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Veloumourougane G, Ramamurthy P, Thilakan P, Raghuraman P, Vimal J. Prevalence of generalized anxiety disorder among patients attending medicine outpatient department in a tertiary care center: A cross-sectional study. Ind Psychiatry J 2024; 33:76-80. [PMID: 38853800 PMCID: PMC11155652 DOI: 10.4103/ipj.ipj_77_23] [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: 04/07/2023] [Revised: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 06/11/2024] Open
Abstract
Background Generalized anxiety disorder is commonly underdiagnosed and undertreated in medical settings. Aim The objectives of this study were to determine the prevalence and correlates of generalized anxiety disorder among patients presenting to medicine outpatient department in a tertiary care centre. Materials and Methods A cross-sectional observational study was conducted among the patients visiting the outpatient department of General Medicine in a tertiary care teaching hospital. Sociodemographic and clinical parameters were collected using a structured pro forma. All patients were administered Generalized Anxiety Disorder-7 (GAD-7) to screen for the presence of generalized anxiety disorder. Patients who score 10 or more underwent a semi-structured evaluation using a generalized anxiety disorder module of Structured Clinical Interview for DSM-IV Axis I disorders. Results Two hundred and fifty patients were recruited for the study. The mean age of the participants was 40.66 ± 12.8 years. More than one-fourth of them had diabetes mellitus and about one-fifth of the participants had systemic hypertension and hypothyroidism. Thirty five (14%) participants screened positive on GAD-7 scale. On detailed evaluation using SCID-I, 19 (7.6%) participants were confirmed to have a generalized anxiety disorder. Female gender was associated with the presence of GAD. Conclusion One in thirteen patients presenting to the medicine outpatient department were found to have generalized anxiety disorder. Female patients had a greater prevalence of generalized anxiety disorder compared to male patients.
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Affiliation(s)
- Gokoul Veloumourougane
- Department of Psychiatry, Pondicherry Institute of Medical Sciences, Ganapathychettykulam, Pondicherry, India
| | - Parthasarathy Ramamurthy
- Department of Psychiatry, Pondicherry Institute of Medical Sciences, Ganapathychettykulam, Pondicherry, India
| | - Pradeep Thilakan
- Department of Psychiatry, Pondicherry Institute of Medical Sciences, Ganapathychettykulam, Pondicherry, India
| | | | - Joseph Vimal
- Department of General Medicine, Pondicherry Institute of Medical Sciences, Ganapathychettykulam, Pondicherry, India
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Roddy Mitchell A, Gordon H, Atkinson J, Lindquist A, Walker SP, Middleton A, Tong S, Hastie R. Prevalence of Perinatal Anxiety and Related Disorders in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis. JAMA Netw Open 2023; 6:e2343711. [PMID: 37976063 PMCID: PMC10656650 DOI: 10.1001/jamanetworkopen.2023.43711] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/09/2023] [Indexed: 11/19/2023] Open
Abstract
Importance Anxiety disorders are associated with poor maternal and neonatal outcomes. Women in low- and middle-income countries (LMICs) are thought to be disproportionally burdened by these disorders, yet their prevalence is unclear. Objective To conduct a systematic review and meta-analysis to determine the prevalence of 6 anxiety and related disorders among perinatal women in LMICs. Data Sources Embase, MEDLINE, PsycINFO, Cochrane Library, CINAHL, and Web of Science databases were searched from inception until September 7, 2023. Study Selection Studies conducted in World Bank-defined LMICs and reporting prevalence of generalized anxiety disorder, obsessive-compulsive disorder, social anxiety disorder, posttraumatic stress disorder, panic disorder, or adjustment disorder during the perinatal period (conception to 12 months post partum) using a validated method were included. Data Extraction and Synthesis This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline. Study eligibility, extracted data, and risk of bias of included studies were assessed by 2 independent reviewers. Random-effects meta-analysis was used to estimate pooled point prevalence. Subgroup analyses were performed by specific anxiety disorder. Main Outcomes and Measures Main outcomes were prevalence estimates of each anxiety disorder, measured as percentage point estimates and corresponding 95% CIs. Results At total of 10 617 studies were identified, 203 of which met the inclusion criteria and reported the outcomes of 212 318 women from 33 LMICs. Generalized anxiety disorder was the most reported (184 studies [90.6%]) and most prevalent disorder at 22.2% (95% CI, 19.4%-25.0%; n = 173 553). Posttraumatic stress disorder was the second most prevalent (8.3%; 95% CI, 5.0%-12.2%; 33 studies; n = 22 452). Adjustment disorder was least prevalent (2.9%; 95% CI, 0.0%-14.1%; 2 studies; n = 475). The prevalence of generalized anxiety varied by country income status, with the highest prevalence among lower-middle-income countries (27.6%; 95% CI, 21.6%-33.9%; 59 studies; n = 25 109), followed by low-income (24.0%; 95% CI, 15.3%-33.8%; 11 studies; n = 4961) and upper-middle-income (19.1%; 95% CI, 16.0%-22.4%; 110 studies; n = 138 496) countries. Conclusions and Relevance These findings suggest that 1 in 5 women living in LMICs experience anxiety disorders during pregnancy and post partum. Targeted action is needed to reduce this high burden.
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Affiliation(s)
- Alexandra Roddy Mitchell
- Mercy Perinatal, Department of Obstetrics and Gynaecology, The University of Melbourne, Heidelberg, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Hannah Gordon
- Mercy Perinatal, Department of Obstetrics and Gynaecology, The University of Melbourne, Heidelberg, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Jessica Atkinson
- Mercy Perinatal, Department of Obstetrics and Gynaecology, The University of Melbourne, Heidelberg, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Anthea Lindquist
- Mercy Perinatal, Department of Obstetrics and Gynaecology, The University of Melbourne, Heidelberg, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Susan P. Walker
- Mercy Perinatal, Department of Obstetrics and Gynaecology, The University of Melbourne, Heidelberg, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Anna Middleton
- Mercy Perinatal, Department of Obstetrics and Gynaecology, The University of Melbourne, Heidelberg, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Stephen Tong
- Mercy Perinatal, Department of Obstetrics and Gynaecology, The University of Melbourne, Heidelberg, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Roxanne Hastie
- Mercy Perinatal, Department of Obstetrics and Gynaecology, The University of Melbourne, Heidelberg, Victoria, Australia
- Mercy Hospital for Women, Heidelberg, Victoria, Australia
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Sahoo S, Gill G, Sikka P, Nehra R. Antenatal depression and anxiety in Indian women: A systematic review. Ind Psychiatry J 2023; 32:222-233. [PMID: 38161466 PMCID: PMC10756614 DOI: 10.4103/ipj.ipj_156_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/31/2023] [Accepted: 02/14/2023] [Indexed: 01/03/2024] Open
Abstract
There is good evidence to suggest that high prevalence of depression and anxiety in the postpartum period. However, very few studies have focused on antenatal depression and anxiety disorders and their associated risk factors. Further, there are only a handful of studies from India on common antenatal mental health disorders. With this background, we reviewed the existing evidence on antenatal depression and anxiety from the studies conducted in Indian pregnant women during the antenatal period and to explore the associated risk factors. All the major databases were searched systematically for English language studies on prevalence and risk factors for antenatal depression and anxiety in Indian pregnant females, published during the period January 2000 to May 2022. Quality assessment of studies was done with the modified version of Newcastle Ottawa Scale for cross-sectional studies. We found the overall prevalence of antenatal depression was ranged from 3.8% to 65% and antenatal anxiety from 13 to 55%. The most relevant risk factors associated with antenatal depression and anxiety during pregnancy were preference to have a male child, intimate partner violence, history of abortions, marital conflict, poor relationship with the husband/in-laws and lack of social support. To conclude, the systematic review suggests that depressive and anxiety disorders are quite common in Indian pregnant women in antepartum period with varying prevalence depending on various settings and scales used. Steps should be taken to promote obstetricians for regular mental health screening during the antenatal visits and prompt referral to mental health professionals when suspected.
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Affiliation(s)
- Swapnajeet Sahoo
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Gursahiba Gill
- Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Pooja Sikka
- Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Ritu Nehra
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Takelle GM, Nakie G, Rtbey G, Melkam M. Depressive symptoms and associated factors among pregnant women attending antenatal care at Comprehensive Specialized Hospitals in Northwest Ethiopia, 2022: an institution-based cross-sectional study. Front Psychiatry 2023; 14:1148638. [PMID: 37415690 PMCID: PMC10322208 DOI: 10.3389/fpsyt.2023.1148638] [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: 01/20/2023] [Accepted: 05/30/2023] [Indexed: 07/08/2023] Open
Abstract
Background Depression during pregnancy has a significant impact on public health as it can adversely affect both the mother's and the child's health. These can have devastating effects on the mother, the unborn child, and the entire family. Objective This study aimed to determine the prevalence of depressive symptoms and associated factors among pregnant women in Ethiopia. Method An institutional-based cross-sectional study was conducted among pregnant women attending antenatal care services at comprehensive specialized hospitals in Northwest Ethiopia from May to June 2022. Measurement The desired data were collected through face-to-face interview techniques by using validated questionnaires such as the Edinburgh Postnatal Depression Scale, the Oslo-3 social support scale, and the Abuse Assessment Screen tools. The data were analyzed by using SPSS Version 25. Logistic regression analysis was used to identify factors associated with antenatal depressive symptoms. Variables having a p-value of <0.2 in the bivariate analysis were entered into the multivariable logistic regression. A p-value of <0.05 was considered statistically significant, at 95% CI. Results This study revealed that 91 (19.2%) pregnant women screened positive for depressive symptoms. According to multivariable logistic regression, living in rural areas (adjusted odds ratio (AOR) = 2.58, 95% CI: 1.267, 5.256), being in the second or third trimesters of gestational phase (AOR = 4.40, 95% CI: 1.949, 9.966 and AOR = 5.42, 95% CI: 2.438, 12.028, respectively), having a history of alcohol use (AOR = 2.41, 95% CI: 1.099, 5.260), having moderate or poor social support (AOR = 2.55, 95% CI: 1.220, 5.338 and AOR = 2.41, 95% CI: 1.106, 5.268), and having a history of intimate partner violence (AOR = 2.67, 95% CI: 1.416, 5.016) were the factors significantly associated with depressive symptoms at a p-value of ≤ 0.05. Conclusion and recommendation The prevalence of depressive symptoms among pregnant women was high. Living in rural areas, second and third trimesters, use of alcohol, having moderate to poor social support, and having a history of intimate partner violence were variables significantly associated with depressive symptoms during pregnancy.
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Priyadarshini U, Rao AP, Dash S. Recommendations for maternal mental health policy in India. J Public Health Policy 2023; 44:90-101. [PMID: 36624268 PMCID: PMC9827439 DOI: 10.1057/s41271-022-00384-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2022] [Indexed: 01/11/2023]
Abstract
Mental illnesses are a serious concern in India where every seventh person suffers from mental health problems-with women more affected than men. While the burden of perinatal mental illnesses grows, India lacks exclusive policies to address it. The COVID-19 pandemic has had an impact on routine antenatal care and institutional deliveries and has also affected the mental health of pregnant women and mothers. We evaluated existing policies. Policy options were evaluated against criteria like cost-benefit analysis, administrative feasibility, human resources, and equity along with the intended and unintended consequences. We propose three policy options: (1) strengthening and focused implementation of the existing national mental health program (NMHP), (2) integrating mental health in the ongoing Reproductive, Maternal, Newborn, Child and Adolescent Health Program, and (3) including a 'maternal' component in NMHP. We offered policy recommendations to fill the gap in addressing the maternal mental health challenge in India.
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Affiliation(s)
| | - Arathi P Rao
- Department of Health Policy, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Sambit Dash
- Division of Biochemistry, Department of Basic Medical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India.
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Koly KN, Tasnim Z, Ahmed S, Saba J, Mahmood R, Farin FT, Choudhury S, Ashraf MN, Hasan MT, Oloniniyi I, Modasser RB, Reidpath DD. Mental healthcare-seeking behavior of women in Bangladesh: content analysis of a social media platform. BMC Psychiatry 2022; 22:797. [PMID: 36529761 PMCID: PMC9760542 DOI: 10.1186/s12888-022-04414-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Mental health remains a highly stigmatized area of healthcare, and people often conceal their concerns rather than seek assistance or treatment. The Women Support Initiative Forum (WSIF) is a social media platform established in 2018 to provide expert and peer-led psychosocial support services to women of all ages in Bangladesh. The anonymous nature of the forum means that mental health concerns can be aired without fear of identification. METHOD A content analysis was conducted on the anonymous posts retrieved from the WSIF platform between 8th March 2020 and 7th July 2022. Around 1457 posts were initially selected for analysis which was reduced to 1006 after removing duplicates and non-relevant posts, such as queries about the addresses of the doctors and other non-mental health-related issues. A thematic analysis of the data was conducted using an inductive approach. RESULT The 1006 posts generated four themes and nine sub-themes. All the women mentioned mental health symptoms (n = 1006; 100%). Most also mentioned reasons for seeking mental healthcare (n = 818; 81.31%), healthcare-seeking behavior (n = 667; 66.30%), and barriers to seeking mental healthcare (n = 552; 54.87%). The majority of women described symptoms of stress, depression, and anxiety-like symptoms, which were aggregated under common mental health conditions. Mental health symptoms were ascribed to various external influences, including marital relationship, intrafamilial abuse, and insecurities related to the COVID-19 pandemic. A large proportion of posts were related to women seeking information about mental healthcare services and service providers (psychologists or psychiatrists). The analysis found that most women did not obtain mental healthcare services despite their externalized mental health symptoms. The posts identified clear barriers to women accessing mental health services, including low mental health literacy, the stigma associated with mental healthcare-seeking behavior, and the poor availability of mental health care services. CONCLUSION The study revealed that raising mass awareness and designing culturally acceptable evidence-based interventions with multisectoral collaborations are crucial to ensuring better mental healthcare coverage for women in Bangladesh.
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Affiliation(s)
- Kamrun Nahar Koly
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
| | - Zarin Tasnim
- grid.52681.380000 0001 0746 8691BRAC James P Grant School of Public Health, BRAC University, Dhaka, 1213 Bangladesh
| | - Sharmin Ahmed
- Department of Epidemiology, National Institute of Preventive and Social Medicine (NIPSOM), Dhaka, 1212 Bangladesh
| | - Jobaida Saba
- grid.414142.60000 0004 0600 7174Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh ,grid.411808.40000 0001 0664 5967Department of Public Health and Informatics, Jahangirnagar University, Dhaka, 1342 Bangladesh
| | - Rudbar Mahmood
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Dhaka, 1229 Bangladesh
| | - Faria Tasnim Farin
- grid.254444.70000 0001 1456 7807Department of Family Medicine and Public Health Sciences, School of Medicine, Wayne State University, Detroit, MI USA
| | - Sabrina Choudhury
- Department of Epidemiology, National Institute of Preventive and Social Medicine (NIPSOM), Dhaka, 1212 Bangladesh
| | - Mir Nabila Ashraf
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Dhaka, 1229 Bangladesh
| | - M. Tasdik Hasan
- grid.1002.30000 0004 1936 7857Action Lab, Department of Human Centred Computing, Faculty of Information Technology, Monash University, Melbourne, Australia ,grid.443034.40000 0000 8877 8140Department of Public Health, State University of Bangladesh, Dhaka, Bangladesh ,grid.10025.360000 0004 1936 8470Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
| | - Ibidunni Oloniniyi
- grid.10824.3f0000 0001 2183 9444Departmental of Mental Health, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria ,grid.459853.60000 0000 9364 4761Mental Health Unit, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun Nigeria
| | - Rifath Binta Modasser
- grid.443005.60000 0004 0443 2564School of Public Health, Independent University Bangladesh (IUB), Bashundhara, Dhaka, 1229 Bangladesh
| | - Daniel D. Reidpath
- grid.440425.30000 0004 1798 0746Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Subang Jaya, Malaysia
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Bachani S, Sahoo SM, Nagendrappa S, Dabral A, Chandra P. Anxiety and depression among women with COVID-19 infection during childbirth-experience from a tertiary care academic center. AJOG GLOBAL REPORTS 2021; 2:100033. [PMID: 34841377 PMCID: PMC8604795 DOI: 10.1016/j.xagr.2021.100033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Pregnancy and postpartum are vulnerable periods for mental health problems and distress. Studies conducted worldwide have highlighted the role of the COVID-19 pandemic in adding to the rates of depression and anxiety in the perinatal period. However, there are very few reports on mothers who were identified as having COVID-19 infection at the time of childbirth. OBJECTIVE Our study aimed to find the prevalence of depression and anxiety among pregnant women who were admitted for labor and tested positive for COVID-19 infection. We also aimed to study the association of various sociodemographic, social support, and obstetrical factors and that of COVID-19-related worries with depression and anxiety. STUDY DESIGN The study was conducted at the obstetrics inpatient setting in a public hospital in New Delhi, which had a separate designated COVID-19 block. Pregnant and postpartum women >18 years of age who were admitted to the COVID-19 maternity ward for delivery were included for this study. The women were interviewed within the first week of admission and after 6 to 8 weeks of childbirth. The sociodemographic and obstetrical details and COVID-19-related worries and concerns were assessed. Depression and anxiety were assessed using the Patient Health Questionnaire version 9 and the Generalized Anxiety Disorder 7-item Scale, respectively. The normally distributed variables are expressed as mean±standard deviation and continuous variables with skewed distribution as median (interquartile range). The categorical data presented as proportions of categorical variables were compared using the chi-square or the Fischer exact test. All the tests are 2-sided, with a significance level of 5%. The data were analyzed using the SPSS software version 24. The rates of depression and anxiety were calculated and univariate analysis was done to identify the factors associated with moderate and severe anxiety and depression using various sociodemographic and obstetrical variables, the total COVID anxiety scale scores, and the social support score. RESULTS The mean age of the women was 26.86 years (±4.31). Of the 243 women assessed using the Patient Health Questionnaire version 9, 168 (69.13%) had mild depressive disorder, and 29 (11.3%) had moderate depressive disorder. Of the 187 women who were assessed at the 6-weeks follow-up, 31 (16.57%) had minimal depression, 131 (70.05%) had mild depression, and 25 (13.36%) had moderate depression. Mild anxiety was seen in 121 cases (49.79%) and 13 (5.34%) had moderate anxiety symptoms. Women reported several worries, especially about the stigma of COVID-19 infection, support for infant care, and access to infant health services. CONCLUSION Screening for common mental illnesses with the timely identification of associated risk factors should be done, with a liaison between obstetricians and mental health professionals. Obstetricians can address and reassure pregnant women regarding concerns about contracting the infection, worries about the possible effects of COVID-19 on the fetus and the newborn, and concerns about future consultations. In case the worries are out of proportion and necessitate intervention by mental health professionals, referral services should be made available. Hence, identifying and addressing the mental health concerns will help provide the optimum perinatal care during the pandemic.
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Affiliation(s)
- Sumitra Bachani
- Vardhaman Mahavir Medical College and Safdurjung Hospital, New Delhi, India
| | | | | | - Anjali Dabral
- Vardhaman Mahavir Medical College and Safdurjung Hospital, New Delhi, India
| | - Prabha Chandra
- National Institute of Mental Health and Neurosciences, Bengaluru, India
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Fellmeth G, Kishore MT, Verma A, Desai G, Bharti O, Kanwar P, Singh S, Thippeswamy H, Chandra PS, Kurinczuk JJ, Nair M, Alderdice F. Perinatal mental health in India: protocol for a validation and cohort study. J Public Health (Oxf) 2021; 43:ii35-ii42. [PMID: 34622290 PMCID: PMC8498097 DOI: 10.1093/pubmed/fdab162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/07/2021] [Accepted: 05/05/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Common mental disorders (CMD) are among the largest contributors to global maternal morbidity and mortality. Although research on perinatal mental health in India has grown in recent years, important evidence gaps remain, especially regarding CMD. Our study aims to improve understanding of CMD among perinatal and non-perinatal women of reproductive age across two settings in India: Bangalore (Karnataka) and Tanda (Himachal Pradesh). METHODS The study is embedded within the Maternal and Perinatal Health Research Collaboration India (MaatHRI). This mixed-methods observational study comprises three consecutive phases: (i) focus group discussions and individual interviews to explore women's knowledge and seek feedback on CMD screening tools; (ii) validation of CMD screening tools; and (iii) prospective cohort study to identify CMD incidence, prevalence and risk factors among perinatal and non-perinatal women. Results of the three phases will be analyzed using inductive thematic analysis, psychometric analysis and multivariable regression analysis, respectively. CONCLUSION Improving understanding, detection and management of CMD among women is key to improving women's health and promoting gender equality. This study will provide evidence of CMD screening tools for perinatal and non-perinatal women in two diverse Indian settings, produce data on CMD prevalence, incidence and risk factors and enhance understanding of the specific contribution of the perinatal state to CMD.
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Affiliation(s)
- G Fellmeth
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - M T Kishore
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - A Verma
- Department of Obstetrics and Gynaecology, Dr Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India
| | - G Desai
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - O Bharti
- State Institute of Health and Family Welfare, Department of Health and Family Welfare, Government of Himachal Pradesh, India
| | - P Kanwar
- Department of Psychiatry, Dr Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India
| | - S Singh
- Department of Psychiatry, Dr Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India
| | - H Thippeswamy
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - P S Chandra
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - J J Kurinczuk
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - M Nair
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - F Alderdice
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.,School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
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