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King JD, Crowley G, El-Maraghy M, Davis W, Jauhari A, Wilson-Jones C. Perinatal mental health in medical school curricula: a national scoping survey of British universities and student psychiatry societies. BJPsych Bull 2024; 48:51-56. [PMID: 36632805 PMCID: PMC10801407 DOI: 10.1192/bjb.2022.91] [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: 01/27/2022] [Revised: 10/14/2022] [Accepted: 11/28/2022] [Indexed: 01/13/2023] Open
Abstract
AIMS AND METHOD With increasing recognition of the prevalence and impact of perinatal mental health (PMH) disorders comes a responsibility to ensure that tomorrow's doctors can support families during the perinatal period. Online surveys seeking information about the inclusion of PMH education in undergraduate curricula were sent to psychiatry curriculum leads and student psychiatry societies from each university medical school in the UK between April and September 2021. RESULTS Responses were received from 32/35 (91.4%) medical schools. Two-thirds reported specific inclusion of PMH content in the core curriculum, typically integrated into general adult psychiatry or obstetric teaching. Students at the remaining schools were all likely to be examined on the topic or see perinatal cases during at least one clinical attachment. CLINICAL IMPLICATIONS PMH education offers an opportunity for collaboration between psychiatry and other disciplines. Future work looking at educational case examples with objective outcomes would be valuable.
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Affiliation(s)
- Jacob D. King
- Imperial College London, UK
- Central and North West London NHS Foundation Trust, UK
| | - Grace Crowley
- South London and Maudsley NHS Foundation Trust, UK
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Manal El-Maraghy
- Essex Partnership University NHS Foundation Trust, Wickford, UK
- Anglia Ruskin University, Chelmsford, UK
| | - William Davis
- Lancashire and South Cumbria NHS Foundation Trust, Preston, UK
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Frayne J, Seddon S, Lebedevs T, Milroy T, Teh B, Nguyen T. General practitioner perceptions and experiences of managing perinatal mental health: a scoping review. BMC Pregnancy Childbirth 2023; 23:832. [PMID: 38042768 PMCID: PMC10693076 DOI: 10.1186/s12884-023-06156-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 11/24/2023] [Indexed: 12/04/2023] Open
Abstract
BACKGROUND General Practitioners (GPs) are involved in preconception, pregnancy, and postnatal care. Overall, mental health remains a significant contributor to disease burden affecting 1 in 4 pregnant women. Psychotropic medication prescribing occurs in almost 1 in 12 pregnancies, and appears to be increasing, along with the prevalence of mental health disorders in women of reproductive age. Perinatal mental health management is therefore not an unlikely scenario within their clinical practice. This scoping review aims to map current research related to GPs perceptions and experiences of managing perinatal mental health. METHOD A comprehensive search strategy using nine electronic databases, and grey literature was undertaken between December 2021 and February 2023. Relevant studies were sourced from peer review databases using key terms related to perinatal mental health and general practitioners. Search results were screened on title, abstract and full text to assess those meeting inclusion criteria and relevance to the research question. RESULTS After screening, 16 articles were included in the scoping review. The majority focused on perinatal depression. Findings support that GPs express confidence with diagnosing perinatal depression but report issues of stigma navigating a diagnosis. Over the last two decades, prescribing confidence in perinatal mental health remains variable with concerns for the safety profile of medication, low level of confidence in providing information and a strong reliance on personal experience. Despite the establishment of perinatal guidelines by countries, the utilisation of these and other existing resources by GPs appears from current literature to be infrequent. Many challenges exist for GPs around time pressures, a lack of information and resources, and difficulty accessing referral to services. CONCLUSION Recommendations following this scoping review include targeted perinatal education programs specific for GPs and embedded within training programs and the development of practice guidelines and resources specific to general practice that recognises time, services, and funding limitations. To achieve this future research is first needed on how guidelines and resources can be developed and best delivered to optimise GP engagement to improve knowledge and enhance patient care.
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Affiliation(s)
- Jacqueline Frayne
- Medical School, Discipline of General practice, The University of Western Australia, Crawley, Australia.
| | - Sarah Seddon
- Medical School, Discipline of General practice, The University of Western Australia, Crawley, Australia
| | - Tamara Lebedevs
- Pharmacy Department, Women's and Newborn Health Service, King Edward Memorial Hospital, Subiaco, Australia
| | - Talila Milroy
- Medical School, Discipline of General practice, The University of Western Australia, Crawley, Australia
| | - Beverly Teh
- South Metropolitan Health Services, Perth, Australia
| | - Thinh Nguyen
- Peel and Rockingham Kwinana Mental Health Services, Rockingham, Australia
- Medical School, Discipline of Psychiatry, The University of Western Australia, Crawley, Australia
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Sim CSM, Chen H, Chong SL, Xia OJ, Chew E, Guo X, Ng LP, Ch'ng YC, Ong JLH, Tan J, Ng DCC, Tan NC, Chan YH. Primary health level screening for postpartum depression during well-child visits: Prevalence, associated risk factors, and breastfeeding. Asian J Psychiatr 2023; 87:103701. [PMID: 37517174 DOI: 10.1016/j.ajp.2023.103701] [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: 05/04/2023] [Revised: 07/14/2023] [Accepted: 07/16/2023] [Indexed: 08/01/2023]
Abstract
Postpartum depression (PPD) is a public health problem that is associated with detrimental effects on the wellbeing of the mother, child and family. Early detection for PPD at the primary health level provides an opportunity for intervention. We aim to examine: (1) the prevalence rate of PPD in the primary care population, (2) acceptance and attendance rates of intervention for women who screened positive for PPD, (3) sociodemographic and maternal risk factors of PPD, and (4) the impact of PPD on breastfeeding. We implemented a mother-child dyadic screening program using the modified Patient Health Questionnaire-2 during routine well-child visits at 2 or 3 months postpartum between July 2019 and December 2021. We performed multivariable logistic regression to identify independent risk factors for PPD and described using adjusted odds ratio (OR) with corresponding 95 % confidence intervals. Among 5561 mothers, the prevalence rate of probable PPD was 2.4 %. About half (54.4 %) of mothers who screened positive accepted intervention and of these, about two-thirds accepted onward referrals to tertiary care and community mental health service, with higher attendance at the latter. In the final adjusted model, mothers who had probable PPD were more likely to be older than age 35 years (OR 1.88, 95 % CI 1.05-3.45; p < 0.05) and not breastfeeding (OR 1.9, 95 % CI 1.06-3.38; p < 0.05). Overall, our findings highlight the importance of early PPD screening and management in primary care. These findings can help inform maternal mental health service development and utilization, thereby optimizing maternal and infant outcomes.
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Affiliation(s)
- Cherie Sze Min Sim
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore
| | - Helen Chen
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore; SingHeatlth-Duke NUS Paediatric Medicine Academic Clinical Programme, Singapore.
| | - Shu-Ling Chong
- SingHeatlth-Duke NUS Paediatric Medicine Academic Clinical Programme, Singapore; Paediatric Emergency Medicine Department, KK Women's and Children's Hospital, Singapore
| | | | - Elaine Chew
- SingHeatlth-Duke NUS Paediatric Medicine Academic Clinical Programme, Singapore; Adolescent Medicine Service, KK Women's and Children's Hospital, Singapore
| | - Xiaoxuan Guo
- SingHealth Polyclinics, Singapore; SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore
| | - Lai Peng Ng
- SingHealth Polyclinics, Singapore; SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore
| | - Ying Chia Ch'ng
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore
| | | | | | - David Chee Chin Ng
- SingHealth Polyclinics, Singapore; SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore
| | - Ngiap Chuan Tan
- SingHealth Polyclinics, Singapore; SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore
| | - Yoke Hwee Chan
- SingHeatlth-Duke NUS Paediatric Medicine Academic Clinical Programme, Singapore; Division of Medicine, KK Women's and Children's Hospital, Singapore
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Bakhteh A, Salari N, Jaberghaderi N, Khosrorad T. Investigating the Relationship between Self-Compassion and Body Image with Postpartum Depression in Women Referring to Health Centres in Iran. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2023; 28:411-416. [PMID: 37694201 PMCID: PMC10484387 DOI: 10.4103/ijnmr.ijnmr_269_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 03/03/2023] [Accepted: 04/19/2023] [Indexed: 09/12/2023]
Abstract
Background Depression is the most important postpartum mental disorder that can lead to irreversible damage to family health if not addressed, including inability to provide maternal care, impaired mother-child relationship, impaired growth, and development of the child, to marital problems, and sometimes the risk of suicide and infant death. The aim of this study was to investigate the relationship between self-compassion and body image with postpartum depression. Material and Method In this study, 150 pregnant women in the third trimester and 6 weeks postpartum completed the Short Form Self-Compassion Questionnaire (SCS-SF), Multidimensional Self-Body Relationships (MBSRQ), and Edinburgh Postpartum Depression Inventory (EPDS). Depending on the type of study, descriptive statistics such as mean, median, and standard deviation were calculated for quantitative, frequency, and relative frequency variables. Kolmogorov-Smirnov test was used to evaluate the normality of the distribution of scores in each questionnaire. Data were analyzed using parametric proportional statistical tests (paired t-test, Pearson correlation, and linear regression) at the level of significance less than 0.05. Results Based on the findings, the relationship between self-compassion and postpartum depression was not significant. Self-kindness had a significant positive relationship, and self-judgement had a significant negative relationship with depression (p < 0.01). Body image had a significant predictive effect on postpartum depression (p < 0.05). Conclusions Negative body image as a risk factor for postpartum depression should be considered by healthcare providers and used in the prevention and treatment of postpartum depression.
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Affiliation(s)
- Azam Bakhteh
- Department of Reproductive Health, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nasrin Jaberghaderi
- Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Tahereh Khosrorad
- Department of Midwifery, Kermanshah University of Medical Sciences, Dolat Abad Town, Isar Square, Kermanshah, Iran
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Gupta J, Kaushal S, Priya T. Knowledge, attitude, and practices of healthcare providers about perinatal depression in Himachal Pradesh-A cross-sectional study. J Family Med Prim Care 2023; 12:478-483. [PMID: 37122653 PMCID: PMC10131966 DOI: 10.4103/jfmpc.jfmpc_1170_22] [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: 05/31/2022] [Revised: 09/12/2022] [Accepted: 10/10/2022] [Indexed: 05/02/2023] Open
Abstract
Introduction Perinatal depression is defined as depression occurring in a woman during pregnancy or within 12 months of delivery. It has been associated with many poor outcomes, including maternal, child, and family unit challenges. This study aimed to assess the knowledge, attitude, and practices of obstetricians and primary healthcare professionals so that the knowledge gap could be assessed and they could be educated regarding the screening and treatment/referral of patients with peripartum depression. Methods The study used a cross-sectional study design with convenience sampling. The data were collected through an online survey among healthcare providers using the Google Forms application. Submission of filled questionnaire implied consent for participation. Ethical approval for the study was obtained from the institutional ethics committee. The results were reported as mean and percentages. All data were analysed using Excel software 2019. Results A total of 53 doctors responded to participate in the study. More than 98% of them were aware of an entity called perinatal depression. Around 89% of the participants do not screen patients for the perinatal period routinely using a screening questionnaire. About 90% of participants agreed with the need for screening for perinatal depression. Less than 50% of participants had heard about the screening questionnaire for the same. Around 89% agreed that all health professionals should have skills in recognising and managing depression. Conclusion There is a need to educate healthcare workers including obstetricians about screening for perinatal depression, thus improving the quality of life of perinatal women and preventing complications due to untreated depression.
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Affiliation(s)
- Jyoti Gupta
- Department of Psychiatry, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh, India
| | - Sushruti Kaushal
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh, India
- Address for correspondence: Dr. Sushruti Kaushal, Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh, India. E-mail:
| | - Tanu Priya
- Department of Obstetrics and Gynaecology, Dr. Rajendra Prasad Government Medical College, Kangra at Tanda, Himachal Pradesh, India
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Pham L, Moles RJ, O’Reilly CL, Carter S, Raynes-Greenow C, Chen TF, Raduescu C, Randall S, Bloomfield J, Strowel C, Murphy A, Gardner D, El-Den S. Perinatal Women's Views of Pharmacist-Delivered Perinatal Depression Screening: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16295. [PMID: 36498368 PMCID: PMC9738857 DOI: 10.3390/ijerph192316295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/23/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
Internationally, 20% of women experience perinatal depression (PND). Healthcare providers including general practitioners and midwives are critical in providing PND screening and support; however, the current workforce is unable to meet growing demands for PND care. As accessible and trusted primary healthcare professionals, pharmacists could provide PND care to complement existing services, thereby contributing to early detection and intervention. This study aimed to explore perinatal women's views of community pharmacist-delivered PND screening and care, with a focus on their attitudes towards and acceptability of PND screening implementation in community pharmacy. Semi-structured interviews with women (n = 41) were undertaken, whereby interview data were transcribed verbatim and then inductively and thematically analysed. Five overarching themes emerged; "patient experience with existing PND support and screening services"; "familiarity with pharmacists' roles"; "pharmacist visibility in PND screening care"; "patient-pharmacist relationships" and "factors influencing service accessibility". Themes and subthemes were mapped to the Consolidated Framework for Implementation Research. Findings highlight participants' generally positive attitudes towards community pharmacist-delivered PND screening and care, and the potential acceptability of such services provided pharmacists are trained and referral pathways are established. Addressing perceived barriers and facilitators would allow community pharmacist-delivered PND screening and care to support existing PND care models.
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Affiliation(s)
- Lily Pham
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Rebekah J. Moles
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Claire L. O’Reilly
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Stephen Carter
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Camille Raynes-Greenow
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia
| | - Timothy F. Chen
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Corina Raduescu
- The University of Sydney Business School, University of Sydney, Sydney, NSW 2050, Australia
| | - Sue Randall
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia
| | - Jacqueline Bloomfield
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia
| | - Clara Strowel
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia
| | - Andrea Murphy
- College of Pharmacy, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - David Gardner
- College of Pharmacy, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
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Lamere K, Golova N. Screening for Postpartum Depression During Infant Well Child Visits: A Retrospective Chart Review. Clin Pediatr (Phila) 2022; 61:699-706. [PMID: 35588233 DOI: 10.1177/00099228221097272] [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] [Indexed: 11/17/2022]
Abstract
The American Academy of Pediatrics (AAP) recommends that pediatricians screen mothers for postpartum depression (PPD) at the infant's 1, 2, 4, and 6-month well child (WC) visits. Despite these recommendations, less than 50% of mothers are screened nationally. We evaluated the impact of a statewide quality improvement initiative that implemented routine screening for PPD utilizing the Edinburgh Postpartum Depression Scale (EPDS) at AAP recommended WC visits. A total of 224 patients were included. Screening rates increased significantly at all four WC visits (P < .01). A higher prevalence of positive EPDS screens was detected in mothers with a history of a mental health condition (P = .009) and in mothers who reported recent food or housing insecurity (P = .02). EPDS screening was successfully implemented through a statewide initiative in a busy hospital-based pediatric clinic. Pediatricians play an important role in identifying mothers with PPD and referring them to adequate treatment.
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Affiliation(s)
- Kathryn Lamere
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, USA.,Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Natalia Golova
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, USA
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Pawils S, Kochen E, Weinbrenner N, Loew V, Döring K, Daehn D, Martens C, Kaczmarek P, Renneberg B. [Postpartum depression-who cares? Approaches to care via midwifery, gynaecology, paediatrics and general practice]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2022; 65:658-667. [PMID: 35554610 PMCID: PMC9132831 DOI: 10.1007/s00103-022-03545-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/03/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Postpartum depression (PPD) is one of the most common mental illnesses in the postpartum period. If left untreated, it can have serious consequences for the mother-child relationship and the development of the child. In order to prevent possible negative effects, early diagnosis of affected mothers and professional care are essential. AIM OF THE STUDY This article explores the sense of responsibility of the four primary care providers in the postpartum period-midwives, gynaecologists, general practitioners and paediatricians-and examines how they deal with the disease as well as the barriers and possibilities for optimisation in care. MATERIALS AND METHODS The primary care providers of postpartum women in Germany were interviewed in four independent studies. Quantitative questionnaires were used to interview midwives, gynaecologists and general practitioners, and a qualitative telephone survey was conducted with representatives of the German Association of Paediatricians and Adolescents (BVKJ). A systematic comparative analysis was carried out. RESULTS AND DISCUSSION Midwives and gynaecologists showed a significantly higher sense of responsibility for the recognition and treatment of PPD than general practitioners and paediatricians. Closer interdisciplinary cooperation and thus a wider range of referral and therapy options were named by all four professional groups as a central prerequisite for improving the care situation in Germany. A uniform regulation of financial remuneration is also an important aspect for all providers.
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Affiliation(s)
- Silke Pawils
- Zentrum für Medizinische Psychologie, Institut und Poliklinik für Medizinische Psychologie, Universitätsklinik Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.
| | - Eileen Kochen
- Zentrum für Medizinische Psychologie, Institut und Poliklinik für Medizinische Psychologie, Universitätsklinik Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Nora Weinbrenner
- Zentrum für Medizinische Psychologie, Institut und Poliklinik für Medizinische Psychologie, Universitätsklinik Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Viola Loew
- Zentrum für Medizinische Psychologie, Institut und Poliklinik für Medizinische Psychologie, Universitätsklinik Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Kornelia Döring
- Zentrum für Medizinische Psychologie, Institut und Poliklinik für Medizinische Psychologie, Universitätsklinik Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Daria Daehn
- Fachbereich Erziehungswissenschaften und Psychologie, Klinische Psychologie und Psychotherapie, Freie Universität Berlin, Berlin, Deutschland
| | - Claudia Martens
- Zentrum für Medizinische Psychologie, Institut und Poliklinik für Medizinische Psychologie, Universitätsklinik Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Philip Kaczmarek
- Zentrum für Medizinische Psychologie, Institut und Poliklinik für Medizinische Psychologie, Universitätsklinik Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Babette Renneberg
- Fachbereich Erziehungswissenschaften und Psychologie, Klinische Psychologie und Psychotherapie, Freie Universität Berlin, Berlin, Deutschland
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Branquinho M, Shakeel N, Horsch A, Fonseca A. Frontline health professionals’ perinatal depression literacy: A systematic review. Midwifery 2022; 111:103365. [DOI: 10.1016/j.midw.2022.103365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 03/15/2022] [Accepted: 05/09/2022] [Indexed: 11/15/2022]
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Promotion and Prevention of Perinatal Mood and Anxiety Disorders: Doulas’ Roles and Challenges. J Perinat Educ 2022; 31:82-93. [PMID: 35386494 PMCID: PMC8970132 DOI: 10.1891/jpe-2021-00058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Doulas are uniquely positioned to support women during birth and the postpartum period and can serve as a great asset to identify symptoms of perinatal mood and anxiety disorders (PMADs) and refer women to treatment. The goal of this study is to increase knowledge of doulas’ training on PMADs and their work with women who experienced symptoms. Results from a survey of 156 doulas and interviews with 27 doulas indicate that they felt ill-prepared to identify PMAD symptoms. They struggled in referring patients to the appropriate services and finding professional support related to supporting clients with PMADs. The study concludes that there is a need to develop a standardized model for postpartum doula care that explicitly addresses PMADs.
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Mohammed-Durosinlorun A, Mamoon N, Yakasai B. Screening for postpartum depression by health-care workers in Kaduna, North-Western Nigeria: A cross sectional study. JOURNAL OF CLINICAL SCIENCES 2022. [DOI: 10.4103/jcls.jcls_38_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Dadi AF, Miller ER, Azale T, Mwanri L. "We do not know how to screen and provide treatment": a qualitative study of barriers and enablers of implementing perinatal depression health services in Ethiopia. Int J Ment Health Syst 2021; 15:41. [PMID: 33952338 PMCID: PMC8098000 DOI: 10.1186/s13033-021-00466-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 04/27/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Qualitative studies evaluating maternal mental health services are lacking in Ethiopia, and the available evidence targets severe mental illnesses in the general population. We conducted a qualitative study to explore barriers to, enablers of, or opportunities for perinatal depression health services implementations in Ethiopia. METHODS We conducted a total of 13 face to face interviews with mental and maternal health service administrators from different levels of the Ethiopian healthcare system. We interviewed in Amharic (a local language), transcribed and translated into English, and imported into NVivo. We analysed the translated interviews inductively using thematic framework analysis. RESULTS The study identified: (i) health administrators' low literacy about perinatal depression as individual level barriers; (ii) community low awareness, health-seeking behaviours and cultural norms about perinatal depression as socio-cultural level barriers; (iii) lack of government capacity, readiness, and priority of screening and managing perinatal depression as organisational level barriers; and (iv) lack of mental health policy, strategies, and healthcare systems as structural level barriers of perinatal mental health implementation in Ethiopia. The introduction of the new Mental Health Gap Action Programme (mhGap), health professionals' commitment, and simplicity of screening programs were identified enablers of, or opportunities for, perinatal mental health service implementation. CONCLUSIONS This qualitative inquiry identified important barriers and potential opportunities that could be used to address perinatal depression in Ethiopia. Building the capacity of policy makers and planners, strengthening the mental healthcare system and governance should be a priority issue for an effective integration of maternal mental health care with the routine maternal health services in Ethiopia.
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Affiliation(s)
- Abel Fekadu Dadi
- College of Medicine and Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA 5042 Australia
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Emma R. Miller
- College of Medicine and Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA 5042 Australia
| | - Telake Azale
- Department of Health Education and Behavioural Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Lillian Mwanri
- College of Medicine and Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA 5042 Australia
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Long MM, Cramer RJ, Leiferman JA, Bennington LK, Paulson JF. Perinatal Depression Educational Training for Graduate Nursing Students. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2021; 42:272684X211004685. [PMID: 33745397 DOI: 10.1177/0272684x211004685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to implement and assess an educational intervention for nursing students pertaining to perinatal depression (PD) screening and treatment. A single group (n = 59), repeated-measures design (i.e., pre- and post-intervention assessments) was used to assess the impact of an online intervention. Demographics, Theory of Planned Behavior constructs, intention to screen and treat PD, and PD-related knowledge were tested. The intervention resulted in positive gains in PD-related perceived behavioral control (PBC), attitudes, subjective norms, knowledge, intention to screen and treat PD, and perceived importance of screening and treating PD from pre- to post-intervention. PBC demonstrated a small-to-moderate positive association with perceived importance of screening and treating PD at post-intervention. Results from the current study suggest that the PD online educational intervention is effective in improving participants' PD-related PBC, attitudes, subjective norms, knowledge, and intention to screen and treat PD.
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Affiliation(s)
- Molly M Long
- Centerstone's Research Institute, Nashville, Tennesse, United States
| | - Robert J Cramer
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, United States
| | - Jenn A Leiferman
- Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, United States
| | | | - James F Paulson
- Virginia Consortium Program in Clinical Psychology, Norfolk, USA
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
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Albanese AM, Geller PA, Sikes CA, Barkin JL. The Importance of Patient-Centered Research in the Promotion of Postpartum Mental Health. Front Psychiatry 2021; 12:720106. [PMID: 34603105 PMCID: PMC8481568 DOI: 10.3389/fpsyt.2021.720106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 08/23/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ariana M Albanese
- Women's Health Psychology Laboratory, Department of Psychology, Drexel University, Philadelphia, PA, United States
| | - Pamela A Geller
- Women's Health Psychology Laboratory, Department of Psychology, Drexel University, Philadelphia, PA, United States
| | - Christina A Sikes
- Houston Country Health Department, Georgia Department of Public Health, Warner Robbins, GA, United States
| | - Jennifer L Barkin
- Department of Community Medicine, Mercer University School of Medicine, Macon, GA, United States
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Coffman MJ, Scott VC, Schuch C, Mele C, Mayfield C, Balasubramanian V, Stevens A, Dulin M. Postpartum Depression Screening and Referrals in Special Supplemental Nutrition Program for Women, Infants, and Children Clinics. J Obstet Gynecol Neonatal Nurs 2020; 49:27-40. [DOI: 10.1016/j.jogn.2019.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2019] [Indexed: 12/20/2022] Open
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Bina R, Glasser S, Honovich M, Levinson D, Ferber Y. Nurses perceived preparedness to screen, intervene, and refer women with suspected postpartum depression. Midwifery 2019; 76:132-141. [DOI: 10.1016/j.midw.2019.05.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 05/16/2019] [Accepted: 05/24/2019] [Indexed: 10/26/2022]
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Russomagno S, Waldrop J. Improving Postpartum Depression Screening and Referral in Pediatric Primary Care. J Pediatr Health Care 2019; 33:e19-e27. [PMID: 31227124 DOI: 10.1016/j.pedhc.2019.02.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 02/22/2019] [Accepted: 02/25/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Postpartum depression (PPD) affects up to 20% of American mothers and, if left untreated, can have serious, lifelong effects on women and their children. The American Academy of Pediatrics recommends that pediatric practices screen for PPD at the 1-, 2-, 4-, and 6-month well-child checks; however, few pediatric practices oblige. METHODS This project standardized the PPD screening schedule and developed a novel referral algorithm that was concurrently implemented in a rural primary care pediatric practice. RESULTS The project significantly increased the clinic's screening rate from 33% to 80% (p < .001) and improved referral rates from 66% to 79%. DISCUSSION By standardizing PPD screening and implementing a referral algorithm in the ambulatory pediatric setting, more PPD cases can be identified, further evaluated, and, hopefully, treated to improve maternal and infant health outcomes.
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Improving Postpartum Depression Screening in Pediatric Primary Care: A Quality Improvement Project. J Pediatr Nurs 2019; 46:83-88. [PMID: 30865875 DOI: 10.1016/j.pedn.2019.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 02/24/2019] [Accepted: 03/01/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Despite recommendations for standardized postpartum depression screening in primary care pediatrics, few pediatric healthcare providers are adequately screening mothers for postpartum depression. AIMS To improve standardized screening for postpartum depression in the pediatric primary care setting. Secondary aims were to determine if infant and family characteristics (gender of infant, feeding method, insurance type, income level, ethnicity of infant) were associated with positive postpartum depression screening. METHODS This quality improvement project involved implementing a standardized postpartum depression screening tool into pediatric primary care practice. Independent samples t-test and logistic regression were used for data analysis. RESULTS Postpartum depression screening practices improved from 83% to 88% (p = 0.096). Although not statistically significant, infant characteristics of male gender, Medicaid or sliding-scale payment for services, and Hispanic ethnicity were associated with higher rates of positive postpartum depression screens. CONCLUSIONS Pediatric health care providers can effectively screen for postpartum depression. Certain infant and family characteristics may alert the provider to higher risks for mothers.
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Alfayumi-Zeadna S, Froimovici M, Azbarga Z, Grotto I, Daoud N. Barriers to postpartum depression treatment among Indigenous Bedouin women in Israel: A focus group study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:757-766. [PMID: 30488992 DOI: 10.1111/hsc.12693] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 10/26/2018] [Accepted: 10/27/2018] [Indexed: 06/09/2023]
Abstract
Postpartum depression (PPD), a common mental health problem among mothers worldwide, is higher among minority women. However, little is known about barriers faced by minority women when accessing mental health care services (MHCS) for PPD treatment. Drawing on McLeroy et al (Health Education Quartely 15: 351, 1988) ecological model, the current study explores barriers to mental health services among pregnant and postpartum minority Bedouin women in southern Israel. We conducted eight focus groups (FGs) in Arabic with 75 Bedouin women recruited using snowball sampling. Participants completed a socio-demographic questionnaire at each FG. Discussions were recorded and transcribed verbatim. Next, we conducted simultaneous thematic analysis and coded transcripts into conceptual categories based on the ecological model. We found multiple barriers that manifest at different levels (individual, family, organisational, economic, and public policy) and interact to limit Bedouin women's access to PPD treatment. At the individual level, factors included: women's negative attitudes toward PPD, women's societal status, grand multipara, gender, and limited knowledge about PPD; at the family level: low awareness among husbands and other family members regarding PPD symptoms and treatment, and lack of social support; at the organisational level: lack of culturally appropriate (health care services) HCSs, lack of PPD screening, and lack of PPD detection by family physicians; at the community level: economic barriers and poverty, stigmatisation of mental health problems, polygamy, and multiple births; finally, at the public policy level: residence in unrecognised villages lacking basic infrastructure. Our study thus sheds light on multilevel barriers impacting PPD prevention and treatment among Bedouin women. Policies and intervention programmes should seek to remove these barriers and protect Bedouin women and their children from the consequences of PPD.
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Affiliation(s)
- Samira Alfayumi-Zeadna
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Clalit Health Services, Beer-Sheva, Southern Region, Israel
| | | | - Zoya Azbarga
- Clalit Health Services, Beer-Sheva, Southern Region, Israel
| | - Itmar Grotto
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Public Health Services, Ministry of Health, Jerusalem, Israel
| | - Nihaya Daoud
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Noonan M, Doody O, Jomeen J, O'Regan A, Galvin R. Family physicians perceived role in perinatal mental health: an integrative review. BMC FAMILY PRACTICE 2018; 19:154. [PMID: 30193572 PMCID: PMC6128990 DOI: 10.1186/s12875-018-0843-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 08/27/2018] [Indexed: 02/05/2023]
Abstract
Background Responding to and caring for women who experience mental health problems during the perinatal period, from pregnancy up to one year after birth, is complex and requires a multidisciplinary response. Family physicians are ideally placed to provide an effective response as it is recognised that they are responsible for organising care and supports for women and their families. This paper reports an integrative review undertaken to examine family physicians’ perceived role in perinatal mental health care and concludes with recommendations for health policy, research and practice. Method A systematic search of literature in seven databases from January 2000 to March 2016 identified a total of 1125 articles. Qualitative, quantitative and mixed-method studies were eligible for inclusion if they explored family physicians’ experiences of caring for women who experience perinatal mental health problems. Results Thirteen articles reporting 11 studies met the inclusion criteria for this review and quality of included studies were assessed using published criteria for the critical appraisal of qualitative and quantitative research methods. Cross-study narrative syntheses of quantitative and qualitative findings are presented under three themes: identification of perinatal mental health problems, management of perinatal mental health problems and barriers to care provision. While family physicians recognise their role in relation to perinatal mental health the collective interpretation revealed that; they receive variable levels of preparation for this role, no consistent approach to screening exists, pharmacological management of mood disorders is the main treatment modality and limited access to specialist perinatal mental health services exists which impacts on pharmacology decisions. Conclusion Family physicians require timely access to local integrated care pathways that provide a wide range of services that are culturally sensitive, perinatal mental health specific, support psychological well-being and infant/family mental health. Family physicians are open to incorporating a brief validated screening tool into primary practice supported by succinct guidelines. Research that examines training needs in relation to perinatal mental health could be used to inform family physician training programmes and curriculum development around perinatal mental health.
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Affiliation(s)
- Maria Noonan
- Department of Nursing and Midwifery, Faculty of Education & Health Sciences Health Sciences Building, University of Limerick, Limerick, Ireland.
| | - Owen Doody
- Department of Nursing and Midwifery, Faculty of Education & Health Sciences Health Sciences Building, University of Limerick, Limerick, Ireland
| | - Julie Jomeen
- Faculty of Health and Social Care, University of Hull, Hull, UK
| | - Andrew O'Regan
- Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland
| | - Rose Galvin
- School of Allied Health, Faculty of Education & Health Sciences, Health Sciences Building, University of Limerick, Limerick, Ireland
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Zhou C, Zheng W, Yuan Q, Zhang B, Chen H, Wang W, Huang L, Xu L, Yang L. Associations between social capital and maternal depression: results from a follow-up study in China. BMC Pregnancy Childbirth 2018; 18:45. [PMID: 29394914 PMCID: PMC5797398 DOI: 10.1186/s12884-018-1673-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 01/25/2018] [Indexed: 01/15/2023] Open
Abstract
Background This study aims to investigate the association between social capital (SC) and depressive symptoms among Chinese primiparas at different time-points from their late pregnancy to postpartum. Methods A total of 450 primiparas were recruited for the current study. The assessments were conducted at three different time-points: T1 – while the participants were recruited at their 30–36 weeks of pregnancy in the antenatal clinic in the maternity hospital in Zhejiang, China; T2 – at their 2nd or 3rd days in the wards after delivery; T3 – at week 6 to 8 after the delivery in the postpartum examination clinic. SC was measured by the 29-item SC scale; while depressive symptoms were measured by the Edinburgh Postnatal Depression Scale. The relationships between SC and depressive symptoms were explored separately at each of the three time-points. Results The prevalence of depression among the primiparas was 25% at T1, 13.5% at T2 and 20.8% at T3, respectively. However, the score of SC and its components at three time-points followed an opposite ‘V’ direction, with the highest score at T2, following by T3 and T1. At T1, the analysis suggested that depressive symptoms among the primiparas were negatively correlated with their social trust and social network levels. At T2, only social trust was negatively associated with depression. While at T3, it is social trust and social participations that were significantly negatively associated with depression. Conclusions SC was associated with depression at all three time-points during and after pregnancy. More attention should be given to SC in the maternal health promotion programs of community pregnancy health care management. Electronic supplementary material The online version of this article (10.1186/s12884-018-1673-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chi Zhou
- Medical School, Hangzhou Normal University, 16 Xuelin Rd., Xiasha District, Hangzhou, 310036, China
| | - Weijun Zheng
- School of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Qi Yuan
- Research Division, Institute of Mental Health, Singapore, 539747, Singapore
| | - Baodan Zhang
- Medical School, Hangzhou Normal University, 16 Xuelin Rd., Xiasha District, Hangzhou, 310036, China
| | - Hao Chen
- Medical School, Hangzhou Normal University, 16 Xuelin Rd., Xiasha District, Hangzhou, 310036, China
| | - Weijue Wang
- Medical School, Hangzhou Normal University, 16 Xuelin Rd., Xiasha District, Hangzhou, 310036, China
| | - Liu Huang
- Medical School, Hangzhou Normal University, 16 Xuelin Rd., Xiasha District, Hangzhou, 310036, China
| | - Liangwen Xu
- Medical School, Hangzhou Normal University, 16 Xuelin Rd., Xiasha District, Hangzhou, 310036, China.
| | - Lei Yang
- Medical School, Hangzhou Normal University, 16 Xuelin Rd., Xiasha District, Hangzhou, 310036, China.
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Abstract
Perinatal mental health has important implications for maternal and child outcomes. Most women with psychiatric disorders during pregnancy go undiagnosed and untreated, despite widespread initiatives for early identification. Universal screening for psychiatric disorders, particularly depression and anxiety, has been implemented in obstetric and primary care settings. However, there is little evidence regarding the effectiveness on psychiatric symptom reduction or prevention of adverse outcomes in children. Recently, comprehensive screening and follow-up programs integrated within obstetric or primary care settings have shown promising results in improving maternal mental health outcomes. Further work is needed to determine best clinical and most cost-effective practices.
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Affiliation(s)
- Shannon N Lenze
- Department of Psychiatry, Washington University School of Medicine, Campus Box 8504, 660 South Euclid Avenue, St Louis, MO 63110, USA.
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Rashid A. Yonder: Hearing aids, postpartum depression, acute asthma, and online records. Br J Gen Pract 2016; 66:147. [PMID: 26917644 PMCID: PMC4758482 DOI: 10.3399/bjgp16x684049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Affiliation(s)
- Ahmed Rashid
- NIHR Academic Clinical Fellow in General Practice, University of Cambridge, Cambridge. E-mail: @Dr_A_Rashid
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