Depression and Domestic Violence Experiences Among Asian Women: A Systematic Review

Integrated domestic violence and reproductive health interventions in India: a systematic review

BACKGROUND

Domestic violence is a leading cause of poor health outcomes during pregnancy and the postpartum period. Therefore, there is a need for integrated domestic violence interventions in reproductive health care settings. India has one of the highest maternal and child mortality rates. This review aimed to identify characteristics of existing evidence-based integrated domestic violence and reproductive healthcare interventions in India to identify gaps and components of interventions that demonstrate effectiveness for addressing domestic violence.

METHODS

A systematic review of intervention studies was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Three research team members performed independent screening of title, abstracts and full-texts.

RESULTS

The search resulted in 633 articles, of which 13 articles met inclusion criteria for full text screening and analysis. Common components of integrated violence and reproductive health interventions that were effective in addressing domestic violence included: psychoeducation/education (n = 5), skill building (n = 5), counseling (n = 5), engaging stakeholders with use of trained lay peer facilitators (n = 3), and engaging male spouses (n = 3).

CONCLUSIONS

Interventions in India for domestic violence that are integrated with reproductive health care remain few, and there are fewer with effective outcomes for domestic violence. Of those with effective outcomes, all of the interventions utilized psychoeducation/education, skill building, and counseling as part of the intervention.

Social capital as a moderator of the relationship between violent community environment and psychological distress

OBJECTIVE

To evaluate the modifying effect of social capital on the relationship between living in violent communities and the presence of psychological distress in adolescents and youth in Mexico.

METHOD

The analysis of the Social Cohesion Survey for the Prevention of Violence and Crime (ECOPRED, by its acronym in Spanish) was conducted. The analytic sample consisted of 39,639 participants aged 12 to 29 years. Community violence and social capital were measured at the census tract level using the average answers of a household's head sample. These environmental variables were independent of the experiences of the participants. Social capital variables included structural (social ties, recreational participation, collaborative participation, and social cohesion), and cognitive (trust in neighbors) dimensions. Multilevel structural equation models were used.

RESULTS

Recreational participation, collaborative participation, and social cohesion modified the relationship between community environments and psychological distress. In females who lived in places with less recreational participation or less social cohesion, the higher the social disorder, the higher the psychological distress. A similar relationship between vandalism and psychological distress was identified, but only in males who lived in places with less collaborative participation, and in females with less social cohesion.

CONCLUSIONS

Our results suggest that dimensions of the structural social capital (organization and interest in the community and its members) were the ones that had the buffering effect of the exposure to disordered community environments on psychological distress.

Domestic Violence in Asian Communities: A Scoping Review of Quantitative Literature

Domestic violence (DV) is a prevalent social problems that threaten individuals' health and well-being, and the issue of DV in Asian communities requires extensive and comprehensive investigation. Following the steps by Arksey and O'Malley, a scoping review was conducted to (a) summarize and synthesize existing quantitative evidence on the topic of DV in Asian immigrant communities in North America, and (b) identify research gaps in the literature to guide future work. Inclusion criteria were that (a) the studies must comprise a sample of Asian immigrants in North America, (b) the focus of the article was specifically on individuals' experiences of DV in the past year or lifetime, (c) DV was measured as either independent or dependent variable, (d) full-text publications written in English, (e) articles must be peer-reviewed, quantitative studies. On completion of the review process, 35 full-text articles were identified for review. Across studies, five main topics emerged: factors related to DV victimization, prevalence and forms of DV, individuals' attitudes and/or perceptions about DV, DV-related consequences, and intervention evaluation. Some less common topics include help-seeking behaviors and sources and culturally responsive scales. The findings of this review suggest that future research will benefit from using a nationally representative Asian sample and culturally sensitive tools, examining potential protective factors against DV victimization, and employing an experimental design to evaluate the effectiveness of culturally sensitive interventions. Policies should provide stronger support to agencies and practitioners to deliver culturally sensitive services.

The Role of Positivity on Depressive Symptoms in Women Seeking Help for Intimate Partner Violence

Intimate partner violence (IPV) is a complex and pervasive global phenomenon. Despite extensive research on physical and sexual violence, there has been a relative lack of investigation into the detrimental and distinctive consequences of psychological violence against women. This is surprising given the profound impact it has on the psychological well-being of victims, notably in the form of depression, which is commonly observed as an outcome in cases of psychological IPV victimization. The present study analyzes the impact of psychological IPV on depressive symptoms, considering the moderating influence of personal positivity, defined as positive self-perceptions, optimistic life perspectives, and a hopeful view of the future in a sample of 171 Italian women seeking assistance from anti-violence centers in different localities of Italy. The findings show that in line with the hypothesis, the association between psychological violence and depressive symptoms is moderated by the levels of perceived positivity, even when controlling for instances of physical violence. These results and implications for interventions are discussed within the framework of existing literature on positive psychology and psychological well-being in the context of IPV.

Postpartum depression and associated factor among mothers attending public health centers of Yeka sub city, addis ababa Ethiopia

Postpartum depression (PPD) is a major public health concern that affects both the mother's health and the development of the child.Postpartum depression is defined by the American Psychiatric Association (APA) as the development of a Major Depressive Episode (MDE) within four weeks of birth. The rate of postpartum depression statistics is lacking in developing countries. This indicates that the data can be much higher if diagnosed and reported.There for this study assessed the magnitude of postpartum depression and its associated factors among mothers attending selected public health center of Yeka sub city, Addis Ababa, Ethiopia.

Method and materials

An institutional-based cross-sectional approach was conducted from December 2021 to January 2022 among 454 postpartum women. A single population proportion equations was used to calculate the sample size for this investigation.A multi-stage sampling method was applied based on the health center they are attending.One of the eleven sub-cities in Addis Abeba, Ethiopia, was chosen for this procedure using a simple random selection technique. Furthermore, four health centers from the selected sub-city were chosen using simple random selection.For data collection, structured questioners were utilised.The Edinburgh Postnatal Depression Scale, also known as the EPDS, was used to assess participants' postpartum depression. The data was validated, coded, and entered into Epi-data before being exported to SPSS for analysis. Bivariable and multivariable logistic regression were used. P-values less than 0.05 were deemed statistically significant.

Result

The overall prevalence of postpartum depression was 23.8 % [95 % CI (20-27.8)].Being single [AOR = 7.4, 95 % CI (4.2-12.9)], having complications during pregnancy [AOR = 2.1, 95 % CI (1.16-3.82)], Bottle feeding immediately after birth [AOR = 0.3, 95 % CI (0.13-0.66)], and having low perceived psycho-social support [AOR = 3.5, 95 % CI (1.4-8.5)] were significantly associated with postpartum depression.

Conclusion and recommendation

The current study found that post postpartum depression is highly prevalent among women. As a result, we recommend that to have regular screening, follow up and mental health care in postnatal periods of pregnancy. Because the period following childbirth is stressful, especially for new mothers, emotional and psychosocial support should be provided both in the community and in health care settings. Keywords:Postpartum depression, Women, Edinburgh Postnatal Depression Scale (EPDS),Ethiopia.

Relationship Between the Psychological Distress and Spiritual Well-Being in Pregnant Women Exposed to Domestic Violence: A Cross-Sectional Study in Iran

Maternal psychological distress is often associated with domestic violence. Spiritual well-being can affect the psychological capacity to deal with distress. This study aimed to investigate the relationship between psychological distress and spiritual well-being in pregnant women exposed to domestic violence. This cross-sectional study was conducted on 305 pregnant women subjected to domestic violence in southern Iran. The participants were selected using the census method. Data were collected using the Spiritual Well-being Scale (SWB), the Kessler Psychological Distress Scale (K10), and the Hurt, Insult, Threaten, Scream (HITS) screening tool (short form) and were analyzed with descriptive and inferential statistics (t-test, ANOVA, the Spearman correlation coefficient, and multiple linear regression) in SPSS software version 24. The mean scores ± standard deviation of the participants' psychological distress, spiritual well-being, and domestic violence were 24.68 ± 6.43, 79.89 ± 18.98, and 11.24 ± 1.5, respectively. The results showed that psychological distress had a significant negative correlation with spiritual well-being (ρ = - 0.84, P < 0.001) and domestic violence (ρ = - 0.73, P < 0.001). The results of the multiple linear regression analysis also showed that spiritual well-being and domestic violence could predict the psychological distress of pregnant women who were exposed to domestic violence, which explained 73% of the psychological distress in the participants. According to the study results, spiritually oriented education can be provided for women to reduce their psychological distress. Also, it is recommended that necessary interventions be used to reduce domestic violence and empower women to prevent it.

Depression and Its Determinants among Postpartum Mothers Attending at Universal College of Medical Sciences and Teaching Hospital, Bhairahawa, Rupandehi, Nepal

Background

Postpartum depression is a serious mental health issue linked to maternal morbidity and negative effects for infant's normal growth, development, and well-being. This study is aimed at assessing the prevalence and factors associated with postpartum depression among mothers attending a tertiary hospital in Nepal.

Methods

A hospital-based cross-sectional study was conducted among 173 postpartum mothers (<6 weeks postdelivery) who were receiving care either at the postnatal ward or immunization clinic of Universal College of Medical Sciences and Teaching Hospital in Bhairahawa, Rupandehi district, Nepal. The study was carried out from October 2020 to February 2021 by using purposive sampling technique for selecting respondents. The variables that showed significant association with the dependent variable having p value < 0.05 in bivariate analysis were entered into multivariate logistic regression model to find the final associated factors.

Results

The prevalence of postpartum depression was 20.2% among mothers attending a tertiary hospital in Nepal. The mean age of the respondents was 24.77 ± 3.47. Factors such as mothers having female child (AOR = 6.39, CI = 1.54 - 26.46), unplanned pregnancy (AOR = 10.08, CI = 2.91 - 34.94), pregnancy-induced health problems (AOR = 9.68, CI: 3.51-26.64) were associated with an increased risk of postpartum depression. Similarly, mothers having formal education (AOR = 0.28, CI: 0.08-0.91), whose spouses have secondary and above education (AOR = 0.16, CI: 0.03-0.85), and who have ≥4 ANC visits (AOR = 0.15, CI = 0.05 - 0.40) were significantly associated but have a protective effect with postpartum depression.

Conclusions

Sex of newborn, mother's and spouse's education, intention of pregnancy, ANC visits, and pregnancy-induced health problems were found to be significantly associated with postpartum depression. Hence, specific health education program regarding maternal and child health integrating mental health should be provided to pregnant women, mothers, and their husbands, focusing on gender discrimination. Similarly specific orientation program should be provided to local health worker about the importance of planned pregnancy, in order to reduce pregnancy related health problems during ANC visits and to mothers after their delivery to reduce further chances of postpartum depression.

Predicting Depression Among Spouses of Ex-POWs: The Contribution of Exposure to Violence, Trauma, and Stress Through the Life Cycle

The current longitudinal study focused on predicting depression among spouses of former Israeli war veterans (combat veterans or ex-prisoners of war [ex-POWs]). The research examined the direct and moderating role of secondary trauma related to their husbands' war-related experiences, stress related to being exposed to intimate partner violence in their relationship, being a second-generation Holocaust (SGH) survivor, and the effects of additional stressful life events (SLEs) since the end of the war. Wives of ex-POWs and combat veterans (N = 129) participated in two time measurements. Spouses of ex-POWs were found to be at higher risk of depression and psychological violence. Psychological violence was a risk factor for depression. The three-way interaction among psychological violence, being a SGH survivor, and experiencing SLEs was significant. In addition, experiencing earlier stressful events had a protective effect. The findings suggest that the association between early exposure and additive exposure through life is a complex iteration of factors and does not necessarily follow the vulnerability perspective.

Relationship between family cohesion/adaptability and postpartum depressive symptoms: A single-center retrospective study

BACKGROUND

Depression is the most common mental illness in postpartum mothers, and the etiology of postpartum depression remains poorly understood. Over the past several decades, studies have reported that postpartum depression is caused by multiple factors, such as genetic, psychological, pregnancy, and environmental factors, with the family environment being an important environmental factor. The theory of family cohesion and adaptability put forward by Olson is a classic model that describes the level of family function. However, to date, this model has not been examined regarding its applicability to patients with postpartum depression.

AIM

To investigate the relationship between family cohesion and adaptability and the risk of postpartum depressive symptoms.

METHODS

We retrospectively analyzed 1446 patients admitted to the postpartum healthcare clinic of the Affiliated Foshan Maternity and Child Healthcare Hospital from April 2021 to December 2021. Patients were grouped according to whether postpartum depression symptoms were reported (symptoms, n = 454; no symptoms, n = 992). All patients completed the Edinburgh Postpartum Depression Scale and the Chinese version of the Family Cohesion and Adapt-ability Assessment Scale II. Baseline and clinical data were compared between groups. Univariate regression analysis was used to investigate the association between different types of family cohesion and postpartum depressive symptoms and the association between different family adaptability types and postpartum depressive symptoms.

RESULTS

After adjusting for age, education, occupation, gravidity, parity, and mode of delivery, disengaged [adjusted odds ratio (AOR) = 3.36, 95%CI: 1.91–5.91], and separated (AOR = 1.97, 95%CI: 1.34–2.90) family cohesion types showed a higher risk of postpartum depression than the connection type, whereas the enmeshed type (AOR = 0.38, 95%CI: 0.28–0.51) protected against postpartum depressive symptoms. Rigid (AOR = 4.41, 95%CI: 3.02–6.43) and structured families (AOR = 1.88, 95%CI: 1.34–2.63) had a higher risk of postpartum depressive symptoms than flexible families, whereas chaotic families (AOR = 0.35, 95%CI: 0.24–0.51) protected against postpartum depressive symptoms.

CONCLUSION

Family cohesion and adaptability are influencing factors for postpartum depressive symptoms, with higher family cohesion and adaptability being associated with a lower risk of postpartum depressive symptoms.

Exposure to violence and the presence of suicidal and self-harm behaviour predominantly in Asian females: scoping review

Background

Exposure to violence is associated with psychological distress, mental disorders such as depression, and suicidal behaviour. Most of the studies are conducted in the West, with limited publications from Asia. Thus, we conducted a scoping review of studies investigating the association between experiences of violence and later suicidal ideation/attempts from Asia in the twenty-first century.

Results

Many studies focused on domestic violence toward women in the Southeast Asian region. Sociocultural factors such as family disputes, public shaming, dowry, lack of education opportunities, and marriage life perceptions mediated the association. Many women exposed to violence and attempted suicide suffered from mental disorders such as depression, anxiety, and post-traumatic stress. The small number of suitable studies and the possible effect of confounders on participants were limitations in the review. Future studies would have to focus on specific types of violence and ethnoreligious beliefs.

Conclusion

Women in Asia exposed to violence appear to have an increased risk of suicidal behaviour and mental disorders. The early screening of psychological distress with culturally validated tools is essential for preventing suicides in Asian victims of violence.

Perinatal mental health around the world: priorities for research and service development in The Netherlands

The Netherlands has an unique system of perinatal and postpartum healthcare. Pregnancy care is delivered predominantly by primary care midwives and childbirth services predominantly involve hospital care. The first week postpartum, all women receive daily care from maternity nurses. In addition, hospitals and out-patient clinics offer perinatal mental healthcare. More specifically, ‘POP care’ (psychiatry, obstetrics and paediatrics) was developed to promote multidisciplinary collaboration in this regard. Although clinical practices and government initiatives to improve pregnancy-related mental healthcare work well, they have yet to be fully described and evaluated. The current COVID-19 pandemic has an impact on health services and perinatal mental health.

Visual, hearing, and dual sensory impairment are associated with higher depression and anxiety in women

OBJECTIVE

We investigated cross-sectional gender-specific associations with vision, hearing, and both (dual) impairment with depression and chronic anxiety using a large representative sample of Spanish adults.

METHODS

The present study utilized data from the Spanish National Health Survey 2017. A total of 23,089 adults (15-103 years, 45.9% men) participated in this survey. Participants self-reported whether they had suffered depression and/or anxiety, and also whether they experience vision, hearing and both vision/hearing (dual) impairment. Multivariable logistic regression analyses were conducted to assess the associations between the three types of sensory impairment and anxiety or depression, in men and women.

RESULTS

Across the whole sample (n = 23,089) the prevalence of depression and anxiety was between 2.00 and 2.56 times higher in women compared to men. Dual sensory impairment (hearing and vision) was associated with higher levels of depression (odds ratio [OR] = 2.980, 95% confidence interval [CI]: 2.170-4.091) and anxiety (OR = 2.636, 95% CI: 1.902-3.653) compared to single sensory impairment. Stratified associations by gender showed higher odd ratios for women with dual sensory loss (3.488 for depression and 3.478 for anxiety) compared to men (2.773 for depression and 1.803 for anxiety).

CONCLUSIONS

Dual sensory impairment (hearing and seeing) is are associated with increased depression and anxiety. Women with dual sensory impairment showed stronger associations compared to men among adults in Spain. Interventions are needed to address vision and/or hearing impairment in order to reduce anxiety and depression especially in women.

Postnatal Depression Risk Factors: An Overview of Reviews to Inform COVID-19 Research, Clinical, and Policy Priorities

The disruption of normal life due to the COVID-19 pandemic is expected to exacerbate extant risk factors for mental health problems. This may be particularly true for women who give birth during the crisis, especially those at risk for postnatal depression. Maternal postnatal depression has been identified as a public health issue with profound impacts on maternal and child well-being. Evidence from previous crises (e.g., earthquakes, terrorist attacks) has shown that crises significantly impact maternal mental health and some perinatal health outcomes. The aims of this paper were therefore to conduct a review to identify the established risk factors for maternal postnatal depression, and generate evidence-based hypotheses about whether the COVID-19 crisis would likely increase or decrease postnatal depression rates based on the identified risk factors. Several databases were searched during May-June 2020 for review papers (i.e., systematic reviews, meta-analyses, qualitative syntheses) using the following keywords: Depression, perinatal, postnatal, postpartum, systematic, review, predictors. Risk factors were extracted in conjunction with indicators for their strength of evidence (i.e., effect sizes, qualitative coding). Risk factors were critically evaluated in relation to their susceptibility to the impacts of the COVID-19 crisis. It was hypothesized that several health policies that were necessary to reduce the spread of COVID-19 (e.g., required restrictions) may be simultaneously impacting a range of these known risk factors and placing a larger number of women at heightened risk for postnatal depression. For instance, factors at a strong risk of being exacerbated include: Perceived low social support; exposure to traumatic events during or prior to pregnancy; significant life events occurring during pregnancy; and high stress associated with care of children. Future research and policy implications are discussed, including how policy makers could attempt to ameliorate the identified risk factors for postnatal depression following the current COVID-19 pandemic.