothers to prioritise their own well-being. Service providers should ensure that treatment is tailored to the specifics of the perinatal period, providing specialist advice around medication, and therapy that fits with the demands of caring for a new baby.
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Affiliation(s)
| | | | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
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Hu L, Mei H, Feng H, Huang Y, Cai X, Xiang F, Chen L, Xiao H. Exposure to bisphenols, parabens and phthalates during pregnancy and postpartum anxiety and depression symptoms: Evidence from women with twin pregnancies. ENVIRONMENTAL RESEARCH 2023; 221:115248. [PMID: 36623682 DOI: 10.1016/j.envres.2023.115248] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/15/2022] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Women are vulnerable to suffer from the common mental disorders like anxiety and depression during the postpartum period. Exposure to bisphenols, parabens, and phthalates has been linked to anxiety and depression symptoms in the general population. However, little is known about their impacts on postpartum women. OBJECTIVE To evaluate the effects of individual and joint exposure to 11 nonpersistent chemicals during pregnancy on postpartum anxiety and depression. METHODS Among 278 mothers from the Wuhan Twin Birth Cohort (WTBC), bisphenols, parabens, and phthalate metabolites were measured in maternal urine samples from each trimester. Self-rating Anxiety Scale (SAS) and Edinburgh Postnatal Depression Scale (EPDS) were administrated at early pregnancy and 1 month and 6 months postpartum to determine anxiety and depression symptoms, respectively. Associations between urinary chemical biomarkers (individual or mixtures) and anxiety and depression symptoms were estimated using multiple informant model and quantile-based g-computation. RESULTS With adjustment for confounders, one quartile increase in the overall chemical mixture (bisphenols, parabens and phthalate metabolites) during the second trimester was associated with 1.03-point (95% CI: 0.07, 1.99, P = 0.036) higher EPDS score at 1 month postpartum, in which bisphenol A (BPA) and bisphenol F (BPF) contributed the most to the positive association. Consistent effects were also observed in the multiple informant models. We found that second-trimester BPA and BPF exposure individually showed the strongest and significant associations with anxiety and depression symptoms, and some of associations differed across trimesters (Ptrimester-int < 0.05). CONCLUSIONS Second-trimester nonpersistent chemical exposure was associated with increased postpartum anxiety and depression symptoms.
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Affiliation(s)
- Liqin Hu
- Institute of Maternal and Child Health, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Hong Mei
- Institute of Maternal and Child Health, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Huan Feng
- Department of Obstetrics, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Yufang Huang
- Department of Obstetrics, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Xiaonan Cai
- Institute of Maternal and Child Health, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Feiyan Xiang
- Institute of Maternal and Child Health, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Luyi Chen
- Maternal Health Care Department, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.
| | - Han Xiao
- Institute of Maternal and Child Health, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.
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10
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Dachew BA, Heron JE, Alati R. Parental depressive symptoms across the first three years of a child's life and emotional and behavioural problem trajectories in children and adolescents. J Psychiatr Res 2023; 159:135-144. [PMID: 36716565 DOI: 10.1016/j.jpsychires.2023.01.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 11/22/2022] [Accepted: 01/10/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND The risk associated with parental perinatal depressive symptoms and the continuum of emotional and behavioural problems in offspring is unclear. This study aimed to investigate the association between maternal and paternal perinatal depressive symptoms and behavioural problem trajectories in offspring aged 3-16 years. METHODS We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC) in Bristol, Avon, United Kingdom (UK). Parental perinatal depressive symptoms in the first three years of a child's life were measured using the Edinburgh Postnatal Depression Scale (EPDS). Offspring emotional- and behavioural problems were measured using the Strengths and Difficulties Questionnaire (SDQ) when the child was 3.5, 7, 9, 11, and 16 years. A group-based trajectory modelling was used to identify the distinct trajectories of emotional and behavioural problems. Multinomial logistic regression analyses were used to examine associations, and z-scores were calculated to compare maternal and paternal associations. RESULTS We identified three trajectories of emotional and behavioural problems in offspring between the ages of 3.5 and 16: low, moderate and high symptom trajectories. We found that maternal and paternal antenatal and postnatal depressive symptoms were associated with high levels of emotional and behavioural problem trajectories in offspring. We also found that children exposed to maternal (adjusted RR = 8.11; 95% CI: 5.26-12.48) and paternal (adjusted RR = 2.32; 1.05-5.14) persistent depressive symptoms were more likely to be in high levels of total behavioural problem trajectory group than in the normal trajectory group. The maternal-effect was stronger (p < 0.001). CONCLUSION Our findings suggest that exposure to parental depressive symptoms were associated with high levels of emotional and behavioural problem trajectories in offspring, with the maternal effect being stronger than the paternal effect.
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Affiliation(s)
| | - Jon E Heron
- Department of Population Health Sciences, University of Bristol, Bristol, UK
| | - Rosa Alati
- School of Population Health, Curtin University, Perth, Australia; Institute for Social Science Research, The University of Queensland, Brisbane, Australia
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11
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Wang H, Ren T, Zhang N, Xia W, Xiang M, Ran J, Zhang J. Poly- and perfluoroalkyl substances exposure during pregnancy and postpartum depression: Evidence from the Shanghai birth cohort. CHEMOSPHERE 2023; 318:137941. [PMID: 36702402 DOI: 10.1016/j.chemosphere.2023.137941] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/19/2023] [Accepted: 01/21/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Exposure to poly-and perfluoroalkyl substances (PFASs) has been linked to psychiatric disorders in the general population. Because women in the postpartum period are susceptible to mental disorders, we aimed to investigate the association between exposure to PFASs during pregnancy and postpartum depression (PPD). METHODS Our study consisted of 2741 pregnant women who were enrolled in the Shanghai Birth Cohort during the early pregnancy and gave birth to a singleton live birth between 2013 and 2016. A total of 10 PFASs were measured in maternal plasma collected in early gestation by high-performance liquid chromatography/tandem mass spectrometry. PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS) at 42 days after the child birth. We used multivariable logistic regression to estimate the association between exposure to PFASs and PPD, adjusted for potential confounders. Negative binomial regression was used to assess the association between PFASs exposure during pregnancy and EPDS subscales including anhedonia, anxiety, and depression. A quantile-based g-computation approach was used to evaluate the joint and independent effects of PFASs on PPD. RESULTS Around 11.7% of the mothers had probable PPD (EPDS cut-off ≥10). Overall, exposure to PFASs in early pregnancy was not associated with PPD or EPDS subscales. Quantile g-computation method also showed that increasing PFASs mixture by one quartile was not associated with PPD (odds ratio, 1.08; 95% confidence interval: 0.91, 1.29). CONCLUSION Our findings indicate that exposure to PFASs during pregnancy was not associated with PPD at 6 weeks postpartum.
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Affiliation(s)
- Hui Wang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Tai Ren
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Na Zhang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiping Xia
- Department of Medical Psychology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, China
| | - Mi Xiang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jinjun Ran
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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12
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McGovern M, Rokicki S, Von Jaglinsky A, Reichman NE. Neighborhood-level housing affordability and maternal depression. SSM - MENTAL HEALTH 2023. [DOI: 10.1016/j.ssmmh.2023.100192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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13
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Maternal prenatal psychological distress and motor/cognitive development in two-year-old offspring: The Japan Environment and Children's Study. J Dev Orig Health Dis 2023; 14:389-401. [PMID: 36650740 DOI: 10.1017/s2040174422000691] [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] [Indexed: 01/19/2023]
Abstract
Maternal prenatal psychological distress, including depression and anxiety, may affect offspring's motor/cognitive development. However, research findings have been inconsistent. We used a dataset from the Japan Environment and Children's Study to evaluate associations between maternal six-item Kessler Psychological Distress Scale (K6) scores and motor/cognitive development among offspring at two years of age. Their offspring's motor/cognitive development was assessed using the Kyoto Scale of Psychological Development 2001. Records for 1859 male and 1817 female offspring were analyzed. The maternal K6 was administered twice during pregnancy: at a median of 14.6 weeks (M-T1) and 27.3 weeks (M-T2) of gestation. Multiple regression analysis was performed with the group with K6 scores ≤4 at both M-T1 and M-T2 as a reference. In the group with K6 scores ≥5 at both M-T1 and M-T2, male offspring had significantly lower developmental quotients (DQ) in the posture-motor area (partial regression coefficient [B]: -3.68, 95% confidence interval [CI]: -5.92 to -1.44) and language-social area (B: -1.93; 95%CI: -3.73 to -0.12), while female offspring had a lower DQ for the language-social area (B: -1.95; 95%CI: -3.73 to -0.17). In those with K6 scores ≥5 only at M-T1 or M-T2, male and female offspring did not differ significantly in DQ for any area. Continuous maternal psychological distress from the first to the second half of pregnancy was associated with lower motor and verbal cognitive development in male offspring and lower verbal cognitive development in female offspring at 2 years compared with the group without persistent maternal prenatal psychological distress.
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14
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Feng SV, van den Boom W, De Iorio M, Thng GJ, Chan JKY, Chen HY, Tan KH, Kee MZL. Joint modelling of mental health markers through pregnancy: a Bayesian semi-parametric approach. J Appl Stat 2023; 51:388-405. [PMID: 38283054 PMCID: PMC10810649 DOI: 10.1080/02664763.2022.2154329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 09/23/2022] [Indexed: 01/14/2023]
Abstract
Maternal depression and anxiety through pregnancy have lasting societal impacts. It is thus crucial to understand the trajectories of its progression from preconception to postnatal period, and the risk factors associated with it. Within the Bayesian framework, we propose to jointly model seven outcomes, of which two are physiological and five non-physiological indicators of maternal depression and anxiety over time. We model the former two by a Gaussian process and the latter by an autoregressive model, while imposing a multidimensional Dirichlet process prior on the subject-specific random effects to account for subject heterogeneity and induce clustering. The model allows for the inclusion of covariates through a regression term. Our findings reveal four distinct clusters of trajectories of the seven health outcomes, characterising women's mental health progression from before to after pregnancy. Importantly, our results caution against the loose use of hair corticosteroids as a biomarker, or even a causal factor, for pregnancy mental health progression. Additionally, the regression analysis reveals a range of preconception determinants and risk factors for depressive and anxiety symptoms during pregnancy.
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Affiliation(s)
| | - Willem van den Boom
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Agency for Science, Technology and Research, Singapore Institute for Clinical Sciences, Singapore, Singapore
| | - Maria De Iorio
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Agency for Science, Technology and Research, Singapore Institute for Clinical Sciences, Singapore, Singapore
- Department of Statistical Science, University College London, London, UK
| | - Gladi J. Thng
- Agency for Science, Technology and Research, Singapore Institute for Clinical Sciences, Singapore, Singapore
| | - Jerry K. Y. Chan
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Helen Y. Chen
- Duke-NUS Medical School, Singapore, Singapore
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Kok Hian Tan
- Duke-NUS Medical School, Singapore, Singapore
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Michelle Z. L. Kee
- Agency for Science, Technology and Research, Singapore Institute for Clinical Sciences, Singapore, Singapore
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15
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Morales-Munoz I, Ashdown-Doel B, Beazley E, Carr C, Preece C, Marwaha S. Maternal postnatal depression and anxiety and the risk for mental health disorders in adolescent offspring: Findings from the Avon Longitudinal Study of Parents and Children cohort. Aust N Z J Psychiatry 2023; 57:82-92. [PMID: 35234057 PMCID: PMC9791327 DOI: 10.1177/00048674221082519] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The impacts of postnatal psychiatric disorders on different types of mental health problems in offspring are unclear. We investigated the prospective associations of maternal postnatal depression, and anxiety, with offspring depression, anxiety, psychotic-like experiences and Borderline Personality Disorder symptoms, in adolescence, and examined whether these were independent of each other. METHODS Data were obtained from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. Maternal postnatal depression and anxiety at 8 weeks were measured using the Edinburgh Postnatal Depression Scale and Crown-Crisp Index, respectively. Offspring mental health outcomes were measured at 10-13 years old, using a variety of questionnaire-based and interview assessments. Logistic regression analyses were used to assess the associations between maternal postnatal risk factors and offspring mental health, and path analysis was used to investigate the pathways of maternal postnatal factors to adolescent offspring outcomes. RESULTS Data were available for 14,054 mothers with information reported on postnatal depression and 13,892 on postnatal anxiety. Logistic regression analyses found significant associations between maternal postnatal depression and offspring anxiety at 10 years old (odds ratio = 1.039, 95% confidence interval = [1.005, 1.073], p = 0.022) and between maternal postnatal anxiety and offspring psychotic experiences at 12/13 years old (odds ratio = 1.042, 95% confidence interval = [1.008, 1.077], p = 0.016). These significant associations remained after applying path analyses, when we controlled for potential offspring psychopathological overlay. CONCLUSION These findings suggest that mothers with postnatal depression are more likely to have offspring with anxiety at 10 years old, and that mothers with postnatal anxiety are more likely to have offspring with psychotic experiences at 12/13 years old. Our findings suggest specific pathways in the association between postnatal anxiety/depression and offspring mental health and contribute to the importance of identifying mothers and their offspring with increased vulnerability to adverse outcomes resulting from postnatal mental health disorders.
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Affiliation(s)
- Isabel Morales-Munoz
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK,Department of Public Health Solutions, Finnish Institute for Health and Welfare (THL), Helsinki, Finland,Isabel Morales-Muñoz, Institute for Mental Health, School of Psychology, University of Birmingham, 52 Pritchattss Road, Birmingham B15 2SA, UK.
| | - Brooklyn Ashdown-Doel
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Emily Beazley
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Camilla Carr
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Cristina Preece
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Steven Marwaha
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK,Specialist Mood Disorders Clinic, Birmingham and Solihull Mental Health NHS Trust, Birmingham, UK
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16
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Guo J, Li X, He J, Ai M, Gan Y, Zhang Q, Zheng A, Chen W, Chen L, Liang S, Yu X, Kuang L. A propensity score matching study: The prevalence of mental health problems among pregnant women at first antenatal care increased in Chongqing during the first wave of the COVID-19 pandemic. Front Public Health 2023; 11:1142461. [PMID: 37124799 PMCID: PMC10140498 DOI: 10.3389/fpubh.2023.1142461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/13/2023] [Indexed: 05/02/2023] Open
Abstract
Background The 2019 coronavirus disease (COVID-19) pandemic increased the risks of mental health challenges, especially anxiety and depression. However, the impact of COVID-19 on mental health during pregnancy has not been fully established. Therefore, we investigated the impact of the COVID-19 pandemic on maternal mental health. Methods Two cohorts of pregnant women at their first antenatal care in the First Affiliated Hospital of Chongqing Medical University were enrolled in this study. One cohort was enrolled before the COVID-19 outbreak, from 1 June to 31 December 2019 (n = 5,728, pre-COVID-19 group), while the other was enrolled during the COVID-19 pandemic, from 24 January to 23 March 2020 (n = 739, COVID-19 pandemic group). Symptoms of depression, anxiety, and somatization disorders were assessed by the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-15 (PHQ-15), with a cutoff point of 10 for moderate-to-severe depression, anxiety, and somatoform symptoms. The propensity score matching method (1:1) was used to balance differences in demographic characteristics between groups. A chi-square analysis was performed to compare differences in demographic characteristics between the groups. Results Prevalence of moderate-to-severe depression, anxiety, and somatoform symptoms among pregnant women at their first antenatal care visit during the COVID-19 pandemic (9.5, 2.2, and 20.8%, respectively) was significantly lower than those before the pandemic (16.3, 4.4, and 25.7%, respectively) (p < 0.05). Compared with the same period before the pandemic, during the pandemic, the number of women newly registered for antenatal care decreased by nearly 50%. There were significant differences in the distributions of demographic characteristics between the groups (p < 0.05). After matching the demographic characteristics, differences in the prevalence of maternal mental health disorders between the groups reversed dramatically. Prevalence of moderate-to-severe depression, anxiety, and somatoform symptoms during the COVID-19 pandemic in this population (2.3, 9.6, and 20.8%, respectively) was significantly higher than those before the pandemic (0.3, 3.9, and 10%, respectively) (p < 0.05). Conclusion The COVID-19 pandemic increased mental health risks among pregnant women. As a large proportion of pregnant women with mental health challenges delay their prenatal care or change healthcare facilities after the outbreak of public health emergencies, there is a need to establish a balanced healthcare system in medical institutions at all levels.
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Affiliation(s)
- Jiamei Guo
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiao Li
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jinglan He
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ming Ai
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yao Gan
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qi Zhang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Anhai Zheng
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wanjun Chen
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lulu Chen
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Sisi Liang
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoyu Yu
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li Kuang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Li Kuang,
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17
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Szpunar MJ, Freeman MP, Kobylski LA, Caplin PS, Gaccione P, Viguera AC, Chitayat D, Hernández-Díaz S, Cohen LS. Risk of major malformations in infants after first-trimester exposure to benzodiazepines: Results from the Massachusetts General Hospital National Pregnancy Registry for Psychiatric Medications. Depress Anxiety 2022; 39:751-759. [PMID: 35909254 DOI: 10.1002/da.23280] [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: 01/21/2022] [Revised: 05/05/2022] [Accepted: 06/27/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Perinatal anxiety affects 20% of women, and untreated maternal mental illness can cause deleterious effects for women and their children. Benzodiazepines are commonly used to treat anxiety disorders. The reported risk of congenital malformations after in utero benzodiazepine exposure has been inconsistent. METHODS The Massachusetts General Hospital National Pregnancy Registry for Psychiatric Medications prospectively enrolls pregnant women with psychiatric illness who take one or more psychiatric medications. Participants are interviewed twice during pregnancy and at 12 weeks postpartum. Women taking any benzodiazepine during the first trimester of pregnancy were compared with a group of women taking psychiatric medication(s) other than benzodiazepines during pregnancy. RESULTS A total of 1053 women were eligible for this analysis; N = 151 women who had taken a benzodiazepine during the first trimester, and the comparison group was N = 902 women. There were 5 (3.21%) major malformations in the exposure group and 32 (3.46%) in the comparison group (odds ratio 0.92; 95% confidence interval 0.35-2.41). CONCLUSION This ongoing pregnancy registry offers reassurance that benzodiazepines do not appear to have major teratogenic effects. The precision of relative risk estimate will improve as the number of participants increases. This and other pregnancy registries will better inform the reproductive safety of benzodiazepines.
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Affiliation(s)
- Mercedes J Szpunar
- Ammon-Pinizzotto Center for Women's Mental Health, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Marlene P Freeman
- Ammon-Pinizzotto Center for Women's Mental Health, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Lauren A Kobylski
- Ammon-Pinizzotto Center for Women's Mental Health, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Phoebe S Caplin
- Ammon-Pinizzotto Center for Women's Mental Health, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Peter Gaccione
- Ammon-Pinizzotto Center for Women's Mental Health, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Adele C Viguera
- Ammon-Pinizzotto Center for Women's Mental Health, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA.,Cleveland Clinic, Cleveland Clinical Neurological Institute, Cleveland, Ohio, USA
| | - David Chitayat
- Prenatal Diagnosis and Medical Genetic Program, Mount Sinai Hospital, Toronto, Ontario, Canada, USA
| | | | - Lee S Cohen
- Ammon-Pinizzotto Center for Women's Mental Health, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
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18
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Gastaldon C, Solmi M, Correll CU, Barbui C, Schoretsanitis G. Risk factors of postpartum depression and depressive symptoms: umbrella review of current evidence from systematic reviews and meta-analyses of observational studies. Br J Psychiatry 2022; 221:591-602. [PMID: 35081993 DOI: 10.1192/bjp.2021.222] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Evidence on risk factors for postpartum depression (PPD) are fragmented and inconsistent. AIMS To assess the strength and credibility of evidence on risk factors of PPD, ranking them based on the umbrella review methodology. METHOD Databases were searched until 1 December 2020, for systematic reviews and meta-analyses of observational studies. Two reviewers assessed quality, credibility of associations according to umbrella review criteria (URC) and evidence certainty according to Grading of Recommendations-Assessment-Development-Evaluations criteria. RESULTS Including 185 observational studies (n = 3 272 093) from 11 systematic reviews, the association between premenstrual syndrome and PPD was the strongest (highly suggestive: odds ratio 2.20, 95%CI 1.81-2.68), followed by violent experiences (highly suggestive: odds ratio (OR) = 2.07, 95%CI 1.70-2.50) and unintended pregnancy (highly suggestive: OR=1.53, 95%CI 1.35-1.75). Following URC, the association was suggestive for Caesarean section (OR = 1.29, 95%CI 1.17-1.43), gestational diabetes (OR = 1.60, 95%CI 1.25-2.06) and 5-HTTPRL polymorphism (OR = 0.70, 95%CI 0.57-0.86); and weak for preterm delivery (OR = 2.12, 95%CI 1.43-3.14), anaemia during pregnancy (OR = 1.47, 95%CI 1.17-1.84), vitamin D deficiency (OR = 3.67, 95%CI 1.72-7.85) and postpartum anaemia (OR = 1.75, 95%CI 1.18-2.60). No significant associations were found for medically assisted conception and intra-labour epidural analgesia. No association was rated as 'convincing evidence'. According to GRADE, the certainty of the evidence was low for Caesarean section, preterm delivery, 5-HTTLPR polymorphism and anaemia during pregnancy, and 'very low' for remaining factors. CONCLUSIONS The most robust risk factors of PDD were premenstrual syndrome, violent experiences and unintended pregnancy. These results should be integrated in clinical algorithms to assess the risk of PPD.
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Affiliation(s)
- Chiara Gastaldon
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Italy; and Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, New York, USA
| | - Marco Solmi
- Department of Neuroscience, University of Padua, Italy; and Padua Neuroscience Center, University of Padua, Italy
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, New York, USA; Department of Psychiatry and Molecular Medicine, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA; Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, New York, USA; and Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Germany
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Italy
| | - Georgios Schoretsanitis
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, New York, USA; and Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
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19
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Freeman MP, Szpunar MJ, Kobylski LA, Harmon H, Viguera AC, Cohen LS. Pregnancy outcomes after first-trimester exposure to buspirone: prospective longitudinal outcomes from the MGH National Pregnancy Registry for Psychiatric Medications. Arch Womens Ment Health 2022; 25:923-928. [PMID: 35840767 DOI: 10.1007/s00737-022-01250-8] [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: 03/23/2022] [Accepted: 07/07/2022] [Indexed: 11/25/2022]
Abstract
Buspirone is commonly used to treat anxiety disorders among reproductive-aged women. To date, the reproductive safety of buspirone in humans has been particularly sparse. We sought to provide preliminary data from the Massachusetts General Hospital National Pregnancy Registry for Psychiatric Medications (NPRPM) on the risk of major malformations after first-trimester buspirone exposure. The NPRPM enrolls pregnant women with psychiatric disorders to prospectively assess for major congenital malformations after in utero exposure to psychotropics. Women are interviewed twice during pregnancy and once at 12 weeks postpartum. Data regarding women who took buspirone during the first trimester were extracted from the NPRPM database. Data were assessed as a rigorously ascertained case series to determine the incidence of major malformations among those exposed to buspirone. The primary outcome was obtained by maternal postpartum interview and medical record review. As of January 6, 2022, N = 97 women enrolled in the registry took buspirone during their first trimester. Of these women, 68 were evaluable and eligible for this analysis. Four women had twins, resulting in 72 infants. Among this sample, there were no malformations present. These preliminary data represent the only prospectively ascertained sample of pregnancy outcomes after first-trimester buspirone exposure. Albeit a small sample, no major malformations were observed in this cohort. The rigorous prospective ascertainment of outcomes is a strength of this study. Future analyses are planned that will include larger numbers of women with exposures to buspirone and comparison with control groups matched for demographic and diagnostic variables.
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Affiliation(s)
- Marlene P Freeman
- Massachusetts General Hospital, Ammon Pinizzotto Center for Women's Mental Health, Boston, MA, USA.
| | - Mercedes J Szpunar
- Massachusetts General Hospital, Ammon Pinizzotto Center for Women's Mental Health, Boston, MA, USA
| | - Lauren A Kobylski
- Massachusetts General Hospital, Ammon Pinizzotto Center for Women's Mental Health, Boston, MA, USA
| | - Heather Harmon
- Massachusetts General Hospital, Ammon Pinizzotto Center for Women's Mental Health, Boston, MA, USA
| | - Adele C Viguera
- Massachusetts General Hospital, Ammon Pinizzotto Center for Women's Mental Health, Boston, MA, USA.,Cleveland Clinic, Cleveland Clinic Neurological Institute, Cleveland, OH, USA
| | - Lee S Cohen
- Massachusetts General Hospital, Ammon Pinizzotto Center for Women's Mental Health, Boston, MA, USA
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20
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McGovern ME, Rokicki S, Reichman NE. Maternal depression and economic well-being: A quasi-experimental approach. Soc Sci Med 2022; 305:115017. [PMID: 35605471 DOI: 10.1016/j.socscimed.2022.115017] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/17/2022] [Accepted: 05/05/2022] [Indexed: 11/19/2022]
Abstract
Maternal depression is associated with adverse impacts on the health of women and their children. However, further evidence is needed on the extent to which maternal depression influences women's economic well-being and how unmeasured confounders affect estimates of this relationship. In this study, we aimed to measure the association between maternal depression and economic outcomes (income, employment, and material hardship) over a 15-year time horizon. We conducted longitudinal analyses using the Fragile Families and Child Wellbeing Study, an urban birth cohort study in the United States. We assessed the potential contribution of time-invariant unmeasured confounders using a quasi-experimental approach and also investigated the role of persistent versus transient depressive symptoms on economic outcomes up to 15 years after childbirth. In models that adjusted for time-invariant unmeasured confounders, maternal depression was associated with not being employed (an adjusted risk difference of 3 percentage points (95% CI 0.01 to 0.05)) and experiencing any material hardship (an adjusted risk difference of 14 percentage points (95% CI 0.12 to 0.16)), as well as with reductions in the ratio of household income to poverty by 0.10 units (95% CI -0.16 to -0.04) and annual household income by $2114 (95% CI -$3379 to -$850). Impacts at year 15 were strongest for those who experienced persistent depression. Results of our study strengthen the case for viewing mental health support services as interventions that may also foster economic well-being, and highlight the importance of including economic impacts in assessments of the cost-effectiveness of mental health interventions.
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Affiliation(s)
- Mark E McGovern
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, USA
| | - Slawa Rokicki
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, USA; Geary Institute for Public Policy, University College Dublin, Dublin, Ireland.
| | - Nancy E Reichman
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA; Child Health Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA; Princeton University, Princeton, NJ, USA
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21
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Bradshaw H, Riddle JN, Salimgaraev R, Zhaunova L, Payne JL. Risk factors associated with postpartum depressive symptoms: A multinational study. J Affect Disord 2022; 301:345-351. [PMID: 34979186 DOI: 10.1016/j.jad.2021.12.121] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 12/03/2021] [Accepted: 12/30/2021] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To evaluate the association between maternal age, parity, gestational number (singleton vs twin), newborn gender and self-reported postpartum depressive symptoms (PDS) in a large multinational sample using survey data from a digital telephone application. METHODS Women using the Flo app answered a survey (available in 10 languages) from January 2018 to April 2020. A survey question asking about emotional state was used to determine the presence of PDS. Chi-squared statistics were used to compare groups. A weighted mean prevalence was calculated based upon the socioeconomic status and reproductive population of each country in 2020. RESULTS Over a million women from 138 countries participated. Of all respondents, 9.4% endorsed PDS. The weighted mean prevalence of PDS was 11%. We found that PDS decreased with advancing age. First-time mothers reported higher rates of PDS. Twin births were associated with a higher symptom burden than singleton births and mothers of twins in the oldest age group reported the greatest burden. We did not find a clinically significant difference in rates of PDS between mothers of singleton girls and boys. CONCLUSIONS To our knowledge, this study is the first to examine risk factors for postpartum symptoms using the same survey across a large international population. These results can further research and clinical aims to identify and treat maternal depression more effectively. LIMITATIONS Data was aggregated, thereby limiting analysis of individual associations. The survey was self-report and not diagnostic for postpartum depression. Generalizability of risks of postpartum depression should be approached with caution.
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Affiliation(s)
- Helen Bradshaw
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Women's Mood Disorders Center, 550 North Broadway, Suite 305, Baltimore, MD 21025, USA
| | - Julia N Riddle
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Women's Mood Disorders Center, 550 North Broadway, Suite 305, Baltimore, MD 21025, USA
| | - Rodion Salimgaraev
- Flo Health, Inc. 1013 Centre Road, Suite 403-B, Wilmington, DE, 19805, USA
| | - Liudmila Zhaunova
- Flo Health, Inc. 1013 Centre Road, Suite 403-B, Wilmington, DE, 19805, USA
| | - Jennifer L Payne
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Women's Mood Disorders Center, 550 North Broadway, Suite 305, Baltimore, MD 21025, USA; Department of Psychiatry and Neurobehavioral Sciences, Reproductive Pschiatry Research Program, PO Box 800548, Charlottesville, VA 22908.
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22
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Rokicki S, McGovern M, Von Jaglinsky A, Reichman NE. Depression in the Postpartum Year and Life Course Economic Trajectories. Am J Prev Med 2022; 62:165-173. [PMID: 34696940 PMCID: PMC8748295 DOI: 10.1016/j.amepre.2021.08.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/02/2021] [Accepted: 08/05/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Perinatal depression affects 13% of childbearing individuals in the U.S. and has been linked to an increased risk of household economic insecurity in the short term. This study aims to assess the relationship between perinatal depression and long-term economic outcomes. METHODS This was a longitudinal analysis of a cohort of mothers from the Fragile Families and Child Wellbeing Study starting at delivery in 1998-2000 and followed until 2014-2017. Analysis was conducted in 2021. Maternal depression was assessed using the Composite International Diagnostic Interview-Short Form 1 year after childbirth, and the outcomes included measures of material hardship, household poverty, and employment. Associations between maternal depression and outcomes were analyzed using logistic regression and group-based trajectory modeling. RESULTS In total, 12.2% of the sample met the criteria for a major depressive episode 1 year after delivery. Maternal depression had a strong and sustained positive association with material hardship and not working for pay in Years 3, 5, 9, and 15 after delivery. Maternal depression also had a significant positive association with household poverty across Years 3-9 and with unemployment in Year 3. Trajectory modeling established that maternal depression was associated with an increased probability of being in a persistently high-risk trajectory for material hardship, a high-risk trajectory for household poverty, and a high-declining risk trajectory for unemployment. CONCLUSIONS Supporting perinatal mental health is crucial for strengthening the economic well-being of childbearing individuals and reducing the impact of maternal depression on intergenerational transmission of adversity.
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Affiliation(s)
- Slawa Rokicki
- From the Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey
| | - Mark McGovern
- From the Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey.
| | - Annette Von Jaglinsky
- From the Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey
| | - Nancy E Reichman
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey; Child Health Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey; and the Department of Economics, Princeton University, Princeton, New Jersey
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23
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Peifer JS, Bradley E, Taasoobshirazi G. Pilot Testing a Brief Partner-Inclusive Hybrid Intervention for Perinatal Mood and Anxiety Disorders. Front Psychiatry 2022; 13:735582. [PMID: 35633795 PMCID: PMC9130596 DOI: 10.3389/fpsyt.2022.735582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 04/22/2022] [Indexed: 11/28/2022] Open
Abstract
The necessity of hybrid and more accessible options for perinatal mood and anxiety disorders (PMADs) has taken on increased urgency in the wake of the COVID-19 pandemic and its lasting impacts. In the New Family Wellness Project (NFWP), participants engage in a hybrid in-person and teletherapy six-session intervention for new parents early in their postpartum period. This small, phase 1 clinical research examined early outcomes of the NFWP's cognitive behavioral intervention on adverse mental health outcomes (i.e., perinatal depression and anxiety, overall mental illness symptoms) and adaptive outcomes and protective factors (i.e., relational health, social support, flourishing, self-efficacy). Despite a small sample size (N = 12), paired t-tests yielded significant effects for improvements in mental health symptoms at posttest, as well as marginally significant improvements in postpartum anxiety and self-efficacy. Findings suggest the brief, partner-inclusive, hybrid intervention shows promise for further study. Lessons learned from this small phase 1 clinical study and recommendations for revising the intervention prior to future trials are discussed.
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Affiliation(s)
- Janelle S Peifer
- Department of Psychology, University of Richmond, Richmond, VA, United States
| | - Erin Bradley
- Department of Public Health, Agnes Scott College, Decatur, GA, United States
| | - Gita Taasoobshirazi
- School of Data Science and Analytics, Kennesaw State University, Kennesaw, GA, United States
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24
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Lund RJ, Kyläniemi M, Pettersson N, Kaukonen R, Konki M, Scheinin NM, Karlsson L, Karlsson H, Ekholm E. Placental DNA methylation marks are associated with maternal depressive symptoms during early pregnancy. Neurobiol Stress 2021; 15:100374. [PMID: 34401410 PMCID: PMC8353413 DOI: 10.1016/j.ynstr.2021.100374] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 07/13/2021] [Accepted: 07/29/2021] [Indexed: 01/02/2023] Open
Abstract
Maternal depressive symptoms during pregnancy are a significant risk factor for adverse developmental and health outcomes of the offspring. The molecular mechanisms mediating the long-term effects of this exposure are not well understood. Previous studies have found association between prenatal exposure to maternal psychological distress and placental DNA methylation of candidate genes, which can influence placental barrier function and development of the fetus. Our objective in this study was to determine epigenome wide association of maternal depressive symptoms in early pregnancy with the placental DNA methylation. For this purpose we examined DNA methylomes of 92 placental samples by using reduced representation bisulfite sequencing. The placental samples were collected after deliveries of 39 girls and 59 boys, whose mothers had Edinburgh Postnatal Depression Score ranging from 0 to 19 at gestational week 14. According to our results maternal depressive symptoms are associated with DNA methylation of 2833 CpG sites, which are particularly over-represented in genic enhancers. The genes overlapping or nearest to these sites are functionally enriched for development of neurons and show expression enrichment in several regions of developing brain. The genomic regions harboring the DNA methylation marks are enriched for single nucleotide polymorphisms associated with mental disease trait class. Potential cellular signaling cascades mediating the effects include inflammatory and hormonal pathways. As a conclusion our results suggest that maternal depressive symptoms during early pregnancy are associated with DNA methylation marks in placenta in genes, which are important for the development and long-term health of the brain. Whether similar marks can be detected in exposed children remains to be elucidated in further studies.
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Affiliation(s)
- Riikka J. Lund
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland
| | - Minna Kyläniemi
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland
| | - Nina Pettersson
- Department of Obstetrics and Gynecology, Turku University Central Hospital and University of Turku, Turku, Finland
| | - Riina Kaukonen
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland
| | - Mikko Konki
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland
| | - Noora M. Scheinin
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry and Turku Brain and Mind Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku, Turku University Hospital, Turku, Finland
- Department of Pediatrics, University of Turku, Turku University Hospital, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku, Turku University Hospital, Turku, Finland
- Department of Psychiatry and Turku Brain and Mind Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Eeva Ekholm
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Obstetrics and Gynecology, Turku University Central Hospital and University of Turku, Turku, Finland
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25
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Guo J, Zheng A, He J, Ai M, Gan Y, Zhang Q, Chen L, Liang S, Yu X, Kuang L. The prevalence of and factors associated with antenatal depression among all pregnant women first attending antenatal care: a cross-sectional study in a comprehensive teaching hospital. BMC Pregnancy Childbirth 2021; 21:713. [PMID: 34702205 PMCID: PMC8545620 DOI: 10.1186/s12884-021-04090-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 08/29/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Antenatal depression has become a common and serious problem, significantly affecting maternal and fetal health. However, evaluation and intervention methods for pregnant women in obstetric clinics are inadequate. This study aimed to determine the prevalence of and risk factors for depression among all pregnant women at their first attending antenatal care in the obstetrics clinic, a comprehensive teaching hospital, southwest of China. METHODS From June to December 2019, 5780 pregnant women completed online psychological assessments, and data from 5728 of the women were analyzed. The women were categorized into two groups according to the presence or absence of depression. Depression was assessed by the Patient Health Questionnaire-9 (PHQ-9), with a cutoff point of 10 for depression. Anxiety and somatic symptoms were measured by the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-15 (PHQ-15), respectively. Univariate analysis and binary logistic regression analysis were used to determine the association among antenatal depression, anxiety, somatic symptoms and participants' characteristics. RESULTS The prevalence of antenatal depression among all the pregnant women at their first attending antenatal care was 16.3%, higher in the first trimester (18.1%). Anxiety symptoms (Mild anxiety AOR = 2.937; 95% CI: 2.448-3.524) and somatic symptoms (Mild somatic symptoms AOR = 3.938; 95% CI: 2.888-3.368) were major risk factors for antenatal depression among women and the risk increased more with the anxiety level or somatic symptoms level. Gestational weeks (second trimester AOR = 0.611; 95% CI: 0.483-0.773; third trimester AOR = 0.337; 95% CI: 0.228-0.498) and urban residence (AOR = 0.786; 95% CI: 0.652-0.947) were protective factors for antenatal depression among women. CONCLUSIONS About one in six pregnant women would experience depression, and special attention should be paid to some risk factors (i.e., early pregnancy, anxiety symptoms, somatic symptoms, rural residence). Online psychological assessments might be a time-saving and convenient screening method for pregnant women in obstetric clinics.
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Affiliation(s)
- Jiamei Guo
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Anhai Zheng
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Jinglan He
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Ming Ai
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Yao Gan
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Qi Zhang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Lulu Chen
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Sisi Liang
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Xiaoyu Yu
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Li Kuang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China.
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26
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Liu Y, Zhang L, Guo N, Jiang H. Postpartum depression and postpartum post-traumatic stress disorder: prevalence and associated factors. BMC Psychiatry 2021; 21:487. [PMID: 34610797 PMCID: PMC8491367 DOI: 10.1186/s12888-021-03432-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 08/18/2021] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Despite the increased global interest from researchers in postpartum depression (PPD) and postpartum post-traumatic stress disorder (PP-PTSD), studies of PPD in China have shown a wide range of variability. Indeed, the prevalence and risk factors for PP-PTSD have received little attention in China. AIM To determine the prevalence of PPD and PP-PTSD in China, and to examine the relationships between a range of sociodemographic, pregnancy-related, and newborn-related variables, and PPD and PP-PTSD. METHODS A cross-sectional study involving 1136 women who returned to the obstetrics clinic for routine postpartum examination were enrolled. The sociodemographic, pregnancy-related, and newborn-related characteristics were collected. Social support, and PPD and PP-PTSD symptoms were measured by the Perceived Social Support Scale (PSSS), the Edinburgh Postnatal Depression Scale (EPDS), and the Perinatal Post-traumatic Stress Questionnaire (PPQ). RESULTS The prevalence rates of PPD and PP-PTSD symptoms were 23.5 and 6.1%, respectively. A multivariate model showed that the presence of PP-PTSD was the strongest risk factor for PPD symptoms and vice versa. Other risk factors for PPD included low sleep quality, low social support and newborn's incubator admission. In terms of PP-PTSD symptoms, risk factors included the presence of PPD symptoms, non-Han ethnicity, and low social support, while having one child was a protective factor. CONCLUSIONS This study addressed some gaps in the literature and provided a better understanding of PPD and PP-PTSD in China, which may contribute to early detection and intervention. Attention should be paid to women who are most susceptible to PPD and/or PP-PTSD, including those with low social support, low sleep quality, newborn's incubator admission, non-Han ethnicity, and women with siblings.
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Affiliation(s)
- Ying Liu
- Nursing Department, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No.2699, West Gaoke Road, Pudong New Area, Shanghai, 201204 China
| | - Lan Zhang
- Nursing Department, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No.2699, West Gaoke Road, Pudong New Area, Shanghai, 201204 China
| | - Nafei Guo
- Nursing Department, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No.2699, West Gaoke Road, Pudong New Area, Shanghai, 201204 China
| | - Hui Jiang
- Nursing Department, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No.2699, West Gaoke Road, Pudong New Area, Shanghai, 201204 China
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27
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Su Y, D'Arcy C, Meng X. Research Review: Developmental origins of depression - a systematic review and meta-analysis. J Child Psychol Psychiatry 2021; 62:1050-1066. [PMID: 33259072 PMCID: PMC8451906 DOI: 10.1111/jcpp.13358] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/11/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Many observational studies have found a direct association between adverse in utero, perinatal and postnatal exposures and offspring's depression. These findings are consistent with the 'developmental origins of disease hypothesis'. But no review has comprehensively summarized the roles of these exposures. This review aims to systematically scrutinize the strength of associations between individual prenatal, perinatal, and postnatal exposures and subsequent depression in offspring. METHODS We conducted a systematic review and meta-analysis to synthesize the literature from the EMBASE, HealthStar, PsychoInfo, and Medline databases since their inception to September 1, 2019. English language articles on population-based prospective cohort studies examining the associations between in utero, perinatal, and postnatal exposures and offspring's depression were searched. Random-effects models were used to calculate pooled estimates, and heterogeneity and sensitivity tests were conducted to explore potential confounders in the relationships of depression and early-life factors. Qualitative analysis was also conducted. RESULTS Sixty-four prospective cohort studies with 28 exposures studied in the relationships to offspring's depression met inclusion criteria. The meta-analysis found 12 prenatal, perinatal, and postnatal characteristics were associated with an increased risk of depression in offspring: low birth weight, premature birth, small gestational age, maternal education, socioeconomic status, having younger parents (<20 years), having older parents (≥35 years), maternal smoking, paternal smoking, maternal stress, maternal anxiety, and prenatal depression. Heterogeneity and sensitivity tests supported the findings. By and large, study characteristics had no effects on conclusions. Qualitative analyses generally supported the findings of meta-analysis and reported on additional risk factors. CONCLUSIONS This review provides a robust and comprehensive overview of the lasting psychopathological effects of in utero, perinatal, and postnatal exposures. The findings highlight the need for clinical and public health interventions focusing on the identified risk factors. Large prospective cohort studies are warranted to investigate the combined effects of multiple co-existing early-life exposures.
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Affiliation(s)
- Yingying Su
- School of Public HealthUniversity of SaskatchewanSaskatoonSKCanada
| | - Carl D'Arcy
- School of Public HealthUniversity of SaskatchewanSaskatoonSKCanada
- Department of PsychiatryCollege of MedicineUniversity of SaskatchewanSaskatoonSKCanada
| | - Xiangfei Meng
- Department of PsychiatryMcGill UniversityMontrealQCCanada
- Douglas Research CentreMontrealQCCanada
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28
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Mazo GE, Kasyanov ED, Nikolishin AE, Rukavishnikov GV, Shmukler AB, Golimbet VE, Neznanov NG, Kibitov AO. [Family history of affective disorders, the gender factor and clinical characteristics of depression]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:75-83. [PMID: 34405661 DOI: 10.17116/jnevro202112105275] [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: 11/17/2022]
Abstract
OBJECTIVE Analysis of clinical features of development and course of depression in patients with FH of mood disorders taking into account sex differences. MATERIAL AND METHODS This multicenter cross-sectional study included patients over 18 years of age with depressive episode/recurrent depressive disorder. Clinical characteristics of depression, presence of comorbid mental illness and family history (FH) information were obtained in a structured clinical interview. RESULTS One hundred and seventy-one patients (mean age (M (SD)) 40.87 (15.86) y.o.), including 64.5% of women, were enrolled in the study. FH was revealed in 30.2% of patients. The proportion of FH did not differ in men and women (p=0.375). Generalized anxiety disorder (GAD) was more frequent in FH positive patients (p=0.016). Logistic regression also revealed that FH is a risk factor for concomitant GAD (p=0.019, OR=2.4). The GLM demonstrated a significant joint effect of FH and sex on the maximum duration of a depressive episode (p=0.044), as well on the number of suicide attempts (p=0.055) and the number of depressive episodes as a trend (p=0.072). CONCLUSION We have demonstrated the specific interaction of FH of mood disorders with sex on clinical course of depression. Thus, the manifestation of a genetic influence on the clinical phenotype of depression can be significantly moderated by sex.
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Affiliation(s)
- G E Mazo
- Bekhterev National Medical Research Center For Psychiatry And Neurology, St Petersburg, Russia
| | - E D Kasyanov
- Bekhterev National Medical Research Center For Psychiatry And Neurology, St Petersburg, Russia.,Saint-Petersburg State University Pirogov Clinic of High Medical Technologies, St. Petersburg, Russia
| | - A E Nikolishin
- Serbsky National Medical Research Center on Psychiatry and Addictions, Moscow, Russia
| | - G V Rukavishnikov
- Bekhterev National Medical Research Center For Psychiatry And Neurology, St Petersburg, Russia
| | - A B Shmukler
- Bekhterev National Medical Research Center For Psychiatry And Neurology, St Petersburg, Russia.,Serbsky National Medical Research Center on Psychiatry and Addictions, Moscow, Russia
| | - V E Golimbet
- Bekhterev National Medical Research Center For Psychiatry And Neurology, St Petersburg, Russia.,Mental Health Research Center, Moscow, Russia
| | - N G Neznanov
- Bekhterev National Medical Research Center For Psychiatry And Neurology, St Petersburg, Russia.,Pavlov First Saint-Petersburg State Medical University, St. Petersburg, Russia
| | - A O Kibitov
- Bekhterev National Medical Research Center For Psychiatry And Neurology, St Petersburg, Russia.,Serbsky National Medical Research Center on Psychiatry and Addictions, Moscow, Russia
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29
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Nguyen MX, McNaughton Reyes HL, Pence BW, Muessig K, Hutton HE, Latkin CA, Dowdy D, Chander G, Lancaster KE, Frangakis C, Sripaipan T, Ha Tran V, Go VF. The longitudinal association between depression, anxiety symptoms and HIV outcomes, and the modifying effect of alcohol dependence among ART clients with hazardous alcohol use in Vietnam. J Int AIDS Soc 2021; 24 Suppl 2:e25746. [PMID: 34165258 PMCID: PMC8222856 DOI: 10.1002/jia2.25746] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 04/14/2021] [Accepted: 04/28/2021] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION Mental health disorders may negatively impact HIV outcomes, such as viral suppression (VS) and antiretroviral (ART) adherence among people with HIV (PWH) with hazardous alcohol use. This study evaluates the longitudinal association between depression, anxiety symptoms, VS and complete ART adherence among ART clients with hazardous alcohol use in Vietnam; and examines alcohol dependence as a modifier in this association. METHODS This was a secondary data analysis of a trial for hazardous drinking ART clients in Thai Nguyen, Vietnam. From March 2016 to May 2018, 440 ART clients with an Alcohol Use Disorders Identification Test-Concise (AUDIT-C) score ≥4 for men and ≥3 for women were enrolled. Individuals were randomized to either a combined intervention, a brief intervention or a standard of care. Data on sociodemographics, depression, anxiety symptoms, alcohol use, VS and ART adherence were collected at baseline, three, six, and twelve months. Generalized estimating equation models controlling for intervention exposure were used to estimate time-lagged associations. Risk ratios were estimated using Poisson regression with robust variance estimation. RESULTS The mean age of participants was 40.2. The majority was male (96.8%), had at least some secondary school education (85.0%) and had a history of injection drug use (80.9%). No overall effect of depression and anxiety symptoms on VS was observed. When stratified by time, increased anxiety symptoms at six months were associated with VS at 12 months (adjusted risk ratio (aRR) = 1.09; 95% CI 1.02 to 1.17). An increase in depression or anxiety symptoms was associated with a decreased probability of complete ART adherence (depression symptoms: aRR = 0.95; 95% CI: 0.91 to 0.99; anxiety symptoms: aRR = 0.93; 85% CI: 0.88 to 0.99). The negative effects of anxiety symptoms on ART adherence were stronger among participants with alcohol dependence, compared to those without. CONCLUSIONS Depression and anxiety symptoms had no overall effect on VS, although they were associated with a lower probability of complete ART adherence. Interventions focusing on mental healthcare for PWH with hazardous alcohol use are needed, and integration of mental healthcare and alcohol reduction should be implemented in HIV primary care settings.
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Affiliation(s)
- Minh X Nguyen
- Department of Health BehaviorGillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - H. Luz McNaughton Reyes
- Department of Health BehaviorGillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Brian W Pence
- Department of EpidemiologyGillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Kate Muessig
- Department of Health BehaviorGillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Heidi E Hutton
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMDUSA
| | - Carl A Latkin
- Department of Health, Behavior and SocietyJohns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
| | - David Dowdy
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
| | | | - Kathryn E Lancaster
- Department of EpidemiologyCollege of Public HealthOhio State UniversityColumbusOHUSA
| | - Constantine Frangakis
- Department of BiostatisticsJohns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
| | - Teerada Sripaipan
- Department of Health BehaviorGillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Viet Ha Tran
- Department of Health BehaviorGillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Vivian F Go
- Department of Health BehaviorGillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNCUSA
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Fitzgerald E, Parent C, Kee MZL, Meaney MJ. Maternal Distress and Offspring Neurodevelopment: Challenges and Opportunities for Pre-clinical Research Models. Front Hum Neurosci 2021; 15:635304. [PMID: 33643013 PMCID: PMC7907173 DOI: 10.3389/fnhum.2021.635304] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 01/21/2021] [Indexed: 12/12/2022] Open
Abstract
Pre-natal exposure to acute maternal trauma or chronic maternal distress can confer increased risk for psychiatric disorders in later life. Acute maternal trauma is the result of unforeseen environmental or personal catastrophes, while chronic maternal distress is associated with anxiety or depression. Animal studies investigating the effects of pre-natal stress have largely used brief stress exposures during pregnancy to identify critical periods of fetal vulnerability, a paradigm which holds face validity to acute maternal trauma in humans. While understanding these effects is undoubtably important, the literature suggests maternal stress in humans is typically chronic and persistent from pre-conception through gestation. In this review, we provide evidence to this effect and suggest a realignment of current animal models to recapitulate this chronicity. We also consider candidate mediators, moderators and mechanisms of maternal distress, and suggest a wider breadth of research is needed, along with the incorporation of advanced -omics technologies, in order to understand the neurodevelopmental etiology of psychiatric risk.
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Affiliation(s)
- Eamon Fitzgerald
- Department of Psychiatry, Faculty of Medicine, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, QC, Canada
| | - Carine Parent
- Department of Psychiatry, Faculty of Medicine, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, QC, Canada
| | - Michelle Z. L. Kee
- Translational Neuroscience Programme, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Michael J. Meaney
- Department of Psychiatry, Faculty of Medicine, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, QC, Canada
- Translational Neuroscience Programme, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Wensu Z, Xidi Z, Shaojie L, Baohua Z, Yunhan Y, Huilan X, Zhao H, Xiyue X. Does the Presence of Anxiety and Depression Symptoms Mediate the Association Between Family Functions and Self-Efficacy in Pregnant Women in the Third Trimester?: A Community-Based Cross-Sectional Survey. Front Psychiatry 2021; 12:726093. [PMID: 34803756 PMCID: PMC8599816 DOI: 10.3389/fpsyt.2021.726093] [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: 06/16/2021] [Accepted: 10/04/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Pregnant women in the third trimester can be more vulnerable to adverse mental health outcomes, but there is limited research on the association between family function and self-efficacy and potential mediation by symptoms of anxiety and depression. Methods: The cross-sectional study enrolled 813 pregnant women in the third trimester from 14 communities of Hengyang city, Hunan province of China. All of the participants completed a battery of self-report measures of family function (Family Adaptation Partnership Growth and Resolve Index, APGAR-family), self-efficacy (General Self-Efficacy Scale, GSES), anxiety (measured by Generalized Anxiety Disorder scale with seven items, GAD-7), and depression symptoms (Patient Health Questionnaire with nine items, PHQ-9). The correlation analysis was performed using Spearman's correlation coefficient. Baron and Kenny's method and multiple mediation models with bootstrapping were used to determine whether the symptoms of anxiety and depression mediated the association between family functions and self-efficacy. Results: There were 22.6% pregnant women in the low level of self-efficacy, with 60.9% in the moderate level and 16.5% of respondents in the high level. Self-efficacy had significant correlations with both anxiety symptoms (r = -0.19, p < 0.05), depression symptoms (r = -0.22, p < 0.05), and family function (r = 0.31, p < 0.05). Anxiety symptoms were significantly associated with self-efficacy (β = -0.016, p < 0.05). Depression symptoms were significantly associated with self-efficacy (β = -0.024, p < 0.05). Anxiety and depression symptoms partly mediated the association between family function and self-efficacy, accounting for 11.4 and 16.4% of total effect, respectively. It was indicated that pregnant women with a high degree of family function are less likely to have emotional symptoms and predicted to have higher levels of self-efficacy. Conclusions: Anxiety and depression show mediating effects in the association between family function and self-efficacy. Improved family function can have a positive impact on pregnant women in the third trimester.
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Affiliation(s)
- Zhou Wensu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Zhu Xidi
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Li Shaojie
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Zheng Baohua
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yu Yunhan
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xu Huilan
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Hu Zhao
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xiong Xiyue
- NHC Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China.,Department of Child Rehabilitation, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
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Taka-Eilola T. Parental perinatal depression and offspring psychotic experiences. Lancet Psychiatry 2020; 7:377-378. [PMID: 32353263 PMCID: PMC7185917 DOI: 10.1016/s2215-0366(20)30154-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 04/06/2020] [Indexed: 10/25/2022]
Affiliation(s)
- Tiina Taka-Eilola
- Department of Psychiatry, University of Oulu, Oulu FIN-90014, Finland; Basic Health Care District of Kallio, Ylivieska, Finland; Department of Psychiatry, Middle Ostrobothnia Central Hospital, Kokkola, Finland.
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