|
1
|
Akalin A, D’haenens F, Tricas-Sauras S, Vermeulen J, Demedts D, Buyl R, Fobelets M. Awareness, knowledge, and attitudes of the Belgian general population towards paternal perinatal depression: a descriptive cross-sectional study. Front Psychiatry 2025; 15:1455629. [PMID: 39845366 PMCID: PMC11753207 DOI: 10.3389/fpsyt.2024.1455629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Accepted: 12/17/2024] [Indexed: 01/24/2025] Open
Abstract
Background Paternal perinatal depression affects 10% of fathers, implying a significant burden on families and public health. A better insight into the population's health literacy could guide professionals and policymakers in addressing these men and making better use of existing healthcare options. It is also crucial for caregivers, as they play a vital role in identifying symptoms, encouraging help-seeking, and reducing stigma. This study aimed to explore the awareness, knowledge, and attitudes of the general population in Belgium towards paternal perinatal depression, using the validated DDads (Depression in Dads) questionnaire. Methods This descriptive, cross-sectional study was conducted between March and May 2020-2022 using convenience sampling. Participants aged over 18 years, with a good understanding of Dutch and residing in the Brussels-Capital Region or Flemish Brabant were invited to participate. Data were analysed using descriptive statistics, Chi² analysis, and independent sample t-test. Results A total of 314 participants, including women (n=165) and men (n=149) completed the questionnaire. Anxiousness was the most frequently cited mental health problem for men during their partners' pregnancy (82.5%) and in the postnatal period (68.5%). Over one-third (37.3%) viewed paternal depression as a 'normal' part of the transition to fatherhood. The recommended treatment for paternal depression was mostly non-pharmacological, with family support ranking first (79.9%) and seeking support from informal networks being the most recommended approach (45.2%). New personality characteristics such as withdrawal, cynicism, raging attacks, and irritability, among others, were seen as common symptoms (64.6%). Although 70% of respondents believed that perinatal depression requires specialized treatment, only 39.2% agreed that all men should be screened for depression during pregnancy. Conclusions Recognition of paternal depression symptoms was relatively low but higher among females, participants with higher education, and those aware of paternal depression. Professional support recommendations were limited, especially among young people and those without children. The terms 'paternal perinatal depression' and 'perinatal mental health' are poorly understood. The findings highlight critical gaps in awareness and attitudes, offering valuable insights. Future research should develop tailored interventions to support men's mental well-being during the perinatal period. Targeted awareness campaigns and healthcare improvements are crucial for addressing this issue.
Collapse
Affiliation(s)
- Ayse Akalin
- Department of Healthcare, Design, & Technology, Brussels Expertise Centre for Healthcare Innovation (BruCHI), Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium
- Department of Nursing, Faculty of Health Sciences, Düzce University, Düzce, Türkiye
| | - Florence D’haenens
- Department of Healthcare, Design, & Technology, Brussels Expertise Centre for Healthcare Innovation (BruCHI), Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium
| | - Sandra Tricas-Sauras
- Department of Healthcare, Design, & Technology, Brussels Expertise Centre for Healthcare Innovation (BruCHI), Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium
- Public Health School, CR5 - Department of Social Approaches to Health (CRISS), Université Libre de Bruxelles, Brussels, Belgium
| | - Joeri Vermeulen
- Department of Healthcare, Design, & Technology, Brussels Expertise Centre for Healthcare Innovation (BruCHI), Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium
- Department of Public Health, Biostatistics and Medical Informatics Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Department of Life sciences and Medicine, Faculty of Science, Technology and Medicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Dennis Demedts
- Department of Healthcare, Design, & Technology, Brussels Expertise Centre for Healthcare Innovation (BruCHI), Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium
- Department of Public Health, Mental Health and Wellbeing Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Ronald Buyl
- Department of Public Health, Biostatistics and Medical Informatics Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Maaike Fobelets
- Department of Public Health, Biostatistics and Medical Informatics Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Department of Teacher Education, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| |
Collapse
|
|
2
|
Nechaeva E, Kharkova O, Postoev V, Grjibovski AM, Darj E, Odland JØ. Awareness of postpartum depression among midwives and pregnant women in Arkhangelsk, Arctic Russia. Glob Health Action 2024; 17:2354008. [PMID: 38828500 PMCID: PMC11149570 DOI: 10.1080/16549716.2024.2354008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 05/08/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Postpartum depression (PPD) affects approximately 17% of the women worldwide with nearly half of all cases going undetected. More research on maternal mental health, particularly among healthcare professionals and pregnant mothers, could help identify PPD risks and reduce its prevalence. OBJECTIVE Given that awareness of PPD is a crucial preventive factor, we studied PPD awareness among midwives and pregnant women in Arkhangelsk, Arctic Russia. METHODS A qualitative study was conducted using in-depth semi-structured interviews. Midwives and pregnant women were recruited from the women's clinic of the Arkhangelsk municipal polyclinic. Seven midwives and 12 pregnant mothers were interviewed. RESULTS Midwives described limited time for psychological counselling of pregnant women; they reported that their primary focus was on the physiological well-being of women. Pregnant women have expressed a desire for their families to share responsibilities. The participants considered PPD as a mix of psychological and physiological symptoms, and they also highlighted a discrepancy between the expectations of pregnant women and the reality of motherhood. The present study underscored the limited understanding of PPD identification. CONCLUSIONS The findings suggest that there is a need for increased awareness among midwives and pregnant women regarding PPD. Prevention programs targeting PPD with a specific emphasis on enhancing maternal mental health knowledge are warranted.
Collapse
Affiliation(s)
- Elena Nechaeva
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Olga Kharkova
- Department of Pedagogy and Psychology, Northern State Medical University, Arkhangelsk, Russia
| | - Vitaly Postoev
- Department of Public Health, Health Care and Social Work, Northern State Medical University, Arkhangelsk, Russia
| | - Andrej M. Grjibovski
- Department of Health Policy and Management, Al-Farabi Kazakh National University, Almaty, Kazakhstan
- Department of Epidemiology and Modern Vaccination Technologies, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Central Scientific Research Laboratory, Northern State Medical University, Arkhangelsk, Russia
- Department of Biology, Ecology and Biotechnology, Northern (Arctic) Federal University, Arkhangelsk, Russia
| | - Elisabeth Darj
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Jon Øyvind Odland
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Department of General Hygiene, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| |
Collapse
|
|
3
|
Gusak N, Kendall S, Nizalova O. Understanding of perinatal mental health and its psychosocial determinants through Ukrainian women's experience. Eur J Midwifery 2024; 8:EJM-8-29. [PMID: 38841270 PMCID: PMC11151686 DOI: 10.18332/ejm/188194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 04/29/2024] [Accepted: 05/11/2024] [Indexed: 06/07/2024] Open
Abstract
INTRODUCTION Perinatal mental health defines new mothers, their families, and the social, emotional, and cognitive development of their children. The factors contributing to Ukrainian mothers' mental health are not well-defined in the literature. This study aims to explore how Ukrainian women understand mental health and its psychosocial determinants through their perinatal experience. METHODS This qualitative analysis is part of a larger mixed-methods study exploring perinatal mental health in Ukraine. Five online focus groups (n=30) with Ukrainian mothers of children aged 0-5 years were conducted in June-July 2020. The participants were selected from a pool of 1634 women who completed an online questionnaire and agreed to participate in further research. Informed consent was obtained. The data collected from the focus groups were transcribed verbatim and analyzed thematically using Dedoose software. RESULTS The study identified two themes. The first theme was: 'Understanding perinatal mental health through women's experience', which covers five subthemes. The second theme was 'Psychosocial determinants of maternal mental health', which includes six subthemes. Overall, women's feelings of guilt, blame, and shame during their perinatal journey are influenced by socio-cultural factors and can lead to mental health problems and reluctance to seek proper help. CONCLUSIONS The study has identified some factors that can contribute to the enhancement of mental health and well-being of mothers in Ukraine during their perinatal journey. Negative emotions such as guilt, blame, and shame can have a significant impact on their ability to seek the necessary support, and should be addressed by midwives and other healthcare professionals.
Collapse
Affiliation(s)
- Nataliia Gusak
- Department of Social Work, National University of KyivMohyla Academy, Kyiv, Ukraine
| | | | | |
Collapse
|
|
4
|
Wang K, Li R, Li Q, Li Z, Li N, Yang Y, Wang J. Knowledge, attitude, and practice toward postpartum depression among the pregnant and lying-in women. BMC Pregnancy Childbirth 2023; 23:762. [PMID: 37904090 PMCID: PMC10614410 DOI: 10.1186/s12884-023-06081-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 10/20/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Postpartum depression (PPD) is considered an important public health problem, and early recognition of PPD in pregnant and lactating women is critical. This study investigated the knowledge, attitude, and practice (KAP) toward PPD among pregnant and lying-in women. METHODS This cross-sectional study was conducted at Binzhou Medical University Hospital between September 2022 and November 2022 and included pregnant and lying-in women as study participants. A questionnaire was designed by the researchers that included demographic data and knowledge, attitude, and practice dimensions. Correlations between knowledge, attitude, and practice scores were evaluated by Pearson correlation analysis. Factors associated with practice scores were identified by multivariable logistic regression. RESULTS All participants scored 6.27 ± 2.45, 36.37 ± 4.16, and 38.54 ± 7.93 93 from three sub-dimensions of knowledge, attitudes, and practices regarding PPD, respectively, with statistical differences in the three scores by age, education, and job status (p < 0.05). There were no significant differences between maternal (6.24 ± 2.34, 36.67 ± 3.82 and 38.31 ± 7.27, respectively) and pregnant women (6.30 ± 2.49, 36.00 ± 4.53 and 38.83 ± 8.69, respectively) in the total scores of knowledge, attitude, and practice dimensions. According to the results of multivariate logistic regression, the knowledge (OR = 1.235[1.128-1.353], P < 0.001) and attitude (OR = 1.052[1.005-1.102], P = 0.030) dimension scores were factors influencing the practice dimension scores. CONCLUSION The KAP of pregnant and lying-in women toward PPD is low. This study suggests that maternal awareness of PPD should be increased through the knowledge and attitudinal dimensions. Preventing PPD in pregnant and lying-in women can be achieved by improving both dimensions, thus enhancing practice.
Collapse
Affiliation(s)
- Kai Wang
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - Rui Li
- Department of Obstetrics and Gynecology, Binzhou Medical University Hospital, Binzhou, China
| | - Qingqing Li
- Department of Obstetrics and Gynecology, Binzhou Medical University Hospital, Binzhou, China
| | - Zhenzhen Li
- Department of Obstetrics and Gynecology, Binzhou Medical University Hospital, Binzhou, China
| | - Ning Li
- Department of Obstetrics and Gynecology, Binzhou Medical University Hospital, Binzhou, China
| | - Yandong Yang
- Department of Obstetrics and Gynecology, Binzhou Medical University Hospital, Binzhou, China
| | - Jia Wang
- Department of Obstetrics and Gynecology, Binzhou Medical University Hospital, Binzhou, China.
- Department of Obstetrics and Gynecology, Shanghai Putuo District Liqun Hospital, Shanghai, China.
| |
Collapse
|
|
5
|
He L, Soh KL, Yu J, Chen A, Dong X. Effect of family-centered interventions for perinatal depression: an overview of systematic reviews. Front Psychiatry 2023; 14:1094360. [PMID: 37324817 PMCID: PMC10267375 DOI: 10.3389/fpsyt.2023.1094360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 05/15/2023] [Indexed: 06/17/2023] Open
Abstract
Objective This study aimed to evaluate and conclude the quality of critically systematic reviews (SRs) of the efficacy of family-centered interventions on perinatal depression. Methods SRs of the efficacy of family-centered interventions on perinatal depression were systematically searched in nine databases. The retrieval period was from the inception of the database to December 31, 2022. In addition, two reviewers conducted an independent evaluation of the quality of reporting, bias risk, methodologies, and evidence using ROBIS (an instrument for evaluating the bias risk of SRs), Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), AMSTAR 2 (an assessment tool for SRs), and grading of recommendations, assessment, development and evaluations (GRADE). Results A total of eight papers satisfied the inclusion criteria. In particular, AMSTAR 2 rated five SRs as extremely low quality and three SRs as low quality. ROBIS graded four out of eight SRs as "low risk." Regarding PRISMA, four of the eight SRs were rated over 50%. Based on the GRADE tool, two out of six SRs rated maternal depressive symptoms as "moderate;" one out of five SRs rated paternal depressive symptoms as "moderate;" one out of six SRs estimated family functioning as "moderate," and the other evidence was rated as "very low" or "low." Of the eight SRs, six (75%) reported that maternal depressive symptoms were significantly reduced, and two SRs (25%) were not reported. Conclusion Family-centered interventions may improve maternal depressive symptoms and family function, but not paternal depressive symptoms. However, the quality of methodologies, evidence, reporting, and bias of risk in the included SRs of family-centered interventions for perinatal depression was not satisfactory. The above-mentioned demerits may negatively affect SRs and then cause inconsistent outcomes. Therefore, SRs with a low risk of bias, high-quality evidence, standard reporting, and strict methodology are necessary to provide evidence of the efficacy of family-centered interventions for perinatal depression.
Collapse
Affiliation(s)
- Liping He
- Department of Nursing, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Department of Nursing, Chang Zhi Medical College, Changzhi, Shanxi, China
| | - Kim Lam Soh
- Department of Nursing, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Jiaxiang Yu
- Department of Nursing, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Aixiang Chen
- Department of Nursing, Chang Zhi Medical College, Changzhi, Shanxi, China
| | - Xiujuan Dong
- Department of Nursing, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Department of Nursing, Chang Zhi Medical College, Changzhi, Shanxi, China
| |
Collapse
|
|
6
|
Nwoke CN, Awosoga OA, McDonald S, Bonifacio GT, Leung BMY. African Immigrant Mothers' Views of Perinatal Mental Health and Acceptability of Perinatal Mental Health Screening: Quantitative Cross-sectional Survey Study. JMIR Form Res 2023; 7:e40008. [PMID: 36705944 PMCID: PMC9886220 DOI: 10.2196/40008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Mental health disorders are the most common perinatal conditions. They affect mothers, babies, partners, and support networks. However, <15% of pregnant and postpartum women seek timely help for their mental health care. Low perinatal mental health knowledge and universal screening unacceptability are cited as important deterrents to obtaining timely mental health care. OBJECTIVE The purpose of this quantitative cross-sectional study was 2-fold: (1) to determine African immigrant mothers' views of perinatal mental health and to identify predictors of those views and (2) to identify African immigrant mothers' views regarding perinatal mental health screening and to determine factors associated with those views. METHODS A cross-sectional survey was conducted using a convenience sample of African immigrant women from the province of Alberta, Canada. Respondents were eligible to participate if they were aged ≥18 years, had a live birth, and the infant was aged ≤2 years. Questions were drawn from the Edinburgh Postnatal Depression Scale, the Generalized Anxiety Disorder-7 scale, and additional questions were developed using the Alberta Maternal Mental Health 2012 survey as a guide and tested to reflect the immigrant context. Descriptive and multivariable regression analyses were conducted. RESULTS Among the 120 respondents, 46.5% (53/114) were aged 31-35 years, 76.1% (89/117) were employed or on maternity leave, 92.5% (111/120) were married, and 55.6% (65/117) had younger infants aged 0 to 12 months. Significantly more respondents had higher levels of knowledge of postnatal (109/115, 94.8%) than prenatal (57/110, 51.2%) mental health (P<.001). Only 25.4% (28/110) of the respondents accurately identified that prenatal anxiety or depression could negatively impact child development. Personal knowledge of postpartum anxiety and depression was a significant predictor of prenatal and postnatal mental health knowledge. Most respondents strongly agreed or agreed that all women should be screened in the prenatal (82/109, 75.2%) and postnatal (91/110, 82.7%) periods. Respondents reported that their partner would be their first choice when seeking help and support. The acceptability of postnatal screening was a significant predictor of prenatal mental health knowledge (P<.001), whereas the acceptability of prenatal screening was a significant predictor of postnatal mental health knowledge (P=.03). Prenatal mental health knowledge was a significant predictor of both prenatal (P<.001) and postnatal (P=.001) screening acceptability. CONCLUSIONS Although African mothers' knowledge of postnatal mental health is high, their prenatal mental health knowledge and its influence on child development are limited. Perinatal mental health interventions for African immigrant mothers in Alberta should target these knowledge gaps. The high acceptability of universal perinatal mental health screening among African mothers provides a promising strategy for perinatal mental health literacy initiatives to achieve optimal perinatal mental health.
Collapse
Affiliation(s)
| | | | - Sheila McDonald
- Department of Pediatrics and Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada
| | - Glenda T Bonifacio
- Department of Women and Gender Studies, University of Lethbridge, Lethbridge, AB, Canada
| | - Brenda M Y Leung
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada
| |
Collapse
|
|
7
|
Alsabi RNS, Zaimi AF, Sivalingam T, Ishak NN, Alimuddin AS, Dasrilsyah RA, Basri NI, Jamil AAM. Improving knowledge, attitudes and beliefs: a cross-sectional study of postpartum depression awareness among social support networks during COVID-19 pandemic in Malaysia. BMC Womens Health 2022; 22:221. [PMID: 35690751 PMCID: PMC9187926 DOI: 10.1186/s12905-022-01795-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 05/23/2022] [Indexed: 11/24/2022] Open
Abstract
Background Postpartum depression (PPD) is the most prevalent mental health disorder after childbirth, notably during the COVID-19 pandemic. In addition, PPD is known to have a long-term influence on the mother and the newborn, and the role of social support network is crucial in early illness recognition. This study aims to evaluate the social support networks’ level of knowledge, attitudes and beliefs regarding PPD and examine their sociodemographic variables and exposure to the public information relating to PPD during the COVID-19 pandemic in Malaysia. Methods A cross-sectional study was conducted via an online Google Form disseminated to people in Klang Valley through WhatsApp, Email, Facebook, Instagram and other available social media among postpartum women’s social support networks aged 18 years and living in the Klang Valley area (N = 394). Data were collected from 1 March to 5 July 2021 and analysed using the Mann–Whitney U-test and generalised linear mixed models. Results During the COVID-19 epidemic in Klang Valley, most participants had good knowledge, negative attitudes and awareness of PPD. Marital status, gender and parity all had significant correlations with the amount of awareness regarding PPD. Ethnicity, gender, parity and educational level showed significant association with attitude towards PPD. No significant relationship was noted between sociodemographic variables and PPD beliefs. Public awareness of PPD was also associated with knowledge and attitude towards it. Conclusions A significant positive knowledge, negative attitude and negative awareness level of PPD exist among social support networks for postnatal women. However, no significant effect of belief on PPD awareness level was noted. Implications Insight campaigns and public education about PPD should be conducted to enhance postnatal mothers’ awareness and knowledge. Postnatal care, mental check-ups and counselling sessions for the new mothers are recommended. In future studies, a closer assessment of postpartum social support, variances and similarities across women from diverse racial/ethnic origins is critical.
Strengths and limitations This cross-sectional study is one of the early studies on the area of PPD in the Malaysian region during COVID-19. Numerous data have been collected using low-cost approaches using self-administered surveys through Google Forms in this research.
Collapse
|
|
8
|
Trinh TG, Schwarze CE, Müller M, Goetz M, Hassdenteufel K, Wallwiener M, Wallwiener S. Implementing a Perinatal Depression Screening in Clinical Routine: Exploring the Patient's Perspective. Geburtshilfe Frauenheilkd 2022; 82:1082-1092. [PMID: 36186149 PMCID: PMC9525145 DOI: 10.1055/a-1844-9246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/08/2022] [Indexed: 11/01/2022] Open
Abstract
Introduction Perinatal depression (PND) is a frequently observed mental disorder, showing a prevalence of up to 20% and resulting in unfavorable maternal and neonatal outcomes. Targeted screening for PND offers the potential to identify and treat undiagnosed cases and help prevent its deleterious consequences. The aim of the present study was to evaluate participants' personal attitudes and acceptance of a routine screening program for PND in pregnancy care, identify any potential underlying factors, and appraise the general perspective on perinatal mental health problems. Methods In total, 732 women in their second trimester of pregnancy took part in a PND screening program that was incorporated in routine prenatal care using the Edinburgh Postnatal Depression Scale (EPDS) and completed a web-based survey on screening acceptance. Results Participants viewed PND screening as useful (78.7%, n = 555/705), especially in terms of devoting attention to perinatal mental health problems (90.1%, n = 630/699), easy to complete (85.4%, n = 606/710), and without feelings of discomfort (88.3%, n = 628/711). Furthermore, women with previous or current mental health issues rated the usefulness of screening significantly higher, as did women with obstetric risks (p < 0.01 - p = 0.04). The final regression model explained 48.4% of the variance for screening acceptance. Conclusion Patient acceptance for PND screening was high in our study cohort, supporting the implementation of screening programs in routine pregnancy care with the potential to identify, sensitize, and treat undiagnosed patients to reduce stigmatization and offer access to tailored dedicated PND care programs.
Collapse
Affiliation(s)
- Thuy Giang Trinh
- Department of Obstetrics and Gynecology, Heidelberg University, Heidelberg, Germany
| | | | - Mitho Müller
- Department of Psychology, Ludwig Maximilian University, Munich, Germany
| | - Maren Goetz
- Department of General Pediatrics, University Childrenʼs Hospital, Heidelberg, Germany
| | | | - Markus Wallwiener
- Department of Obstetrics and Gynecology, Heidelberg University, Heidelberg, Germany
| | - Stephanie Wallwiener
- Department of Obstetrics and Gynecology, Heidelberg University, Heidelberg, Germany,Correspondence Prof. Stephanie Wallwiener, MD Department of Obstetrics and GynecologyHeidelberg
UniversityIm Neuenheimer Feld 44069120
HeidelbergGermany
| |
Collapse
|
|
9
|
Daehn D, Rudolf S, Pawils S, Renneberg B. Perinatal mental health literacy: knowledge, attitudes, and help-seeking among perinatal women and the public - a systematic review. BMC Pregnancy Childbirth 2022; 22:574. [PMID: 35854232 PMCID: PMC9295513 DOI: 10.1186/s12884-022-04865-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 06/23/2022] [Indexed: 11/16/2022] Open
Abstract
Background The perinatal period is a time of increased vulnerability to mental health problems, however, only a small proportion of women seek help. Poor mental health literacy (MHL) is a major barrier to seeking help for mental health problems. This study aimed to collect the existing evidence of MHL associated with perinatal mental health problems (PMHP) among perinatal women and the public. This review analysed which tools were used to assess perinatal MHL as well as the findings concerning individual components of perinatal MHL. Methods Four electronic databases (PubMed, PsycINFO, Web of Science, and CINAHL) were analysed from their inception until September 1, 2020. Not only quantitative studies reporting on components of MHL (knowledge, attitudes, and help-seeking), but also studies reporting overall levels of MHL relating to PMHP were taken into account. Two independent reviewers were involved in the screening and extraction process and data were analysed descriptively. Results Thirty-eight of the 13,676 retrieved articles satisfied the inclusion criteria. The majority of selected studies examined MHL related to PMHP in perinatal women (N = 28). The most frequently examined component of MHL in the selected data set was help-seeking. A lack of uniformity in assessing MHL components was found. The most common focus of these studies was postpartum depression. It was found that the ability to recognize PMHP and to identify relevant symptoms was lacking among both perinatal women and the public. Perinatal women had low intentions of seeking help for PMHP and preferred seeking help from informal sources while reporting a variety of structural and personal barriers to seeking help. Stigmatizing attitudes associated with PMHP were found among the public. Conclusions There is a need for educational campaigns and interventions to improve perinatal MHL in perinatal women and the public as a whole. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04865-y.
Collapse
Affiliation(s)
- Daria Daehn
- Department of Clinical Psychology and Psychotherapy, Freie Universitaet Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany.
| | - Sophie Rudolf
- Department of Clinical Psychology and Psychotherapy, Freie Universitaet Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany
| | - Silke Pawils
- Department of Medical Psychology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Babette Renneberg
- Department of Clinical Psychology and Psychotherapy, Freie Universitaet Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany
| |
Collapse
|
|
10
|
Standardising Training of Nurses in an Evidence-Based Psychosocial Intervention for Perinatal Depression: Randomized Trial of Electronic vs. Face-to-Face Training in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074094. [PMID: 35409775 PMCID: PMC8998312 DOI: 10.3390/ijerph19074094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/24/2022] [Accepted: 03/25/2022] [Indexed: 11/16/2022]
Abstract
Background: Rates of perinatal depression in China are high. The Thinking Healthy Programme is a WHO-endorsed, evidence-based psychosocial intervention for perinatal depression, requiring five days of face-to-face training by a specialist trainer. Given the paucity of specialist trainers and logistical challenges, standardized training of large numbers of nurses is a major challenge for scaling up. We developed an electronic training programme (e-training) which eliminates the need for specialist-led, face-to-face training. The aim of this study was to evaluate the effectiveness of the e-training compared to conventional face-to-face training in nursing students. Methods: A single blind, non-inferiority, randomized controlled trial was conducted. One hundred nursing students from two nursing schools were randomly assigned to either e-training or conventional face-to-face training. Results: E-training was not inferior to specialist-led face-to-face training immediately post-training [mean ENhancing Assessment of Common Therapeutic factors (ENACT) score (M) 45.73, standard deviation (SD) 4.03 vs. M 47.08, SD 4.53; mean difference (MD) −1.35, 95% CI; (−3.17, 0.46), p = 0.14]. There was no difference in ENACT scores at three months [M = 42.16, SD 4.85 vs. M = 42.65, SD 4.65; MD = −0.481, 95% CI; (−2.35, 1.39), p = 0.61]. Conclusions: E-training is a promising tool with comparative effectiveness to specialist-led face-to-face training. E-training can be used for training of non-specialists for evidence-based psychosocial interventions at scale and utilized where there is a shortage of specialist trainers, but practice under supervision is necessary to maintain competence. However, continued practice under supervision may be necessary to maintain competence.
Collapse
|
|
11
|
Antoniou E, Stamoulou P, Tzanoulinou MD, Orovou E. Perinatal Mental Health; The Role and the Effect of the Partner: A Systematic Review. Healthcare (Basel) 2021; 9:1572. [PMID: 34828618 PMCID: PMC8624285 DOI: 10.3390/healthcare9111572] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/10/2021] [Accepted: 11/17/2021] [Indexed: 11/17/2022] Open
Abstract
Pregnancy is a transitional period involving the most complex experiences in a woman's life, during which the woman's psychological status can be affected by a wide range of psychosocial variables. However, positive interpersonal relationships appear to constitute a supportive network that significantly influences perinatal mental health. Therefore, the presence of a supportive partner works psycho-protectively against the difficulties and pressures created by the transition to maternity. The aim of this study was to review systematically the influence of the partner on the woman's psychology during the perinatal period. Fourteen research articles from PubMed/Medline, Google Scholar and PsycINFO were included in the review from a total of 1846 articles. Most studies have shown a correlation between the support from the partner and prenatal depression and anxiety. Support from the spouse during childbirth is related to the extent to which women feel safe during labor as well as the stress during childbirth. The role of the partner is very important in the occurrence of perinatal mental disorders in women. Of course, more research needs to be done in the field of perinatal mental health. The risk factors that lead to mental disorders need to be clarified and the role of the partner in the perinatal period requires reinforcement and needs to be given the necessary importance.
Collapse
Affiliation(s)
- Evangelia Antoniou
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (P.S.); (M.-D.T.); (E.O.)
| | | | | | | |
Collapse
|
|
12
|
Kusumawati Y, Widyawati W, Dewi FST. Development and Validation of a Survey to Evaluate Mental Health Knowledge: The Case of Indonesian Pregnant Women. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.5844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Internationally, many instruments have been designed to evaluate mental health knowledge; however, in pregnant women is very limited.
AIM: Therefore, this study aimed to develop and validate a survey to measure the mental health knowledge of pregnant women.
METHODS: In this cross-sectional study, 13 midwives attended the FGD and 10 pregnant women were invited for in-depth interviews to develop an item pool. The content validity was carried out by a panel of 6 experts. The face validity was performed with 5 pregnant women. Next, the construct validity test involved 150 pregnant women who were selected by stratified sampling from 13 public health centers in Surakarta, Indonesia. Analyses were conducted to check content validity, face validity, construct validity, internal consistency reliability, difficulty index, and exploratory factor analysis.
RESULTS: A final 20-item Mental Health Knowledge Scale (MHKS) has a content validity index of 0.97 and a correlation value per item greater than the r-table (i.e., 0.1603). In addition, the MHKS has a Kuder–Richardson 20 reliability coefficient of 0.717. Furthermore, the difficulty index ranged from 0.39 to 0.82 which was considered in the good and acceptable category. Construct validity was confirmed using exploratory factor analysis KMO = 0.713, Bartlett’s test p < 0.001.
CONCLUSION: Based on the findings, the final version of the MHKS was considered a valid and reliable tool. The instrument can be applied to measure the understanding of pregnant women about pregnancy depression. Further studies require adjustment items to other participants regarding mental health knowledge.
Collapse
|
|
13
|
A Review of the Involvement of Partners and Family Members in Psychosocial Interventions for Supporting Women at Risk of or Experiencing Perinatal Depression and Anxiety. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105396. [PMID: 34070148 PMCID: PMC8158393 DOI: 10.3390/ijerph18105396] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/05/2021] [Accepted: 05/11/2021] [Indexed: 11/23/2022]
Abstract
A maternal experience of perinatal mental health conditions can have serious short- and long-term consequences for child development and family relationships. Women with perinatal depression and/or anxiety are primarily supported by their partner/spouse and family. The aim of this review was to synthesise data from studies that have examined the inclusion of partners or family members in psychosocial interventions for women at risk of or experiencing perinatal depression and/or anxiety. A systematic search of five databases was conducted to identify literature published between 2010 and 2020. Nine empirical studies met the eligibility criteria and were independently assessed by two authors using the National Heart, Lung and Blood Institute Quality Assessment Tools and data were extracted and narratively synthesised guided by TIDieR (Template for Intervention Description and Replication) checklist. Eligible studies detailed diverse interventions facilitated by a variety of programme facilitators, with no central model of intervention or study outcome measures evident across the studies. All studies except one reported a significant change in maternal depression and anxiety scores. The interventions had limited evaluation of the woman’s, partner’s or family member’s experiences of involvement in the intervention. Further research is required to firmly establish the effectiveness of co-designed interventions to support the sustainable integration of such interventions into routine perinatal mental health services.
Collapse
|
|
14
|
Knowledge and attitudes of family members towards postpartum depression. Arch Psychiatr Nurs 2020; 34:492-496. [PMID: 33280671 DOI: 10.1016/j.apnu.2020.09.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 09/03/2020] [Accepted: 09/05/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Postpartum depression (PPD) has been recently recognized as a public health issue. While family members play an important role in early recognition of PPD among women, research that explores family members awareness on PPD is limited from India. AIM To explore the knowledge and attitudes of family members towards postpartum depression. METHODS This was a cross-sectional survey carried out among family members of postpartum women (N = 202) at a pediatric tertiary care center. The data was collected through face to face interview technique using a structured questionnaire. RESULTS The mean scores on knowledge (18.92 ± 3.27) attitude (31.39 ± 4.91) scales suggest that a majority of the participants had a good level of knowledge (54%) and positive attitudes (69.7%) towards women with postpartum depression. However, misconceptions and negative stereotypes related to postpartum depression still prevailed. Family members who had a good level of education (χ2 = 4.21, p < 0.05) and had come across women with postpartum depression (χ2 = 13.27, p < 0.001) hold positive attitudes towards postpartum depression compared to family members with a lower level of education and those did not come across women with postpartum depression. CONCLUSION The findings of the present study suggest the need for educational campaigns to improve perinatal mental health literacy and address prejudices and negative stereotypes related to postpartum depression among family members.
Collapse
|
|
15
|
Marshall EJ, Thompson AP. Shedding Light on the Difficulties and Challenges Experienced by Mothers of Infants. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/j.1742-9544.2012.00093.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Emma J Marshall
- School of Psychology, Charles Sturt University, Wagga Wagga,
| | | |
Collapse
|
|
16
|
Pilkington PD, Whelan TA, Milne LC. A review of partner‐inclusive interventions for preventing postnatal depression and anxiety. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12054] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Pamela D. Pilkington
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia,
| | - Thomas A. Whelan
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia,
| | - Lisa C. Milne
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia,
| |
Collapse
|
|
17
|
Branquinho M, Canavarro MC, Fonseca A. Postpartum Depression in the Portuguese Population: The Role of Knowledge, Attitudes and Help-Seeking Propensity in Intention to Recommend Professional Help-Seeking. Community Ment Health J 2020; 56:1436-1448. [PMID: 32072375 DOI: 10.1007/s10597-020-00587-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 02/13/2020] [Indexed: 01/10/2023]
Abstract
Professional help-seeking for postpartum depression is very uncommon, despite its adverse effects. However, women's support network can have an important role in the professional help-seeking behaviour. This study aimed to characterize the intentions to recommend professional help-seeking for postpartum depression in the Portuguese population, as well as to analyse its determinants. A cross-sectional internet survey including 621 people of general population was conducted. Participants reported a high intention to recommend professional help-seeking for postpartum depression. Greater knowledge about postpartum depression, lower stigma and high perceived utility of mental health help-seeking were associated with high intention to recommend professional help-seeking for PPD, both directly and indirectly, through less negative attitudes towards postpartum depression and higher help-seeking propensity. Education campaigns are needed to increase knowledge and to promote positive attitudes towards postpartum depression in the general population. Moreover, the results highlight the importance of implementing strategies aimed at reducing the stigma associated to help-seeking, of increasing the perception of utility of mental health services and of including the women's support network in perinatal care to facilitate their help-seeking process.
Collapse
Affiliation(s)
- Mariana Branquinho
- Research Group "Relationships, Development & Health", Centre for Research in Neuropsychology and Cognitive-Behavioural Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115, Coimbra, Portugal
| | - Maria Cristina Canavarro
- Research Group "Relationships, Development & Health", Centre for Research in Neuropsychology and Cognitive-Behavioural Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115, Coimbra, Portugal
| | - Ana Fonseca
- Research Group "Relationships, Development & Health", Centre for Research in Neuropsychology and Cognitive-Behavioural Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115, Coimbra, Portugal.
| |
Collapse
|
|
18
|
Swami V, Vintila M, Goian C, Tudorel O, Bucur V. Mental Health Literacy of Maternal and Paternal Postnatal Depression in a Community Sample of Romanian Adults. ACTA ACUST UNITED AC 2020. [DOI: 10.1037/ipp0000130] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Postnatal depression affects a large proportion of Romanian parents, but no existing research has examined knowledge of postnatal depression in Romanian adults. To rectify this, we examined the ability of Romanian adults to correctly identify cases of maternal and paternal postnatal depression, as well as attitudes toward cases of postnatal depression. A total of 1,248 Romanian adults were presented with vignettes describing cases of maternal or paternal postnatal depression. Based on the vignettes, participants were asked to report if they thought anything was wrong with the targets and, if so, to describe what they thought was wrong. Participants also rated the targets on several attitudinal dimensions. Participants were more likely to indicate that something was wrong when the target was female (67.9%) compared with male (46.4%). Of those who believed something was wrong, 57.7% of participants correctly described the female target as experiencing postnatal depression, but only 37.1% did so for the male target. Women held significantly more positive attitudes toward the targets than men, particularly when the target was female. Mental health literacy of postnatal depression appears to be poor in Romanian adults compared with other national groups, especially in the case of paternal postnatal depression.
Collapse
Affiliation(s)
- Viren Swami
- Division of Psychology and Sport Science, Anglia Ruskin University, and Centre for Psychological Medicine, Perdana University
| | - Mona Vintila
- Department of Psychology, West University of Timișoara
| | - Cosmin Goian
- Department of Social Work, West University of Timișoara
| | | | - Venera Bucur
- Department of Social Work, West University of Timișoara
| |
Collapse
|
|
19
|
Forder PM, Rich J, Harris S, Chojenta C, Reilly N, Austin MP, Loxton D. Honesty and comfort levels in mothers when screened for perinatal depression and anxiety. Women Birth 2020; 33:e142-e150. [DOI: 10.1016/j.wombi.2019.04.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 03/13/2019] [Accepted: 04/02/2019] [Indexed: 10/26/2022]
|
|
20
|
Vermeulen J, Buyl R, D'haenens F, Demedts D, Tricas-Sauras S, Haddani I, Fobelets M. The Development of the DDads Questionnaire: Awareness, Knowledge and Attitudes of the General Population Towards Paternal Depression. Front Psychiatry 2020; 11:561954. [PMID: 33551859 PMCID: PMC7859093 DOI: 10.3389/fpsyt.2020.561954] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 12/21/2020] [Indexed: 11/14/2022] Open
Abstract
Objectives: Paternal perinatal depression affects ~10% of new fathers and is known to have a negative impact on men's relationship with their partner as well as with their baby. The attitudes of the general population toward paternal depression have received scant attention in the scientific literature. A better understanding of paternal depression might improve the health literacy of the population and also assist professionals and policy makers to adequately address this issue, to ultimately refine the existing health care alternatives for them. This paper describes the Belgian development, face and content validation of the DDads (Depression in Dads) questionnaire. Its focus is to identify the awareness, knowledge and attitudes of the general population toward paternal perinatal depression. Study Design: The DDads was developed using a three-step model with the following phases: (1) identification of the content domain, (2) item generation and (3) construction of the questionnaire. For the DDads validation a (a) Delphi method with content experts (n = 17) and (b) a cognitive debriefing method with lay experts (n = 20) were used to assess the clarity, relevance, wording and layout. Results: The questionnaire consists of three main components comprising: (1) three questions on awareness, (2) three questions on knowledge and (3) one question on attitudes and beliefs. After round one validation, all questions were considered content valid for relevance (I-CVI 0.94-1.00), and six questions for clarity (I-CVI 0.65-1.00). Scale content (S-CVI/Ave 0.93) and face validity (Face Validity Index 1.00) was obtained. One question was revised and split into two questions in a second round. For one of these questions, item content (0.80-0.93), scale content (0.92) and face validity (1.00) was reached. The one question, exploring the causes of paternal perinatal depression, remained inappropriate and was removed from the DDads. One last question was removed after interviews with lay experts. Conclusions: We developed an instrument to establish awareness, knowledge and attitudes of the general population toward paternal perinatal depression in Belgium. The DDads can be valuable in identifying knowledge gaps. It can help to inform policy makers and health professionals to identify gaps and predisposed attitudes in society toward paternal depression which may hinder appropriate management.
Collapse
Affiliation(s)
- Joeri Vermeulen
- Department Health Care, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium.,Department of Public Health, Biostatistics and Medical Informatics Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ronald Buyl
- Department of Public Health, Biostatistics and Medical Informatics Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Florence D'haenens
- Department Health Care, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium
| | - Dennis Demedts
- Department Health Care, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium.,Department of Public Health, Mental Health and Wellbeing Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Sandra Tricas-Sauras
- Department Health Care, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium.,Public Health School, CR5 - Department of Social Approaches to Health (CRISS), Université Libre de Bruxelles, Brussels, Belgium
| | - Ihsane Haddani
- Department Health Care, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium
| | - Maaike Fobelets
- Department Health Care, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium.,Department of Public Health, Biostatistics and Medical Informatics Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| |
Collapse
|
|
21
|
Ransing R, Kukreti P, Deshpande S, Godake S, Neelam N, Raghuveer P, Mahadevaiah M, Kataria D, Patil S, Puri M, Padma K. Perinatal depression-knowledge gap among service providers and service utilizers in India. Asian J Psychiatr 2020; 47:101822. [PMID: 31710947 DOI: 10.1016/j.ajp.2019.10.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 10/01/2019] [Accepted: 10/01/2019] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Lack of access to perinatal mental health (PMH) services is a significant public health problem in India. Barriers to accessing PMH services include the stigma, non-availability of services, poor knowledge, negative perception, attitude among perinatal women (PWs) and service providers. The present study attempted to examine the knowledge gap regarding perinatal depression (PD) among service providers [Nursing providers (NPs), Medical Practitioners (MPs)] and service utilizers (PWs). METHODS This cross-sectional study was conducted in two tertiary care teaching hospitals of India, one in a major metro and the other in a rural area. PWs, MPs and NPs were assessed for knowledge about PD using a semi-structured proforma and Perinatal Depression Monitor. RESULTS Among the 270 PWs, 8.51% were knowledgeable (PWA) and 91.49% were ignorant (PWB) about depression. PWB group were low educated (n = 140, 56.68%), and unemployed (n = 207, 83.80%) with lower family income [(≤₹10,356 per month), n = 170, 68.28%)]. There was knowledge discrepancy among NPs, MPs and PWA group in terms of a) PD is a normal part of pregnancy (agree- NPs = 71.52%, MPs = 10.00%, PWA-17.39%), b)biological causes of PD (agree- NPs = 45.23%, MPs = 70.00%, PWA = 26.03%) and c)antidepressant medications for PD (useful- NPs = 23.80%, MPs = 70.00%, PWA = 21.73%). Majority of the respondents agreed that all women should be screened for depression during pregnancy (NPs = 34.78%, MPs = 80.95%, PWA = 95.00%) and postpartum periods (NPs = 34.78%, MPs = 76.19%, PWA = 90.00%). CONCLUSIONS Low PD literacy among the PWs, misconception about aetiology and management among the NPs could be major barrier for delivery and utilisation of PD services. Thus, there is an urgent need to improve PD literacy among PWs and NPs.
Collapse
Affiliation(s)
- Ramdas Ransing
- Department of Psychiatry, BKL Walawalkar Rural Medical college
| | - Prerna Kukreti
- Lady Hardinge Medical College, Department of Psychiatry, C-604 Shaheed Bhagat Singh, Road, DI, India.
| | - Smita Deshpande
- Department of Psychiatry, Atal Bihari Vajpayee Institute of Medical Sciences & Dr. Ram Manohar Lohia Hospital, Banga Bandhu Sheikh Mujib Road, New Delhi 110001
| | - Shashwati Godake
- Department of Psychiatry, BKL Walawalkar Rural Medical College, Ratnagiri
| | - Neelam Neelam
- Department of Psychiatry, Lady Hardinge Medical College, New Delhi
| | | | - Mahesh Mahadevaiah
- Department of Psychiatry, Dharwad institute of Mental Health and Neurosciences (DIMHANS)
| | - Dinesh Kataria
- Department of Psychiatry, Lady Hardinge Medical College, New Delhi
| | - Suvarna Patil
- Department of Medicine, BKL Walawalkar Rural Medical College
| | - Manju Puri
- Department of Obstetrics and Gynecology, Lady Hardinge Medical College
| | - Kumari Padma
- Department of Psychiatry, BKL Walawalkar Rural Medical College
| |
Collapse
|
|
22
|
Kornaros K, Zwedberg S, Nissen E, Salomonsson B. A hermeneutic study of integrating psychotherapist competence in postnatal Child Health Care: Parents' perspectives. Infant Ment Health J 2019; 41:108-125. [PMID: 31583752 DOI: 10.1002/imhj.21828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A child's emotional and social development depends on the parents' provision of optimal support. Many parents with perinatal distress experience difficulties in mastering parenthood and seek help from professionals within primary healthcare. A clinical project was launched in Stockholm, where psychodynamic psychotherapists provided short-term consultations at Child Health Centers. This study qualitatively explored parents' experiences of perinatal distress and of receiving help by nurses and therapists in the project. Thirteen parents were interviewed, and their responses were analyzed with a hermeneutical method. Three main themes crystallized; accessibility of psychological help and detection of emotional problems; experiences of therapy at the Child Health Center; and the therapists' technique. Parents were also clustered into three so-called ideal types: the insecure; parents in crisis; and parents with lifelong psychological problems. Parents experienced obstacles in accessing psychological care within primary healthcare. Psychotherapists with a holistic family perspective and who managed to oscillate between insight-promoting and supportive interventions were especially appreciated. Patient categories who benefitted from insight promotion and support, respectively, were identified.
Collapse
Affiliation(s)
- Katarina Kornaros
- Department of Women's and Children's Health, Karolinska Institutet, Tomtebodavägen, 18 A, 171 77, Stockholm, Sweden
| | | | - Eva Nissen
- Department of Women's and Children's Health, Karolinska Institutet, Tomtebodavägen, 18 A, 171 77, Stockholm, Sweden
| | - Björn Salomonsson
- Department of Women's and Children's Health, Karolinska Institutet, Tomtebodavägen, 18 A, 171 77, Stockholm, Sweden
| |
Collapse
|
|
23
|
Smith T, Gemmill AW, Milgrom J. Perinatal anxiety and depression: Awareness and attitudes in Australia. Int J Soc Psychiatry 2019; 65:378-387. [PMID: 31148499 DOI: 10.1177/0020764019852656] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Better community mental health literacy is associated with positive help-seeking behaviours and reduced stigma. There are relatively few published surveys of perinatal mental health literacy. AIMS To provide a profile of current awareness, knowledge and attitudes in relation to the mental health of women and men in the perinatal period. METHOD A cross-sectional online survey (n = 1,201) of adults (⩾ 18 years) in each state and territory of Australia was conducted in early 2016. Survey questions were based on a previous 2009 survey, with the addition of several novel items designed to assess knowledge around both perinatal anxiety and men's perinatal mental health. RESULTS Depression (including postnatal depression) was the most frequently cited general health problem for women in the first postnatal year (52% of spontaneous first responses). Over 70% of adults believed that postnatal depression requires specialised treatment and checks for depressive symptoms should occur routinely in pregnancy and the first postnatal year. Women identified postnatal depression at a higher rate than men. Most commonly, postnatal depression was perceived as having a biological rather than psychosocial etiology (34.5%). Men and women differed in their knowledge about the symptoms of postnatal depression with more women correctly identifying core depressive symptoms. The specific term 'perinatal depression' was not well recognised. Although not well recognised as a general health issue, when prompted, 39% of respondents were aware of anxiety as a specific perinatal mental health issue. Most adult Australians (60%) were unaware that perinatal depression and anxiety could be experienced by men. CONCLUSION Awareness of postnatal depression appeared high. However, areas including anxiety, antenatal mental health, and men's mental health were less well-understood. There remains considerable scope, and a need for, continued awareness-raising around anxiety, mental health in pregnancy and men's mental health.
Collapse
Affiliation(s)
- Terri Smith
- 1 Perinatal Anxiety & Depression Australia (PANDA), Melbourne, VIC, Australia
| | - Alan W Gemmill
- 2 Parent-Infant Research Institute, Heidelberg Repatriation Hospital, Austin Health, Melbourne, VIC, Australia
| | - Jeannette Milgrom
- 2 Parent-Infant Research Institute, Heidelberg Repatriation Hospital, Austin Health, Melbourne, VIC, Australia.,3 Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
|
24
|
Knowledge and attitudes about postpartum depression in the Portuguese general population. Midwifery 2019; 77:86-94. [PMID: 31276960 DOI: 10.1016/j.midw.2019.06.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 06/14/2019] [Accepted: 06/25/2019] [Indexed: 01/10/2023]
Abstract
OBJECTIVE This study aimed to characterize the Portuguese general population's knowledge and attitudes about postpartum depression, and analyze its sociodemographic and clinical correlates. DESIGN A cross-sectional internet survey. SETTING Participants were recruited through advertisements on social media websites, in thematic forums and by email. PARTICIPANTS A total of 621 people in the general population (88.1% women) participated in the study. MEASUREMENTS Participants were questioned about sociodemographic and clinical data, personal contact with postpartum depression, awareness of public education campaigns about postpartum depression and knowledge and attitudes towards postpartum depression (outcome variables). FINDINGS The sample presented a good level of knowledge and positive attitudes about postpartum depression despite the existence of some gaps in knowledge and some stereotypes. Personal contact with postpartum depression was associated with higher levels of knowledge (p < .001) and more positive attitudes towards postpartum depression (p < .001) and participants who assisted to public education campaigns reported higher levels of knowledge about postpartum depression (p < .001). Lower levels of knowledge and more negative attitudes about postpartum depression were found in men and older and less educated people. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE These results show the importance of awareness-raising and education campaigns directed at the general population, particularly focusing on people who can act as the postpartum women's support network (e.g., partners, parents, in-laws), to increase the level of knowledge and to foster more positive attitudes towards postpartum depression.
Collapse
|
|
25
|
Swami V, Barron D, Smith L, Furnham A. Mental health literacy of maternal and paternal postnatal (postpartum) depression in British adults. J Ment Health 2019; 29:217-224. [PMID: 31070064 DOI: 10.1080/09638237.2019.1608932] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background: Postnatal depression affects between 6 and 13% of new parents, but only a small proportion of individuals who meet diagnostic criteria receive optimal treatment. One reason for this is poor mental health literacy of postnatal depression.Aims: Studies have examined mental health literacy of maternal postnatal depression, but there are no similar studies of paternal postnatal depression, which we sought to rectify.Methods: A sample of 406 British adults was presented with vignettes describing cases of either maternal or paternal postnatal depression. Based on the vignettes, participants were asked to report if they thought anything was wrong with the targets and, if so, to describe what they thought was wrong. Participants also rated the targets on a range of attitudinal dimensions.Results: Participants were more likely to indicate that something was wrong when the target was female (97.0%) compared to male (75.9%). Of those who believed something was wrong, 90.1% of participants correctly described the female target as experiencing postnatal depression, but only 46.3% did so for the male target. Participants also held more positive attitudes toward the female target than the male target.Conclusions: There is a gender binary in symptom recognition of postnatal depression, which highlights the need for greater awareness of paternal postnatal depression.
Collapse
Affiliation(s)
- Viren Swami
- Division of Psychology, School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, UK.,Centre for Psychological Medicine, Perdana University, Serdang, Malaysia
| | - David Barron
- Centre for Psychological Medicine, Perdana University, Serdang, Malaysia
| | - Lee Smith
- The Cambridge Centre for Sports and Exercise Sciences, Division of Sport Science, School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, UK
| | - Adrian Furnham
- Centre for Psychological Medicine, Perdana University, Serdang, Malaysia.,Department of Leadership and Organizational Behavior, Norwegian Business School, Oslo, Norway
| |
Collapse
|
|
26
|
Koh M, Ahn S, Kim J, Park S, Oh J. Pregnant Women's Antenatal Depression and Influencing Factors. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2019; 25:112-123. [PMID: 37679934 DOI: 10.4069/kjwhn.2019.25.1.112] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 03/04/2019] [Accepted: 03/05/2019] [Indexed: 09/09/2023] Open
Abstract
PURPOSE The objective of this study was to investigate the prevalence of antenatal depression in pregnant women and its influencing factors. METHODS With a cross-sectional survey design, a total of 396 pregnant women were recruited from a local obstetrics and gynecology clinic. Measurements included antenatal depression, perceived stress, predictors of depression during pregnancy, and demographic and obstetric characteristics. RESULTS Mean antenatal depression score was 8.20 (standard deviation=4.95) out of 30, falling into its normal range. However, the prevalence of antenatal depression was 35.9% when cut-point of 9/10 was used. The prevalence of antenatal depression among women in the first trimester was 31.4%. It was slightly increased to 34.9% in the second trimester but significantly increased to 40.5% in the third trimester. In multiple logistic regression analysis, experiencing prenatal anxiety (odds ratio [OR], 4.16), having no job (OR, 2.90), lower self-esteem (OR, 1.62), and higher perceived stress (OR, 1.32) were significant factors influencing antenatal depression. CONCLUSION Negative feeling such as feeling anxious, lower self-esteem, and higher perceived stress during pregnancy are key factors affecting antenatal depression. Thus, antenatal nursing intervention focusing on pregnant women's feeling upon their job status is necessary to improve their antenatal psychological well-being.
Collapse
Affiliation(s)
- Minseon Koh
- PhD Student, College of Nursing, Chungnam National University, Daejeon, Korea
| | - Sukhee Ahn
- PhD Student, College of Nursing, Chungnam National University, Daejeon, Korea
| | - Jisoon Kim
- PhD Student, College of Nursing, Chungnam National University, Daejeon, Korea
| | - Seyeon Park
- PhD Student, College of Nursing, Chungnam National University, Daejeon, Korea
| | - Jiwon Oh
- PhD Student, College of Nursing, Chungnam National University, Daejeon, Korea
| |
Collapse
|
|
27
|
Wilson N, Wynter K, Anderson C, Rajaratnam SMW, Fisher J, Bei B. More than depression: a multi-dimensional assessment of postpartum distress symptoms before and after a residential early parenting program. BMC Psychiatry 2019; 19:48. [PMID: 30696418 PMCID: PMC6352433 DOI: 10.1186/s12888-019-2024-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 01/11/2019] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Parents are vulnerable to psychological distress symptoms in the postpartum period. It is routine to screen for depressive symptoms, but anxiety, stress, fatigue, irritability and insomnia symptoms are less often assessed despite their prevalence. This study aimed to assess multiple dimensions of psychological distress, and their reliable change and clinically significant change among women admitted to a residential program for assistance with unsettled infant behaviors (UIB). METHOD Women admitted to a five-night residential early parenting program completed self-report measures: the Depression Anxiety Stress Scale, Irritability Depression Anxiety Scale, Fatigue Severity Scale, and Insomnia Severity Index. A sub-group completed a computerized emotional Go-NoGo (EGNG) task as a measure of emotional impulsivity. RESULTS Seventy-eight women were recruited (Mage = 34.46, SDage = 4.16). On admission, 48% of women reported clinically elevated depressive symptoms and 97.5% of women not reporting elevated depressive symptoms reported clinical elevations in at least one other form of distress. Upon discharge, all self-report distress symptoms were significantly reduced (all p-values <.001), but reliable and clinically significant change only occurred in a subgroup of women. There were no significant changes in indicators of impulsivity based on the EGNG. CONCLUSIONS In addition to, and often in the absence of, depressive symptoms, women attending an early parenting program experienced a wide range of psychological distress, including fatigue, insomnia, anxiety and stress. Different forms of distress improved in different magnitudes to the treatment provided. These findings highlight the need for a multi-dimensional approach in the assessment and treatment of postpartum distress.
Collapse
Affiliation(s)
- Nathan Wilson
- Faculty of Medicine, Nursing and Health Sciences, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, 18 Innovation Walk, Clayton Campus, Clayton, VIC, 3800, Australia
| | - Karen Wynter
- Global Public Health Unit, School of Public Health and Preventative Medicine, Monash University, Clayton, VIC, Australia
- Centre for Quality and Patient Safety Research - Western Health Partnership, School of Nursing and Midwifery, Faculty of Health, Deakin University, Burwood, VIC, Australia
| | - Clare Anderson
- Faculty of Medicine, Nursing and Health Sciences, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, 18 Innovation Walk, Clayton Campus, Clayton, VIC, 3800, Australia
- Cooperative Research Centre for Alertness, Safety and Productivity, Clayton, VIC, Australia
| | - Shanthakumar M W Rajaratnam
- Faculty of Medicine, Nursing and Health Sciences, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, 18 Innovation Walk, Clayton Campus, Clayton, VIC, 3800, Australia
- Cooperative Research Centre for Alertness, Safety and Productivity, Clayton, VIC, Australia
- NHMRC Centre for Sleep and Circadian Neurobiology, Sydney, NSW, Australia
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Jane Fisher
- Global Public Health Unit, School of Public Health and Preventative Medicine, Monash University, Clayton, VIC, Australia
- Masada Early Parenting Centre, Masada Private Hospital, East St Kilda, VIC, Australia
| | - Bei Bei
- Faculty of Medicine, Nursing and Health Sciences, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, 18 Innovation Walk, Clayton Campus, Clayton, VIC, 3800, Australia.
| |
Collapse
|
|
28
|
Furnham A, Swami V. Mental Health Literacy: A Review of What It Is and Why It Matters. ACTA ACUST UNITED AC 2018. [DOI: 10.1037/ipp0000094] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
An increasing number of scholarly works have attempted to understand the reasons for poor rates of help-seeking for symptoms of mental health disorders all around the world. One particular body of work has focused on “mental health literacy” (MHL), defined as knowledge about mental health disorders that is associated with their recognition, management, and prevention. In this article, we report a nonsystematic review of studies on MHL, to give nonexpert academics, policymakers, and practitioners an understanding of the field. We find that studies consistently show that the general public have relatively poor recognition of the symptoms of mental health disorders and appear to emphasize self-help over traditional medical treatments. In addition, we find that there are age, gender, educational, urban−rural, and cross-cultural differences in MHL, which may differentially affect rates of help-seeking in different contexts. Implications and future directions for research are considered in conclusion.
Collapse
Affiliation(s)
- Adrian Furnham
- Department of Leadership and Organizational Behavior, Norwegian Business School
| | - Viren Swami
- School of Psychology and Sports Science, Anglia Ruskin University
| |
Collapse
|
|
29
|
El-Den S, O'Reilly CL, Chen TF. Development and Psychometric Evaluation of a Questionnaire to Measure Attitudes Toward Perinatal Depression and Acceptability of Screening: The PND Attitudes and Screening Acceptability Questionnaire (PASAQ). Eval Health Prof 2018; 42:498-522. [PMID: 30265131 DOI: 10.1177/0163278718801434] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Prior to implementing perinatal depression (PND) screening, health-care professionals' acceptability of screening and their attitudes toward PND should be explored. We aimed to develop and psychometrically evaluate a questionnaire measuring PND attitudes and screening acceptability. A 31-item questionnaire was developed based on published questionnaires and a systematic review on PND screening acceptability. Principal components analysis with direct oblimin rotation was used to determine construct validity. Reliability of the resulting components was explored using Cronbach's α. Pharmacists (N = 153) were recruited from the Australian Association of Consultant Pharmacy. The scree plot and parallel analysis indicated a six-component solution. Due to cross-loadings (<.2 difference) and low loadings (<.445), it was necessary to delete 7 items. The six components explored PND screening acceptability, screening readiness, stigma, attitudes toward treatment efficacy, medication counseling responsibility, and the effect PND has on others. The six components explained 59.8% of the variance. Item loadings ranged from .445 to .880. Cronbach's α for each component ranged from .45 to .86. The construct validity and internal consistency reliability of the PND attitudes and screening acceptability questionnaire have been explored. Future measurements of these constructs using uniform, psychometrically sound scales may facilitate comparisons across studies.
Collapse
Affiliation(s)
- Sarira El-Den
- Faculty of Pharmacy, The University of Sydney, Camperdown, New South Wales, Australia
| | - Claire L O'Reilly
- Faculty of Pharmacy, The University of Sydney, Camperdown, New South Wales, Australia
| | - Timothy F Chen
- Faculty of Pharmacy, The University of Sydney, Camperdown, New South Wales, Australia
| |
Collapse
|
|
30
|
Fletcher R, May C, Attia J, Garfield CF, Skinner G. Text-Based Program Addressing the Mental Health of Soon-to-be and New Fathers (SMS4dads): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2018; 7:e37. [PMID: 29410387 PMCID: PMC5820459 DOI: 10.2196/resprot.8368] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 11/20/2017] [Accepted: 12/08/2017] [Indexed: 11/25/2022] Open
Abstract
Background Recent estimates indicating that approximately 10% of fathers experience Paternal Perinatal Depression (PPND) and the increasing evidence of the impact of PPND on child development suggest that identifying and assisting distressed fathers is justified on public health grounds. However, addressing new fathers’ mental health needs requires overcoming men’s infrequent contact with perinatal health services and their reluctance to seek help. Text-based interventions delivering information and support have the potential to reach such groups in order to reduce the impact of paternal perinatal distress and to improve the wellbeing of their children. While programs utilising mobile phone technology have been developed for mothers, fathers have not been targeted. Since text messages can be delivered to individual mobile phones to be accessed at a time that is convenient, it may provide a novel channel for engaging with “hard-to-reach” fathers in a critical period of their parenting. Objective The study will test the efficacy of SMS4dads, a text messaging program designed specifically for fathers including embedded links to online information and regular invitations (Mood Tracker) to monitor their mood, in order to reduce self-reported depression, anxiety and stress over the perinatal period. Methods A total of 800 fathers-to-be or new fathers from within Australia will be recruited via the SMS4dads website and randomized to the intervention or control arm. The intervention arm will receive 14 texts per month addressing fathers’ physical and mental health, their relationship with their child, and coparenting with their partner. The control, SMS4health, delivers generic health promotion messages twice per month. Messages are timed according to the babies’ expected or actual date of birth and fathers can enroll from 16 weeks into the pregnancy until their infant is 12 weeks of age. Participants complete questionnaires assessing depression, anxiety, stress, and alcohol at baseline and 24 weeks postenrolment. Measures of coparenting and parenting confidence are also completed at baseline and 24 weeks for postbirth enrolments. Results Participant were recruited between October 2016 and September 2017. Follow-up data collection has commenced and will be completed in March 2018 with results expected in June 2018. Conclusions This study’s findings will assess the efficacy of a novel text-based program specifically targeting fathers in the perinatal period to improve their depression, anxiety and distress symptoms, coparenting quality, and parenting self-confidence. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12616000261415; https://www.anzctr.org.au/ Trial/Registration/TrialReview.aspx?id=370085 (Archived by WebCite at http://www.webcitation.org/6wav55wII).
Collapse
Affiliation(s)
- Richard Fletcher
- Family Action Centre, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| | - Chris May
- Family Action Centre, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| | - John Attia
- Hunter Medical Research Institute, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| | - Craig Franklin Garfield
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Geoff Skinner
- School of Electrical Engineering and Computing, Faculty of Engineering and Built Environment, University of Newcastle, Callaghan, Australia
| |
Collapse
|
|
31
|
Kalra H, Reilly N, Austin MP. An evaluation of routine antenatal depression screening and psychosocial assessment in a regional private maternity setting in Australia. Aust N Z J Obstet Gynaecol 2018; 58:629-635. [PMID: 29380345 DOI: 10.1111/ajo.12777] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 12/20/2017] [Indexed: 01/26/2023]
Abstract
BACKGROUND There is limited information relating to routine depression screening and psychosocial assessment programs in private maternity settings in Australia. AIMS To describe the psychosocial profile of a sample of private maternity patients who participated in a depression screening and psychosocial risk assessment program as part of routine antenatal care, and to explore women's experience of receiving this component of pregnancy care. MATERIALS AND METHODS We conducted a retrospective medical records audit of 455 consecutive women having a routine psychosocial assessment and referral. Assessment was undertaken using the Edinburgh Postnatal Depression Scale (EPDS) and the Antenatal Risk Questionnaire (ANRQ) for psychosocial risk; 101 women completed a feedback survey about their experience of receiving routine psychosocial care. RESULTS Of the 87.7% of women who completed both EPDS and ANRQ, 4.3% scored 13 or more on the EPDS. On the ANRQ, 25.3% of women endorsed one risk factor, 11.6% two risk factors and 10.5% three or more risk factors. Elevated EPDS scores were associated with major stresses in the last 12 months, high trait anxiety and significant past mental health issue/s. Acceptability of depression screening and psychosocial risk assessment was high. CONCLUSIONS This study highlights the need for, and acceptability of, depression and psychosocial assessment in the private maternity sector. These findings are particularly timely given the provision of new Medicare Benefits Scheme items for obstetricians to undertake psychosocial assessment (both antenatally and postnally) in line with recommended clinical best practice.
Collapse
Affiliation(s)
- Harish Kalra
- Raphael Services Ballarat, St John of God Health Care and Mair St Clinic, Ballarat, Victoria, Australia
| | - Nicole Reilly
- Perinatal and Women's Mental Health Unit, St John of God Health Care and School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Marie-Paule Austin
- Perinatal and Women's Mental Health Unit, St John of God Health Care and School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.,Black Dog Institute, Sydney, New South Wales, Australia
| |
Collapse
|
|
32
|
Coates D, Saleeba C, Howe D. Profile of consumers and their partners of a perinatal and infant mental health (PIMH) service in Australia. HEALTH & SOCIAL CARE IN THE COMMUNITY 2018; 26:e154-e163. [PMID: 28868664 DOI: 10.1111/hsc.12489] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/09/2017] [Indexed: 06/07/2023]
Abstract
The perinatal period is a time of great vulnerability for many women, in particular those with a range of psychosocial vulnerabilities and mental health risk factors. This paper outlines the psychosocial and mental health profile of consumers and their partners of a perinatal and infant mental health (PIMH) service in Australia. To establish the consumer profile, we analysed client vulnerabilities and demographical information maintained over a 6-year period for 406 consumers. Consumer information, including mental health problems, psychosocial vulnerabilities and demographical information, was entered into a standalone database by the allocated clinicians upon service allocation and throughout treatment. The women accepted by PIMH presented with an average of nine different vulnerabilities. Frequently endorsed risk factors included depression (72.66%), anxiety (71.43%), comorbid depression and anxiety (58.13%), self-harm (past, 7.88%, present, 16.26%), a history of family mental health issues (39.66%), childhood trauma (57.88%), limited support (68.84%), relationship conflict with partners (38.92%) and financial stress (47.29%). The women's partners also presented with a range of vulnerabilities, in particular childhood trauma (34.11%) and mental health issues (30.81%). This study contributes to our understanding of the profile of vulnerable women in the perinatal period, and in particular contributes to the literature by highlighting that in addition to depression, anxiety, self-harm and trauma are also significant in PIMH service delivery.
Collapse
Affiliation(s)
- Dominiek Coates
- Children and Young People's Mental Health, Central Coast Local Health District, Central Coast Mental Health, Gosford, NSW, Australia
| | - Christine Saleeba
- Children and Young People's Mental Health, Central Coast Local Health District, Central Coast Mental Health, Gosford, NSW, Australia
| | - Deborah Howe
- Children and Young People's Mental Health, Central Coast Local Health District, Central Coast Mental Health, Gosford, NSW, Australia
| |
Collapse
|
|
33
|
Depression Literacy and Awareness of Psychopathological Symptoms During the Perinatal Period. J Obstet Gynecol Neonatal Nurs 2017; 46:197-208. [DOI: 10.1016/j.jogn.2016.10.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2016] [Indexed: 11/22/2022] Open
|
|
34
|
Pilkington P, Milne L, Cairns K, Whelan T. Enhancing reciprocal partner support to prevent perinatal depression and anxiety: a Delphi consensus study. BMC Psychiatry 2016; 16:23. [PMID: 26842065 PMCID: PMC4739319 DOI: 10.1186/s12888-016-0721-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 01/18/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Systematic reviews have established that partner support protects against perinatal mood problems. It is therefore a key target for interventions designed to prevent maternal and paternal depression and anxiety. Nonetheless, the extant literature is yet to be translated into specific actions that parents can implement. Prevention efforts aiming to facilitate reciprocal partner support within the couple dyad need to provide specific guidance on how partners can support one another to reduce their vulnerability to perinatal depression and anxiety. METHOD Two panels of experts in perinatal mental health (21 consumer advocates and 39 professionals) participated in a Delphi consensus study to establish how partners can support one another to reduce their risk of developing depression and anxiety during pregnancy and the postpartum period. RESULTS A total of 214 recommendations on how partners can support each other were endorsed by at least 80 % of both panels as important or essential in reducing the risk of perinatal depression and anxiety. The recommendations were grouped under the following categories: becoming a parent, supporting each other through pregnancy and childbirth, communication, conflict, division of labor, practical support, emotional support, emotional closeness, sexual satisfaction, using alcohol and drugs, encouraging self-care, developing acceptance, and help-seeking. CONCLUSION This study established consensus between consumers and professionals in order to produce a set of guidelines on how partners can support each other to prevent depression and anxiety during pregnancy and following childbirth. It is hoped that these guidelines will inform the development of perinatal depression and anxiety prevention efforts.
Collapse
Affiliation(s)
- Pamela Pilkington
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Locked Bag 4115, Fitzroy, Victoria, 3065, Australia.
| | - Lisa Milne
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Locked Bag 4115, Fitzroy, Victoria, 3065, Australia.
| | - Kathryn Cairns
- Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Melbourne, Victoria, 3010, Australia.
| | - Thomas Whelan
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Locked Bag 4115, Fitzroy, Victoria, 3065, Australia.
| |
Collapse
|
|
35
|
Gausia K, Thompson SC, Nagel T, Schierhout G, Matthews V, Bailie R. Risk of antenatal psychosocial distress in indigenous women and its management at primary health care centres in Australia. Gen Hosp Psychiatry 2015; 37:335-9. [PMID: 25920681 DOI: 10.1016/j.genhosppsych.2015.04.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 04/06/2015] [Accepted: 04/07/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE This study explored the risk of antenatal psychosocial distress (APD) and associated potential factors and examined management aspects of risk of APD in women attending Aboriginal primary health care services in Australia. METHOD Audits of medical records of 797 pregnant women from 36 primary health centres in five jurisdictions (NSW, QLD, SA, WA and NT) were undertaken as part of a quality improvement programme. Information collected included mental health assessed by a standard screening tools, enquiry regarding social and emotional well-being (SEWB), depression management (including antidepressant medications) and referral. RESULTS Around 18% (n=141) of women were at risk of APD based on assessment using a standard screening tool or by SEWB enquiry. There was a significant association between risk of distress and women's life style behaviours (e.g., alcohol, illicit drug use) and health centre characteristics. Of the 141 women, 16% (n= 22) were prescribed antidepressant drugs during pregnancy. A range of nonpharmaceutical mental health interventions were also recorded, including brief intervention of 61% (n=86), counselling of 57% (n=80) and cognitive behaviour therapy of 5% (n=7). About 39% (n=55) of women with APD were referred to external services for consultations with a psychiatrist, psychologist or social worker or to a women's refuge centre. CONCLUSIONS The higher risk of APD associated with women's life style behaviour indicates that the better understanding of mental health in its cultural context is essential.
Collapse
Affiliation(s)
- Kaniz Gausia
- Western Australian Centre for Rural Health, University of Western Australia, 167 Fitzgerald Street, Geraldton, WA 6530, Australia.
| | - Sandra C Thompson
- Western Australian Centre for Rural Health, University of Western Australia, 167 Fitzgerald Street, Geraldton, WA 6530, Australia.
| | - Tricia Nagel
- Mental Health, Wellbeing and Chronic Diseases Division, Menzies School of Health Research, Casuarina, NT 0811, Australia.
| | - Gill Schierhout
- Menzies School of Health Research, Casuarina, NT 0811, Australia.
| | - Veronica Matthews
- ABCD National Research Partnership Project, Menzies School of Health Research, Level 1, 147 Wharf Street, Spring Hill, QLD 4000, Australia.
| | - Ross Bailie
- ABCD National Research Partnership Project, Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Casuarina, NT 0810, Australia.
| |
Collapse
|
|
36
|
Rowe HJ, Fisher JR. Do contemporary social and health discourses arouse peripartum anxiety? A qualitative investigation of women's accounts. WOMENS STUDIES INTERNATIONAL FORUM 2015. [DOI: 10.1016/j.wsif.2015.05.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
|
37
|
Khajehei M. Mental health of perinatal women. World J Obstet Gynecol 2015; 4:46-51. [DOI: 10.5317/wjog.v4.i2.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 01/06/2015] [Accepted: 03/18/2015] [Indexed: 02/05/2023] Open
Abstract
Pregnancy and childbirth are major stressors for some women. They can be followed by deterioration in mental health status and cause mental illnesses during perinatal period. Undetected and untreated perinatal mental illnesses can have negative unexpected impacts on parenting skills of the women and children’s development. Mentally ill mothers may not effectively attend their children’s needs in a timely manner and may experience an unfavourable mother-child attachment affecting the child’s language, social, emotional and cognitive development. The rate of pregnancy and postnatal health complications and interventions is higher among mentally ill women with some certain risk factors. The mentally ill mothers along with their partners need comprehensive support and counselling to be able to care for their infants and establish strong parent-child bond and attachment. Mental health campaigns across the world have endeavoured to increase the knowledge and awareness of the public towards perinatal mental health illnesses. To this aim, a routine screening is recommended in order to identify the women who are at risk of mood or anxiety disorder during perinatal period. The development of knowledge on perinatal mental illnesses among public and the health professionals has resulted in timely recognition and treatment of perinatal mental illnesses. Although great volumes of research show high prevalence of perinatal mental illnesses and their impacts on parenting confidence and competence as well as child’s developmental process, there is still lack of research on various aspects of perinatal mental illnesses. To enable early prevention, diagnosis and intervention, it is crucial to identify families who are at an increased risk of perinatal mental illnesses and provide support and intervention to minimise the adverse outcomes. The children’s needs may not be met by providing treatment to parental mental illnesses alone. It is also important to understand the impact of specific parenting behaviours on child outcomes which is modified by the quality of parenting.
Collapse
|
|
38
|
Qualitative insights into women's personal experiences of perinatal depression and anxiety. Women Birth 2014; 27:179-84. [DOI: 10.1016/j.wombi.2014.05.003] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 05/01/2014] [Accepted: 05/10/2014] [Indexed: 02/02/2023]
|
|
39
|
The impact of routine assessment of past or current mental health on help-seeking in the perinatal period. Women Birth 2014; 27:e20-7. [PMID: 25154772 DOI: 10.1016/j.wombi.2014.07.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 07/21/2014] [Accepted: 07/22/2014] [Indexed: 01/03/2023]
Abstract
BACKGROUND Clinical practice guidelines now recommend that women be asked about their past or current mental health as a routine component of maternity care. However, the value of this line of enquiry in increasing engagement with support services, as required, remains controversial. AIM The current study aimed to examine whether assessment of past or current mental health, received with or without referral for additional support, is associated with help-seeking during pregnancy and the postpartum. METHODS A subsample of women drawn from the Australian Longitudinal Study on Women's Health (young cohort) who reported experiencing significant emotional distress during pregnancy (N=398) or in the 12 months following birth (N=380) participated in the study. RESULTS Multivariate analysis showed that women who were not asked about their emotional health were less likely to seek any formal help during both pregnancy (adjOR=0.09, 95%CI: 0.04-0.24) and the postpartum (adjOR=0.07, 95%CI: 0.02-0.13), as were women who were asked about these issues but who were not referred for additional support (antenatal: adjOR=0.26, 95%CI: 0.15-0.45; postnatal: adjOR=0.14, 95%CI: 0.07-0.27). However, considerable levels of consultation with general practitioners, midwives and child health nurses, even in the absence of referral, were evident. CONCLUSION This study demonstrates that enquiry by a health professional about women's past or current mental health is associated with help-seeking throughout the perinatal period. The clinical and resource implications of these findings for the primary health care sector should be considered prior to the implementation of future routine perinatal depression screening or psychosocial assessment programmes.
Collapse
|
|
40
|
Kingston DE, Mcdonald S, Austin MP, Hegadoren K, Lasiuk G, Tough S. The Public's views of mental health in pregnant and postpartum women: a population-based study. BMC Pregnancy Childbirth 2014; 14:84. [PMID: 24564783 PMCID: PMC3941946 DOI: 10.1186/1471-2393-14-84] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 02/18/2014] [Indexed: 12/02/2022] Open
Abstract
Background We used population-based data to determine the public’s views of prenatal and postnatal mental health and to identify predictors of those views. Methods A computer-assisted telephone survey was conducted by the Population Health Laboratory (University of Alberta) with a random sample of participants from the province of Alberta, Canada. Respondents were eligible to participate if they were: 1) ≥18 years; and 2) contacted by direct dialing. Questions were drawn from the Perinatal Depression Monitor, an Australian population-based survey on perinatal mental health; additional questions were developed and tested to reflect the Canadian context. Descriptive and multivariable regression analyses were conducted. Results Among the 1207 respondents, 74.7% had post-secondary education, 16.3% were in childbearing years, and over half (57.4%) reported knowing a woman who had experienced postpartum depression. Significantly more respondents had high levels of knowledge of postnatal (87.4%) than prenatal (70.5%) mental health (p < .01). Only 26.6% of respondents accurately identified that prenatal anxiety/depression could negatively impact child development. Personal knowledge of a woman with postpartum depression was a significant predictor of prenatal and postnatal mental health knowledge. Conclusions While the public’s knowledge of postnatal mental health is high, knowledge regarding prenatal mental health and its influence on child development is limited. Strategies for improving perinatal mental health literacy should target these knowledge deficits.
Collapse
Affiliation(s)
- Dawn E Kingston
- 5-258 Edmonton Clinic Health Academy, Faculty of Nursing, University of Alberta, 11405-87th Avenue, Edmonton, AB T6C 1C9, Canada.
| | | | | | | | | | | |
Collapse
|
|
41
|
Kingston D, McDonald S, Tough S, Austin MP, Hegadoren K, Lasiuk G. Public views of acceptability of perinatal mental health screening and treatment preference: a population based survey. BMC Pregnancy Childbirth 2014; 14:67. [PMID: 24521267 PMCID: PMC3925362 DOI: 10.1186/1471-2393-14-67] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 02/05/2014] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND At a prevalence rate of 13-25%, mental health problems are among the most common morbidities of the prenatal and postnatal periods. They have been associated with increased risk of preterm birth and low birthweight, child developmental delay, and poor child mental health. However, very few pregnant and postpartum women proactively seek help or engage in treatment and less than 15% receive needed mental healthcare. While system-related barriers limit accessibility and availability of mental health services, personal barriers, such as views of mental health and its treatment, are also cited as significant deterrents of obtaining mental healthcare. The purposes of this population-based study were to identify the public's views regarding mental health screening and treatment in pregnant and postpartum women, and to determine factors associated with those views. METHODS A computer-assisted telephone survey was conducted by the Population Research Laboratory with a random sample of adults in Alberta, Canada. Questions were drawn from the Perinatal Depression Monitor, an Australian population-based survey on perinatal mental health; additional questions were developed and tested to reflect the Canadian context. Interviews were conducted in English and were less than 30 minutes in duration. Descriptive and multivariable regression analyses were conducted. RESULTS Among the 1207 respondents, 74.8% had post-secondary education, 16.3% were 18-34 years old, and two-thirds (66.1%) did not have children <18 years living at home. The majority of respondents strongly agreed/agreed that all women should be screened in the prenatal (63.0%) and postpartum periods (72.7%). Respondents reported that when seeking help and support their first choice would be a family doctor. Preferred treatments were talking to a doctor or midwife and counseling. Knowledge of perinatal mental health was the main factor associated with different treatment preferences. CONCLUSIONS The high acceptability of universal perinatal mental health screening among the public provides a strong message regarding the public value for routine screening during pregnancy and postpartum periods. Perinatal mental health literacy is the most prominent determinant of screening and treatment acceptability and preference. Efforts to enhance population literacy as part of a multifaceted perinatal mental health strategy may optimize pregnant and postpartum women's mental health.
Collapse
Affiliation(s)
- Dawn Kingston
- University of Alberta, 11405-87th Avenue, Edmonton, T6G 1C9 Alberta, Canada
| | | | | | | | - Kathy Hegadoren
- University of Alberta, 11405-87th Avenue, Edmonton, T6G 1C9 Alberta, Canada
| | - Gerri Lasiuk
- University of Alberta, 11405-87th Avenue, Edmonton, T6G 1C9 Alberta, Canada
| |
Collapse
|
|
42
|
Thorsteinsson EB, Loi NM, Moulynox AL. Mental Health Literacy of Depression and Postnatal Depression: A Community Sample. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/ojd.2014.33014] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
|
43
|
Milgrom J, Gemmill AW. Screening for perinatal depression. Best Pract Res Clin Obstet Gynaecol 2013; 28:13-23. [PMID: 24095728 DOI: 10.1016/j.bpobgyn.2013.08.014] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 06/20/2013] [Accepted: 08/22/2013] [Indexed: 01/03/2023]
Abstract
Perinatal depression is prevalent, under-diagnosed and can have serious long-term effects on the wellbeing of women, their partners and infants. In the absence of active identification strategies, most women with perinatal depression will neither seek nor receive help. To enable early detection and timely intervention, universal screening is coming to be seen as best practice in many settings. Although the strength of recommendations and the preferred methods of identification vary in different countries (e.g. the Edinburgh Postnatal Depression Scale, brief case-finding questions), appropriate training for health professionals in wider psychosocial assessment is essential to maximise usefulness while minimising potential harms. Clear pathways of systematic follow up of all positive screening results with a diagnostic procedure and access to effective treatment are centrally important both for the clinical effectiveness of screening and for health system costs. It is also necessary to further build on the emerging evidence base for the clinical effectiveness of screening.
Collapse
Affiliation(s)
- Jeannette Milgrom
- Parent-Infant Research Institute, Department of Clinical and Health Psychology, Austin Health, Melbourne, Victoria 3081, Australia; Melbourne School of Psychological Sciences, University of Melbourne, Victoria, Australia.
| | - Alan W Gemmill
- Parent-Infant Research Institute, Department of Clinical and Health Psychology, Austin Health, Melbourne, Victoria 3081, Australia
| |
Collapse
|
|
44
|
Dennis CL, Dowswell T. Interventions (other than pharmacological, psychosocial or psychological) for treating antenatal depression. Cochrane Database Syst Rev 2013; 2013:CD006795. [PMID: 23904069 PMCID: PMC11536339 DOI: 10.1002/14651858.cd006795.pub3] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND A meta-analysis of 21 studies suggests the mean prevalence rate for depression across the antenatal period is 10.7%, ranging from 7.4% in the first trimester to a high of 12.8% in the second trimester. Due to maternal treatment preferences and potential concerns about fetal and infant health outcomes, diverse non-pharmacological treatment options are needed. OBJECTIVES To assess the effect of interventions other than pharmacological, psychosocial, or psychological interventions compared with usual antepartum care in the treatment of antenatal depression. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2013), scanned secondary references and contacted experts in the field to identify other published or unpublished trials. SELECTION CRITERIA All published and unpublished randomised controlled trials of acceptable quality evaluating non-pharmacological/psychosocial/psychological interventions to treat antenatal depression. DATA COLLECTION AND ANALYSIS Both review authors participated in the evaluation of methodological quality and data extraction. Results are presented using risk ratio (RR) for categorical data and mean difference (MD) for continuous data. MAIN RESULTS Six trials were included involving 402 women from the United States, Switzerland, and Taiwan. For most comparisons a single trial contributed data and there were few statistically significant differences between control and intervention groups.In a trial with 38 women maternal massage compared with non-specific acupuncture (control group) did not significantly decrease the number of women with clinical depression or depressive symptomatology immediately post-treatment (risk ratio (RR) 0.80, 95% confidence interval (CI) 0.25 to 2.53; mean difference (MD) -2.30, 95% CI -6.51 to 1.91 respectively). In another trial with 88 women there was no difference in treatment response or depression remission rates in women receiving maternal massage compared with those receiving non-specific acupuncture (RR 1.33, 95% CI 0.82 to 2.18; RR 1.14, 95% CI 0.59 to 2.19 respectively).In a trial with 35 women acupuncture specifically treating symptoms of depression, compared with non-specific acupuncture, did not significantly decrease the number of women with clinical depression or depressive symptomatology immediately post-treatment (RR 0.47, 95% CI 0.11 to 2.13; MD -3.00, 95% CI -8.10 to 2.10). However, women who received depression-specific acupuncture were more likely to respond to treatment compared with those receiving non-specific acupuncture (RR 1.68, 95% CI 1.06 to 2.66).In a trial with 149 women, maternal massage by a woman's significant other, compared with standard care, significantly decreased the number of women with depressive symptomatology immediately post-treatment (MD -6.70, 95% CI -9.77 to -3.63). Further, women receiving bright light therapy had a significantly greater change in their mean depression scores over the five weeks of treatment than those receiving a dim light placebo (one trial, n = 27; MD -4.80, 95% CI -8.39 to -1.21). However, they were not more likely to have a treatment response or experience a higher remission rate (RR 1.79, 95% CI 0.90 to 3.56; RR 1.89, 95% CI 0.81 to 4.42).Lastly, two trials examined the treatment effect of omega-3 oils. Women receiving omega-3 had a significantly lower mean depression score following eight weeks of treatment than those receiving a placebo (one trial, n = 33; MD -4.70, 95% CI -7.82 to -1.58). Conversely, in a smaller trial (21 women) there was no significant difference in the change in mean depression scores for women receiving omega-3 and those receiving a placebo (MD 0.36, 95% CI -0.17 to 0.89), and women who received omega-3 were no more likely to respond to treatment (RR 2.26, 95% CI 0.78 to 6.49) or have higher remission rates (RR 2.12, 95% CI 0.51 to 8.84). Women in the placebo group were just as likely to report a side effect as those in the omega-3 group (RR 1.12, 95% CI 0.56 to 2.27). AUTHORS' CONCLUSIONS The evidence is inconclusive to allow us to make any recommendations for depression-specific acupuncture, maternal massage, bright light therapy, and omega-3 fatty acids for the treatment of antenatal depression. The included trials were too small with non-generalisable samples, to make any recommendations.
Collapse
Affiliation(s)
- Cindy-Lee Dennis
- University of Toronto and Women’s College Research Institute, Toronto, Canada.
| | | |
Collapse
|
|
45
|
Rowe HJ, Holton S, Fisher JRW. Postpartum emotional support: a qualitative study of women's and men's anticipated needs and preferred sources. Aust J Prim Health 2013; 19:46-52. [PMID: 22951012 DOI: 10.1071/py11117] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Accepted: 12/12/2011] [Indexed: 11/23/2022]
Abstract
Australian health policy emphasises prevention, early intervention and improved pathways to treatment for perinatal mental disorders. Primary care is vital to achieving these aims. The aim of this study was to understand the anticipated needs and preferred sources of mental health information and support of men and women expecting their first baby. Nulliparous English-speaking expectant parents attending childbirth education programs in public and private hospitals participated in single sex small group discussions in late pregnancy. Discussions were audio-recorded, transcribed and analysed thematically using the group as the unit of analysis. Eight groups (22 women; 16 men) encompassing diverse socioeconomic circumstances were conducted. Analyses showed idealised fantasies consistently tempered with realistic expectations about adjustment to life with a baby. However, there were diverse and gendered views about whether primary care providers should discuss mental health with parents of infants and willingness to complete written questionnaires or be referred for specialist mental health care. Men regard primary family care as mother not father inclusive. Expectant parents readily anticipate realistic postnatal adjustment and need for emotional support. Increased provision of services that meet men's needs and public understanding and acceptance of Australian integrated models of primary postnatal mental health care are needed.
Collapse
Affiliation(s)
- Heather J Rowe
- School of Public Health and Preventive Medicine, Monash University, Clayton, Australia.
| | | | | |
Collapse
|