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Kuppermann M, Pressman A, Coleman-Phox K, Afulani P, Blebu B, Carraway K, Butcher BC, Curry V, Downer C, Edwards B, Felder JN, Fontenot J, Garza MA, Karasek D, Lessard L, Martinez E, McCulloch CE, Oberholzer C, Ramirez GR, Tesfalul M, Wiemann A. A randomized comparative-effectiveness study of two enhanced prenatal care models for low-income pregnant people: Engaging Mothers & Babies; Reimagining Antenatal Care for Everyone (EMBRACE). Contemp Clin Trials 2024; 143:107568. [PMID: 38750950 DOI: 10.1016/j.cct.2024.107568] [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: 11/21/2023] [Revised: 04/18/2024] [Accepted: 05/04/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND Improving perinatal mental health and care experiences and preventing adverse maternal and infant outcomes are essential prenatal care components, yet existing services often miss the mark, particularly for low-income populations. An enhanced group prenatal care program, "Glow! Group Prenatal Care and Support," was developed in California's Central Valley in response to poor perinatal mental health, disrespectful care experiences, and high rates of adverse birth outcomes among families with low incomes. METHODS Engaging Mothers & Babies; Reimagining Antenatal Care for Everyone (EMBRACE) is a pragmatic, two-arm, randomized, comparative-effectiveness study designed to assess depression (primary outcome), the experience of care (secondary outcome), and preterm birth (exploratory outcome) among Medi-Cal (California's Medicaid program)-eligible pregnant and birthing people, comparing those assigned to Glow! Group Prenatal Care and Support (Glow/GC) with those assigned to enhanced, individual prenatal care through the California Department of Public Health's Comprehensive Perinatal Services Program (CPSP/IC). Participating clinical practices offer the two comparators, alternating between comparators every 6 weeks, with the starting comparator randomized at the practice level. Participant-reported outcomes are assessed through interviewer-administered surveys at study entry, during the participant's third trimester, and at 3 months postpartum; preterm birth and other clinical outcomes are abstracted from labor and delivery records. Patient care experiences are further assessed in qualitative interviews. The protocol complies with the Standard Protocol Items for Randomized Trials. CONCLUSIONS This comparative-effectiveness study will be used to determine which of two forms of enhanced prenatal care is more effective, informing future decisions regarding their use. TRIAL REGISTRATION ClinicalTrials.gov: NCT04154423.
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Affiliation(s)
- Miriam Kuppermann
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, United States of America; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States of America; The California Preterm Birth Initiative, University of California, San Francisco, San Francisco, CA, United States of America.
| | - Alice Pressman
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States of America
| | - Kimberly Coleman-Phox
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, United States of America; The California Preterm Birth Initiative, University of California, San Francisco, San Francisco, CA, United States of America
| | - Patience Afulani
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, United States of America; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States of America; The California Preterm Birth Initiative, University of California, San Francisco, San Francisco, CA, United States of America
| | - Bridgette Blebu
- The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, United States of America
| | - Kristin Carraway
- Central Valley Health Policy Institute, California State University, Fresno, Fresno, CA, United States of America
| | - Brittany Chambers Butcher
- Department of Human Ecology, College of Agricultural and Environmental Sciences, University of California, Davis, Davis, CA, United States of America
| | - Venise Curry
- Central Valley Health Policy Institute, California State University, Fresno, Fresno, CA, United States of America
| | - Chris Downer
- Medical Education Program, University of California, San Francisco, Fresno, CA, United States of America
| | - Brittany Edwards
- Central Valley Health Policy Institute, California State University, Fresno, Fresno, CA, United States of America
| | - Jennifer N Felder
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, United States of America
| | - Jazmin Fontenot
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, United States of America; The California Preterm Birth Initiative, University of California, San Francisco, San Francisco, CA, United States of America
| | - Mary A Garza
- Central Valley Health Policy Institute, California State University, Fresno, Fresno, CA, United States of America; Department of Public Health, College of Health and Human Services, California State University, Fresno, Fresno, CA, United States of America
| | - Deborah Karasek
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, United States of America; The California Preterm Birth Initiative, University of California, San Francisco, San Francisco, CA, United States of America
| | - Lauren Lessard
- Central Valley Health Policy Institute, California State University, Fresno, Fresno, CA, United States of America; Institute for Circumpolar Health Studies, University of Alaska, Anchorage, Anchorage, AK, United States of America
| | - Erica Martinez
- Central Valley Health Policy Institute, California State University, Fresno, Fresno, CA, United States of America
| | - Charles E McCulloch
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States of America
| | - Christy Oberholzer
- Central Valley Health Policy Institute, California State University, Fresno, Fresno, CA, United States of America
| | - Guadalupe R Ramirez
- Children and Families Commission of Fresno County, Fresno, CA, United States of America
| | - Martha Tesfalul
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, United States of America; The California Preterm Birth Initiative, University of California, San Francisco, San Francisco, CA, United States of America
| | - Andrea Wiemann
- Central Valley Health Policy Institute, California State University, Fresno, Fresno, CA, United States of America
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Nacev EC, Martinez Acevedo AC, Kaufman M, Fuerst MF, Knapp JM, Rodriguez MI. Differences between rural and urban residence in the detection and treatment of perinatal mood and anxiety disorders. AJOG GLOBAL REPORTS 2024; 4:100351. [PMID: 38737436 PMCID: PMC11088345 DOI: 10.1016/j.xagr.2024.100351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND Perinatal mood and anxiety disorders are common, serious complications of pregnancy. Disparities exist by race and income in the prevalence and treatment of these conditions, and overall treatment rates remain low. Outside of pregnancy, a small body of literature suggests that rural residency may contribute to higher rates of depression for those who identify as women. However, among more diverse populations, evidence suggests urban residency may be associated with higher rates of depression among women of color. It is not known whether these trends hold for mood and anxiety disorders during pregnancy and postpartum. OBJECTIVE We examined differences in the detection and treatment of perinatal mood and anxiety disorders by rural and urban residents and assessed if the observed differences varied by maternal race or ethnicity. STUDY DESIGN We conducted a cross-sectional study using linked Medicaid claims and birth certificate records from Oregon and South Carolina from 2016 to 2020. We identified perinatal mood and anxiety disorder diagnoses during the perinatal period (pregnancy and within 60 days postpartum) using International Classification of Disease 10th edition codes and enumerated receipt of pharmacotherapy and psychotherapy treatment using Medicaid claims. We used logistic regression models controlling for relevant clinical and sociodemographic characteristics to estimate associations between rural residence and mood disorder detection and treatment. RESULTS Among the 185,809 births in our sample, 27% of births (n=50,820) were to people who lived in rural areas and 73% (n=134,989) to those in urban areas. The prevalence of any perinatal mood and anxiety disorders diagnosis was higher for urban residents (19.5%) than for rural residents (18.0%; P<.001). Overall treatment rates were low among people with a perinatal mood and anxiety disorder (42% [n=14,789]). In our adjusted models, those living in urban areas had higher odds of a perinatal mood and anxiety disorder diagnosis (adjusted odds ratio, 1.059 [95% confidence interval, 1.059-1.059], P<.001). We found a significant interaction between maternal race and rurality (P<.001). When we stratified by race, we found that among those who identified as Black, the odds of a perinatal mood and anxiety disorder diagnosis were increased for urban residents (odds ratio, 1.188 [95% confidence interval, 1.188-1.188]), whereas among those who identified as White, there were no such increased odds (odds ratio, 1.027 [95% confidence interval, 0.843-1.252]). CONCLUSION We saw small but meaningful differences between rural and urban residents in perinatal mood and anxiety disorder diagnosis rates. We detected an interaction between race and rural vs urban maternal residence that impacted the observed differences. By elucidating the intersection between race and other sociodemographic factors, we hope more targeted and meaningful investments can be made in the communities most in need.
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Affiliation(s)
- Erin C. Nacev
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR (Drs Nacev, Fuerst, Knapp, and Rodriguez)
| | - Ann C. Martinez Acevedo
- Center for Health Systems Effectiveness, Oregon Health & Science University; Portland, OR (Ms Martinez Acevedo and Dr Kaufman)
| | - Menolly Kaufman
- Center for Health Systems Effectiveness, Oregon Health & Science University; Portland, OR (Ms Martinez Acevedo and Dr Kaufman)
| | - Megan F. Fuerst
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR (Drs Nacev, Fuerst, Knapp, and Rodriguez)
| | - Jacquelyn M. Knapp
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR (Drs Nacev, Fuerst, Knapp, and Rodriguez)
| | - Maria I. Rodriguez
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR (Drs Nacev, Fuerst, Knapp, and Rodriguez)
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Obiakor GC, Banta JE, Sinclair RG, Baba Djara M, Mataya R, Wiafe S. The Impact of Social Determinants of Maternal Mental Health in Marginalized Mothers. J Womens Health (Larchmt) 2024; 33:650-661. [PMID: 38662499 DOI: 10.1089/jwh.2022.0137] [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] [Indexed: 05/29/2024] Open
Abstract
Background: A deeper understanding of the key determinants of maternal mental health is important for improving care for women, especially women who are at an economic disadvantage. Objectives: To explore the associations of select social determinants: access, social support, and stress, with the onset of antepartum depression in low-income mothers. Participants: The Pregnancy Risk Assessment Monitoring System (PRAMS) is an ongoing, population-based surveillance system with selected data from 2016 to 2019, establishing a randomly selected sample of women with a recent live birth at most 4 months postdelivery, between 1,300 and 3,400 women per state (n ∼ 162,558). Methods: In this cross-sectional study, the phase 8 PRAMS was adapted to measure social support, access, stress, and their relationships with the onset of antepartum depression in low-income mothers. To assess low-income marginalization, a threshold was established based on income levels within 130% of the federal poverty level; antepartum (n ∼ 41,289). Results: The defined access, social support, and stress factors showed a statistically significant association with the onset of antepartum depression among low-income mothers. Of women in this sample, 22.6% indicated antepartum depression (p < 0.001; R2 = 0.066). Negative social support indicators were associated with an increased likelihood of antepartum depression; 3.71 increased odds of depression for abuse during pregnancy, and 0.79 decreased odds with positive acknowledgment of paternity. Access indicator terms showed an association with the decreased likelihood of antepartum depression through breastfeeding information support (Info from Baby Doc, odds ratio [OR] = 0.86), prenatal care utilization (12+ visits, OR = 0.82), and specific insurance type (insurance by job, OR = 0.82). All instances of stressful life events showed an increased likelihood of depression during pregnancy (for majority of stressful life events: OR >1.12). Conclusions: Economically marginalized mothers face unmet social and health care needs leading to poorer outcomes during pregnancy. These findings provide additional support for improved policy and public health efforts, such as assessment, education, and interventions, to decrease prevalence and improve treatment for antepartum depression among marginalized mothers.
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Affiliation(s)
- Gina C Obiakor
- Department of Health Policy and Leadership, School of Public Health, Loma Linda University, Loma Linda, California, USA
| | - Jim E Banta
- Department of Health Policy and Leadership, School of Public Health, Loma Linda University, Loma Linda, California, USA
| | - Ryan G Sinclair
- Department of Environmental Health, School of Public Health, Loma Linda University, Loma Linda, California, USA
| | - Monita Baba Djara
- Department of Global Health, School of Public Health, Loma Linda University, Loma Linda, California, USA
| | - Ronald Mataya
- Department of Global Health, School of Public Health, Loma Linda University, Loma Linda, California, USA
| | - Seth Wiafe
- Department of Health Policy and Leadership, School of Public Health, Loma Linda University, Loma Linda, California, USA
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Girma B, Bimer K, Kassaw C, Mengistu N, Zewdie A, Sewalem J, Madoro D. Common mental disorders and associated factors among mothers of children attending severe acute malnutrition treatment in Gedio Zone, Southern Ethiopia, 2022: a cross-sectional study. BMC Psychiatry 2024; 24:276. [PMID: 38609954 PMCID: PMC11010270 DOI: 10.1186/s12888-024-05741-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 04/04/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Common mental disorders describe the physical, mental, and social disturbances that are more prevalent in low and middle-income countries. Mothers are among the more vulnerable groups especially mothers having children with under-nutrition. However, there are limited studies about the magnitude of common mental disorders among mothers of undernourished children in Ethiopia. Therefore, we aimed to assess the magnitude of common mental disorders and associated factors among mothers of children attending severe acute malnutrition treatment in Gedio Zone, Southern Ethiopia. METHODS A cross-sectional study was employed on 405 systematically selected participants. The outcome variable was assessed by a self-reporting questionnaire (SRQ-20) which was applicable and validated in Ethiopia. Data were entered and analyzed by EPi data version 5 software and SPSS version 25 respectively. Model fitness was checked by Hosmer Lemeshow's test. Logistic regression was employed to identify significant determinants. A p-value < 0.05 was used to declare association and expressed by odds ratio with a 95% CI. RESULT In this study, the magnitude of common mental disorders was 33.16% (95% CI [28.5-38])). In multivariable analysis, six factors poor social support [AOR: 14.0, 95% CI (5.45, 35.9)], educational status [AOR: 1.95, 95% CI (1.07. 3.55)], cigarette smoking [AOR: 10.9, 95% CI (1.78, 67.01)], mother of a child with another chronic disease [AOR: 3.19, 95% CI (1.13, 8.99)], sexual violence [AOR: 4.14, 95% CI (1.38, 12.4)] and mothers with chronic disease [AOR: 3.44, 95% CI (1.72, 6.86)] were significantly associated with common mental disorders. CONCLUSION The magnitude of common mental disorders was high. Six factors were significantly associated with common mental disorders; social support, sexual violence, maternal chronic illness, educational status, smoking, and mother of child with other chronic disease. Community awareness regarding the effect of violence, substance use, and social support on mental health should be created by the local stakeholders.
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Affiliation(s)
- Bekahegn Girma
- Department of Nursing, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia.
| | - Kirubel Bimer
- Department of Nursing, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Chalachew Kassaw
- Department of Psychiatry, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
| | - Nebiyu Mengistu
- Department of Psychiatry, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
| | - Ashenafi Zewdie
- Department of Nursing, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Jerusalem Sewalem
- Department of Psychiatry, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
| | - Derebe Madoro
- Department of Psychiatry, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
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Khan AN, Jawarkar RD, Zaki MEA, Al Mutairi AA. Natural compounds for oxidative stress and neuroprotection in schizophrenia: composition, mechanisms, and therapeutic potential. Nutr Neurosci 2024:1-15. [PMID: 38462971 DOI: 10.1080/1028415x.2024.2325233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
OBJECTIVE An imbalance between the generation of reactive oxygen species (ROS) and the body's antioxidant defense mechanisms is believed to be a critical factor in the development of schizophrenia (SCZ) like neurological illnesses. Understanding the roles of ROS in the development of SCZ and the potential activity of natural antioxidants against SCZ could lead to more effective therapeutic options for the prevention and treatment of the illness. METHODS SCZ is a mental disorder characterised by progressive impairments in working memory, attention, and executive functioning. In present investigation, we summarized the experimental findings for understanding the role of oxidative stress (OS) in the development of SCZ and the potential neuroprotective effects of natural antioxidants in the treatment of SCZ. RESULTS Current study supports the use of the mentioned antioxidant natural compounds as a potential therapeutic candidates for the treatment of OS mediated neurodegeneration in SCZ. DISCUSSION Elevated levels of harmful ROS and reduced antioxidant defense mechanisms are indicative of increased oxidative stress (OS), which is associated with SCZ. Previous research has shown that individuals with SCZ, including non-medicated, medicated, first-episode, and chronic patients, exhibit decreased levels of total antioxidants and GSH. Additionally, they have reduced antioxidant enzyme levels such as catalase (CAT), glutathione (GPx), and, superoxide dismutase (SOD) and lower serum levels of brain-derived neurotrophic factor (BDNF) in their brain tissue. The mentioned natural antioxidants may assist in reducing oxidative damage in individuals with SCZ and increasing BDNF expression in the brain, potentially improving cognitive function and learning ability.
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Affiliation(s)
- Anam N Khan
- Department of Pharamacognosy, Dr. Rajendra Gode Institute of Pharmacy, Amravati, India
| | - Rahul D Jawarkar
- Department of Medicinal Chemistry, Dr. Rajendra Gode Institute of Pharmacy, Amravati, India
| | - Magdi E A Zaki
- Department of Chemistry, Faculty of Science, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Aamal A Al Mutairi
- Department of Chemistry, Faculty of Science, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
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Kułak-Bejda A, Shpakou A, Khvoryk N, Hutsikava L, Aydin Avci I, Eren DC, Kourkouta L, Tsaloglidou A, Koukourikos K, Waszkiewicz N. Impact of pregnancy/childbirth on dispositional optimism in the context of risk of depression, mental health status and satisfaction with life. Front Psychiatry 2024; 14:1271033. [PMID: 38260803 PMCID: PMC10801721 DOI: 10.3389/fpsyt.2023.1271033] [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: 08/01/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Life optimism is an inseparable element accompanying every human being. It takes different values depending on the life situation. The present study aimed to measure the level of dispositional optimism in postpartum and pregnant women, compared to women who are not pregnant and have never given birth in Poland, Greece, Turkey, Belarus, and Russia, depending on the level of life satisfaction, risk of depression and mental health. Materials and methods A case-control study was carried out among 2017 women, including 584 pregnant women, 528 postpartum women, and 906 women who had never been pregnant and had never given birth (control group) from Poland, Greece, Turkey, Belarus, and Russia.The study used the LOT-R Life Orientation Test, the Beck Depression Scale (BDI), the Satisfaction With Life Scale (SWLS), the GHQ- 28, and the Edinburgh Postnatal Depression Scale (EPDS) - only in the postpartum group. Results Women from the control group showed an average level of optimism, obtaining an average of 16 points in Belarus, 13.4 points in Poland, 13.3 points in Greece, 13.5 points in Turkey, and Russia - 16.3 points. Pregnant women from Belarus had a high level of optimism (17 points), and in other countries, an average level of optimism was in Poland - 14.5 points, Greece - 14.0 points, Turkey - 14.3 points, and Russia - 16.5 points. Women after childbirth had a high level of optimism in Belarus (17.4 points) and Russia (17.2 points), and in other countries had the average level of optimism. In these countries, the lowest level of optimism was found in non-pregnant women. No significant correlation between age and life optimism was found in any group. In Poland, life optimism increased with age in women who had never been pregnant, and in Turkey, in women who were pregnant and after childbirth. Conclusion Pregnant women from Belarus had a higher level of optimism than other countries. Non-pregnant women had an average level of optimism. Future studies should include larger groups of women and consider other factors that may additionally contribute to dispositional optimism.
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Affiliation(s)
| | - Andrei Shpakou
- Department of Integrated Medical Care, Medical University of Białystok, Białystok, Poland
| | - Natallia Khvoryk
- Department of Obstetrics and Gynecology, Grodno State Medical University, Grodno, Belarus
| | - Liudmila Hutsikava
- Department of Obstetrics and Gynecology, Grodno State Medical University, Grodno, Belarus
| | - Ilknur Aydin Avci
- Department of Nursing, Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Türkiye
| | - Dilek Celik Eren
- Department of Nursing, Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Türkiye
| | - Lambrini Kourkouta
- Department of Nursing, International Hellenic University, Thessaloniki, Greece
| | - Areti Tsaloglidou
- Department of Nursing, International Hellenic University, Thessaloniki, Greece
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Kim J, Linos E, Rodriguez CI, Chen ML, Dove MS, Keegan TH. Prevalence and associations of poor mental health in the third year of COVID-19: U.S. population-based analysis from 2020 to 2022. Psychiatry Res 2023; 330:115622. [PMID: 38006717 DOI: 10.1016/j.psychres.2023.115622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/27/2023] [Accepted: 11/19/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND Poorer mental health was found early in the COVID-19 pandemic, yet mental health in the third year of COVID-19 has not been assessed on a general adult population level in the United States. METHODS We used a nationally representative cross-sectional survey (Health Information National Trends Survey, HINTS 5 2020 n = 3,865 and HINTS 6 2022 n = 6,252). The prevalence of poor mental health was examined using a Patient Health Questionnaire-4 scale in 2020 and 2022. We also investigated the factors associated with poor mental health in 2022 using a weighted multivariable logistic regression adjusting for sociodemographic and health status characteristics to obtain the odds ratio (OR). OUTCOMES The prevalence of poor mental health in adults increased from 2020 to 2022 (31.5% vs 36.3 %, p = 0.0005). U.S. adults in 2022 were 1.28 times as likely to have poor mental health than early in the pandemic. Moreover, individuals with food insecurity, housing instability, and low income had greater odds of poor mental health (ORs=1.78-2.55). Adults who were females, non-Hispanic Whites, or age 18-64 years were more likely to have poor mental health (ORs=1.46-4.15). INTERPRETATION Mental health of U.S. adults worsened in the third year of COVID-19 compared to the beginning of the pandemic.
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Affiliation(s)
- Jiyeong Kim
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA, USA; Stanford Center for Digital Health, Department of Medicine, Stanford University, Stanford, CA, USA; Program for Clinical Research & Technology, School of Medicine, Stanford University, Stanford, CA, USA.
| | - Eleni Linos
- Stanford Center for Digital Health, Department of Medicine, Stanford University, Stanford, CA, USA; Program for Clinical Research & Technology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Carolyn I Rodriguez
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Michael L Chen
- Stanford Center for Digital Health, Department of Medicine, Stanford University, Stanford, CA, USA; Program for Clinical Research & Technology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Melanie S Dove
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA, USA
| | - Theresa H Keegan
- Division of Hematology and Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA
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Semeraro C, Giofrè D, Coppola G, Verri V, Bottalico M, Cassibba R, Taurino A. The role of maladaptive personality traits on psychological stress the mediating effects of COVID-19-related worries and emotional dysregulation. PERSONALITY AND INDIVIDUAL DIFFERENCES 2023; 213:112270. [PMID: 37333976 PMCID: PMC10229649 DOI: 10.1016/j.paid.2023.112270] [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: 10/14/2022] [Revised: 05/21/2023] [Accepted: 05/25/2023] [Indexed: 06/20/2023]
Abstract
There is increasing evidence that dysfunctional personality traits, related to psychological maladjustment and psychopathology, can play an important role in a person's ability to cope with major stressful events. Relatively little is known about the specific effect of the emotional component on the relationship between maladaptive personality traits and psychological stress. Therefore, the aim of the present study was to investigate the relationship between the maladaptive personality traits of psychoticism, detachment, and negative affect, and psychological stress, considering the effects of COVID-19-related worries and emotional dysregulation. An online survey was administered to 1172 adult participants. A series of path analysis models showed that maladaptive personality traits (psychoticism, detachment, and negative affect) are related to psychological stress. COVID-19-related worries and emotional dysregulation partially explained this association. The results suggest that in the early months of 2022, during the reduction of government restrictions, although the world population was no longer in nationwide lockdown, the COVID-19-related emotional component could still explain, at least in part, the association between maladaptive personality traits and psychological stress.
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Affiliation(s)
- Cristina Semeraro
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
| | - David Giofrè
- Department of Educational Sciences, University of Genova, Italy
| | - Gabrielle Coppola
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
| | - Veronica Verri
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
| | - Morena Bottalico
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
| | - Rosalinda Cassibba
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
| | - Alessandro Taurino
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
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Han J, Allison S, Looi JCL, Chan SKW, Bastiampillai T. A systematic review of the role of clozapine for severe borderline personality disorder. Psychopharmacology (Berl) 2023; 240:2015-2031. [PMID: 37572113 PMCID: PMC10506937 DOI: 10.1007/s00213-023-06431-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 07/21/2023] [Indexed: 08/14/2023]
Abstract
RATIONALE Clozapine is a unique medication with a potential role in the treatment of severe borderline personality disorder (BPD). OBJECTIVES The review examines the effectiveness of clozapine as a medication for management for severe BPD with high risk of suicide, violence or imprisonment, and aims to help guide clinical practice in managing severe BPD. METHODS A database search of the terms "Clozapine" AND "BPD"; "Antipsychotics" AND "BPD"; "Clozapine" AND "Borderline Personality Disorder"; and "Antipsychotics" AND "Borderline Personality Disorder" were performed in CINAHL, Cochrane Library, Embase, Medline, PsychINFO, PubMed, and Web of Science. Full-text articles of clinical clozapine use for BPD were included for review. RESULTS A total of 24 articles consisting of 1 randomised control trial, 10 non-controlled trials, and 13 case reports were identified. Most of the studies reported benefits from clozapine when used for severe BPD. Many of the studies focused on clozapine use in BPD patients at high risk of suicide. Results from these non-controlled and case reports support the use of clozapine in patients with severe BPD at high risk of suicide. CONCLUSION There may be a role for clozapine in treating severe treatment refractory BPD, especially for those patients at high risk of suicide and frequent hospitalisations.
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Affiliation(s)
- Joshua Han
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
| | - Stephen Allison
- Discipline of Psychiatry, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Consortrium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), ACT, Canberra, Australia
| | - Jeffrey C L Looi
- Consortrium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), ACT, Canberra, Australia
- Academic Unit of Psychiatry and Addiction Medicine, The Australian National University School of Medicine and Psychology, Canberra Hospital, Canberra, ACT, Australia
| | - Sherry Kit Wa Chan
- Department of Psychiatry, the School of Clinical Medicine, The University of Hong Kong, Hong Kong, Hong Kong
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Hong Kong
| | - Tarun Bastiampillai
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Discipline of Psychiatry, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Department of Psychiatry, Monash University, Wellington Road, Clayton, Victoria, Australia
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10
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Kim J, Linos E, Dove MS, Hoch JS, Keegan TH. Impact of COVID-19, cancer survivorship and patient-provider communication on mental health in the US Difference-In-Difference. NPJ MENTAL HEALTH RESEARCH 2023; 2:14. [PMID: 38609572 PMCID: PMC10955924 DOI: 10.1038/s44184-023-00034-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 08/15/2023] [Indexed: 04/14/2024]
Abstract
Poor mental health has been found to be more prevalent among those with cancer and is considered a public health crisis since COVID-19. This study assessed the impact of COVID-19 and cancer survivorship on mental health and investigated factors, including online patient-provider communications (OPPC; email/internet/tablet/smartphone), associated with poor mental health prior to and during the early COVID-19. Nationally representative Health Information National Trends Survey data during 2017-2020 (n = 15,871) was used. While the prevalence of poor mental health was high (40-42%), Difference-In-Difference analyses revealed that cancer survivorship and COVID-19 were not associated with poor mental health. However, individuals that used OPPC had 40% higher odds of poor mental health. Low socioeconomic status (low education/income), younger age (18-64 years), and female birth gender were also associated with poor mental health. Findings highlight the persistence of long-standing mental health inequities and identify that OPPC users might be those who need mental health support.
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Affiliation(s)
- Jiyeong Kim
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA.
- Stanford Center for Digital Health, School of Medicine, Stanford, CA, USA.
| | - Eleni Linos
- Stanford Center for Digital Health, School of Medicine, Stanford, CA, USA
- Program for Clinical Research & Technology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Melanie S Dove
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA
| | - Jeffrey S Hoch
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA
| | - Theresa H Keegan
- Division of Hematology and Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA
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11
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Premo EM, Magnuson KA, Lorenzo NE, Fox NA, Noble KG. Mental health and sleep quality of low-income mothers of one-year-olds during the COVID-19 pandemic. Infant Ment Health J 2023; 44:572-586. [PMID: 37439103 PMCID: PMC10403317 DOI: 10.1002/imhj.22074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 03/23/2023] [Accepted: 03/28/2023] [Indexed: 07/14/2023]
Abstract
The COVID-19 pandemic and subsequent social restrictions created an unprecedented context for families raising young children. Although studies have documented detrimental effects of the pandemic on maternal well-being, less is known about how the pandemic specifically impacted low-income mothers. We examined depression, anxiety, and sleep quality among low-income mothers of one-year-olds during the early months of the pandemic using data from the Baby's First Years study. Focusing on the control group (n = 547), we compared mothers interviewed before March 14th, 2020 (n = 342) to mothers interviewed between March 14th and June 30th, 2020 (n = 205) to determine whether the pandemic was associated with differences in mental health and sleep quality. Mothers were recruited from four cities in the United States, and most of the sample identified as Hispanic (42.2%) or Black, non-Hispanic (38.6%). We found that mothers interviewed during the pandemic reported better mental health and sleep quality. While we cannot speak to longer-term impacts of the pandemic, it is possible low-income mothers experienced relief from daily stressors during the initial shelter-in-place orders, which may have led to improvements in well-being. These results have implications for understanding how complex life stressors influence mental health and sleep quality among low-income mothers raising young children.
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Affiliation(s)
- Elizabeth M. Premo
- Sandra Rosenbaum School of Social Work, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Katherine A. Magnuson
- Sandra Rosenbaum School of Social Work, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Nicole E. Lorenzo
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland, USA
| | - Nathan A. Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland, USA
| | - Kimberly G. Noble
- Department of Biobehavioral Sciences and Human Development, Teachers College, Columbia University, New York City, New York, USA
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12
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Glaze K, Sward A, Lenne E, Brown S, Rogers L, Frankel KA, Klawetter S. Impact of COVID-19 on Referral Patterns and Service Delivery for an Integrated Behavioral Health Program. FAMILIES IN SOCIETY : THE JOURNAL OF CONTEMPORARY HUMAN SERVICES 2023; 104:142-153. [PMID: 38587508 PMCID: PMC9791057 DOI: 10.1177/10443894221133500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 04/09/2024]
Abstract
The emergence and rapid spread of COVID-19 led to unprecedented changes for families and systems of care. This study sought to understand the needs of families participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) before and during the pandemic and considers the impact remote service delivery has on access to an integrated behavioral health intervention to support the psychosocial needs of children and caregivers. Needs for referral varied significantly pre- and post-pandemic onset. Analyses revealed that significantly more referrals were made regarding social determinants of health after the onset of COVID-19 (13.8%) compared with prior to the COVID-19 pandemic (4.1%, p < .05). Providers' transition to telehealth services sufficiently served WIC families.
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Affiliation(s)
- Kelly Glaze
- PsyD, assistant professor, University of Colorado School of Medicine, Aurora, CO, USA
| | - Ashley Sward
- PsyD, assistant professor, University of Colorado School of Medicine, Aurora, CO, USA
| | - Eline Lenne
- MOT, OTR/L, PhD student, Portland State University, Portland, OR, USA
| | - Samantha Brown
- PhD, assistant professor, Colorado State University, Fort Collins, CO, USA
| | - Lindsey Rogers
- PsyD, instructor, University of Colorado School of Medicine, Aurora, CO, USA
| | - Karen A Frankel
- PhD, professor, University of Colorado School of Medicine, Aurora, CO, USA
| | - Susanne Klawetter
- PhD, LCSW, assistant professor, Portland State University, Portland, OR, USA
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13
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Gao Y(A, Krans EE, Chen Q, Rothenberger SD, Zivin K, Jarlenski MP. Sex-related differences in the prevalence of substance use disorders, treatment, and overdose among parents with young children. Addict Behav Rep 2023; 17:100492. [PMID: 37214425 PMCID: PMC10195847 DOI: 10.1016/j.abrep.2023.100492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/31/2023] [Accepted: 04/22/2023] [Indexed: 05/24/2023] Open
Abstract
Introduction Risk factors and treatment rates for substance use disorders (SUDs) differ by sex. Females often have greater childcare and household responsibilities than males, which may inhibit SUD treatment. We examined how SUD, medication for opioid use disorder (MOUD) receipt, and overdose rates differ by sex among parents with young children (<5 years). Methods Using deidentified national administrative healthcare data from Optum's Clinformatics® Data Mart Database version 8.1 (2007-2021), we identified parents aged 26-64 continuously enrolled in commercial insurance for ≥ 30 days and linked to ≥ 1 dependent child < 5 years from January 1, 2016-February 29, 2020. We used generalized estimating equations to estimate the average predicted prevalence of SUD diagnosis, MOUD receipt after opioid use disorder (OUD) diagnosis, and overdose by parent sex in any month, adjusting for age, race/ethnicity, state of residence, enrollment month, and mental health conditions. Results From 2016 to 2020, there were 2,241,795 parents with a dependent child < 5 years, including 1,155,252 (51.5%) females and 1,086,543 (48.5%) males. Male parents had a higher average predicted prevalence of an SUD diagnosis (11.1% [11, 11.16]) than female parents (5.5% [5.48, 5.58]). Among parents with OUD, the average predicted prevalence of receiving MOUD was 27.4% [26.1, 28.63] among male and 19.7% [18.34, 21.04] among female parents, with no difference in overdose rates by sex. Conclusion Female parents are less likely to be diagnosed with an SUD or receive MOUD than male parents. Removing policies that criminalize parental SUD and addressing childcare-related barriers may improve SUD identification and treatment.
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Affiliation(s)
- Yitong (Alice) Gao
- Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, PA, United States
| | - Elizabeth E. Krans
- Department of Obstetrics, Gynecology & Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA, United States
| | - Qingwen Chen
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Scott D. Rothenberger
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Kara Zivin
- Department of Psychiatry, University of Michigan Medical School, Veterans Affairs Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, United States
| | - Marian P. Jarlenski
- Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, PA, United States
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14
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Call CC, Magee K, Conlon RPK, Hipwell AE, Levine MD. Disordered eating during pregnancy among individuals participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Eat Behav 2023; 49:101726. [PMID: 37079978 PMCID: PMC10247396 DOI: 10.1016/j.eatbeh.2023.101726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/26/2023] [Accepted: 04/05/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND Food insecurity is associated with adverse psychosocial and health consequences in pregnancy. In non-pregnant populations, evidence suggests that food insecurity is linked to eating pathology, independent of depression or anxiety. Food assistance programs intended to reduce food insecurity, such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), may unintentionally contribute to eating pathology through a "feast-or-famine" cycle (i.e., cyclical periods of food deprivation and food access over the benefit month). Thus, the present study examined associations between WIC participation and disordered eating in pregnancy, covarying for depressive symptoms. METHODS The present study is a secondary analysis of the Pittsburgh Girls Study (PGS), a 21-year prospective longitudinal study that over-sampled households in low resourced neighborhoods. The present analysis included a subset of pregnant PGS participants (N = 210; 13-25 years of age) who reported on WIC participation, and disordered eating and depressive symptoms on validated measures. RESULTS Negative binomial regression models covarying for participant's age at conception and gestational age at assessment found that WIC participation was associated with higher scores on overall eating pathology as well as dieting and oral control subscales, but not bulimic or food preoccupation subscales, or a binge-eating item. Patterns of findings did not change when depressive symptom severity was included in models. DISCUSSION WIC participation was associated with eating pathology during pregnancy. Future research should clarify directional relationships among food insecurity, food assistance, and eating behavior in pregnancy to promote health equity.
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Affiliation(s)
- Christine C Call
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Kelsey Magee
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Rachel P K Conlon
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alison E Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA; Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michele D Levine
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA; Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
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15
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Karbassi Yazdi A, Muneeb FM, Wanke PF, Hanne T, Ali A. How, When, & Where temporary hospitals fit in turbulent times: A hybrid MADM optimization in the middle east. COMPUTERS & INDUSTRIAL ENGINEERING 2023; 175:108761. [PMID: 36466770 PMCID: PMC9707025 DOI: 10.1016/j.cie.2022.108761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Governments have been challenged to provide temporary hospitals and other types of facilities to face the COVID-19 pandemic. This research proposes a novel multi-attribute decision-making (MADM) model to help determine how, when, and where these temporary facilities should be installed based on a set of critical success factors (CSFs) mapped in an uncertain environment. We portray the available facilities for temporary hospitals based on the CSFs that must be considered to make critical decisions regarding the optimal position based on the government's strategic decision-making process, thus indirectly providing better services and maximizing resources. In relation to earlier work, this research builds upon hybrid Pythagorean fuzzy numbers to find weights in Best-Worst Methods and rank temporary facilities based on evaluation by an area-based method for ranking. Policy implications and future directions are derived.
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Affiliation(s)
- Amir Karbassi Yazdi
- School of Engineering, Universidad Católica del Norte, Larrondo 1281, 1781421, Coquimbo, Chile
| | | | - Peter Fernandes Wanke
- Center for Logistics Studies, COPPEAD - The Graduate School of Business Administration Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Thomas Hanne
- Institute for Information Systems, University of Applied Sciences and Arts Northwestern Switzerland, Switzerland
| | - Adnan Ali
- School of Management, Xi'an Jiaotong University, Shaanxi, Xi'an, PR China
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16
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Bahramian A, Shabani A, Naserbakht M, Hadi F. Traumatic Events Exposure and Post Traumatic Stress Disorder in Caregivers of Patients with Bipolar Disorder, Bipolar Disorder and Comorbid Post Traumatic Stress Disorder and Multiple Sclerosis. Med J Islam Repub Iran 2023; 37:4. [PMID: 37123338 PMCID: PMC10134095 DOI: 10.47176/mjiri.37.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Indexed: 05/02/2023] Open
Abstract
Background Chronic diseases affect the lives of the patient and caregiver. Caring for a patient with a chronic psychiatric illness, such as bipolar disorder, is a stressful and challenging activity. Caregivers of severe psychiatric patients are the primary victims of violence by patients. Caring for these patients can be very stressful for the caregiver to the extent of experiencing post-traumatic stress symptoms. This study compares the frequency of trauma exposure and PTSD in the caregivers of patients with bipolar disorder type 1(BD-1), bipolar disorder type 1, comorbid post-traumatic stress disorder (BD-1+PTSD), and multiple sclerosis (MS).The MS group served as the control group. Methods This cross-sectional study with convenient sampling was conducted at three hospitals in Tehran, Iran, from April 2020 to January 2022. One hundred eighty caregivers answered a clinical demographic questionnaire. We then used the Trauma History Questionnaire (THQ) to assess the frequency of exposure to different types of trauma. Then, the Persian version of the SCID-5, a valid and reliable instrument for psychiatric diagnoses, was used to diagnose PTSD. Chi-square was used for analyzing data. Results Exposure to trauma has a significant difference between the groups. BD-1 + PTSD patients' caregivers were exposed to more physical assaults than others (P < 0.0001) There was a significant difference between sexual harassment in the MS group (P = 0.010). There was a significant difference between the three groups in the development of PTSD (P = 0.003). PTSD prevalence in the BD-1 + PTSD caregiver group is more than in other groups. In the caregivers of BD-1+PTSD, the caregiving experience caused traumatic exposure and the development of PTSD in all caregivers. Conclusion This study shows that the prevalence of exposure to traumatic events and PTSD is higher in the caregivers of BD-1 patients, especially if the patient has comorbid PTSD. Detecting these symptoms early and using intervention can make the caregiving burden more tolerable.
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Affiliation(s)
- Alaleh Bahramian
- Mental Health Research Center, Department of Psychiatry, School of Medicine, Iran University of Medical Science, Tehran, Iran
- Corresponding author:Alaleh Bahramian,
| | - Amir Shabani
- Mental Health Research Center, Department of Psychiatry, School of Medicine, Iran University of Medical Science, Tehran, Iran
| | - Morteza Naserbakht
- Mental Health Research Center, Department of Psychiatry, School of Medicine, Iran University of Medical Science, Tehran, Iran
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17
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Ashley-Norman T, Fellmeth G, Brummaier T, Nosten S, Oo MM, Phichitpadungtham Y, Wai K, Khirikoekkong N, Plugge E, McGready R. Persistent depression in pregnant refugee and migrant women living along the Thai-Myanmar Border: a secondary qualitative analysis. Wellcome Open Res 2022. [DOI: 10.12688/wellcomeopenres.17744.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Antepartum depression affects around 15% of pregnant women worldwide, and may negatively impact their infants' physical, cognitive and social development, and confer a greater risk of emotional dysregulation in their children. Risk factors for antepartum depression disproportionately affect women from resource-sparse settings. In particular, pregnant refugee and migrant women face many barriers to diagnosis and care of mental health conditions, yet this group is under-represented in the literature. This study explores what refugee and migrant women living along the Thai-Myanmar border perceive as being contributory and protective factors to their antepartum depression, through secondary qualitative analysis of responses to clinical interviews for depression. Methods Previous research investigating perinatal depression in pregnant refugee and migrant women on the Thai-Myanmar border involved assessing 568 women for depression, using the Structured Clinical Interview for the diagnosis of DSM-IV Disorders (SCID). This study analyses a subsample of 32 women, diagnosed with persistent depression during the antepartum period. Thematic analysis of responses to the SCID and social and demographic surveys was undertaken to investigate factors which contribute towards, or protect against, persistent antepartum depression. Results Major themes which women described as contributing towards persistent antepartum depression were financial problems, interpersonal violence, substance misuse among partners, social problems and poor health. Factors women considered as protecting mental wellbeing included social support, accessible healthcare and distractions, highlighting the need for focus on these elements within refugee and migrant settings. Commonly expressed phrases in local Karen and Burmese languages were summarised. Conclusions Knowledge of factors affecting mental wellbeing in the study population and how these are phrased, may equip stakeholders to better support women in the study area. This study highlighted the limitations of contextually generic diagnostic tools, and recommends the development of tools better suited to marginalised and non-English speaking groups.
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18
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Bhola S, Trisal J, Thakur V, Kaur P, Kulshrestha S, Bhatia SK, Kumar P. Neurological toll of COVID-19. Neurol Sci 2022; 43:2171-2186. [PMID: 35034236 PMCID: PMC8761097 DOI: 10.1007/s10072-022-05875-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/04/2022] [Indexed: 02/08/2023]
Abstract
The first case of coronavirus illness was discovered in Wuhan, China, in January 2020 and quickly spread worldwide within the next couple of months. The condition was initially only linked with respiratory disorders. After the evolution of various variants of the SARS-CoV-2, the critical impact of the virus spread to multiple organs and soon, neurological disorder manifestations started to appear in the infected patients. The review is focused on the manifestation of various neurological disorders linked with both the central nervous system and peripheral nervous system. Disorders such as cytokine release syndrome, encephalitis, acute stroke, and Bell's palsy are given specific attention and psychological manifestations are also investigated. For a clear conclusion, cognitive impairment, drug addiction disorders, mood and anxiety disorders, and post-traumatic stress disorder are all fully examined. The association of the SARS-CoV-2 with neurological disorders and pathway is yet to be clear. For better understanding, the explanation of the possible mechanism of viral infection influencing the nervous system is also attempted in the review. While several vaccines and drugs are already involved in treating the SARS-CoV-2 condition, the disease is still considered fatal and more likely to leave permanent neurological damage, which leads to an essential requirement for more research to explore the neurological toll of the COVID-19 disease.
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Affiliation(s)
- Shivam Bhola
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Solan, Himachal Pradesh, India
| | - Jhillika Trisal
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Solan, Himachal Pradesh, India
| | - Vikram Thakur
- Department of Virology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, Pin-160012, India
| | - Parneet Kaur
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Solan, Himachal Pradesh, India
| | - Saurabh Kulshrestha
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Solan, Himachal Pradesh, India
| | - Shashi Kant Bhatia
- Department of Biological Engineering, Konkuk University, Seoul, 05029, Republic of Korea
| | - Pradeep Kumar
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Solan, Himachal Pradesh, India.
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19
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Advancing research on perinatal depression trajectories: Evidence from a longitudinal study of low-income women. J Affect Disord 2022; 301:44-51. [PMID: 34995707 DOI: 10.1016/j.jad.2022.01.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/02/2021] [Accepted: 01/02/2022] [Indexed: 01/13/2023]
Abstract
OBJECTIVES The current study aimed to describe and predict perinatal depression trajectories in a sample of low-income women from the first trimester of pregnancy to six months postpartum. METHODS The study sample consisted of 899 women in Wisconsin who received home visiting services. Eligible participants were screened for depressive symptoms by home visitors using the Edinburgh Postnatal Depression Scale at least three times across four time periods from the first trimester of pregnancy to six months postpartum. Growth Mixture Modeling was applied to identify distinct trajectory classes, and multinomial logistic regressions were performed to analyze predictors of class membership. RESULTS Mean depressive symptom scores in this racially/ethnically diverse sample of low-income women decreased significantly over time from a high of 8.1 at time1 to a low of 6.8 at time4. Four classes were identified, including a low-stable group (78.2% of sample), a high-stable group (10.6%) along with decreasing (7.1%) and increasing (4.1%) trajectories. Women with a history of abuse and mental health difficulties were more likely to be classified in the high-stable and decreasing depression groups than the low-stable group. Low social support was linked to an increasing trajectory that resulted in high levels of postpartum depression. CONCLUSIONS AND IMPLICATIONS Although most women exhibited stable and positive trajectories, more than one out of five presented with either persistently or intermittently high depression scores. Taken together, the findings underscore the importance of depression screening throughout the perinatal period and identifying factors that may be used to target resources to at-risk populations.
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Ruyak SL, Kivlighan KT. Perinatal Behavioral Health, the COVID-19 Pandemic, and a Social Determinants of Health Framework. J Obstet Gynecol Neonatal Nurs 2021; 50:525-538. [PMID: 34146480 PMCID: PMC8256336 DOI: 10.1016/j.jogn.2021.04.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2021] [Indexed: 12/01/2022] Open
Abstract
The United States has greater prevalence of mental illness and substance use disorders than other developed countries, and pregnant women are disproportionately affected. The current global COVID-19 pandemic, through the exacerbation of psychological distress, unevenly affects the vulnerable population of pregnant women. Social distancing measures and widespread closures of businesses secondary to COVID-19 are likely to continue for the foreseeable future and to further magnify psychosocial risk factors. We propose the use of a social determinants of health framework to integrate behavioral health considerations into prenatal care and to guide the implementation of universal and comprehensive psychosocial assessment in pregnancy. As the most numerous and well-trusted health care professionals, nurses are ideally positioned to influence program and policy decisions at the community and regional levels and to advocate for the full integration of psychosocial screening and behavioral health into prenatal and postpartum care as core components.
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21
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Klawetter S, Glaze K, Sward A, Frankel KA. Warm Connections: Integration of Infant Mental Health Services into WIC. Community Ment Health J 2021; 57:1130-1141. [PMID: 33159630 PMCID: PMC10027377 DOI: 10.1007/s10597-020-00744-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 11/03/2020] [Indexed: 10/23/2022]
Abstract
Low-income women experience disproportionately high rates of adverse maternal mental health outcomes, such as pregnancy-related depression, and have less access to behavioral health support. Adverse maternal mental health affects children through compromising bonding, impeding early childhood development, and increasing risks of child maltreatment. Integrated behavioral health approaches can improve access to behavioral health services by locating services in community-based settings routinely accessed by low-income families. Warm Connections is an innovative integrated behavioral health program delivered in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and rooted in an infant and early childhood mental health (IECMH) framework. This exploratory study describes Warm Connections and provides evaluation results from its pilot implementation. Findings suggest Warm Connections may reduce distress and increase parenting efficacy among low-income mothers and support further research of this program's feasibility.
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Affiliation(s)
- Susanne Klawetter
- School of Social Work, Portland State University, PO Box 751-SSW, Portland, OR, 97207, USA.
| | - Kelly Glaze
- Department of Psychiatry, Anschutz Medical Campus, University of Colorado School of Medicine, 13001 E. 17th Place, Box F546, Aurora, CO, 80045, USA
| | - Ashley Sward
- Department of Psychiatry, Anschutz Medical Campus, University of Colorado School of Medicine, 13001 E. 17th Place, Box F546, Aurora, CO, 80045, USA
| | - Karen A Frankel
- Departments of Psychiatry and Pediatrics, Anschutz Medical Campus, University of Colorado School of Medicine, 13001 E. 17th Place, Box F546, Aurora, CO, 80045, USA
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22
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Anderson CA, Ruiz J. Depressive Symptoms Among Hispanic Adolescents and Effect on Neonatal Outcomes. HISPANIC HEALTH CARE INTERNATIONAL 2021; 20:25-32. [PMID: 33813920 DOI: 10.1177/15404153211003223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Hispanics have the highest birth rate among adolescents and may be vulnerable to experience depression. The purpose of this study was to explore the prevalence of perinatal depression and effects upon neonatal outcomes among Hispanic adolescents 13-19 years old. METHODS Available data from a previously conducted study examining the prevalence of adolescent depression and post-traumatic stress were used for the current secondary analysis. Perinatal data reflected a rating of prenatal depression and scores from the Edinburgh Postpartum Depression Scale (EPDS). Adverse infant outcomes included preterm birth, low birth weight, and neonatal complications. RESULTS Over 20% of adolescents reported an adverse infant outcome. About one third of adolescents reported perinatal depression: prenatally (14%) and postnatally (14% minor depression/12.7% major depression). Significant associations were found between EPDS scores, gestational age, and feelings during pregnancy; however, perinatal depression was not found to predict adverse infant outcomes. CONCLUSION Prenatally depressed adolescents are vulnerable to postpartum depression and if experience an adverse infant outcome, postpartum depression may be more likely reported. Therefore, prenatal- and afterbirth-focused assessments and care, including plans for follow-up, are essential.
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Affiliation(s)
- Cheryl Ann Anderson
- College of Nursing and Health Innovation, 12329The University of Texas at Arlington, TX, USA
| | - Jocelyn Ruiz
- The 12329TUniversity of Texas at Arlington, TX, USA
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23
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Ramratnam SK, Lockhart A, Visness CM, Calatroni A, Jackson DJ, Gergen PJ, Bacharier LB, O'Connor GT, Sandel MT, Kattan M, Wood RA, Gern JE. Maternal stress and depression are associated with respiratory phenotypes in urban children. J Allergy Clin Immunol 2021; 148:120-127. [PMID: 33713764 DOI: 10.1016/j.jaci.2021.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 02/03/2021] [Accepted: 03/03/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Prenatal and early-life exposure to maternal stress and depression is linked to development of recurrent wheezing in young children. OBJECTIVE We sought to determine whether maternal stress and depression in early life are associated with nonatopic wheezing phenotype in urban children. METHODS The Urban Environment and Childhood Asthma Study examined a birth cohort of children at high risk for asthma in low-income neighborhoods. Prenatal and postnatal (through age 3 years) maternal stress and depression scores were compared with respiratory phenotypes through age 10 years (multinomial regression), self-reported colds (linear regression), and detection of respiratory viruses (Poisson regression). RESULTS Scores for maternal depression, and, to a lesser extent, maternal perceived stress, were positively related to multiple wheezing phenotypes. In particular, cumulative measures of maternal depression in the first 3 years were related to the moderate-wheeze-low-atopy phenotype (odds ratio, 1.13; [1.05, 1.21]; P < .01). Considering indicators of respiratory health that were used to identify the phenotypes, there were multiple positive associations between early-life scores for maternal stress and depression and increased wheezing illnesses, but no consistent relationships with lung function and some inverse relationships with allergic sensitization. Cumulative maternal stress and depression scores were associated with cumulative number of respiratory illnesses through age 3 years. CONCLUSIONS Among high-risk, urban children, maternal stress and depression in early life were positively associated with respiratory illnesses and a moderate-wheeze-low-atopy phenotype. These results suggest that treating stress and depression in expectant and new mothers could reduce viral respiratory illnesses and recurrent wheeze during the preschool years and some forms of childhood asthma.
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Affiliation(s)
- Sima K Ramratnam
- Department of Pediatrics, University of Wisconsin - Madison, Madison, Wis.
| | | | | | | | - Daniel J Jackson
- Department of Pediatrics, University of Wisconsin - Madison, Madison, Wis
| | - Peter J Gergen
- National Institute of Allergy and Infectious Diseases, Rockville, Md
| | - Leonard B Bacharier
- Department of Pediatrics, Washington University School of Medicine and St Louis Children's Hospital, St Louis, Mo
| | - George T O'Connor
- Department of Medicine, Boston University School of Medicine, Boston, Mass
| | - Megan T Sandel
- Department of Medicine, Boston University School of Medicine, Boston, Mass
| | - Meyer Kattan
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY
| | - Robert A Wood
- Department of Pediatrics, Johns Hopkins University Medical Center, Baltimore, Md
| | - James E Gern
- Department of Pediatrics, University of Wisconsin - Madison, Madison, Wis
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24
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Endomba FT, Ndoadoumgue AL, Mbanga CM, Nkeck JR, Ayissi G, Danwang C, Bigna JJ. Perinatal depressive disorder prevalence in Africa: A systematic review and Bayesian analysis. Gen Hosp Psychiatry 2021; 69:55-60. [PMID: 33550036 DOI: 10.1016/j.genhosppsych.2021.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To curb the burden of perinatal depression (PND) in Africa, it is important to have an accurate estimate of its burden in the continent. Hence, we determined the prevalence of (major) depressive disorder in the perinatal period in Africa. METHODS We searched PubMed, EMBASE, Africa Index Medicus, and Africa Journal Online, to identify studies reporting the prevalence of (major) depressive disorder in the perinatal period in Africa, between January 1st 2000 and February 17th 2020. PND prevalence was estimated using Bayesian modelling. RESULTS We identified 154 studies (192 data points; 113,147 women). In pregnant women, the prevalence of depressive disorder was 22.8% (95%Credible interval [CrI]: 21.5-24.1) among women with no specific condition and 31.9% (95%CrI: 30.2-33.6) among those with HIV. In post-partum, the prevalence was 21.2% (95%CrI: 20.0-22.5), 30.0% (95%CrI: 28.2-31.8), and 44.6% (95%CrI: 35.9-53.8) among women with no specific condition, with HIV, and with poor pregnancy outcomes, respectively. CONCLUSIONS This study depicted a high prevalence of PND in Africa. This prevalence varied across pre-defined clinical profiles. HIV-infected women or those with poor pregnancy outcomes having a higher prevalence of depression. This highlights the need for more attention and preventive interventions geared towards these sub-groups.
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Affiliation(s)
- Francky Teddy Endomba
- Health Economics & Policy Research and Evaluation for Development Results Group, Yaoundé, Cameroon; Psychiatry Internship Program, University of Bourgogne, 21000 Dijon, France
| | | | - Clarence M Mbanga
- Health Economics & Policy Research and Evaluation for Development Results Group, Yaoundé, Cameroon; School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Jan René Nkeck
- Health Economics & Policy Research and Evaluation for Development Results Group, Yaoundé, Cameroon; Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Gregory Ayissi
- Health Economics & Policy Research and Evaluation for Development Results Group, Yaoundé, Cameroon; Department of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Celestin Danwang
- Health Economics & Policy Research and Evaluation for Development Results Group, Yaoundé, Cameroon; Epidemiology and Biostatistics Unit, Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Brussels, Belgium
| | - Jean Joel Bigna
- Department of Epidemiology and Public Health, Centre Pasteur of Cameroon, Yaoundé, Cameroon.
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25
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Dagher RK, Bruckheim HE, Colpe LJ, Edwards E, White DB. Perinatal Depression: Challenges and Opportunities. J Womens Health (Larchmt) 2021; 30:154-159. [PMID: 33156730 PMCID: PMC7891219 DOI: 10.1089/jwh.2020.8862] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Perinatal depression (PND) is a major depressive episode during pregnancy or within 4 weeks after childbirth up to a year. Risk factors for PND include stressful life events, history of depression, poor social support, unplanned and unwanted pregnancies, poor relationship quality, current or previous abuse, and low socioeconomic status. This mental disorder has been shown to have negative effects on mothers' quality of life and their intimate relationships, birth outcomes, and breastfeeding likelihood, as well as long-term effects on children's cognitive and emotional development. To date, no nationally representative study has examined whether there are socioeconomic and/or racial/ethnic differences in PND. This study discusses the prevalence and risk factors for PND, as well as its health consequences for mothers and children, the reasons for its underreporting and undertreatment, the evidence for different screening instruments and different treatment options, and the existing supportive policies to address this disorder in the United States. We conclude with outlining next steps in addressing the gaps in the literature on PND.
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Affiliation(s)
- Rada K. Dagher
- Division of Scientific Programs, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Lisa J. Colpe
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Emmeline Edwards
- Division of Extramural Research, National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Della B. White
- Division of Extramural Research, National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland, USA
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