Sense of Coherence Mediates the Links between Job Status Prior to Birth and Postpartum Depression: A Structured Equation Modeling Approach

Factors influencing postpartum depression among Japanese parents: A prospective longitudinal study

AIM

Postpartum depression (PPD) may have negative effects on the parents and lead to impaired cognitive, socioemotional, and behavioral development in their children. The purpose of this study was to examine factors associated with PPD in parents during the first year after delivery.

METHODS

This study used a self-administered questionnaire. Questionnaires were mailed at 5 days, 3 months, 6 months, and 1 year after delivery, respectively. The particpants were 107 pairs of mothers and fathers. PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS). Data on sense of coherence (SOC), Quality Marriage Index, Social Support Scale, Mother-to-Infant Bonding Scale, and sociodemographic variables were collected. Multiple regression analysis was performed to examine the strength of the association between several variables and the EPDS at each survey period for fathers and mothers, respectively.

RESULTS

The prevalence of PPD in the first-year postpartum ranged from 12.1%-23.4% to 7.5%-8.4% for fathers and mothers, respectively. SOC had the strongest impact on EPDS scores for both fathers and mothers at all four survey periods.

CONCLUSIONS

Our findings suggest that stress coping skills are an important factor affecting PPD throughout the first-year postpartum for both fathers and mothers.

Association between sense of coherence and depression in patients with chronic pain: A systematic review and meta-analysis

BACKGROUND

Chronic pain is a common complaint having distressing consequences for those that suffer from it. Pain and depression concur within the context of comorbidity, and both share underlying stress conditions. Sense of coherence (SOC) is a factor that determines how well an individual manages stress and stays healthy. Its relationship with depression has been frequently reported in the literature. Our objective was to assess the amount of evidence available regarding the association between SOC and depression in patients suffering from chronic pain.

METHODS

A systematic review and meta-analysis were performed. Searches were conducted between November 01 and December 31, 2020 in PubMed, Web of Science, Embase, PsycINFO, Psicodoc, ScienceDirect and Dialnet. There were no restrictions regarding the date of publication of the study. Evidence related to the relationship between SOC and depression in patients with chronic pain was summarized and compared.

RESULTS

A total of 163 articles were identified. We included 9 papers in the qualitative and quantitative synthesis. The pooled correlation coefficient was -0.55 (95%: -0.70; -0.41) and was not modified after removing any study. The heterogeneity across the studies was considerable (I2 = 94.8%; p < 0.001). The random-effects meta-regression models for the association between SOC and depression showed that age (p = 0.148) and percentage of women (p = 0.307) were not related to heterogeneity across studies. No publication bias was detected (p = 0.720).

CONCLUSIONS

At first glance, the included studies give the impression that SOC is an important factor in depression levels of patients with chronic pain. Most of the included studies revealed a moderate association between SOC and depressive symptoms.

Posttraumatic growth and postpartum depression in women after childbirth: The moderating role of postpartum negative life events

AIM

This study aimed to investigate the implications of postpartum negative life events on postpartum depression and posttraumatic growth in women after childbirth.

METHODS

A sample of 280 postpartum women at a level III hospital in China provided data on postpartum depression, negative life events, and posttraumatic growth with a cross-sectional design.

RESULTS

The scores of both postpartum depression and negative life events exhibited a quadratic correlation with posttraumatic growth in women after childbirth, and negative life events significantly moderated the associations between depression and overall posttraumatic growth and its three dimensions: personal strength, spirit change, and relating to others.

CONCLUSIONS

Women can experience positive psychological growth after childbirth, and this study provides new evidence of an interaction between postpartum depression and negative life events in the prediction of psychological growth, highlighting the moderating role of negative life events. This study could help direct mental health professionals to target interventions that provide more psychological support to reduce the impact of depression and negative life events, which will be conducive to improving women's psychological growth.

Treating Postpartum Depression: What Do We Know about Brexanolone?

Postpartum depression (PPD) is defined as the onset of major depressive disorder in mothers, occurring during pregnancy or within 4 weeks post-delivery. With 7% of pregnancy-related death in the United States owing to mental health conditions, including PPD, and a global prevalence of 12%, PPD is a growing public health concern. In 2019, the Food and Drug Administration (FDA) approved brexanolone, an exogenous analog of allopregnanolone, as the first ever drug to be specifically indicated for treating patients with PPD. This approval was preceded by an open-label study and three randomized placebo-controlled trials, each assessing the safety, tolerability, and efficacy of brexanolone, using mean Hamilton Rating Scale for Depression (HAM-D) score reduction as the primary outcome. In each randomized controlled trial, the drug was administered as an intravenous infusion given over 60 h. Enrolled participants were followed up on days 7 and 30 to evaluate the sustained effect. A statistically significant reduction in mean HAM-D score compared to placebo was observed in all three studies, supporting brexanolone's use in treating moderate-to-severe PPD. Therefore, this article attempts to briefly review the pharmacology of brexanolone, evaluate the latest available clinical data and outcomes concerning its use, reevaluate its position as a 'breakthrough' in managing PPD, and review the cost-related barriers to its worldwide standardized use.