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Harel D, Levis B, Ishihara M, Levis AW, Vigod SN, Howard LM, Thombs BD, Benedetti A, He C, Krishnan A, Wu Y, Bhandari PM, Neupane D, Negeri Z, Imran M, Rice DB, Azar M, Chiovitti MJ, Saadat N, Riehm KE, Boruff JT, Cuijpers P, Gilbody S, Ioannidis JPA, Kloda LA, Patten SB, Shrier I, Ziegelstein RC, Comeau L, Mitchell ND, Tonelli M, Barnes J, Beck CT, Bindt C, de Figueiredo FP, Fellmeth G, Figueiredo B, Green EP, Helle N, Kettunen PA, Kohlhoff J, Kozinszky Z, Leonardou AA, Nakić Radoš S, Rochat TJ, Smith‐Nielsen J, Stein A, Stewart RC, Tadinac M, Tandon SD, Tendais I, Töreki A, Tran TD, Turner K, Væver MS, Vega‐Dienstmaier JM. Shortening the Edinburgh postnatal depression scale using optimal test assembly methods: Development of the EPDS-Dep-5. Acta Psychiatr Scand 2021; 143:348-362. [PMID: 33354768 DOI: 10.1111/acps.13272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/09/2020] [Accepted: 12/20/2020] [Indexed: 01/03/2023]
Abstract
AIMS This study used a large database to develop a reliable and valid shortened form of the Edinburgh Postnatal Depression Scale (EPDS), a self-report questionnaire used for depression screening in pregnancy and postpartum, based on objective criteria. METHODS Item responses from the 10-item EPDS were obtained from 5157 participants (765 major depression cases) from 22 primary screening accuracy studies that compared the EPDS to the Structured Clinical Interview for DSM (SCID). Unidimensionality of the EPDS latent construct was verified using confirmatory factor analysis, and an item response theory model was fit. Optimal test assembly (OTA) methods identified a maximally informative shortened form for each possible scale length between 1 and 9 items. The final shortened form was selected based on pre-specified validity and reliability criteria and non-inferiority of screening accuracy of the EPDS as compared to the SCID. RESULTS A 5-item short form of the EPDS (EPDS-Dep-5) was selected. The EPDS-Dep-5 had a Cronbach's alpha of 0.82. Sensitivity and specificity of the EPDS-Dep-5 for a cutoff of 4 or greater were 0.83 (95% CI, 0.73, 0.89) and 0.86 (95% CI, 0.80, 0.90) and were statistically non-inferior to the EPDS. The correlation of total scores with the full EPDS was high (r = 0.91). CONCLUSION The EPDS-Dep-5 is a valid short form with minimal loss of information when compared to the full-length EPDS. The EPDS-Dep-5 was developed with OTA methods using objective, pre-specified criteria, but the approach is data-driven and exploratory. Thus, there is a need to replicate results of this study in different populations.
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Affiliation(s)
- Daphna Harel
- PRIISM Applied Statistics Center, New York University, New York, NY, USA.,Department of Applied Statistics, Social Science, and Humanities, New York University, New York, NY, USA
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada.,Centre for Prognosis Research, School of Medicine, Keele University, Staffordshire, UK
| | - Miyabi Ishihara
- Department of Statistics, University of California Berkeley, Berkeley, California, USA
| | - Alexander W Levis
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Simone N Vigod
- Women's College Hospital and Research Institute, University of Toronto, Toronto, ON, Canada
| | - Louise M Howard
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada.,Department of Medicine, McGill University, Montréal, QC, Canada.,Department of Psychiatry, McGill University, Montréal, QC, Canada.,Department of Psychology, McGill University, Montréal, QC, Canada.,Department of Educational and Counselling Psychology, McGill University, Montréal, QC, Canada.,Biomedical Ethics Unit, McGill University, Montréal, QC, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada.,Department of Medicine, McGill University, Montréal, QC, Canada.,Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montréal, QC, Canada
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Lyubenova A, Neupane D, Levis B, Wu Y, Sun Y, He C, Krishnan A, Bhandari PM, Negeri Z, Imran M, Rice DB, Azar M, Chiovitti MJ, Saadat N, Riehm KE, Boruff JT, Ioannidis JPA, Cuijpers P, Gilbody S, Kloda LA, Patten SB, Shrier I, Ziegelstein RC, Comeau L, Mitchell ND, Tonelli M, Vigod SN, Aceti F, Barnes J, Bavle AD, Beck CT, Bindt C, Boyce PM, Bunevicius A, Chaudron LH, Favez N, Figueiredo B, Garcia-Esteve L, Giardinelli L, Helle N, Howard LM, Kohlhoff J, Kusminskas L, Kozinszky Z, Lelli L, Leonardou AA, Meuti V, Radoš SN, García PN, Pawlby SJ, Quispel C, Robertson-Blackmore E, Rochat TJ, Sharp DJ, Siu BWM, Stein A, Stewart RC, Tadinac M, Tandon SD, Tendais I, Töreki A, Torres-Giménez A, Tran TD, Trevillion K, Turner K, Vega-Dienstmaier JM, Benedetti A, Thombs BD. Depression prevalence based on the Edinburgh Postnatal Depression Scale compared to Structured Clinical Interview for DSM DIsorders classification: Systematic review and individual participant data meta-analysis. Int J Methods Psychiatr Res 2021; 30:e1860. [PMID: 33089942 PMCID: PMC7992289 DOI: 10.1002/mpr.1860] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/28/2020] [Accepted: 10/13/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Estimates of depression prevalence in pregnancy and postpartum are based on the Edinburgh Postnatal Depression Scale (EPDS) more than on any other method. We aimed to determine if any EPDS cutoff can accurately and consistently estimate depression prevalence in individual studies. METHODS We analyzed datasets that compared EPDS scores to Structured Clinical Interview for DSM (SCID) major depression status. Random-effects meta-analysis was used to compare prevalence with EPDS cutoffs versus the SCID. RESULTS Seven thousand three hundred and fifteen participants (1017 SCID major depression) from 29 primary studies were included. For EPDS cutoffs used to estimate prevalence in recent studies (≥9 to ≥14), pooled prevalence estimates ranged from 27.8% (95% CI: 22.0%-34.5%) for EPDS ≥ 9 to 9.0% (95% CI: 6.8%-11.9%) for EPDS ≥ 14; pooled SCID major depression prevalence was 9.0% (95% CI: 6.5%-12.3%). EPDS ≥14 provided pooled prevalence closest to SCID-based prevalence but differed from SCID prevalence in individual studies by a mean absolute difference of 5.1% (95% prediction interval: -13.7%, 12.3%). CONCLUSION EPDS ≥14 approximated SCID-based prevalence overall, but considerable heterogeneity in individual studies is a barrier to using it for prevalence estimation.
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Affiliation(s)
- Anita Lyubenova
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Dipika Neupane
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.,School of Primary, Centre for Prognosis Research, Community and Social Care, Keele University, Keele, Staffordshire, UK
| | - Yin Wu
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.,Department of Psychiatry, McGill University, Montréal, Québec, Canada
| | - Ying Sun
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Chen He
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Ankur Krishnan
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Parash M Bhandari
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Zelalem Negeri
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Mahrukh Imran
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Danielle B Rice
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Psychology, McGill University, Montréal, Québec, Canada
| | - Marleine Azar
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Matthew J Chiovitti
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Nazanin Saadat
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Kira E Riehm
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jill T Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montréal, Québec, Canada
| | - John P A Ioannidis
- Department of Medicine, Stanford University, Stanford, California, USA.,Department of Health Research and Policy, Stanford University, Stanford, California, USA.,Department of Biomedical Data Science, Stanford University, Stanford, California, USA.,Department of Statistics, Stanford University, Stanford, California, USA
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, EMGO Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Simon Gilbody
- Hull York Medical School and the Department of Health Sciences, University of York, Heslington, York, UK
| | - Lorie A Kloda
- Library, Concordia University, Montréal, Québec, Canada
| | - Scott B Patten
- Departments of Community Health Sciences and Psychiatry, University of Calgary, Calgary, Alberta, Canada.,Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Alberta, Canada.,Cuthbertson & Fischer Chair in Pediatric Mental Health, University of Calgary, Calgary, Alberta, Canada
| | - Ian Shrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.,Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Roy C Ziegelstein
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Liane Comeau
- International Union for Health Promotion and Health Education, École de santé publique de l'Université de Montréal, Montréal, Québec, Canada
| | - Nicholas D Mitchell
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada.,Alberta Health Services, Edmonton, Alberta, Canada
| | - Marcello Tonelli
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Simone N Vigod
- Women's College Hospital and Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Franca Aceti
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Jacqueline Barnes
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
| | - Amar D Bavle
- Department of Psychiatry, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India
| | - Cheryl T Beck
- University of Connecticut School of Nursing, Mansfield, Connecticut, USA
| | - Carola Bindt
- Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Philip M Boyce
- Discipline of Psychiatry, Westmead Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Department of Psychiatry, Westmead Hospital, Sydney, New South Wales, Australia
| | - Adomas Bunevicius
- Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Linda H Chaudron
- Departments of Psychiatry, Pediatrics, Obstetrics and Gynecology, School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA
| | - Nicolas Favez
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.,IUP, University of Lausanne, Lausanne, Switzerland
| | | | - Lluïsa Garcia-Esteve
- Perinatal Mental Health Unit CLINIC-BCN, Institut Clínic de Neurociències, Hospital Clínic, Barcelona, Spain.,Vulnerability, Psychopathology and Gender Research Group, Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain
| | - Lisa Giardinelli
- Department of Health Sciences, Psychiatry Unit, University of Florence, Firenze, Italy
| | - Nadine Helle
- Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Louise M Howard
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Jane Kohlhoff
- School of Psychiatry, University of New South Wales, Kensington, New South Wales, Australia.,Ingham Institute, Liverpool, New South Wales, Australia.,Karitane, Carramar, New South Wales, Australia
| | | | - Zoltán Kozinszky
- Department of Obstetrics and Gynecology, Danderyd Hospital, Stockholm, Sweden
| | - Lorenzo Lelli
- Department of Health Sciences, Psychiatry Unit, University of Florence, Firenze, Italy
| | - Angeliki A Leonardou
- First Department of Psychiatry, Women's Mental Health Clinic, Athens University Medical School, Athens, Greece
| | - Valentina Meuti
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Sandra N Radoš
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | - Purificación N García
- Perinatal Mental Health Unit CLINIC-BCN, Institut Clínic de Neurociències, Hospital Clínic, Barcelona, Spain.,Psychology Service, Regidoria de Polítiques de Gènere, Ajuntament de Terrassa, Terrassa, Spain
| | - Susan J Pawlby
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Chantal Quispel
- Department of Obstetrics and Gynaecology, Albert Schweitzer Ziekenhuis, Dordrecht, the Netherlands
| | | | - Tamsen J Rochat
- MRC/Developmental Pathways to Health Research Unit, School of Clinical Medicine, University of Witwatersrand, Johannesburg, South Africa.,Human and Social Development Programme, Human Sciences Research Council, Pretoria, South Africa
| | - Deborah J Sharp
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK
| | - Bonnie W M Siu
- Department of Psychiatry, Castle Peak Hospital, Hong Kong SAR, China
| | - Alan Stein
- Department of Psychiatry, University of Oxford, Oxford, UK.,MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Robert C Stewart
- Division of Psychiatry, University of Edinburgh, Edinburgh, Scotland, UK.,Malawi Epidemiology and Intervention Research Unit (MEIRU), Lilongwe, Malawi
| | - Meri Tadinac
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - S Darius Tandon
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Iva Tendais
- School of Psychology, University of Minho, Braga, Portugal
| | | | - Anna Torres-Giménez
- Perinatal Mental Health Unit CLINIC-BCN, Institut Clínic de Neurociències, Hospital Clínic, Barcelona, Spain.,Vulnerability, Psychopathology and Gender Research Group, Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain
| | - Thach D Tran
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Kylee Trevillion
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Katherine Turner
- Epilepsy Center-Child Neuropsychiatry Unit, ASST Santi Paolo Carlo, San Paolo Hospital, Milan, Italy
| | | | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.,Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montréal, Québec, Canada.,Department of Medicine, McGill University, Montréal, Québec, Canada
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.,Department of Psychiatry, McGill University, Montréal, Québec, Canada.,Department of Psychology, McGill University, Montréal, Québec, Canada.,Department of Medicine, McGill University, Montréal, Québec, Canada.,Department of Educational and Counselling Psychology, McGill University, Montréal, Québec, Canada.,Biomedical Ethics Unit, McGill University, Montréal, Québec, Canada
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3
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Thombs BD, Levis B, Lyubenova A, Neupane D, Negeri Z, Wu Y, Sun Y, He C, Krishnan A, Vigod SN, Bhandari PM, Imran M, Rice DB, Azar M, Chiovitti MJ, Saadat N, Riehm KE, Boruff JT, Cuijpers P, Gilbody S, Ioannidis JPA, Kloda LA, Patten SB, Shrier I, Ziegelstein RC, Comeau L, Mitchell ND, Tonelli M, Barnes J, Beck CT, Bindt C, Figueiredo B, Helle N, Howard LM, Kohlhoff J, Kozinszky Z, Leonardou AA, Radoš SN, Quispel C, Rochat TJ, Stein A, Stewart RC, Tadinac M, Tandon SD, Tendais I, Töreki A, Tran TD, Trevillion K, Turner K, Vega-Dienstmaier JM, Benedetti A. Overestimation of Postpartum Depression Prevalence Based on a 5-item Version of the EPDS: Systematic Review and Individual Participant Data Meta-analysis. Can J Psychiatry 2020; 65:835-844. [PMID: 33104415 PMCID: PMC7658422 DOI: 10.1177/0706743720934959] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE The Maternal Mental Health in Canada, 2018/2019, survey reported that 18% of 7,085 mothers who recently gave birth reported "feelings consistent with postpartum depression" based on scores ≥7 on a 5-item version of the Edinburgh Postpartum Depression Scale (EPDS-5). The EPDS-5 was designed as a screening questionnaire, not to classify disorders or estimate prevalence; the extent to which EPDS-5 results reflect depression prevalence is unknown. We investigated EPDS-5 ≥7 performance relative to major depression prevalence based on a validated diagnostic interview, the Structured Clinical Interview for DSM (SCID). METHODS We searched Medline, Medline In-Process & Other Non-Indexed Citations, PsycINFO, and the Web of Science Core Collection through June 2016 for studies with data sets with item response data to calculate EPDS-5 scores and that used the SCID to ascertain depression status. We conducted an individual participant data meta-analysis to estimate pooled percentage of EPDS-5 ≥7, pooled SCID major depression prevalence, and the pooled difference in prevalence. RESULTS A total of 3,958 participants from 19 primary studies were included. Pooled prevalence of SCID major depression was 9.2% (95% confidence interval [CI] 6.0% to 13.7%), pooled percentage of participants with EPDS-5 ≥7 was 16.2% (95% CI 10.7% to 23.8%), and pooled difference was 8.0% (95% CI 2.9% to 13.2%). In the 19 included studies, mean and median ratios of EPDS-5 to SCID prevalence were 2.1 and 1.4 times. CONCLUSIONS Prevalence estimated based on EPDS-5 ≥7 appears to be substantially higher than the prevalence of major depression. Validated diagnostic interviews should be used to establish prevalence.
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Affiliation(s)
- Brett D Thombs
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, 5620McGill University, Montréal, Québec, Canada.,Department of Psychology, 5620McGill University, Montréal, Québec, Canada.,Department of Psychiatry, 5620McGill University, Montréal, Québec, Canada.,Department of Medicine, 5620McGill University, Montréal, Québec, Canada.,Department of Educational and Counselling Psychology, 5620McGill University, Montréal, Québec, Canada.,Biomedical Ethics Unit, 5620McGill University, Montréal, Québec, Canada
| | - Brooke Levis
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, 5620McGill University, Montréal, Québec, Canada.,Centre for Prognosis Research, School of Primary, Community and Social Care, Keele University, Staffordshire, United Kingdom
| | - Anita Lyubenova
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Dipika Neupane
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, 5620McGill University, Montréal, Québec, Canada
| | - Zelalem Negeri
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, 5620McGill University, Montréal, Québec, Canada
| | - Yin Wu
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, 5620McGill University, Montréal, Québec, Canada.,Department of Psychiatry, 5620McGill University, Montréal, Québec, Canada
| | - Ying Sun
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Chen He
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, 5620McGill University, Montréal, Québec, Canada
| | - Ankur Krishnan
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Simone N Vigod
- Women's College Hospital and Research Institute, University of Toronto, Ontario, Canada
| | - Parash Mani Bhandari
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, 5620McGill University, Montréal, Québec, Canada
| | - Mahrukh Imran
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Danielle B Rice
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Psychology, 5620McGill University, Montréal, Québec, Canada
| | - Marleine Azar
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, 5620McGill University, Montréal, Québec, Canada
| | - Matthew J Chiovitti
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Nazanin Saadat
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Kira E Riehm
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Mental Health, Bloomberg School of Public Health, 1466Johns Hopkins University, Baltimore, MD, USA
| | - Jill T Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, 5620McGill University, Montréal, Québec, Canada
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, EMGO Institute, 1190Vrije Universiteit Amsterdam, the Netherlands
| | - Simon Gilbody
- Department of Health Sciences, Hull York Medical School, 8748University of York, Heslington, York, United Kingdom
| | - John P A Ioannidis
- Department of Medicine, Department of Epidemiology and Population Health, Department of Biomedical Data Science, Department of Statistics, 10624Stanford University, Stanford, CA, USA
| | - Lorie A Kloda
- Library, 5618Concordia University, Montréal, Québec, Canada
| | - Scott B Patten
- Departments of Community Health Sciences and Psychiatry, 2129University of Calgary, Alberta, Canada.,Mathison Centre for Mental Health Research & Education, 2129University of Calgary, Alberta, Canada.,Cuthbertson & Fischer Chair in Pediatric Mental Health, 2129University of Calgary, Alberta, Canada
| | - Ian Shrier
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, 5620McGill University, Montréal, Québec, Canada.,Department of Family Medicine, 5620McGill University, Montréal, Québec, Canada
| | - Roy C Ziegelstein
- Department of Medicine, 1466Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Liane Comeau
- International Union for Health Promotion and Health Education, École de santé publique de l'Université de Montréal, Montréal, Québec, Canada
| | - Nicholas D Mitchell
- Department of Psychiatry, 3158University of Alberta, Edmonton, Alberta, Canada.,Alberta Health Services, Edmonton, Alberta, Canada
| | - Marcello Tonelli
- Department of Medicine, 2129University of Calgary, Alberta, Canada
| | - Jacqueline Barnes
- 215826Department of Psychological Sciences, Birkbeck, University of London, United Kingdom
| | | | - Carola Bindt
- Department of Child and Adolescent Psychiatry, 234015University Medical Center Hamburg-Eppendorf, Germany
| | | | - Nadine Helle
- Department of Child and Adolescent Psychiatry, 234015University Medical Center Hamburg-Eppendorf, Germany
| | - Louise M Howard
- Institute of Psychiatry, Psychology & Neuroscience, 4616King's College London, United Kingdom.,South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Jane Kohlhoff
- School of Psychiatry, 7800University of New South Wales, Kensington, Australia.,Ingham Institute, Liverpool, Australia.,Karitane, Carramar, Australia
| | - Zoltán Kozinszky
- 72227Department of Obstetrics and Gynaecology, Blekinge Hospital, Karlskrona, Sweden
| | - Angeliki A Leonardou
- First Department of Psychiatry, Women's Mental Health Clinic, Athens University Medical School, Greece
| | | | - Chantal Quispel
- Department of Obstetrics and Gynaecology, 2998Albert Schweitzer Ziekenhuis, Dordrecht, the Netherlands
| | - Tamsen J Rochat
- MRC/Developmental Pathways to Health Research Unit, Faculty of Health Sciences, 37707University of Witwatersrand, Johannesburg, South Africa.,Human and Social Development Program, Human Sciences Research Council, South Africa
| | - Alan Stein
- 105611Department of Psychiatry, University of Oxford, Oxford, United Kingdom.,MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, 37707University of the Witwatersrand, Johannesburg, South Africa
| | - Robert C Stewart
- Division of Psychiatry, 270079University of Edinburgh, Scotland.,Malawi Epidemiology and Intervention Research Unit (MEIRU), Lilongwe, Malawi
| | - Meri Tadinac
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Croatia
| | - S Darius Tandon
- 12244Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Iva Tendais
- School of Psychology, 219951University of Minho, Portugal
| | | | - Thach D Tran
- School of Public Health and Preventive Medicine, 161667Monash University, Melbourne, Victoria, Australia
| | - Kylee Trevillion
- Institute of Psychiatry, Psychology & Neuroscience, 4616King's College London, United Kingdom
| | - Katherine Turner
- Epilepsy Cter-Child Neuropsychiatry Unit, 444273ASST Santi Paolo Carlo, San Paolo Hospital, Milan, Italy
| | | | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, 5620McGill University, Montréal, Québec, Canada.,Department of Medicine, 5620McGill University, Montréal, Québec, Canada.,Respiratory Epidemiology and Clinical Research Unit, 5620McGill University Health Centre, Montréal, Québec, Canada
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4
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Linnakaari R, Helle N, Mentula M, Bloigu A, Gissler M, Heikinheimo O, Niinimäki M. Trends in the incidence, rate and treatment of miscarriage-nationwide register-study in Finland, 1998-2016. Hum Reprod 2020; 34:2120-2128. [PMID: 31747000 DOI: 10.1093/humrep/dez211] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 08/02/2019] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION What changes have occurred in the incidence of miscarriage, its treatment options, and the profile of the women having miscarriages in Finland between 1998 and 2016? SUMMARY ANSWER The annual incidence of registry-identified miscarriage has declined significantly between 1998 and 2016, and non-surgical management has become the dominant treatment. WHAT IS KNOWN ALREADY Miscarriage occurs in 8-15% of clinically recognized pregnancies and in ~30% of all pregnancies. Increasing maternal age is associated with an increasing risk of miscarriage. The treatment of miscarriage has evolved significantly in recent years: previously, surgical evacuation of the uterus was the standard of care, but nowadays medical and expectant management are increasingly used. STUDY DESIGN, SIZE, DURATION We conducted a nationwide retrospective cohort study of 128 381 women that had experienced a miscarriage that was managed in public healthcare between 1998 and 2016 in Finland. PARTICIPANTS/MATERIALS, SETTING, METHODS We used the National Hospital Discharge Registry for the data. Women aged 15-49 years that had experienced their first miscarriage during the follow-up period and had miscarriage-related diagnoses during their admission to public hospital were included in the study. Miscarriages were defined by the 10th Revision of the International Statistical Classification of Diseases and related Medical Problems (ICD-10) diagnostic codes O02*, O03* and O08*. Women with ectopic, molar and continuing pregnancies and induced abortions were excluded. Treatment was divided into surgical and non-surgical treatment using the surgical procedure codes. MAIN RESULTS AND THE ROLE OF CHANCE The annual incidence of registry-identified miscarriage has declined from 6.8/1000 15-49-year-old women in 1998 to 5.0/1000 in 2016 (P < 0.001). Also, the incidence rate of registry-identified miscarriage (i.e. the proportion of miscarriages of registry-identified pregnancies [i.e. deliveries, induced abortions, and miscarriages]) has declined from 112/1000 15-49-year-old pregnant women in 1998 to 83/1000 in 2016 (P < 0.001). The largest decrease in this proportion occurred among women over 40 years of age, among whom 26.5% of registry-identified pregnancies in 1998 ended in miscarriage compared to that of 16.4% in 2016. The proportion of missed abortion has increased (30.3 to 38.8%, P < 0.001) whereas that of blighted ovum has decreased (25.4 to 12.8%, P < 0.001). The proportion of registry-identified miscarriages seen among nulliparous women has increased from 43.7 to 49.6% (P < 0.001). Mean age at the time of miscarriage remained at 31 years throughout the study. Altogether, 29% of all miscarriages were treated surgically and 71% underwent medical or expectant management. The proportion of surgical management has decreased from 38.0 to 1.6% for spontaneous abortion, from 60.7 to 9.4% for blighted ovum and 70.9 to 11.2% for missed abortion between 1998 and 2016. LIMITATIONS, REASONS FOR CAUTION This study includes only women with registry-identified pregnancies, i.e. women who were treated in public hospitals. However, the number of women treated elsewhere is presumed to be small. Neither can this study estimate the number of women having spontaneous miscarriage with no hospital contact. WIDER IMPLICATIONS OF THE FINDINGS Both the annual incidence and incidence rate of miscarriage of all registry-identified pregnancies has decreased, and non-surgical management has become the standard of care. These findings are of value when planning allocation of healthcare resources and at individual level considering fertility and miscarriage questions. We speculate that improving ultrasound diagnostics explains the increasing proportion of missed abortion relative to other types of miscarriage. More investigation is needed to examine potential risk factors, complications and morbidity associated with miscarriages. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by the research funds of the Helsinki and Uusimaa hospital system, by a personal grant from Viipurin Tuberkuloosisäätiö to R.L. and by a personal grant from The Finnish Cultural Foundation to N.H. The authors have no conflicts of interest to declare.
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Affiliation(s)
- R Linnakaari
- Department of Obstetrics and Gynaecology, South Karelia Central Hospital, 53130 Lappeenranta, Finland.,Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, 00029 Helsinki, Finland
| | - N Helle
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, 00029 Helsinki, Finland
| | - M Mentula
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, 00029 Helsinki, Finland
| | - A Bloigu
- Department of Obstetrics and Gynaecology, Oulu University Hospital, 90220, Oulu, Finland.,PEDEGO Research Unit, University of Oulu, Oulu, Finland
| | - M Gissler
- National Institute for Health and Welfare (THL), 00300 Helsinki, Finland.,Department of Neurobiology, Care Sciences and Society, Karolinska Institute, SE-171 77 Stockholm, Sweden
| | - O Heikinheimo
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, 00029 Helsinki, Finland
| | - M Niinimäki
- Department of Obstetrics and Gynaecology, Oulu University Hospital, 90220, Oulu, Finland.,PEDEGO Research Unit, University of Oulu, Oulu, Finland.,Medical Research Center Oulu (MRC Oulu), University of Oulu, Oulu, Finland
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5
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Barthel D, Göbel A, Barkmann C, Helle N, Bindt C. Does Birth-Related Trauma Last? Prevalence and Risk Factors for Posttraumatic Stress in Mothers and Fathers of VLBW Preterm and Term Born Children 5 Years After Birth. Front Psychiatry 2020; 11:575429. [PMID: 33384624 PMCID: PMC7769835 DOI: 10.3389/fpsyt.2020.575429] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 11/23/2020] [Indexed: 11/25/2022] Open
Abstract
Previous research suggests that the birth of a preterm child with very low birth weight (VLBW; <1,500 g) can be traumatic for both parents and lead to short-term consequences like clinical levels of posttraumatic stress symptoms (PTSS) or even to the development of a Posttraumatic Stress Disorder (PTSD). However, little is known about possible mid- and long-term psychological consequences in affected parents. The purpose of this study were (a) to examine the prevalence of parental birth-related PTSS and PTSD in a group of parents with VLBW preterm infants compared to parents of full-term infants 5 years after birth and (b) to investigate potential associations with risk factors for parental PTSS at 5 years postpartum. Perinatal factors (VLBW preterm or term, perceived stress during birth), psychological factors (perceived social support and PTSS 4-6 weeks postpartum, psychiatric lifetime diagnosis) and sociodemographic characteristics (number of children, singleton or multiple birth, socio-economic status), were included in the analysis. The sample consisted of 144 families (77 VLBW, 67 term birth) who participated in the prospective longitudinal cohort study "Hamburg study of VLBW and full-term infant development" (HaFEn-study) and were initially recruited at three perinatal care centers in Hamburg, Germany. PTSD prevalence and PTSS of mothers and fathers were assessed with the Impact of Event Scale-Revised (IES-R), social support with the Questionnaire of Social Support (SOZU-K-22), and lifetime psychiatric diagnoses with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID-I). Data were analyzed by hierarchic multiple regression analyses. Results showed that 5 years after birth none of the parents fulfilled the criteria for a birth-related PTSD diagnosis. For mothers, postnatal PTSS and a VLBW preterm birth significantly predicted PTSS 5 years postpartum. For fathers, psychiatric lifetime diagnosis and postnatal PTSS significantly predicted PTSS 5 years after birth. Early identification of parents with higher risk of PTSS, especially after VLBW preterm birth, and their clinical needs seems beneficial to reduce the risk of long-term consequences. More research is needed on the paternal perspective and on potential effects of preterm birth on both parents and their children's mental health outcomes.
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Affiliation(s)
- Dana Barthel
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Ariane Göbel
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Claus Barkmann
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Nadine Helle
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Carola Bindt
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
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6
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Levis B, McMillan D, Sun Y, He C, Rice DB, Krishnan A, Wu Y, Azar M, Sanchez TA, Chiovitti MJ, Bhandari PM, Neupane D, Saadat N, Riehm KE, Imran M, Boruff JT, Cuijpers P, Gilbody S, Ioannidis JPA, Kloda LA, Patten SB, Shrier I, Ziegelstein RC, Comeau L, Mitchell ND, Tonelli M, Vigod SN, Aceti F, Alvarado R, Alvarado-Esquivel C, Bakare MO, Barnes J, Beck CT, Bindt C, Boyce PM, Bunevicius A, Couto TCE, Chaudron LH, Correa H, de Figueiredo FP, Eapen V, Fernandes M, Figueiredo B, Fisher JRW, Garcia-Esteve L, Giardinelli L, Helle N, Howard LM, Khalifa DS, Kohlhoff J, Kusminskas L, Kozinszky Z, Lelli L, Leonardou AA, Lewis BA, Maes M, Meuti V, Nakić Radoš S, Navarro García P, Nishi D, Okitundu Luwa E-Andjafono D, Robertson-Blackmore E, Rochat TJ, Rowe HJ, Siu BWM, Skalkidou A, Stein A, Stewart RC, Su KP, Sundström-Poromaa I, Tadinac M, Tandon SD, Tendais I, Thiagayson P, Töreki A, Torres-Giménez A, Tran TD, Trevillion K, Turner K, Vega-Dienstmaier JM, Wynter K, Yonkers KA, Benedetti A, Thombs BD. Comparison of major depression diagnostic classification probability using the SCID, CIDI, and MINI diagnostic interviews among women in pregnancy or postpartum: An individual participant data meta-analysis. Int J Methods Psychiatr Res 2019; 28:e1803. [PMID: 31568624 PMCID: PMC7027670 DOI: 10.1002/mpr.1803] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 08/05/2019] [Accepted: 08/16/2019] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES A previous individual participant data meta-analysis (IPDMA) identified differences in major depression classification rates between different diagnostic interviews, controlling for depressive symptoms on the basis of the Patient Health Questionnaire-9. We aimed to determine whether similar results would be seen in a different population, using studies that administered the Edinburgh Postnatal Depression Scale (EPDS) in pregnancy or postpartum. METHODS Data accrued for an EPDS diagnostic accuracy IPDMA were analysed. Binomial generalised linear mixed models were fit to compare depression classification odds for the Mini International Neuropsychiatric Interview (MINI), Composite International Diagnostic Interview (CIDI), and Structured Clinical Interview for DSM (SCID), controlling for EPDS scores and participant characteristics. RESULTS Among fully structured interviews, the MINI (15 studies, 2,532 participants, 342 major depression cases) classified depression more often than the CIDI (3 studies, 2,948 participants, 194 major depression cases; adjusted odds ratio [aOR] = 3.72, 95% confidence interval [CI] [1.21, 11.43]). Compared with the semistructured SCID (28 studies, 7,403 participants, 1,027 major depression cases), odds with the CIDI (interaction aOR = 0.88, 95% CI [0.85, 0.92]) and MINI (interaction aOR = 0.95, 95% CI [0.92, 0.99]) increased less as EPDS scores increased. CONCLUSION Different interviews may not classify major depression equivalently.
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Affiliation(s)
- Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Dean McMillan
- Hull York Medical School and the Department of Health Sciences, University of York, York, UK
| | - Ying Sun
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Chen He
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Danielle B Rice
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Psychology, McGill University, Montréal, Québec, Canada
| | - Ankur Krishnan
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Yin Wu
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Psychiatry, McGill University, Montréal, Québec, Canada
| | - Marleine Azar
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Tatiana A Sanchez
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Matthew J Chiovitti
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Parash Mani Bhandari
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Dipika Neupane
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Nazanin Saadat
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Kira E Riehm
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Mahrukh Imran
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Jill T Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montréal, Québec, Canada
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, EMGO Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Simon Gilbody
- Hull York Medical School and the Department of Health Sciences, University of York, York, UK
| | - John P A Ioannidis
- Department of Medicine, Department of Health Research and Policy, Department of Biomedical Data Science, Department of Statistics, Stanford University, Stanford, CA, USA
| | - Lorie A Kloda
- Library, Concordia University, Montréal, Québec, Canada
| | - Scott B Patten
- Department of Community Health Sciences, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.,Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Alberta, Canada.,Cuthbertson & Fischer Chair in Pediatric Mental Health, University of Calgary, Calgary, Alberta, Canada
| | - Ian Shrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.,Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Roy C Ziegelstein
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Liane Comeau
- International Union for Health Promotion and Health Education, École de santé publique de l'Université de Montréal, Montréal, Québec, Canada
| | - Nicholas D Mitchell
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada.,Alberta Health Services, Edmonton, Alberta, Canada
| | - Marcello Tonelli
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Simone N Vigod
- Women's College Hospital and Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Franca Aceti
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Rubén Alvarado
- Escuela de Salud Pública Dr. Salvador Allende, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Cosme Alvarado-Esquivel
- Laboratorio de Investigación Biomédica, Facultad de Medicina y Nutrición, Avenida Universidad, Durango, Mexico
| | - Muideen O Bakare
- Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu, Nigeria.,Childhood Neuropsychiatric Disorders Initiatives, Enugu, Nigeria
| | - Jacqueline Barnes
- Department of Psychological Sciences, Birkbeck, University of London, Bloomsbury London, UK
| | | | - Carola Bindt
- Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Philip M Boyce
- Discipline of Psychiatry, Westmead Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Department of Psychiatry, Westmead Hospital, Sydney, New South Wales, Australia
| | - Adomas Bunevicius
- Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Tiago Castro E Couto
- School of Medicine, Universidade Federal De Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Linda H Chaudron
- Departments of Psychiatry, Pediatrics, Obstetrics and Gynecology, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| | - Humberto Correa
- Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Valsamma Eapen
- School of Psychiatry, University of New South Wales, Kensington, Australia.,Ingham Institute, Liverpool, New South Wales, Australia.,Sydney South West Local Health District, Liverpool, New South Wales, Australia
| | - Michelle Fernandes
- Faculty of Medicine, Department of Paediatrics, University of Southampton and Southampton Children's Hospital, Southampton, UK.,The Nuffield Department of Women's & Reproductive Health, John Radcliffe Hospital and Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, UK
| | | | - Jane R W Fisher
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Lluïsa Garcia-Esteve
- Perinatal Mental Health Unit CLINIC-BCN, Institut Clínic de Neurociències, Hospital Clínic, Barcelona, Spain.,Vulnerability, Psychopathology and Gender Research Group, Generalitat de Catalunya, Catalonia, Spain.,August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain
| | - Lisa Giardinelli
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Nadine Helle
- Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Louise M Howard
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Dina Sami Khalifa
- Faculty of Health Sciences, Ahfad University for Women, Omdurman, Sudan.,Department of Community Medicine, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.,The Center for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jane Kohlhoff
- School of Psychiatry, University of New South Wales, Kensington, Australia.,Ingham Institute, Liverpool, New South Wales, Australia.,Karitane, Carramar, New South Wales, Australia
| | | | - Zoltán Kozinszky
- Department of Obstetrics and Gynaecology, Blekinge Hospital, Karlskrona, Sweden
| | - Lorenzo Lelli
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Angeliki A Leonardou
- First Department of Psychiatry, Women's Mental Health Clinic, Athens University Medical School, Athens, Greece
| | - Beth A Lewis
- School of Kinesiology, University of Minnesota, Minneapolis, MN, USA
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Impact Strategic Research Center, Deakin University, Geelong, Victoria, Australia
| | - Valentina Meuti
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Sandra Nakić Radoš
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | - Purificación Navarro García
- Perinatal Mental Health Unit CLINIC-BCN, Institut Clínic de Neurociències, Hospital Clínic, Barcelona, Spain.,Psychology Service, Regidoria de Polítiques de Gènere, Ajuntament de Terrassa, Terrassa, Spain
| | - Daisuke Nishi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Mental Health Policy, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Daniel Okitundu Luwa E-Andjafono
- Unité de Neuropsychologie, Département de Neurologie, Centre Neuro-psycho-pathologique, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | | | - Tamsen J Rochat
- MRC/Developmental Pathways to Health Research Unit, School of Clinical Medicine, University of Witwatersrand, Johannesburg, South Africa.,Human and Social Development Programme, Human Sciences Research Council, Johannesburg, South Africa
| | - Heather J Rowe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Bonnie W M Siu
- Department of Psychiatry, Castle Peak Hospital, Hong Kong SAR, China
| | - Alkistis Skalkidou
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Alan Stein
- Department of Child and Adolescent Psychiatry, University of Oxford, Oxford, UK.,MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Robert C Stewart
- Department of Mental Health, College of Medicine, University of Malawi, Zomba, Malawi.,Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Kuan-Pin Su
- College of Medicine, China Medical University, Taichung, Taiwan.,Mind-Body Interface Laboratory and Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan
| | | | - Meri Tadinac
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - S Darius Tandon
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Iva Tendais
- School of Psychology, University of Minho, Braga, Portugal
| | - Pavaani Thiagayson
- Institute of Mental Health, Hougang, Singapore.,KK Women's and Children's Hospital, Kallang, Singapore.,National Healthcare Group, Singapore
| | | | - Anna Torres-Giménez
- Perinatal Mental Health Unit CLINIC-BCN, Institut Clínic de Neurociències, Hospital Clínic, Barcelona, Spain.,Vulnerability, Psychopathology and Gender Research Group, Generalitat de Catalunya, Catalonia, Spain.,August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain
| | - Thach D Tran
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Kylee Trevillion
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Katherine Turner
- Epilepsy Center-Child Neuropsychiatry Unit, ASST Santi Paolo Carlo, San Paolo Hospital, Milan, Italy
| | | | - Karen Wynter
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,School of Nursing and Midwifery, Deakin University, Melbourne, Victoria, Australia
| | - Kimberly A Yonkers
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.,Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.,School of Epidemiology and Public Health, Yale University, New Haven, Connecticut, USA
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.,Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montréal, Québec, Canada.,Department of Medicine, McGill University, Montréal, Québec, Canada
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.,Department of Psychology, McGill University, Montréal, Québec, Canada.,Department of Psychiatry, McGill University, Montréal, Québec, Canada.,Department of Medicine, McGill University, Montréal, Québec, Canada.,Department of Educational and Counselling Psychology, McGill University, Montréal, Québec, Canada
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7
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Egmond HPV, Mouriño A, Burdaspal PA, Boenke A, Alvito P, Arevalo F, Botana-López LM, Bustos J, Dietrich R, Donald M, Franco Soler JM, Gago Martinez A, Hald B, Helle N, Hummert C, Ledoux M, Legarda T, Luckas B, Mesego A, Paulsch WE, Rodriguez-Vieytes M, Salgado C, Stockemer J, Usleber E, van den Top HJ, Walther L, Walther M, Winkler F. Development of Reference Materials for Paralytic Shellfish Poisoning Toxins. J AOAC Int 2019. [DOI: 10.1093/jaoac/84.5.1668] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
A project was undertaken to develop mussel reference materials that were certified for their mass fractions of saxitoxin and decarbamoyl-saxitoxin. Fifteen laboratories from various European countries participated. Three of these had major responsibility for substantial parts of the work and overall coordination of the project. The project involved 4 main activities: (1) procurement and characterization of calibrants; (2) improvement of analytical methodology; (3) preparation of reference materials, including homogeneity and stability studies; (4) 2 interlaboratory studies and a certification exercise. The joint activities resulted in 3 homogeneous and stable reference materials: 2 lyophilized mussel materials with and without naturally incurred paralytic shellfish poisoning (PSP) toxins, and a saxitoxin enrichment solution. The reference materials were certified with respect to their saxitoxin and decarbamoyl-saxitoxin content. The lyophilized mussel material with PSP toxins (CRM 542) contained <0.07 mg saxitoxin·2HCl/kg and 1.59 ± 0.20 mg decarbamoyl-saxitoxin·2HCl/kg. The lyophilized mussel material without PSP toxins (CRM 543) contained <0.07 mg saxitoxin·2HCl/kg and <0.04 mg decarbamoyl-saxitoxin·2HCl/kg. The certified value of the saxitoxin mass fraction in the saxitoxin enrichment solution (CRM 663) was 9.8 ± 1.2 μg/g.
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Affiliation(s)
- Hans P van Egmond
- National Institute of Public Health and the Environment, Laboratory for Residue Analysis, PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - Antonio Mouriño
- University of Santiago de Compostela, Departamento de Química Orgánica y Sección de Alcaloides del CSIC, Santiago de Compostela, Spain
| | - Pedro A Burdaspal
- Centro Nacional de Alimentacion (Instituto de Salud Carlos III), 28220 Majadahonda, Madrid, Spain
| | - Achim Boenke
- European Commission, Standards, Measurements and Testing Programme (SMT), 200 Rue de la Loi, Brussels, Belgium
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8
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Helle N, Barkmann C, Ehrhardt S, Wense AVD, Nestoriuc Y, Bindt C. Internalizing symptoms in very low birth weight preschoolers: Symptom level and risk factors from four rating perspectives in a controlled multicenter study. J Affect Disord 2019; 246:74-81. [PMID: 30578949 DOI: 10.1016/j.jad.2018.12.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 10/29/2018] [Accepted: 12/15/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Preterm births rates of infants with very low birth weight (VLBW < 1500 g) are increasing. Prematurity poses several risks for emotional child development, e.g., internalizing symptoms. Our understanding of this condition in young children is limited, for at preschool age, symptoms have mostly been assessed from the mother's perspective only. METHODS As part of the longitudinal HaFEn cohort-study in Hamburg, Germany, we measured the level of internalizing symptoms in VLBW and term preschoolers as well as predictors from four informants' perspectives: mother, father, teacher, and child. A multilevel model was constructed to examine predictors of internalizing symptoms. n = 104 VLBW and n = 79 term children were included. RESULTS From both their parents' perspective, children with VLBW had a significantly higher level of internalizing symptoms. From the teacher's and child's own perspectives, there were no significant mean group differences. In the multilevel analyses, the results were different regarding the four perspectives. VLBW did not predict internalizing symptoms. From mother's perspective, her own postpartum psychological distress, and from father's perspective, his postpartum and current psychological distress predicted a higher level of internalizing symptoms in their offspring. From teacher's perspective, socio-economic status predicted internalizing symptoms. LIMITATIONS The sample size was relatively small. Exclusion criteria and drop out of families could have created some selection bias. CONCLUSIONS Our findings point to the importance of early identification of parental postpartum psychological distress given the potential for later internalizing symptoms in their children or the perception of their offspring as vulnerable and symptomatic, which may also impact the child's development.
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Affiliation(s)
- Nadine Helle
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, W29, 20246 Hamburg, Germany
| | - Claus Barkmann
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, W29, 20246 Hamburg, Germany.
| | - Stephan Ehrhardt
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Axel von der Wense
- Department of Neonatology and Paediatric Critical Care, Neonatal Intensive Care Unit, Altona Children's Hospital, Hamburg, Germany
| | - Yvonne Nestoriuc
- Department of Clinical Psychology, Helmut-Schmidt-University, Hamburg, Germany
| | - Carola Bindt
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, W29, 20246 Hamburg, Germany
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Helle N, Barkmann C, Ehrhardt S, Bindt C. Postpartum posttraumatic and acute stress in mothers and fathers of infants with very low birth weight: Cross-sectional results from a controlled multicenter cohort study. J Affect Disord 2018; 235:467-473. [PMID: 29679899 DOI: 10.1016/j.jad.2018.04.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 03/05/2018] [Accepted: 04/02/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND The birth of a preterm infant can be stressful and traumatic for parents and may cause posttraumatic stress symptoms and disorders. There is a dearth of data from controlled studies regarding level, prevalence, risk, and predictors of these symptoms in parents after preterm birth. METHODS As part of the longitudinal HaFEn-study, data from parents of infants with very low birth weight (VLBW), and term infants were cross-sectionally analyzed. We recruited parents at the three largest perinatal care centers in Hamburg, Germany. Posttraumatic stress symptoms were assessed with a standardized questionnaire, and acute and posttraumatic stress disorders with a clinical interview one month postpartum. Stress during birth, lifetime psychiatric diagnoses, social support, pregnancy risks, and mode of delivery were also evaluated. To examine predictors of posttraumatic stress symptoms in both parents simultaneously, we constructed multiple random coefficient models. RESULTS 230 mothers and 173 fathers were included. The risk for acute stress disorder was increased in mothers with VLBW infants but not in fathers. While the risk for posttraumatic stress disorder was not elevated, the level of posttraumatic stress symptoms was higher in both parents with VLBW infants. Predictors for posttraumatic stress symptoms were stress during birth, low social support, psychiatric lifetime diagnoses, the birth of a VLBW infant, and female parent sex. LIMITATIONS Results reported here are cross-sectional. Thus, no temporal relationships can be established. CONCLUSIONS Although posttraumatic stress disorders were rare, our results suggest that posttraumatic stress symptoms and acute stress disorders are common in parents of VLBW infants.
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Affiliation(s)
- Nadine Helle
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, W29, Hamburg 20246, Germany.
| | - Claus Barkmann
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, W29, Hamburg 20246, Germany
| | - Stephan Ehrhardt
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Carola Bindt
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, W29, Hamburg 20246, Germany
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Barkmann C, Helle N, Bindt C. Is very low infant birth weight a predictor for a five-year course of depression in parents? A latent growth curve model. J Affect Disord 2018; 229:415-420. [PMID: 29331702 DOI: 10.1016/j.jad.2017.12.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 11/20/2017] [Accepted: 12/09/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND A very low birth weight (VLBW) is considered as a significant risk factor for early-onset developmental problems in infants, but is also discussed as a potential risk factor for the development of depressive symptoms in affected parents. METHODS In this study, the 5-year courses of maternal and paternal depression with VLBW and term born infants (n = 250 families) are modeled and predicted by factors existing at the time of birth. RESULTS The dyadic trajectories of depression could be best described by five classes (I no depression, II minor maternal depression, III increasing dyadic depression, IV significant maternal depression, V highly depressed mothers). VLBW was a significant predictor for the course of parental depression - even under control of preexisting psychiatric disorders and other confounders. Interaction effects and a dose-response relationship were not existent. LIMITATIONS Class IV and V had to be merged for the prediction analysis, a missing bias could not be ruled out, and families with a low birth weight (between 2500 and 1500g) were not included. CONCLUSIONS The results are well in line with what is known from studies so far, suggesting that maternal and paternal trajectories of depression show distinctable patterns which are associated with a VLBW. An early screening of mothers and fathers of a VLBW infant seems reasonable to prevent the development of a depression in parents and further difficulties for the child.
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Affiliation(s)
- Claus Barkmann
- Department for Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Germany.
| | - Nadine Helle
- Department for Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Germany
| | - Carola Bindt
- Department for Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Germany
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Helle N, Barkmann C, Ehrhardt S, von der Wense A, Nestoriuc Y, Bindt C. Postpartum anxiety and adjustment disorders in parents of infants with very low birth weight: Cross-sectional results from a controlled multicentre cohort study. J Affect Disord 2016; 194:128-34. [PMID: 26820762 DOI: 10.1016/j.jad.2016.01.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 01/06/2016] [Accepted: 01/10/2016] [Indexed: 01/29/2023]
Abstract
BACKGROUND Both preterm delivery and survival rates of very low birth weight (VLBW: <1500 g) infants are increasing. To date, the focus on studies about postpartum mental health after preterm birth has been on depression and on women. There is a paucity of research regarding prevalence, risks, and predictors of postpartum anxiety in parents after VLBW birth. METHODS Parents with VLBW infants and parents with term infants were recruited into the longitudinal HaFEn-study at the three largest centers of perinatal care in Hamburg, Germany. State anxiety was assessed with the State-Trait-Anxiety Inventory and anxiety and adjustment disorders with a clinical interview one month postpartum. Psychiatric lifetime diagnoses, social support, trait anxiety, stress during birth, socioeconomic status, risks during pregnancy, and mode of delivery were also evaluated. To examine predictors of postpartum state anxiety in both parents simultaneously a multiple random coefficient model was used. RESULTS 230 mothers and 173 fathers were included. The risk for minor/major anxiety symptoms and adjustment disorders was higher in parents with VLBW infants compared to the term group. The risk for anxiety disorders was not higher in parents with VLBW infants. The most important predictors for postpartum state anxiety were high trait anxiety, the birth of a VLBW infant, high stress during birth, and low social support. LIMITATIONS Data reported here are cross-sectional. Thus, temporal relationships cannot be established. CONCLUSIONS Our results emphasize the importance of early screening for postpartum anxiety in both parents with VLBW infants.
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Affiliation(s)
- Nadine Helle
- Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Germany.
| | - Claus Barkmann
- Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Germany
| | - Stephan Ehrhardt
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Axel von der Wense
- Department of Neonatology and Paediatric Critical Care, Neonatal Intensive Care Unit, Altona Children's Hospital, Hamburg, Germany
| | - Yvonne Nestoriuc
- Institute of Psychology, Clinical Psychology and Psychotherapy, Hamburg University, Hamburg, Germany
| | - Carola Bindt
- Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Germany
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Helle N, Barkmann C, Bartz-Seel J, Diehl T, Ehrhardt S, Hendel A, Nestoriuc Y, Schulte-Markwort M, von der Wense A, Bindt C. Very low birth-weight as a risk factor for postpartum depression four to six weeks postbirth in mothers and fathers: Cross-sectional results from a controlled multicentre cohort study. J Affect Disord 2015; 180:154-61. [PMID: 25911131 DOI: 10.1016/j.jad.2015.04.001] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 04/01/2015] [Accepted: 04/01/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Preterm birth and survival rates of very low birth-weight (VLBW: <1.500g) infants have increased. Although new parents are frequently affected by depressive symptoms, little is known about prevalence, risk, and predictors of parental postpartum depression (PPD) following VLBW birth. Furthermore, most studies assessing PPD in parents of preterm children relied on self-report only. METHODS As part of the HaFEn cohort-study, data from the index groups of parents with VLBW infants and the control group of parents with term infants were cross-sectionally analysed. Families were recruited at the three largest centres of perinatal medical care in Hamburg, Germany. PPD was evaluated one month postpartum using standardized questionnaires and clinical interviews. Socioeconomic status, social support, risks during pregnancy, and psychiatric lifetime diagnoses were also assessed. A multiple random coefficient model was used to examine predictors of PPD in both parents simultaneously. RESULTS 230 mothers and 173 fathers were included. Depending on the measure, the risk of being postnatally depressed was 4 to 18 times higher in mothers and 3 to 9 times higher in fathers from the index group. The most relevant risk factor for PPD was the birth of a VLBW infant, followed by female sex, lifetime psychiatric disorder, and low social support. LIMITATIONS Results presented here, are based on cross sectional data. Therefore no temporal relationships can be established. CONCLUSIONS Our findings highlight the importance of early screening for PPD in both parents of VLBW infants. Factors contributing to developing depression should also be considered in neonatal care.
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Affiliation(s)
- Nadine Helle
- Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Germany.
| | - Claus Barkmann
- Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Germany
| | - Jutta Bartz-Seel
- Department of Neonatology and Paediatric Critical Care, Neonatal Intensive Care Unit, Altona Children׳s Hospital, Hamburg, Germany
| | - Thilo Diehl
- Department of Paediatrics, Neonatal Intensive Care Unit, University Medical Center Hamburg-Eppendorf, Germany
| | - Stephan Ehrhardt
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Astrid Hendel
- Department of Neonatology, Neonatal Intensive Care Unit, Asklepios Medical Center Barmbek, Hamburg, Germany
| | - Yvonne Nestoriuc
- Institute of Psychology, Clinical Psychology and Psychotherapy, Hamburg University, Hamburg, Germany
| | - Michael Schulte-Markwort
- Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Germany
| | - Axel von der Wense
- Department of Neonatology and Paediatric Critical Care, Neonatal Intensive Care Unit, Altona Children׳s Hospital, Hamburg, Germany
| | - Carola Bindt
- Department of Child and Adolescent Psychiatry, University Medical Center Hamburg-Eppendorf, Germany
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Erkan N, Helle N, Ozden O. [The content of biogenic amines in canned fish from the Turkish market]. Berl Munch Tierarztl Wochenschr 2001; 114:241-5. [PMID: 11505795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
This paper describes the determination of biogenic amines in a number of canned fish of the Turkish market by means of HPLC. Over all 39 cans of sardine, tuna, sardel, mackerel, pelamide and trout were tested. The determination of agmatine, cadaverine, histamine, putrescine and tyramine was performed by HPLC with post column derivatization with ortho-phthaldialdehyde. Four samples contained higher amounts of biogenic amines (three sardine samples contained more than 1000 mg/kg histamine) while all other samples were acceptable. These results demonstrate the need of instrumental analyses in the quality control system of Turkish producers of canned fish. The quality of the products at least of some producers has to be improved, e.g. by cooperation between the official food control and the quality assurance system of the producers.
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Affiliation(s)
- N Erkan
- Universität Istanbul, Fakultät für Aquatische Produkte, Abteilung für Fischverarbeitung und -technologie, Istanbul, Türkei. oder
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Helle N, Wolbert A, Linke B, Ehlers D, Krüger KE. [Electron spin resonance spectroscopy investigations of fresh fruit. Evidence of treatment with ionizing radiation]. Z Lebensm Unters Forsch 1995; 201:355-60. [PMID: 8525704 DOI: 10.1007/bf01192732] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
This paper describes the development of a method for the identification of irradiated fresh fruits by measurement of the e.p.r. spectra of pips, kernels or stones. Measurement parameters were optimized and the irradiation specific spectrum was assigned to a cellulose radical by comparison with the e.p.r. spectrum of pure cellulose. Several fruits especially different varieties of strawberries were examined giving the following results: Detectable minimum doses were between 0.4 kGy and 0.9 kGy and the intensity of the irradiation specific signals was found to be linear up to doses of 11 kGy. The lifetime of the specific radicals (at room temperature and at deep freezing temperatures) was long enough compared to the storage time of fresh fruits. Additional information about the nature of the unspecific central signal was gained measuring the samples which were stored at different temperatures. The main conclusion of this study is that the e.p.r. method seemes to be well suited for the use in routine control and should be tested in an intercomparison to establish a routine method for the identification of irradiated fresh fruits.
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Affiliation(s)
- N Helle
- Staatliches Veterinäruntersuchungsamt für Fische und Fischwaren Cuxhaven, Germany
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Mischke J, Helle N, Linke B, Schreiber GA, Bögl KW. [Electron spin resonance measurements on dried fruit. Carbohydrate composition and ESR signal structure of irradiated fruit]. Z Ernahrungswiss 1994; 33:258-66. [PMID: 7732704 DOI: 10.1007/bf01614431] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
While in a previous work the ESR spectroscopic detection of irradiated dried fruits was reported, in this paper liquid chromatographic determination of the carbohydrate fraction of these fruits is introduced and connected with the ESR results. After irradiation of dried fruits three different types of ESR spectra are observed. In most cases the dried fruits can be attached to these various types by means of their sugar composition. It was also found that the ESR spectra observed for sucrose-rich fruits are very similar to that of pure sucrose. The structure of the ESR spectra can change with storage. Probably, radical rearrangement reactions in the samples are responsible for these changes.
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Affiliation(s)
- J Mischke
- Bundesinstitut für gesundheitlichen Verbraucherschutz und Veterinärmedizin Fachgebiet Lebensmittelbestrahlung, Berlin
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Schreiber G, Leffke A, Mager M, Helle N, Bögl K. Viscosity of alkaline suspensions of ground black and white pepper samples: An indication or an identification of high dose radiation treatment? Radiat Phys Chem Oxf Engl 1993 1994. [DOI: 10.1016/0969-806x(94)90042-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Schreiber GA, Schulzki G, Spiegelberg A, Helle N, Bögl KW. Evaluation of a gas chromatographic method to identify irradiated chicken, pork, and beef by detection of volatile hydrocarbons. J AOAC Int 1994; 77:1202-17. [PMID: 7950420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A method suitable for routine application was used in an interlaboratory study to detect irradiation treatment of chicken carcass, pork, and beef. By using gas chromatographic analysis, 17 participating laboratories determined the quantity of 4 different radiation-induced volatile hydrocarbons (tetradecene, pentadecane, hexadecadiene, and heptadecene) in the fat fraction of coded specimens approximately 3 and 6 months after irradiation. The specimens of each type of meat were supplied by 2 different producers. The dose range tested (0.6-7.5 kGy) included levels commercially used to reduce the number of contaminating microorganisms (1-5 kGy). The method employed permitted a correct identification of irradiated or nonirradiated in 98.3% of the 864 specimens.
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Affiliation(s)
- G A Schreiber
- Federal Institute for Health Protection of Consumers and Veterinary Medicine, Berlin, Germany
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Schreiber G, Hoffmann A, Helle N, Bögl K. Methods for routine control of irradiated food: Determination of the irradiation status of shellfish by thermoluminescence analysis. Radiat Phys Chem Oxf Engl 1993 1994. [DOI: 10.1016/0969-806x(94)90164-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Spiegelberg A, Schulzki G, Helle N, Bögl K, Schreiber G. Methods for routine control of irradiated food: Optimization of a method for detection of radiation-induced hydrocarbons and its application to various foods. Radiat Phys Chem Oxf Engl 1993 1994. [DOI: 10.1016/0969-806x(94)90059-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Helle N, Knopfe C, Mischke J, Gebhardt G, Bögl KW, Schreiber GA. [ESR and HPLC studies of the detection of gamma irradiation of eggs]. Z Lebensm Unters Forsch 1993; 197:440-3. [PMID: 8273424 DOI: 10.1007/bf01202614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Two methods for the identification of irradiated eggs are presented. Electron spin resonance (ESR) detects radiation-specific radicals in the calcite matrix of eggshells. ESR gives unequivocal results for doses clearly below the technologically relevant dose. The stability of the radical in the calcite matrix was tested over a period of 6 weeks. Products that contain no or only low amounts of fat but a high percentage of protein can be identified by HPLC. Only in the chromatograms of irradiated samples is a peak of the amino acid ortho-tyrosine present. This HPLC method may be of great interest especially for the identification of irradiated pasteurized liquid egg white.
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Affiliation(s)
- N Helle
- Institut für Sozialmedizin und Epidemiologie des Bundesgesundheitsamtes, Berlin, Deutschland
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Helle N, Schulzki G, Linke B, Spiegelberg A, Bögl KW, Schreiber GA, von Grabowski HU, Pfordt J, Mauermann U, Jülicher S. [Identification of irradiated pasteurized egg products: a combined method for use in routine control]. Z Lebensm Unters Forsch 1993; 197:321-31. [PMID: 8249475 DOI: 10.1007/bf01242056] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Pasteurized egg products (whole egg, egg yolk and egg white) were tested for irradiation treatment in the German food control laboratories in Oldenburg/Niedersachsen and Kassel/Hessen as well as in the food irradiation laboratory of the German federal health office. Gas chromatographic/mass spectrometric measurements on the fat components of egg-products showed clearly whether the product had been irradiated or not. While in unirradiated samples no traces of special hydrocarbons (according to the fatty acid composition of egg) and no traces of the irradiation-specific compound 2-Dodecyl-cyclobutanone were found, irradiated control samples as well as products of two Belgian suppliers contained these substances. Additionally, regarding the rather high time consumption of gas chromatography, electron spin resonance (ESR)-measurements were carried out on the packaging material of egg products. Irradiated packaging material (cellulose) could be easily detected by the appearance of a signal pair in the ESR spectrum (cellulose radical). ESR measurements are very fast and easy to perform so that this method can be used for screening. Microbiological investigations showed remarkably reduced total numbers of microorganisms for some irradiated samples, but the microbiological status is influenced by other factors like storage-time and -temperature, so that microbiological tests can not be used successfully for screening on irradiation treatment.
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Affiliation(s)
- N Helle
- Institut für Sozialmedizin u. Epidemiologie des Bundesgesundheitsamtes, Fachgebiet Lebensmittelbestrahlung, Berlin, Deutschland
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Schreiber G, Helle N, Schulzki G, Spiegelberg A, Linke B, Wagner U, Bögl K. Intercomparisons to evaluate the suitability of gaschromatographic, electron- spin-resonance spectrometric and thermoluminescence methods to detect irradiated foods in routine control. Radiat Phys Chem Oxf Engl 1993 1993. [DOI: 10.1016/0969-806x(93)90273-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
Irradiation of food for the purpose of extension of shelf life, control of microbial load, reduction of pathogenic microorganisms and disinfection is regarded by many consumers with suspicion. One reason is the lack of methods within food-controlling laboratories which can detect irradiation treatment and which are applied to control correct labelling. This review describes the potential of various methods to reveal irradiation treatment. Special emphasis is given to the three most successful methods, thermoluminescence, electron spin resonance spectroscopy and detection of volatiles. The possibilities and limitations of applying the methods in routine control are discussed.
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Affiliation(s)
- G A Schreiber
- Institute for Social Medicine and Epidemiology, Federal Health Office (BGA), Berlin, Germany
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Helle N, Linke B, Bögl KW, Schreiber GA. [Electron spin resonance spectroscopy as probes for spices. Detection of treatment with ionizing radiation]. Z Lebensm Unters Forsch 1992; 195:129-32. [PMID: 1326829 DOI: 10.1007/bf01201772] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Detection of irradiated spices by electron spin resonance (ESR) measurements was not successful in the past because a central line of unknown origin was detected in the ESR-spectra of both irradiated and unirradiated samples. Identification of irradiated samples by measuring the increase of intensity of this signal after irradiation is limited because the signal intensity decreases over a period of some weeks of storage and reaches the range of unirradiated samples. By changing the measurement conditions (low microwave power) we could detect two additional lines on both sides of the main signal. This line pair appears only in the spectra of irradiated spices. A similar line pair was found in the spectra of irradiated nutshells and possibly derives from cellulose radicals in the sample. For some spices, especially paprika, the identification of irradiated samples by detecting these additional lines was possible even after relatively long periods of storage.
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Affiliation(s)
- N Helle
- Institut für Sozialmedizin und Epidemiologie, Bundesgesundheitsamtes, Fachgebiet Lebensmittelbestrahlung, Berlin, Bundesrepublik Deutschland
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