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Gingras AS, Brassard A, Péloquin K, Lafontaine MF, Brault-Labbé A, Gosselin P. Anxiety and depressive symptoms in first-time parents: A dyadic longitudinal study based on attachment theory. J Affect Disord 2024; 355:122-130. [PMID: 38552919 DOI: 10.1016/j.jad.2024.01.275] [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: 06/10/2023] [Revised: 12/12/2023] [Accepted: 01/04/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND The aim of this study was to examine the temporal and dyadic associations between anxiety and depressive symptoms during the transition to parenthood (TTP), while exploring the antecedence of attachment insecurities in these associations. METHOD Couples of first-time parents (N = 211) completed the State-Trait Anxiety Inventory, the Edinburgh Postnatal Depression Scale, the Experiences in Close Relationships scale, and a sociodemographic questionnaire during the second trimester of pregnancy and at four and twelve months postpartum. RESULTS Both prenatal anxiety and depressive symptoms predicted postnatal depressive and anxiety symptoms. Prenatal attachment-related anxiety predicted higher postnatal anxiety and depressive symptoms whereas prenatal attachment-related avoidance predicted higher postnatal depressive symptoms only. Parents whose partners had a higher level of prenatal attachment-related anxiety experienced higher postnatal anxious and depressive symptoms via their own's prenatal depressive symptoms. Parents whose partners had a higher level of prenatal attachment-related avoidance experienced higher postnatal depressive symptoms via their own's prenatal anxious symptoms. No gender differences were found for these associations. LIMITATIONS The sample was predominantly composed of educated heterosexual French-Canadian Caucasian couples and all measures were self-reported. CONCLUSIONS Our original findings suggest that professionals should routinely screen for anxiety and depressive symptoms in both partners from pregnancy up to one year postpartum. Also, our findings suggest addressing attachment insecurities with both partners to prevent the development of future symptoms during pregnancy or after childbirth. Finally, our study supports the relevance of considering these symptoms at subclinical levels during the TTP.
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Affiliation(s)
| | - Audrey Brassard
- Department of Psychology, Université de Sherbrooke, Québec, Canada.
| | | | | | | | - Patrick Gosselin
- Department of Psychology, Université de Sherbrooke, Québec, Canada
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DeMairo J, Rimsky L, Moses A, Birndorf C, Bellenbaum P, Van Nortwick N, Osborne LM, Robakis TK. Outcomes at the Motherhood Center: A Comparison of Virtual and On-Site Versions of a Specialized Perinatal Partial Hospitalization Program. Matern Child Health J 2024; 28:828-835. [PMID: 37964152 DOI: 10.1007/s10995-023-03836-9] [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] [Accepted: 10/26/2023] [Indexed: 11/16/2023]
Abstract
OBJECTIVES Remotely administered mental health care is becoming increasingly common for treatment of a range of psychiatric disorders; however, there is a dearth of literature overviewing direct comparisons between remote and in-person interventions for treatment of Perinatal Mood and Anxiety Disorders (PMADs). The sudden advent of the Covid-19 pandemic in New York City forced an abrupt conversion for an intensive day treatment program for new mothers with PMADs, from an on-site to a remote program. METHODS The current report compares outcomes of 81 women who completed the program in-person to those of 60 women who completed the program remotely. RESULTS Improvement in depression scores was statistically superior in the remote program, and improvement in mother-infant bonding was statistically equivalent between the on-site and remote programs. DISCUSSION These findings indicate that specialized partial hospitalization treatment for individuals with moderate to severe psychiatric illness can be effectively provided via telehealth, thus offering improved convenience, accessibility, and safety without compromising care. We conclude that remotely administered group psychotherapy is an effective intervention for women with moderate to severe PMADs.
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Affiliation(s)
- Jeana DeMairo
- The Motherhood Center of New York, New York, NY, USA
| | - Liza Rimsky
- The Motherhood Center of New York, New York, NY, USA
| | - Ada Moses
- The Motherhood Center of New York, New York, NY, USA
| | | | | | | | | | - Thalia K Robakis
- The Motherhood Center of New York, New York, NY, USA.
- Women's Mental Health Program, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, Rm L4-45, New York, NY, USA.
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3
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Etyemez S, Miller KN, Voegtline KM, Özdemir İ, Standeven LR, Santovito LS, Pinna G, Payne JL, Osborne LM. Metabolites of progesterone in pregnancy: Associations with perinatal anxiety. Psychoneuroendocrinology 2023; 156:106327. [PMID: 37423029 PMCID: PMC10530426 DOI: 10.1016/j.psyneuen.2023.106327] [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: 04/27/2023] [Revised: 06/21/2023] [Accepted: 06/24/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND Anxiety disorders are the most common psychiatric disorder during the perinatal period and one of the major risk factors for postpartum depression, yet we know little about biological factors in the etiology of perinatal anxiety. A growing literature points to neuroactive steroid (NAS) dysregulation in perinatal mental illness, but directionality has not been clearly demonstrated, results are not consistent, and no studies have investigated NAS in a population with pure anxiety without comorbid depression. We aimed to add to the limited literature by examining the association between anxiety without comorbid depression and metabolic pathways of NAS longitudinally across the peripartum. METHODS We measured anxiety symptoms by psychological scales and NAS levels using Gas Chromatography-Mass Spectrometry (GC-MS) at the second and third trimester (T2 and T3) and week 6 postpartum (W6) in n = 36 women with anxiety and n = 38 healthy controls. The anxiety group was determined by a data-driven approach, and cross-sectional and longitudinal statistical methods were used to examine the relationship between the study population and NAS. RESULTS We found that anxiety had a significant moderating effect on the relationship between progesterone and allopregnanolone, with no such effect for the relationships between progesterone and the intermediate (5α-DHP) or isomeric (isoallopregnanolone) compounds in this pathway, and no effects on the corresponding pathway converting progesterone to pregnanolone and epipregnanolone. We also found a less precipitous decline in the ratio of allopregnanolone to progesterone between T3 and W6 in the anxiety group compared to the non-anxiety group. A genotype analysis of a single-nucleotide polymorphism in the AKR1C2 gene demonstrated that the relationship of allopregnanolone to the intermediate metabolite, 5α-DHP, differed by genotype. CONCLUSION Our exploratory findings indicate that, for pregnant people with anxiety, metabolism is shunted more aggressively toward the endpoint of the progesterone to allopregnanolone metabolic pathway than it is for those without anxiety.
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Affiliation(s)
- Semra Etyemez
- Department of Obstetrics & Gynecology, Weill Cornell Medicine, 525 E. 68th St., M-706, New York, NY 10065, USA; Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA
| | - Kristen N Miller
- Reproductive Mental Health Center, Departments of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, 550 N. Broadway, Suite 305C, Baltimore, MD 21205, USA
| | - Kristin M Voegtline
- Division of General Pediatrics, Department of Pediatrics, Johns Hopkins University School of Medicine, 200 N. Wolfe St, Room 2076, Baltimore, MD 21287, USA; Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA
| | - İpek Özdemir
- Department of Radiology, Johns Hopkins University School of Medicine, 600 N Wolfe St, Park 367C, Baltimore, MD 21287, USA
| | - Lindsay R Standeven
- Reproductive Mental Health Center, Departments of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, 550 N. Broadway, Suite 305C, Baltimore, MD 21205, USA
| | - Luca Spiro Santovito
- The Psychiatric Institute, Department of Psychiatry, College of Medicine, University of Illinois at Chicago, 1601 W Taylor St, Chicago, 60612 IL, USA
| | - Graziano Pinna
- The Psychiatric Institute, UI Center on Depression and Resilience (UICDR), Center for Alcohol Research in Epigenetics (CARE), Department of Psychiatry, University of Illinois Chicago, 1601 W Taylor St, Chicago, IL 60612, USA
| | - Jennifer L Payne
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, PO Box 800548, Charlottesville, VA, USA
| | - Lauren M Osborne
- Department of Obstetrics & Gynecology, Weill Cornell Medicine, 525 E. 68th St., M-706, New York, NY 10065, USA; Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA.
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4
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Zain E, Fukui N, Watanabe Y, Hashijiri K, Motegi T, Ogawa M, Egawa J, Someya T. High care and low overprotection from both paternal and maternal parents predict a secure attachment style with a partner among perinatal Japanese women. Sci Rep 2023; 13:15684. [PMID: 37735197 PMCID: PMC10514324 DOI: 10.1038/s41598-023-42674-1] [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: 01/11/2023] [Accepted: 09/13/2023] [Indexed: 09/23/2023] Open
Abstract
This study aimed to determine how paternal and maternal parenting before adolescence affects adult attachment to a partner during the perinatal period, using three different models of attachment. We used the Parental Bonding Instrument (PBI) and the Relationship Questionnaire (RQ) to examine perceived parenting practices and adult attachment styles, respectively. The participants included 4586 Japanese women who were pregnant or who had given birth, up until one month after childbirth. We performed structural equation modeling analysis between PBI and RQ scores with three different category models, including the four-category model (secure, fearful, preoccupied, and dismissive attachment) as Model 1, the two-category model (model of the self and others) as Model 2, and the single-category model (total attachment style) as Model 3. Models 1 and 2 showed a good fit. Both path models showed a significant association between adult attachment style and perceived paternal and maternal parenting before adolescence, where high care and low overprotection from both paternal and maternal parents predicted adult attachment. Our findings indicate that attachment styles are best described using the four-category and two-category models, and suggest that both paternal and maternal overprotection and care influence adult attachment with a partner during the perinatal period.
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Affiliation(s)
- Ekachaeryanti Zain
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 757 Asahimachidori-ichibancho, Chuo-ku, Niigata, 951-8510, Japan
- Department of Psychiatry, Faculty of Medicine, Mulawarman University, Samarinda, Indonesia
| | - Naoki Fukui
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 757 Asahimachidori-ichibancho, Chuo-ku, Niigata, 951-8510, Japan
| | - Yuichiro Watanabe
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 757 Asahimachidori-ichibancho, Chuo-ku, Niigata, 951-8510, Japan
| | - Koyo Hashijiri
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 757 Asahimachidori-ichibancho, Chuo-ku, Niigata, 951-8510, Japan
| | - Takaharu Motegi
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 757 Asahimachidori-ichibancho, Chuo-ku, Niigata, 951-8510, Japan
| | - Maki Ogawa
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 757 Asahimachidori-ichibancho, Chuo-ku, Niigata, 951-8510, Japan
| | - Jun Egawa
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 757 Asahimachidori-ichibancho, Chuo-ku, Niigata, 951-8510, Japan
| | - Toshiyuki Someya
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 757 Asahimachidori-ichibancho, Chuo-ku, Niigata, 951-8510, Japan.
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Altamura M, Leccisotti I, De Masi L, Gallone F, Ficarella L, Severo M, Biancofiore S, Denitto F, Ventriglio A, Petito A, Maruotti G, Nappi L, Bellomo A. Coping as a Mediator between Attachment and Depressive Symptomatology Either in Pregnancy or in the Early Postpartum Period: A Structural Equation Modelling Approach. Brain Sci 2023; 13:1002. [PMID: 37508934 PMCID: PMC10377438 DOI: 10.3390/brainsci13071002] [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: 05/24/2023] [Revised: 06/25/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023] Open
Abstract
Peripartum depression (PPD) is a major complication of pregnancy, and numerous risk factors have been associated with its onset, including dysfunctional coping strategies and insecure attachment styles, both during pregnancy and postpartum. The aim of our study was to investigate the role of coping strategies in mediating the relationship between women's attachment style and depressive symptomatology in pregnancy and one week after giving birth in a large sample of women (N = 1664). Our hypothesis was that the relationship between anxious and avoidant attachment and depressive symptomatology would be mediated by use of maladaptive coping strategies. The assessment instruments were Edinburgh Postnatal Depression Scale (EPDS), Brief Coping Orientation for Problem Experiences (COPE), and Experiences in Close Relationship Scale (ECR). The results indicated that the effect of insecure attachment styles (anxious and avoidant attachment) on antepartum depressive symptomatology was partially mediated by dysfunctional coping styles. Anxious attachment also has an indirect significant effect on postpartum depressive symptomatology through emotional coping; however, avoidant attachment does not seem to be significantly related to postpartum depressive symptoms. Our findings revealed that not only is it important to consider attachment in understanding peripartum depressive symptomatology, but also that coping plays an important role in these relationships. These findings would help a preventive coping-based intervention strategy to enhance the capacity of women with insecure attachment styles to use more adaptive coping during and after pregnancy.
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Affiliation(s)
- Mario Altamura
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Ivana Leccisotti
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Laura De Masi
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Fiammetta Gallone
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Livia Ficarella
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Melania Severo
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Simona Biancofiore
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Francesca Denitto
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Annamaria Petito
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Giuseppe Maruotti
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Luigi Nappi
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Antonello Bellomo
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
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Terrone G, Bianciardi E, Fontana A, Pinci C, Castellani G, Sferra I, Forastiere A, Merlo M, Marinucci E, Rinaldi F, Falanga M, Pucci D, Siracusano A, Niolu C. Psychological Characteristics of Women with Perinatal Depression Who Require Psychiatric Support during Pregnancy or Postpartum: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085508. [PMID: 37107790 PMCID: PMC10138626 DOI: 10.3390/ijerph20085508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/20/2023] [Accepted: 04/11/2023] [Indexed: 05/11/2023]
Abstract
Antenatal depression may be distinct from postpartum depression in terms of prevalence, severity of symptoms, comorbidities, prognosis, and risk factors. Although risk factors for perinatal depression have been identified, it is unclear whether there are differences in the onset of perinatal depression (PND). This study explored the characteristics of women requiring mental health support during pregnancy or postpartum. A sample of 170 women (58% in pregnancy; 42% postpartum) who contacted the SOS-MAMMA outpatient clinic was recruited. Clinical data sheets and self-report questionnaires (EPDS, LTE-Q, BIG FIVE; ECR; BSQ; STICSA) were administered, hypothesizing possible risk factors, such as personality traits, stressful life events, body dissatisfaction, attachment style, and anxiety. Hierarchical regression models were carried out in the pregnancy (F10;36 = 8.075, p < 0.001, adjR2 = 0.877) and postpartum groups (F10;38 = 3.082, p < 0.05, adjR2 = 0.809). Recent stressful life events and conscientiousness were associated with depression in both the pregnant (29.3%, 25.5% of variance) and postpartum groups (23.8%, 20.7% of variance). In pregnant women, "openness" (11.6%), body dissatisfaction (10.2%), and anxiety (7.1%) symptoms were predictive of depression. In the postpartum group, "neuroticism" (13.8%) and insecure romantic attachment dimensions (13.4%; 9.2%) were the strongest predictors. Perinatal psychological interventions should consider the differences between mothers with depression during pregnancy and postpartum.
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Affiliation(s)
- Grazia Terrone
- Department of History, Cultural Heritage, Education and Society, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Emanuela Bianciardi
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
- Correspondence:
| | - Andrea Fontana
- Department of Human Sciences, Lumsa University of Rome, 00193 Rome, Italy
| | - Carolina Pinci
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Giulia Castellani
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Irene Sferra
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Anna Forastiere
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Mattia Merlo
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Elicio Marinucci
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Fiamma Rinaldi
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Marina Falanga
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Daniela Pucci
- Department of Mental Health and Pathological Addictions (DSMDP), ASL ROMA 5, 00019 Tivoli (Rome), Italy
| | - Alberto Siracusano
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Cinzia Niolu
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
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The Mother-Baby Bond: Role of Past and Current Relationships. CHILDREN 2023; 10:children10030421. [PMID: 36979979 PMCID: PMC10046950 DOI: 10.3390/children10030421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/13/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023]
Abstract
During the perinatal period, up to 25% of women experience difficulties in relating to their child. The mother-child bond promotes the transition to motherhood, protects the woman from depression, and protects the child from the intergenerational transmission of the disease. This study prospectively investigated if the relationship with the co-parent, the attachment style, and the bond that women had with their parents influenced the mother-fetus and then mother-child bond. We also explored the role of depression and anxiety. One hundred nineteen pregnant women were enrolled. We administered clinical interviews and psychometric tools. A telephone interview was conducted at 1, 3, and 6 months of follow-up. Maternal insecure attachment style (r = −0.253, p = 0.006) and women’s dyadic adjustment in the couple’s relationships (r = 0.182, p = 0.049) were correlated with lower maternal–fetal attachment. Insecure attachment styles and depression correlate with bottle-feeding rather than breastfeeding. The bond women had with their mothers, not their fathers, was associated with breastfeeding. Depression (OR = 0.243, p = 0.008) and anxiety (OR = 0.185, p = 0.004; OR = 0.304, p < 0.0001) were related to mother-infant bonding. Close relationships, past and present, affect the bond with the fetus and the child differently. Psychotherapy can provide reassuring and restorative intersubjective experiences.
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Orsolini L, Pompili S, Mauro A, Volpe U. Foreign Nationality, Family Psychiatry History and Pregestational Neoplastic Disease as Predictors of Perinatal Depression in a Cohort of Healthy Pregnant and Puerperal Women during the COVID-19 Pandemic. Healthcare (Basel) 2023; 11:healthcare11030428. [PMID: 36767003 PMCID: PMC9914901 DOI: 10.3390/healthcare11030428] [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: 12/30/2022] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
Background: Perinatal depression (PND) represents one of the most common mental disorders in the pregnancy and/or postpartum period, with a 5-25% prevalence rate. Our aim was to investigate predictors associated with PND in a cohort of pregnant and puerperal women based in an Italian setting during the COVID-19 pandemic. Methods: We retrospectively recruited 199 (55 pregnant and 144 puerperal) women, afferent to our Perinatal Mental Outpatient Service of Ancona (Italy). Participants were administered an ad hoc case-report form, Whooley Questions (WQ), the General Health Questionnaire-12 (GHQ-12), the Stress Holmes-Rahe scale (HR) and the Edinburgh Postnatal Depression Scale (EPDS). Results: Around 10% of the sample had a confirmed PND. Being a foreigner woman (RR = 3.8), having a positive psychiatric family history (RR = 5.3), a pre-pregnancy medical comorbidity (RR = 1.85) and a comorbid medical illness occurring during the pregnancy (RR = 2) were much likely associated with PND. Multiple linear regression analysis demonstrated that GHQ, medium- and high-risk at the HR, foreign nationality, positive family psychiatric history, and neoplastic disease before conception significantly predicted EPDS [F(1, 197) = 10.086, R2 = 0.324, p < 0.001]. Limitations: The sample size, poor heterogeneity in terms of socio-demographic, clinical and gynecological-obstetric characteristics, the cross-sectional design of the study. Conclusions: Our study showed a set of predictors associated with a higher risk for the PND onset, including gestational and pregestational medical disease. Our findings outline the need to screen all fertile women, particularly in gynecological and medical settings, in order to identify at-risk women for PND and promptly suggest a psychiatric consultation.
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Dragomir C, Popescu R, Bernad ES, Boia M, Iacob D, Dima MA, Laza R, Soldan N, Bernad BC, Semenescu AE, Dragomir I, Angelescu-Coptil CE, Nitu R, Craina M, Balaceanu-Stolnici C, Dehelean CA. The Influence of Maternal Psychological Manifestations on the Mother-Child Couple during the Early COVID-19 Pandemic in Two Hospitals in Timisoara, Romania. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58111540. [PMID: 36363497 PMCID: PMC9695155 DOI: 10.3390/medicina58111540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/23/2022] [Accepted: 10/24/2022] [Indexed: 02/25/2023]
Abstract
Background and objectives: The postpartum maternal physical and psychological state played a fundamental role in the mother−child relationship at the beginning of the COVID-19 pandemic. The aim of the study is to analyze the influence of maternal psychological manifestations on the mother−child couple through three objectives (briefly expressed): (I) Determination of the main acute and chronic conditions of newborns/infants. (II) Verification of the hypothesis of the existence of a link between the following neonatal variables: gestational age, birth weight, number of days of hospitalization, and specific neonatal therapies (oxygen, surfactant, and blood products’ transfusion). (III) Verification of the influence of postpartum maternal psychological status on the mother−child couple through three hypotheses. Materials and methods: This cross-sectional study was conducted in two hospitals in Timișoara, Romania, between 1 March and 1 September 2020, and included 165 mothers and their 175 newborns. Mothers answered the Edinburgh Postnatal Depression Scale, Spielberger’s Inventory of State-Trait Anxiety, and the Collins and Read Revised Adult Attachment Scale. Results: (I) The acute and chronic pathology of the infants in the study group was polymorphic. (II) Large correlations were identified between the following infant variables: gestational age with birth weight, and number of hospitalization days with birth weight, gestational age, and use of blood product transfusion (all p < 0.001). (III) (1) State anxiety was the only significant predictor of number of hospitalization days (p = 0.037), number of acute disorders (p = 0.028), and number of infant chronic diseases (p = 0.037). (2) Maternal depressive symptoms were the only predictor of postpartum maternal attachment (p = 0.018). (3) Depressive symptoms, state, and trait anxiety were non-significant in all models studied (all p > 0.05). Conclusions: Postpartum maternal physical and psychological state plays a fundamental role on the mother−child relationship in the new social and complex family conditions.
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Affiliation(s)
- Cristina Dragomir
- Doctoral School, ‘Victor Babes’ University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Roxana Popescu
- Department II—Microscopic Morphology, Discipline of Cellular and Molecular Biology, ‘Victor Babes’ University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- ANAPATMOL Research Center, ‘Victor Babes’ University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Correspondence: (R.P.); (E.S.B.); Tel.: +40-723-649-886 (R.P.); +40-745-395-220 (E.S.B.)
| | - Elena Silvia Bernad
- Department XII—Obstetrics-Gynecology, Discipline of Obstetrics-Gynecology III, ‘Victor Babes’ University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Correspondence: (R.P.); (E.S.B.); Tel.: +40-723-649-886 (R.P.); +40-745-395-220 (E.S.B.)
| | - Marioara Boia
- Department XII—Obstetrics-Gynecology, Discipline of Neonatology and Childcare, ‘Victor Babes’ University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Daniela Iacob
- Department XII—Obstetrics-Gynecology, Discipline of Neonatology and Childcare, ‘Victor Babes’ University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- ‘Pius Brinzeu’ County Emergency Clinical Hospital, Liviu Rebreanu Bd., No. 156, 300723 Timisoara, Romania
| | - Mirabela Adina Dima
- Department XII—Obstetrics-Gynecology, Discipline of Neonatology and Childcare, ‘Victor Babes’ University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- ‘Pius Brinzeu’ County Emergency Clinical Hospital, Liviu Rebreanu Bd., No. 156, 300723 Timisoara, Romania
| | - Ruxandra Laza
- Department XIII, Discipline of Infectious Disease, ‘Victor Babes’ University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Nicoleta Soldan
- ‘Francisc I. Rainer’ Anthropological Research Center, Romanian Academy, Eroii Sanitari Bd., No. 8, 050474 Bucharest, Romania
| | - Brenda-Cristiana Bernad
- Department VIII—Neurosciences, ‘Victor Babes’ University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Alin Eugen Semenescu
- Department of Psychology, West University of Timisoara, Vasile Parvan Bd., No. 4, 300223 Timisoara, Romania
- Institute for Advanced Environmental Research (ICAM), West University of Timisoara, Vasile Parvan Bd., No. 4, 300223 Timisoara, Romania
| | - Ion Dragomir
- Individual Family Medical Office, 207440 Ostroveni, Romania
| | | | - Razvan Nitu
- Department XII—Obstetrics-Gynecology, Discipline of Obstetrics-Gynecology III, ‘Victor Babes’ University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Marius Craina
- Department XII—Obstetrics-Gynecology, Discipline of Obstetrics-Gynecology III, ‘Victor Babes’ University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Constantin Balaceanu-Stolnici
- Rumanian Academy, Calea Victoriei, No. 125, Sector 1, 010071 Bucharest, Romania
- ‘Francisc I. Rainer’ Institute of Anthropology, Romanian Academy, Eroii Sanitari Bd., No. 8, 050474 Bucharest, Romania
| | - Cristina Adriana Dehelean
- Department of Toxicology and Drug Industry, Faculty of Pharmacy, ‘Victor Babes’ University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- FARMATOX Research Centre for Pharmaco-Toxicological Evaluation, ‘Victor Babes’ University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
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10
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He Z, Chiu JWT, Lin Y, Akinwunmi B, Wong TH, Zhang CJP, Ming WK. The Construct Structures of Psychological and Behavioral Responses to COVID-19 Pandemic in Pregnant Women. Front Psychiatry 2022; 13:796567. [PMID: 35903641 PMCID: PMC9323087 DOI: 10.3389/fpsyt.2022.796567] [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: 10/17/2021] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
AIM The present study aimed to investigate the construct structure behind the psychosocial response, behavioral response, prenatal depression, and post-traumatic stress disorder (PTSD) in pregnant women during the COVID-19 pandemic in China. METHOD The validated Chinese version of the Edinburgh Postnatal Depression Scale (EPDS), PTSD CheckList (PCL)-6, and two newly established scales for COVID-19-related psychological and behavioral responses were used. Structural equation modeling (SEM) analysis was applied to evaluate the structural relationships of psychological and behavioral responses during the COVID-19 pandemic. RESULTS Of the 1,908 mothers who completed the questionnaires, 1,099 met the criteria for perinatal depression, and 287 were positively screened for PTSD, where 264 women exceed the cut-off points for both. Pregnant women with full-time or part-time jobs tended to have the lowest scores of EPDS (10.07 ± 5.11, P < 0.001) and stress levels (23.85 ± 7.96, P = 0.004), yet they were more likely to change their behavior in accordance with the COVID-19 outbreak (13.35 ± 3.42, P = 0.025). The structural model fit the data (χ2 = 43.260, p < 0.001) and resulted in satisfactory fit indices (CFI = 0.984, TLI = 0.959, RMSEA = 0.072, and χ2/df = 10.815), all path loadings were significant (p < 0.05). The SEM indicates that the level of QoL was attributable to the occurrence of PND, leading to PTSD, and COVID-19 related behavioral and psychological responses. CONCLUSION The inter-relationships between the COVID-19-related psychosocial and behavioral responses have been assessed, indicating that the pandemic increased the burden of perinatal depression. Psychoeducation, as well as other psychological interventions, may be needed to alleviate the COVID-19-based anxiety and increase their engagement in protective behaviors.
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Affiliation(s)
- Zonglin He
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Science, City University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Division of Life Science, The Hong Kong University of Science and Technology, Hong Kong, Hong Kong SAR, China
| | - Joyce Wai-Ting Chiu
- International School, Jinan University, Guangzhou, China.,Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.,Department of Psychology, University of York, York, United Kingdom
| | - Yuchen Lin
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Babatunde Akinwunmi
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.,Center for Genomic Medicine (CGM), Massachusetts General Hospital and Harvard Medical School, Harvard University, Boston, MA, United States
| | - Tak Hap Wong
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, Guangzhou, China.,Department of Obstetrics, Guangdong Women and Children Hospital, Guangzhou, China
| | - Casper J P Zhang
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Wai-Kit Ming
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Science, City University of Hong Kong, Hong Kong, Hong Kong SAR, China
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11
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Bellomo A, Severo M, Petito A, Nappi L, Iuso S, Altamura M, Marconcini A, Giannaccari E, Maruotti G, Palma GL, Vicino M, Perrone A, Tufariello AM, Sannicandro V, Milano E, Arcidiacono G, Di Salvatore M, Caroli A, Di Pinto I, Ventriglio A. Perinatal depression screening and prevention: Descriptive findings from a multicentric program in the South of Italy. Front Psychiatry 2022; 13:962948. [PMID: 35990082 PMCID: PMC9389401 DOI: 10.3389/fpsyt.2022.962948] [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: 06/07/2022] [Accepted: 07/07/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Perinatal depression (PD) is a cluster of clinical depressive symptoms occurring globally during pregnancy or after childbirth, with a prevalence of 11.9%. Risk factors for PD among pregnant women may include personality traits of neuroticism, low personal resilience, higher anxiety, avoidance in close relationships, as well as dysfunctional coping strategies. METHODS We report on descriptive findings of a screening/prevention program aimed to detect depressive symptoms and associated risk factors in a large sample of women (N = 1,664) accessing the gynecological departments of the Regione Puglia (South of Italy) from July to November 2020. Pregnant women were assessed in their third trimester of pregnancy (T0), after childbirth (T1), and those at risk for PD within 1 year from delivery (T2-T4); The Edinburgh Postnatal Depression Scale (EPDS) has been employed for the screening of PD over time as well as other standardized measures for neuroticism, resilience, coping strategies, and quality of life. RESULTS Of 1,664, n = 1,541 were tested at T1, and 131 scored ≥ 12 at EPDS (14.6 ± 2.95), showing a higher risk for PD. They were followed over time at 1, 6, and 12 months after childbirth (T2-T4), and 15 of them scored ≥ 12 (EPDS) at T4. Women with a higher risk of PD also reported higher levels of neuroticism, lower levels of personal resilience, more anxiety and avoidance in close relationships, higher employment of dysfunctional coping strategies (e.g., denial, self-blame, etc.), and lower quality of life (0.0008 < all p < 0.0001). CONCLUSION This study confirmed the benefit of screening programs for the early detection of PD among pregnant women. We may suggest a set of risk factors to be considered in the clinical assessment of PD risk as well as the promotion of similar programs to improve depressive outcomes and pathways to care for PD on the basis of a more accurate assessment and referral.
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Affiliation(s)
- Antonello Bellomo
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Melania Severo
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Annamaria Petito
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Luigi Nappi
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Salvatore Iuso
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Mario Altamura
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | | | | | - Giuseppe Maruotti
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | | | - Mario Vicino
- Unit of Gynecology, Di Venere Hospital, Bari, Italy
| | | | - Anna Maria Tufariello
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Valeria Sannicandro
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Eleonora Milano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giulia Arcidiacono
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Melanie Di Salvatore
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | | | - Isabella Di Pinto
- Dipartimento Promozione Della Salute e del Benessere Animale, Regione Puglia, Bari, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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12
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Relationship of post-traumatic stress disorder with disrespect and abuse during childbirth in a group of Iranian postpartum women: a prospective study. Ann Gen Psychiatry 2021; 20:8. [PMID: 33485389 PMCID: PMC7827985 DOI: 10.1186/s12991-021-00331-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Disrespect and abuse (D&A) violate the fundamental principles of ethics, human rights, and basic obligations to protect and relieve patients. This study aimed to identify the status of D&A and its relationship with the post-traumatic stress disorder (PTSD) among Iranian women. METHODS This prospective study was conducted on 288 mothers admitted to the maternity wards of three public and three private hospitals in Tabriz. The data collection tools were socio-demographic and obstetric questionnaires as well as D&A (6-18 h postpartum) and PTSD (one month postpartum) scales, which were completed by participants in interviews. Multivariate logistic regression was employed to determine the relationship between PTSD and D&A in adjusting the socio-demographic and obstetric variables. RESULTS In this study, 74.7% of mothers reported one or multiple types of D&A. According to the diagnostic criteria for PTSD, 16.3% of the participants experienced postpartum PTSD. The mean (± standard deviation) of the PTSD score was reported 7.32 (± 2.0) in the women experiencing D&A, whereas it was 1.0 (± 0.0) in the women having no experiences of D&A. According to the Mann-Whitney U test results, there was a significant relationship between the total and all subscales of PTSD score and D&A (p < 0.001). The multivariate logistic regression results indicated that the likelihood of PTSD was significantly lower in the participants without any D&A experiences than in those with D&A experiences (aOR: 0.06; 95% CI 0.01 to 0.58; p = 0.015). CONCLUSION Given the PTSD-D&A relationship, it is recommended to improve maternal care in maternity facilities to prevent any unintended PTSD complications.
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13
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Chimenti MS, Fonti GL, Conigliaro P, Triggianese P, Bianciardi E, Coviello M, Lombardozzi G, Tarantino G, Niolu C, Siracusano A, Perricone R. The burden of depressive disorders in musculoskeletal diseases: is there an association between mood and inflammation? Ann Gen Psychiatry 2021; 20:1. [PMID: 33397417 PMCID: PMC7783979 DOI: 10.1186/s12991-020-00322-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 12/14/2020] [Indexed: 12/17/2022] Open
Abstract
IMPORTANCE Evidence emerged concerning how inflammatory arthritis and mood disorders can often occur in the same patient and show a similar clinical pattern. An overview of the rheumatological and psychiatric aspects of these diseases can certainly be useful for the improvement of patients' clinical and therapeutic management. OBJECTIVE The aim of this narrative review was to summarize existing literature about common pathogenetic and clinical aspects as a means of improving management and therapeutic approach in patients affected by rheumatoid arthritis, psoriatic arthritis and spondyloarthritis. Outcomes such as disease activity indexes and patient reported outcomes (PROs) were considered. FINDINGS Common pathogenetic pathways emerged between inflammatory arthritis and mood disorders. Pro-inflammatory mechanisms, such as TNFα, IL-6, IL-17 and oxidative stress factors as well as neurotransmitter alterations at the level of CNS and blood-brain barrier (BBB) cells are involved. The activation of these common pathogenetic pathways is, also, affected by the same triggers, such as smoking, stress, lifestyle, and evidence has emerged concerning the possibility of the clinical efficacy of using the same therapeutic approaches. CONCLUSIONS The main causes of the variability in clinical studies outcomes are the rheumatological diseases considered, the prevalence of depression in the general population and in patients with rheumatological diseases and the type of depressive symptom examined. Patients affected by inflammatory arthritis can present symptoms and signs in common with mood disorders, leading to possible clinical overlap. There are still few studies analyzing this concept: they are extremely heterogeneous, both in the characteristics of the population taken into consideration and in the methods used for the definition of depressive disorder, but the suggestions of the data obtained so far are promising and deserve to be pursued.
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Affiliation(s)
- Maria Sole Chimenti
- Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giulia Lavinia Fonti
- Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Paola Conigliaro
- Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Paola Triggianese
- Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Emanuela Bianciardi
- Psychiatric Chair, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, Rome, Italy.
| | - Marialuce Coviello
- Psychiatric Chair, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, Rome, Italy
| | - Ginevra Lombardozzi
- Psychiatric Chair, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, Rome, Italy
| | - Giulia Tarantino
- Psychiatric Chair, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, Rome, Italy
| | - Cinzia Niolu
- Psychiatric Chair, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, Rome, Italy
| | - Alberto Siracusano
- Psychiatric Chair, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, Rome, Italy
| | - Roberto Perricone
- Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
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