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Ture P, Dambhare DG, Mundra A, Raut AV, Maliye CH, Deshmukh PR, Gupta SS, Bharambe MS, Garg BS. Magnitude and determinants of psychological morbidities among pregnant women: Results from a pregnancy cohort in rural Central India. Med J Armed Forces India 2024; 80:210-216. [PMID: 38525463 PMCID: PMC10954507 DOI: 10.1016/j.mjafi.2022.05.008] [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: 02/23/2022] [Accepted: 05/12/2022] [Indexed: 11/22/2022] Open
Abstract
Background Psychological morbidities are one of the emerging global health problems. It affects a considerable number of ante-natal women leading to consequences during the postnatal period as well. We conducted this research to study the magnitude and determinants of psychological morbidities during pregnancy. Methods In this study, we included 650 pregnant women from an established cohort of 2500 pregnant women and assessed the psychological morbidities among them using the GMHAT/PC tool. Results The overall prevalence of psychological morbidities during pregnancy was 14.6%, with anxiety and depression being the leading ones. Low education levels, lower socio-economic status, unintended pregnancy, complicated previous pregnancy, lack of family and social support, and domestic violence increased the odds of psychological morbidity. On Multivariate logistic regression, Low education levels increased the odds to more than twice [illiterate/primary schooling OR: 4.00, p = 0.026; secondary schooling OR: 2.64, p = 0.034; high school OR: 2.60, p = 0.033] unintended pregnancy [OR: 1.91, p = 0.043] and lack of family support [OR: 7.19, p < 0.001] increased the odds of psychological morbidity among pregnant women. Conclusion Bringing these issues to the mainstream and addressing them by developing interventions to address them during the lifecycle of a female will help to prevent episodes of psychological stress and morbidity among pregnant females.
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Affiliation(s)
- Priyadarsh Ture
- Program Coordinator, VBOSM, Society for Community Health Awareness Research & Action (SOCHARA), Bengaluru, India
| | - Dharampal G. Dambhare
- Professor (Community Medicine), Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, India
| | - Anuj Mundra
- Assistant Professor (Community Medicine), Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, India
| | - Abhishek V. Raut
- Professor (Community Medicine), Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, India
| | - Chetna H. Maliye
- Professor (Community Medicine), Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, India
| | - Pradeep R. Deshmukh
- Professor & Head (Community Medicine), All India Institute of Medical Sciences, Nagpur, India
| | - Subodh S. Gupta
- Professor & Head (Community Medicine), Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, India
| | - Madhukar S. Bharambe
- Associate Professor (Community Medicine), Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, India
| | - Bishan S. Garg
- Director-Professor (Community Medicine), Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, India
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Faulks F, Edvardsson K, Mogren I, Gray R, Copnell B, Shafiei T. Common mental disorders and perinatal outcomes in Victoria, Australia: A population-based retrospective cohort study. Women Birth 2024; 37:428-435. [PMID: 38216393 DOI: 10.1016/j.wombi.2024.01.001] [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: 11/05/2023] [Revised: 12/15/2023] [Accepted: 01/02/2024] [Indexed: 01/14/2024]
Abstract
PURPOSE Common mental disorders (non-psychotic mental health conditions which impact on day-to-day functioning) are increasingly common in childbearing women and may impact significantly on both maternal and neonatal outcomes. Our study examines the associations between common mental disorders and perinatal outcomes. METHODS We used routinely collected perinatal data (2009-2016) for this population-based retrospective cohort study (n = 597,522 singleton births). We undertook multiple logistic regression adjusting for key maternal medical conditions and sociodemographic factors to determine associations between maternal common mental disorders and adverse perinatal outcomes with confidence intervals set at 95%. RESULTS Women with common mental disorders were more likely to have an induction of labour and caesarean birth, have a postpartum haemorrhage (PPH), and be admitted to the Intensive Care Unit (ICU) than women without common mental disorders. Neonates of women with common mental disorders were more likely to have an Apgar score at five minutes of less than seven (a measure of neonatal wellbeing at birth), be born preterm and low birthweight, be admitted to the Special Care Nursery or Neonatal Intensive Care Unit (SCN/NICU) and have a congenital anomaly than neonates of women without common mental disorders. CONCLUSION Common mental disorders during the perinatal period were associated with poorer perinatal outcomes for mothers and their neonates. Strategies that enable early recognition and response to maternal common mental disorders should be developed to mitigate the consequential impact on maternal and infant wellbeing.
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Affiliation(s)
- Fiona Faulks
- Judith Lumley Centre, School of Nursing & Midwifery, La Trobe University, Bundoora, Victoria, Australia.
| | - Kristina Edvardsson
- Judith Lumley Centre, School of Nursing & Midwifery, La Trobe University, Bundoora, Victoria, Australia
| | - Ingrid Mogren
- Obstetrics and Gynaecology, Senior consultant in Obstetrics and Gynaecology, Department of Clinical Sciences, Obstetrics and Gynaecology, Umeå University, SE-901 87 Umeå, Sweden
| | - Richard Gray
- Nursing, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia
| | - Beverley Copnell
- Nursing, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia
| | - Touran Shafiei
- Judith Lumley Centre, School of Nursing & Midwifery, La Trobe University, Bundoora, Victoria, Australia
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Abera M, Hanlon C, Daniel B, Tesfaye M, Workicho A, Girma T, Wibaek R, Andersen GS, Fewtrell M, Filteau S, Wells JCK. Effects of relaxation interventions during pregnancy on maternal mental health, and pregnancy and newborn outcomes: A systematic review and meta-analysis. PLoS One 2024; 19:e0278432. [PMID: 38271440 PMCID: PMC10810490 DOI: 10.1371/journal.pone.0278432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 12/23/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Stress during pregnancy is detrimental to maternal health, pregnancy and birth outcomes and various preventive relaxation interventions have been developed. This systematic review and meta-analysis aimed to evaluate their effectiveness in terms of maternal mental health, pregnancy and birth outcomes. METHOD The protocol for this review is published on PROSPERO with registration number CRD42020187443. A systematic search of major databases was conducted. Primary outcomes were maternal mental health problems (stress, anxiety, depression), and pregnancy (gestational age, labour duration, delivery mode) and birth outcomes (birth weight, Apgar score, preterm birth). Randomized controlled trials or quasi-experimental studies were eligible. Meta-analyses using a random-effects model was conducted for outcomes with sufficient data. For other outcomes a narrative review was undertaken. RESULT We reviewed 32 studies comprising 3,979 pregnant women aged 18 to 40 years. Relaxation interventions included yoga, music, Benson relaxation, progressive muscle relaxation (PMR), deep breathing relaxation (BR), guided imagery, mindfulness and hypnosis. Intervention duration ranged from brief experiment (~10 minutes) to 6 months of daily relaxation. Meta-analyses showed relaxation therapy reduced maternal stress (-4.1 points; 95% Confidence Interval (CI): -7.4, -0.9; 9 trials; 1113 participants), anxiety (-5.04 points; 95% CI: -8.2, -1.9; 10 trials; 1965 participants) and depressive symptoms (-2.3 points; 95% CI: -3.4, -1.3; 7 trials; 733 participants). Relaxation has also increased offspring birth weight (80 g, 95% CI: 1, 157; 8 trials; 1239 participants), explained by PMR (165g, 95% CI: 100, 231; 4 trials; 587 participants) in sub-group analysis. In five trials evaluating maternal physiological responses, relaxation therapy optimized blood pressure, heart rate and respiratory rate. Four trials showed relaxation therapy reduced duration of labour. Apgar score only improved significantly in two of six trials. One of three trials showed a significant increase in birth length, and one of three trials showed a significant increase in gestational age. Two of six trials examining delivery mode showed significantly increased spontaneous vaginal delivery and decreased instrumental delivery or cesarean section following a relaxation intervention. DISCUSSION We found consistent evidence for beneficial effects of relaxation interventions in reducing maternal stress, improving mental health, and some evidence for improved maternal physiological outcomes. In addition, we found a positive effect of relaxation interventions on birth weight and inconsistent effects on other pregnancy or birth outcomes. High quality adequately powered trials are needed to examine impacts of relaxation interventions on newborns and offspring health outcomes. CONCLUSION In addition to benefits for mothers, relaxation interventions provided during pregnancy improved birth weight and hold some promise for improving newborn outcomes; therefore, this approach strongly merits further research.
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Affiliation(s)
- Mubarek Abera
- Department of Psychiatry, Faculty of Medical Science, Jimma University, Jimma, Ethiopia
| | - Charlotte Hanlon
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Beniam Daniel
- School of Nursing, College of Medicine and Health Sciences, Arbaminch University, Arbaminch, Ethiopia
| | - Markos Tesfaye
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Abdulhalik Workicho
- Department of Epidemiology, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Tsinuel Girma
- Department of Pediatrics, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Rasmus Wibaek
- Clinical Epidemiology Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Gregers S. Andersen
- Clinical Epidemiology Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Mary Fewtrell
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Suzanne Filteau
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jonathan C. K. Wells
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
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4
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Vidyasagaran AL, McDaid D, Faisal MR, Nasir M, Muliyala KP, Thekkumkara S, Wright J, Huque R, Benkalkar S, Siddiqi N. Prevalence of mental disorders in South Asia: A systematic review of reviews. Glob Ment Health (Camb) 2023; 10:e78. [PMID: 38161740 PMCID: PMC10755414 DOI: 10.1017/gmh.2023.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/24/2023] [Accepted: 11/02/2023] [Indexed: 01/03/2024] Open
Abstract
Mental disorders are increasing in South Asia (SA), but their epidemiological burden is under-researched. We carried out a systematic umbrella review to estimate the prevalence of mental disorders and intentional self-harm in the region. Multiple databases were searched and systematic reviews reporting the prevalence of at least one mental disorder from countries in SA were included. Review data were narratively synthesised; primary studies of common mental disorders (CMDs) among adults were identified from a selected subset of reviews and pooled. We included 124 reviews. The majority (n = 65) reported on mood disorders, followed by anxiety disorders (n = 45). High prevalence of mental disorders and intentional self-harm was found in general adult and vulnerable populations. Two reviews met our pre-defined criteria for identifying primary studies of CMDs. Meta-analysis of 25 primary studies showed a pooled prevalence of 16.0% (95% CI = 11.0-22.0%, I 2 = 99.9%) for depression, 12.0% (5.0-21.0%, I 2 = 99.9%) for anxiety, and 14.0% (10.0-19.0, I 2 = 99.9%) for both among the general adult population; pooled estimates varied by country and assessment tool used. Overall, reviews suggest high prevalence for mental disorders in SA, but evidence is limited on conditions other than CMDs.
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Affiliation(s)
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | | | - Muhammad Nasir
- Department of Economics, Institute of Business Administration (IBA), Karachi, Pakistan
| | - Krishna P. Muliyala
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bengaluru, India
| | | | - Judy Wright
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | | | - Najma Siddiqi
- Department of Health Sciences, University of York, Heslington, UK
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5
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Al-abri K, Edge D, Armitage CJ. Prevalence and correlates of perinatal depression. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1581-1590. [PMID: 36646936 PMCID: PMC9842219 DOI: 10.1007/s00127-022-02386-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 11/14/2022] [Indexed: 01/17/2023]
Abstract
PURPOSE This systematic review of systematic reviews aims to provide the first global picture of the prevalence and correlates of perinatal depression, and to explore the commonalities and discrepancies of the literature. METHODS Seven databases were searched from inception until April 2022. Full-text screening and data extraction were performed independently by two researchers and the AMSTAR tool was used to assess the methodological quality. RESULTS 128 systematic reviews were included in the analysis. Mean overall prevalence of perinatal depression, antenatal depression and postnatal depression was 26.3%, 28.5% and 27.6%, respectively. Mean prevalence was significantly higher (27.4%; SD = 12.6) in studies using self-reported measures compared with structured interviews (17.0%, SD = 4.5; d = 1.0) and among potentially vulnerable populations (32.5%; SD = 16.7, e.g. HIV-infected African women) compared to the general population (24.5%; SD = 8.1; d = 0.6). Personal history of mental illness, experiencing stressful life events, lack of social support, lifetime history of abuse, marital conflicts, maternity blues, child care stress, chronic physical health conditions, preeclampsia, gestational diabetes mellitus, being exposed to second-hand smoke and sleep disturbance were among the major correlates of perinatal depression. CONCLUSION Although the included systematic reviews were all of medium-high quality, improvements in the quality of primary research in this area should be encouraged. The standardisation of perinatal depression assessment, diagnosis and measurement, the implementation of longitudinal designs in studies, inclusions of samples that better represent the population and better control of potentially confounding variables are encouraged.
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Affiliation(s)
- Khalood Al-abri
- Division of Psychology and Mental Health, University of Manchester, G35 Coupland 1 Building, Manchester, UK
- Department of Community and Mental Health, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Dawn Edge
- Division of Psychology and Mental Health, University of Manchester, G35 Coupland 1 Building, Manchester, UK
- Equality, Diversity and Inclusion Research Unit, Greater Manchester Mental Health NHS Trust, Manchester, UK
| | - Christopher J. Armitage
- Division of Psychology and Mental Health, University of Manchester, G35 Coupland 1 Building, Manchester, UK
- Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK
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6
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Soni B, Jayaseelan V, Kattimani S, Rengaraj S, Arikrishnan K, Veerasetty N. Association between common mental disorder and glycemic control in women with gestational diabetes: A mixed-method study. Indian J Psychiatry 2023; 65:941-948. [PMID: 37841546 PMCID: PMC10569327 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_402_23] [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: 05/31/2023] [Revised: 07/29/2023] [Accepted: 08/09/2023] [Indexed: 10/17/2023] Open
Abstract
Background Gestational diabetes mellitus (GDM) is associated with an increased risk of mental health disorders among pregnant women. Poor mental health can negatively impact glycemic control in women with GDM, leading to adverse outcomes for both the mother and the baby. Aim To determine the prevalence of common mental disorder (CMD) in women with GDM and its association with poor glycemic control. Additionally, to explore the reasons and coping strategies for CMD in women with GDM. Methods A sequential explanatory mixed-method study was conducted among 351 women with GDM visiting a tertiary care hospital. The prevalence of CMD was assessed using Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Perceived Stress Scale (PSS). Glycemic control was determined based on two-hour postprandial blood glucose levels. In-depth interviews were conducted with six women who screened positive for CMD and had poor glycemic control. Data were analyzed using SPSS v23 and stats v12. Chi-square test and Poisson regression were performed, and adjusted prevalence ratios (aPRs) were reported. Results The prevalence of CMD was found to be 19.08% (95% CI: 15.32%-23.52%), with 18.2% (95% CI: 14.5%-22.6%) anxiety symptoms 8.3% (95% CI: 5.8%-11.6%) depressive symptoms and stress each. CMD was significantly related to poor glycemic control (aPR: 1.58; 95% CI: 1.23-2.03; P value <0.001). The qualitative analysis revealed individual, family, health, and facility factors influencing mental health and glycemic control. Conclusion Common mental health disorders are prevalent in women with GDM. It has a negative association with glycemic control. Implementing a routine screening program in the ANC clinic can aid in early identification and prompt management of the CMD and its associated complications.
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Affiliation(s)
- Bhanushree Soni
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Venkatachalam Jayaseelan
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Shivanand Kattimani
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Sasirekha Rengaraj
- Department of Obstetrics and Gynecology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Kalaiselvy Arikrishnan
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Naveenkumar Veerasetty
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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Zargar M, Sayyah M, Nikbakht R, Abdipour Z. Comparison of psychological disorders during and after pregnancies caused by assisted reproductive treatments and spontaneous pregnancies. Cent Nerv Syst Agents Med Chem 2023; 23:CNSAMC-EPUB-133742. [PMID: 37592788 DOI: 10.2174/1871524923666230817102216] [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: 05/10/2023] [Revised: 06/24/2023] [Accepted: 07/17/2023] [Indexed: 08/19/2023]
Abstract
INTRODUCTION Mental disorders during pregnancy are one of the major public health problems because of its effect on both mother and child, but the prevalence of psychiatric disorders in infertile women is largely unknown to compare psychiatric disorders during and after pregnancies with assisted reproductive therapies (ART) and spontaneous pregnancies. METHODS This cross-sectional study was conducted on pregnant women referring to midwifery centers in Ahvaz City in 2022. Pregnant women were included in two groups of either pregnancy caused by ART (n= 84) or spontaneous pregnancy (n= 256). The Symptom Checklist-90-R (SCL90-R) was used to assess psychiatric disorders during and after pregnancies. RESULTS A high percentage of women with spontaneous pregnancy (74.6%) and ART (91.7%) had some degree of psychological disorders. The severity of psychological disorders in both groups was higher during pregnancy than after pregnancy (P<0.001). The intensity of various psychological disorders during and after pregnancy in the ART pregnancy group was significantly higher than the control group (P<0.001). An increased risk of psychiatric disorders during pregnancy was associated with the history of psychiatric disorders [odd ratio (OR): 12.393; P= 0.022], family history of psychiatric disorders (OR:26.168; P<0.001), history of infertility (OR: 19.00; P<0.001), primary infertility (OR: 12.714; P=0.004), infertility duration more than three years (OR: 43.424; P<0.001), and frequency of embryo transfer (OR: 18.939; P=0.045). CONCLUSION Psychiatric disorders were prevalent among pregnant women in the study area especially in pregnant women with ART. Regular screening programs for mental health problem should be included in an antenatal care service especially in this high-risk group.
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Affiliation(s)
- Mahvash Zargar
- Department of Obstetrics and Gynecology, School of Medicine, Fertility Infertility and Perinatology Research Center,
Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehdi Sayyah
- Educational Development Center, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Roshan Nikbakht
- Department of Obstetrics and Gynecology, School of Medicine, Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Abdipour
- Department of Obstetrics and Gynecology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Sahoo S, Gill G, Sikka P, Nehra R. Antenatal depression and anxiety in Indian women: A systematic review. Ind Psychiatry J 2023; 32:222-233. [PMID: 38161466 PMCID: PMC10756614 DOI: 10.4103/ipj.ipj_156_22] [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: 09/15/2022] [Revised: 01/31/2023] [Accepted: 02/14/2023] [Indexed: 01/03/2024] Open
Abstract
There is good evidence to suggest that high prevalence of depression and anxiety in the postpartum period. However, very few studies have focused on antenatal depression and anxiety disorders and their associated risk factors. Further, there are only a handful of studies from India on common antenatal mental health disorders. With this background, we reviewed the existing evidence on antenatal depression and anxiety from the studies conducted in Indian pregnant women during the antenatal period and to explore the associated risk factors. All the major databases were searched systematically for English language studies on prevalence and risk factors for antenatal depression and anxiety in Indian pregnant females, published during the period January 2000 to May 2022. Quality assessment of studies was done with the modified version of Newcastle Ottawa Scale for cross-sectional studies. We found the overall prevalence of antenatal depression was ranged from 3.8% to 65% and antenatal anxiety from 13 to 55%. The most relevant risk factors associated with antenatal depression and anxiety during pregnancy were preference to have a male child, intimate partner violence, history of abortions, marital conflict, poor relationship with the husband/in-laws and lack of social support. To conclude, the systematic review suggests that depressive and anxiety disorders are quite common in Indian pregnant women in antepartum period with varying prevalence depending on various settings and scales used. Steps should be taken to promote obstetricians for regular mental health screening during the antenatal visits and prompt referral to mental health professionals when suspected.
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Affiliation(s)
- Swapnajeet Sahoo
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Gursahiba Gill
- Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Pooja Sikka
- Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Ritu Nehra
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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9
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Kurbi HA, Abebe SM, Mengistu NW, Ayele TA, Toni AT. Cultural Adaptation and Validation of the Amharic Version of the World Health Organization's Self Reporting Questionnaire (SRQ-20) Screening Tool Among Pregnant Women in North West Ethiopia, 2022: A Psychometric Validation. Int J Womens Health 2023; 15:779-791. [PMID: 37223068 PMCID: PMC10202208 DOI: 10.2147/ijwh.s402865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/05/2023] [Indexed: 05/25/2023] Open
Abstract
Background The prevalence of prenatal common mental disorders afflicting the global community, including Ethiopia, is thriving. Therefore, a time-efficient and valid screening tool is required. This study aimed to culturally adapt and validate the self-reporting questionnaire-20 tool developed by the World Health Organization among pregnant mothers in Ethiopia. Methods A total of 310 pregnant women completed the questionnaire at two selected health centers in the regional state of Amhara. The World Health Organization's Self Reporting Questionnaire-20 tool was first translated into Amharic by two experts. The back translation was done by two English experts. Internal consistency and reliability were assessed using Cronbach's alpha. Convergent and discriminant validity were assessed using composite reliability and extracted mean variance. SRQ-20 was tested for reliability and validity using principal components analysis and the Kaiser-Meyer-Olkin measure of sample adequacy with a cutoff value of 0.50 for each item. Results The Kaiser-Meyer-Olkin measure (KMO = 0.733) for sample adequacy and the Bartlett's sphericity test for the identity matrix indicated that the data were amenable to exploratory factor analysis. Principal components analysis identified six factors that explained 64% of the variation in the self-report questionnaire 20. Cronbach's alpha was 0.817 for the entire scale and the extracted mean variance was greater than 0.5 for all factors, indicating convergent validity. The extracted mean variance, composite reliability, and factor loadings were all greater than 0.75 for all factors in this study, indicating that convergent validity was satisfactory and that discriminatory validity was also satisfied. The composite factor reliability scores ranged from 0.74 to 0.84, and the square roots of the mean variances were greater than the factor correlation scores. Conclusion The interview-based, culturally-adapted 20-item Amharic version of the SRQ-20 tool demonstrated good cultural adaptation and was also found to be valid and reliable in the present context.
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Affiliation(s)
- Helina Abebe Kurbi
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Kotebe Metropolitan University, Menelik II Health Science College, Department of Mental Health, Addis Ababa, Ethiopia
| | - Solomon Mekonnen Abebe
- Department of Nutrition institute of public health, college of medicine and health sciences, university of Gondar, Gondar, Ethiopia
| | - Nestanet Worku Mengistu
- Department of Nutrition institute of public health, college of medicine and health sciences, university of Gondar, Gondar, Ethiopia
| | - Tadesse Awoke Ayele
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemayehu Teklu Toni
- Department of Pediatrics and School of Medicine, Institute of Public health, college of Medicine and health sciences, university of Gondar, Gondar, Ethiopia
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10
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Guillen-Burgos HF, Galvez-Florez JF, Miranda J, Hincapie-Porras C, Perez-Olivo JL, Piraquive-Caicedo JP, Becerra-Mojica CH, Parra-Ardila SX, Parra-Saavedra MA. Pregnancy and mental health outcomes during the COVID-19 pandemic in Colombia: A nationwide cross-sectional study. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023; 12:100488. [PMID: 36718157 PMCID: PMC9877320 DOI: 10.1016/j.jadr.2023.100488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 01/19/2023] [Accepted: 01/25/2023] [Indexed: 01/27/2023] Open
Affiliation(s)
- Hernan Felipe Guillen-Burgos
- Center for Clinical and Translational Research, La Misericordia Clínica Internacional, Barranquilla, Colombia.,School of Health Sciences, Universidad Simon Bolivar, Barranquilla, Colombia.,Instituto Cardiovascular del Cesar, Valledupar, Atlántico
| | - Juan Francisco Galvez-Florez
- Center for Clinical and Translational Research, La Misericordia Clínica Internacional, Barranquilla, Colombia.,Latin American Society of Consultation-Liaison Psychiatry, Bogota, Colombia
| | - Jezid Miranda
- Department of Obstetrics and Gynecology, School of Medicine, Grupo de Investigación en Cuidado Intensivo y Obstetricia (GRICIO), Universidad de Cartagena, Cartagena de Indias, Bolívar, Colombia.,Department of Maternal-Fetal Medicine, Centro Hospitalario Serena del Mar, Cartagena de Indias, Bolívar, Colombia
| | - Cristian Hincapie-Porras
- Department of Obstetrics and Gynecology, Hospital Universitario San Jorge, Pereira, Risaralda, Colombia
| | - Jose L Perez-Olivo
- Department of Obstetrics and Gynecology, Clínica La Ermita, Cartagena de Indias, Colombia
| | | | - Carlos H Becerra-Mojica
- Centro de Atención Maternofetal INUTERO, Clínica Carlos Ardila Lulle, Bucaramanga, Santander, Colombia.,Department of Obstetrics and Gynecology, School of Medicine, Universidad Industrial de Santander. Bucaramanga, Santander, Colombia
| | - Sonia X Parra-Ardila
- Instituto de Cirugía y Terapia Fetal del Caribe, Barranquilla, Atlántico, Colombia
| | - Miguel A Parra-Saavedra
- School of Health Sciences, Universidad Simon Bolivar, Barranquilla, Colombia.,Instituto de Cirugía y Terapia Fetal del Caribe, Barranquilla, Atlántico, Colombia
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11
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Fraser EE, Ogden KJ, Radford A, Ingram ER, Campbell JE, Dennis A, Corbould AM. Exploring the psychological wellbeing of women with gestational diabetes mellitus (GDM): increased risk of anxiety in women requiring insulin. A Prospective Longitudinal Observational Pilot Study. Health Psychol Behav Med 2023; 11:2170378. [PMID: 36733299 PMCID: PMC9888455 DOI: 10.1080/21642850.2023.2170378] [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] [Indexed: 01/29/2023] Open
Abstract
Introduction Gestational diabetes mellitus (GDM) complicates ∼16% of pregnancies in Australia and has significant implications for health of both mother and baby. Antenatal anxiety and depression are also associated with adverse pregnancy outcomes. The interaction between GDM and mental health in pregnancy is poorly understood. With the aim of exploring the nuanced interaction between GDM and mental health further, we investigated whether GDM treatment modality (diet versus insulin) influenced psychological wellbeing in women with GDM. Methods Psychological wellbeing was assessed in women with GDM treated with diet (GDM-Diet, n = 20) or insulin (GDM-Insulin, n = 15) and pregnant women without GDM (non-GDM, n = 20) using questionnaires [Edinburgh Depression Scale (EDS), State-Trait Anxiety Inventory (STAI-6), and in women with GDM, Problem Areas in Diabetes (PAID)] at 24-34 weeks gestation and again at ∼36 weeks gestation. Results Women in the GDM-insulin group had significantly higher levels of anxiety than the non-GDM group at both time points. Women in the GDM-Diet group had higher levels of anxiety at 24-34 weeks gestation than the non-GDM group but did not differ at ∼36 weeks gestation. Although depression scores tended to be higher in GDM-Insulin and GDM-Diet groups than in the non-GDM group at both time points, this was not statistically significant. Diabetes-related distress was similar in the GDM-Diet and GDM-Insulin groups at both time points and did not change during pregnancy. A high proportion of the GDM-Insulin group had past/current mental illness (60%). Conclusions In this pilot study GDM was associated with differences in psychological wellbeing, specifically increased anxiety in women treated with insulin. Specialised interventions to support women with GDM should be considered, especially those requiring insulin.Trial registration: Not applicable as this was a purely observational study.
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Affiliation(s)
- Emma E. Fraser
- Department of Psychiatry, Austin Hospital, Heidelberg, Australia, Emma E Fraser Department of Psychiatry, Austin Hospital, Studley Road, Heidelberg, Victoria, 3084, Australia
| | - Kathryn J. Ogden
- School of Medicine, Faculty of Health, University of Tasmania, Launceston, Australia
| | - Andrea Radford
- John Morris Diabetes Centre, Launceston General Hospital, Launceston, Australia
| | - Emily R. Ingram
- School of Medicine, Faculty of Health, University of Tasmania, Launceston, Australia
| | - Joanne E. Campbell
- John Morris Diabetes Centre, Launceston General Hospital, Launceston, Australia
| | - Amanda Dennis
- FRANZCOG, Women’s and Children’s Service, Launceston General Hospital, Launceston, Australia
| | - Anne M. Corbould
- John Morris Diabetes Centre, Launceston General Hospital, Launceston, Australia
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12
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Anxiety during the pregnancy and affecting factors: a cross-sectional study. Arch Gynecol Obstet 2023; 307:301-309. [PMID: 35585212 DOI: 10.1007/s00404-022-06590-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 04/22/2022] [Indexed: 02/02/2023]
Abstract
PURPOSE Studies have shown that anxiety in the perinatal period leads to preterm birth and negatively affects mother and fetus. Understanding prenatal anxiety and associated factors may help develop screening strategies to identify high-risk women needing intervention during pregnancy. The aim of this study is to determine the pregnancy-related, state, and trait anxiety in the prenatal period and affecting factors. METHODS This descriptive study was conducted with 203 pregnant women between May 20 and November 30, 2019. Data were collected using socio-demographic and obstetrics characteristics data collection form, Pregnancy-Related Anxiety Questionnaire-Revised-2 (PRAQ-R2), and State-Trait Anxiety Inventory-I and II (STAI-I and STAI-II). RESULTS We found statistically significant correlations between age, employment, and parity with fear of giving birth subscale of PRAQ-R2. Pregnant women's mean scale scores were 35.42 ± 9.11 for STAI-I, 42.21 ± 8.21 for STAI-II, and 25.63 ± 8.58 for PRAQ-R2. We found a positive correlation between PRAQ-R2 scale scores and STAI-I, STAI-II scale scores of pregnant women. CONCLUSIONS Age, parity, income, planning status of the pregnancy, and employment status affected the anxiety levels of pregnant women. Assessing the anxiety with multiple validated tools helps clarify the cause of the anxiety and allows to plan appropriate interventions.
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13
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Farías-Antúnez S, Correia LL, Araújo DABS, Penna AL, de Sousa GDS, Silva ACE, Campos JS, Rocha HAL, Aquino CMD, Castro MC, Tavares Machado MM. Breastfeeding Practices Before and During the COVID-19 Pandemic in Fortaleza, Northeastern Brazil. J Hum Lact 2022; 38:407-421. [PMID: 35695451 DOI: 10.1177/08903344221101874] [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] [Indexed: 11/17/2022]
Abstract
BACKGROUND Physical distancing associated with the COVID-19 pandemic may lead to suboptimal maternal mental health, social support after birth, and infant feeding practices. RESEARCH AIMS To compare breastfeeding prevalence in participants who were pregnant at a time when strict physical distancing measures were imposed in Fortaleza, the capital of Ceará state, Brazil, with the pre-pandemic breastfeeding levels, and to assess the association of breastfeeding prevalence with maternal common mental disorders, and sociodemographic and health predictors. METHOD A cross-sectional prospective two-group comparison design using two population-based surveys was carried out in Fortaleza before and after the pandemic. Participants (n = 351) who had a live birth in Fortaleza in July or August 2020, and participants (n = 222) who had a child younger than 12 months in 2017 were surveyed. Crude and adjusted multinomial logistic regressions with robust variance were used to estimate risk ratios and 95% confidence intervals (CI). RESULTS Similar prevalence of exclusive breastfeeding were observed in 2021 (8.1%) and 2017 (8.5%; p = .790). An increase in predominant (2.2% vs. 13.4%; p < .001) and a decrease in complementary breastfeeding (64.0% vs. 48.4%; p = .037) was observed in 2021, compared to 2017. The prevalence of maternal common mental disorders also increased in 2021 (17.6% vs. 32.5%, p < .001). No statistically significant associations were found between breastfeeding patterns, maternal common mental disorders, and other predictors in 2017 or 2021. CONCLUSIONS Participants who delivered during the COVID-19 pandemic delayed solid foods introduction and breastfed predominantly longer than participants during the pre-pandemic period. While common mental disorders significantly increased, they were not associated with differences in breastfeeding.
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Affiliation(s)
| | | | | | | | | | | | - Jocileide Sales Campos
- Service, Education and Community Integration, University Center Unichristus, Fortaleza, Brazil
| | | | | | - Marcia C Castro
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA
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14
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Sari DN, Diatri H, Siregar K, Pratomo H. The Prevalence of Depression Symptoms among Pregnant Women during the Second Wave of COVID-19. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8255] [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: Pregnant women are vulnerable to depression. We hypothesized that the COVID-19 pandemic would increase depression in pregnancy leading to complications to both mother and fetus.
AIM: This study is aimed to identify antenatal depression symptoms during the second wave COVID-19 pandemic.
METHODS: This was a community-based, cross-sectional study conducted from 10 to 21 June 2021. A number of 130 pregnant women were recruited through both convenience and snowball sampling. An online survey with self-administered Whooley questions was used to assess antenatal depression symptoms.
RESULTS: We found elevated antenatal depression symptoms similar to other countries during the COVID-19 pandemic. The prevalence of pregnant women with depression symptoms was 42.3%. The majority of pregnant women who had antenatal depression symptoms had the following characteristics: About 44.75% lived outside Jakarta, 60% had low education (Junior high school and below), 42.9% aged 20–35 years, and 44.8% of them were housewives.
CONCLUSION: In Indonesia, the second wave of COVID-19 pandemic affected increasing symptoms of depression among pregnant women. Positive protective factors should be taken to prevent negative impacts of both unidentified and untreated antenatal depression among the pregnant women for the sake of maternal and child health.
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Tamiru D, Misgana T, Tariku M, Tesfaye D, Alemu D, Weldesenbet AB, Gebremichael B, Dheresa M. Prevalence and Associated Factors of Common Mental Disorders Among Pregnant Mothers in Rural Eastern Ethiopia. Front Psychiatry 2022; 13:843984. [PMID: 35418883 PMCID: PMC8995426 DOI: 10.3389/fpsyt.2022.843984] [Citation(s) in RCA: 4] [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: 12/27/2021] [Accepted: 03/01/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Antenatal common mental disorder is a significant public health issue, especially in low- and middle-income countries with an extensive treatment gap. Common mental disorders have multifaceted implications on maternal and fetal health outcomes during pregnancy with long-running economic and social sequels. This study aimed to determine the prevalence of common mental disorder and associated factors among pregnant mothers in eastern Ethiopia, Kersa and Haramaya Health, and Demographic surveillance sites. METHODS A community-based cross-sectional study was conducted in Kersa and Haramaya health and demographic surveillance sites from January 30 to April 30, 2021. World Health Organization Self-Reporting Questionnaire (SRQ-20) was used to measure common mental disorder among 1,015 randomly selected pregnant women. Data were collected face-to-face using open data kit software. Logistic regression was fitted to identify factors associated with common mental disorders. RESULTS The overall prevalence of common mental disorders (SRQ > 6) among pregnant women was 37.5% (95% CI: 34.5, 40.5). Current substance use (AOR = 1.99, 95% CI 1.37, 2.88), intimate partner violence (AOR = 2.67, 95% CI 2.02, 3.53), null parity (AOR = 3.10, 95% CI 1.65, 5.84), gestational age [first trimester (AOR = 2.22, 95% CI 1.01, 4.93) and third trimester (AOR = 1.74, 95% CI 1.31, 2.31)], history of abortion (AOR = 2.03, 95% CI 1.27, 3.24), and absence of antenatal care follow-up (AOR = 1.43, 95% CI 1.08, 1.89) were significantly associated with common mental disorder during pregnancy. CONCLUSION Common mental disorders are prevalent among pregnant women in the study area with significant correlates. Administration of regular screening programs for maternal mental health conditions in rural, low-income communities, integrating into primary health care settings is imperative to reduce the risk.
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Affiliation(s)
- Dawit Tamiru
- Department of Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tadesse Misgana
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mandaras Tariku
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dejene Tesfaye
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Daniel Alemu
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Adisu Birhanu Weldesenbet
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Berhe Gebremichael
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Merga Dheresa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Tarafa H, Alemayehu Y, Nigussie M. Factors associated with pregnancy-related anxiety among pregnant women attending antenatal care follow-up at Bedelle general hospital and Metu Karl comprehensive specialized hospital, Southwest Ethiopia. Front Psychiatry 2022; 13:938277. [PMID: 36213901 PMCID: PMC9537765 DOI: 10.3389/fpsyt.2022.938277] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 08/29/2022] [Indexed: 12/02/2022] Open
Abstract
Pregnancy-related anxiety (PRA) is an anxiety related to the pregnancy, involving labor and delivery, the well-being of the fetus/infant and the mother, the availability of quality of healthcare resources, and the capacity to parent. There is scarcity of study conducted on magnitude of Pregnancy-related anxiety and its associated factors among pregnant women in Ethiopia. The main objective of this research was to assess factors associated with Pregnancy-related anxiety among pregnant women attending ANC follow-up at Bedelle general and Metu Karl comprehensive specialized hospitals, Southwest Ethiopia. A hospital-based cross-sectional study design was used among pregnant women attending ANC follow-up. Data were collected from 406 sampled pregnant women who were selected through a systematic random sampling technique. Pregnancy-Related Anxiety Questionnaire-Revised (PRAQ-R2) was used to measure the outcome variable. The collected data were analyzed using Statistical Package for Social Sciences (SPSS) version 26. Logistic regression analyses were done to identify factors associated with Pregnancy-related anxiety and significance level set at p < 0.05. The overall prevalence of PRA in this study was 32.7%. Unwanted pregnancy AOR = 2.77, 95% CI [1.71, 4.54], high perceived stress AOR = 2.39, 95% CI [1.54, 3.62], young age AOR = 2.14, 95% CI [1.49, 2.83], depression AOR = 2.09, 95% CI [1.39, 2.89], low income AOR = 2.01, 95% CI [1.29, 3.14], and poor social support AOR = 1.79, 95% CI [1.14, 3.37] were significantly associated with Pregnancy-related anxiety. The findings of this study showed that the prevalence of Pregnancy-related anxiety was high in the study area and positively associated with young age, low income, poor social support, high perceived stress, depression, and unwanted pregnancy. This finding suggests that clinicians should integrate screening for Pregnancy-related anxiety into clinical standards, more efforts should be made in the future to reduce the anxiety among pregnant women who had an unwanted pregnancy, young women, and poor social support. Also, it is good to encourage the pregnant mother to enhance their social connectedness by creating a self-help group, and increasing early identification of mental health problems throughout their daily ANC follow-up.
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Affiliation(s)
- Hunde Tarafa
- Department of Psychiatry, College of Health Sciences, Metu University, Metu, Ethiopia
| | - Yadeta Alemayehu
- Department of Psychiatry, College of Health Sciences, Metu University, Metu, Ethiopia
| | - Meskerem Nigussie
- Department of Psychiatry, College of Health Sciences, Metu University, Metu, Ethiopia
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Kalra H, Tran T, Romero L, Chandra P, Fisher J. Burden of severe maternal peripartum mental disorders in low- and middle-income countries: a systematic review. Arch Womens Ment Health 2022; 25:267-275. [PMID: 35061103 PMCID: PMC8921056 DOI: 10.1007/s00737-021-01201-9] [Citation(s) in RCA: 4] [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: 10/06/2021] [Accepted: 12/26/2021] [Indexed: 11/27/2022]
Abstract
Peripartum severe mental disorders (PSMDs) encompass schizophrenia, affective psychosis, and psychotic and non-psychotic forms of bipolar disorders. PSMDs are well documented in high-income countries. However, much less is known about the prevalence of PSMDs in low- and middle-income countries (LMICs). The aim was to review the available literature systematically and estimate the prevalence of PSMDs among women in LMICs. We searched the Ovid MEDLINE, Embase, PsycINFO, CINAHL and Maternity and Infant Care databases systematically from the date of inception to Dec 31, 2020, for English-language publications with data on the prevalence of PSMDs among women in World Bank-defined LMICs. Selection of studies, extraction of data and assessment of study quality were each undertaken independently by at least two of the investigators. A total of five studies (completed in three countries spanning two continents) met the inclusion criteria. Five studies reported cumulative incidence of postpartum psychosis (ranging from 1.1 to 16.7 per 1000 births). We found no studies on the prevalence of severe mental disorder during pregnancy in these settings. Marked heterogeneity in methodology precluded meta-analysis. These findings indicate that PSMDs occur at a similar prevalence in low- and middle-income to high-income countries. However overall, there is a paucity of high-quality evidence from these settings. There is a need for rigorous studies with standardized methods to increase knowledge of the nature, prevalence, and determinants of PSMDs among women in resource-constrained LMICs to inform policies, service development, program planning and health professional training.
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Affiliation(s)
- Harish Kalra
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. .,Ballarat Rural Clinical School, University of Notre Dame Australia, Sydney, Australia. .,Grampians Area Mental Health Services, Ballarat, VIC, Australia.
| | - Thach Tran
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Lorena Romero
- The Ian Potter Library, The Alfred Hospital, Melbourne, VIC Australia
| | - Prabha Chandra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Jane Fisher
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Sari DN, Diatri H, Siregar K, Pratomo H. Adaptation of the Edinburgh Postnatal Depression Scale in the Indonesian Version: Self-reported Anxiety and Depression Symptoms in Pregnant WomenAdaptation of the Edinburgh Postnatal Depression Scale in the Indonesian Version: Self-reported Anxiety and Depression Symptoms in Pregnant Women. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7783] [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: Anxiety and depression disorders in pregnant women are often not identified so that early treatment is not optimal. Indonesia already has comprehensive integrated antenatal care, including services for pregnant women with mental disorders, but until now Indonesia does not yet have a standardized instrument that is valid and suitable as a screening tool to assess symptoms of anxiety and depression in pregnant women. The Edinburgh Postnatal Depression Scale (EPDS) is a screening instrument with high sensitivity and specificity, has been translated into Indonesian, but until now, the Indonesian version of the EPDS instrument has not been evaluated for validity and reliability in the population of pregnant women.
AIM: this study aimed to adapt the Indonesian version of the EPDS instrument, including testing the validity and reliability of the instrument when used on pregnant women in Indonesia.
METHODS: This research is a cross sectional study. The number of pregnant women who participated were 125 samples. Data were collected randomly, and the assessment of symptoms of anxiety and depression was self-reported via online. Content validity was assessed with a content validity index from 5 experts, construct validation was analyzed by Explanatory Factor Analysis and Confirmatory Factor Analysis and Convergent Validity. The reliability of the EPDS instrument was assessed by construct reliability and Cronbach's Alpha.
RESULTS: Content validity index shows expert agreement with a value of .98. The Indonesian version of the EPDS shows assessing three factors, namely: Depression (5 items), Anxiety (3 items), and Anhedonia (2 items). The reliability of the Indonesian version of the EPDS instrument is good with Cronbach's Alpha .80 and the internal reliability of the 10 items (Cronbach's Alpha .767-.812).
CONCLUSION: The Indonesian version of the EPDS instrument is valid and reliable to be used to assess symptoms of anxiety and depression in pregnant women in antenatal care in Indonesia.
Keywords: pregnant women, EPDS, validity, reliability
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Tikka SK, Parial S, Pattojoshi A, Bagadia A, Prakash C, Lahiri D, Jaiswal J, Puri M, Kukreti P, Behera RN, Agrawal S, Garg S, Dubey S, Gupta V, Bajaj A, Agrawal A, Singour C, Patel G, Maghade M, Purushotham A, Pany SK, Saurabh, Doria S, Tejan V, Chandra PS. Anxiety among pregnant women during the COVID-19 pandemic in India - A multicentric study. Asian J Psychiatr 2021; 66:102880. [PMID: 34688015 PMCID: PMC8526303 DOI: 10.1016/j.ajp.2021.102880] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 01/27/2023]
Abstract
While higher anxiety during antenatal period cause several maternal and foetal health related complications, lower anxiety levels are found to be associated with lesser "precautionary behaviours" and consequently greater risk of infection, during the COVID-19 pandemic. In this study, we aimed to assess rates and determinants of generalized anxiety at the time of the pandemic as well as anxiety that was specific to the context of being pregnant during the COVID-19 pandemic. (COVID-19-antenatal anxiety) in Indian women. This hospital-based, cross-sectional study using face-to-face interviews was conducted at antenatal clinics of five medical college hospitals in India. The Generalized Anxiety Disorder-7 scale (GAD -7) and a customized scale to assess antenatal COVID-19 anxiety along with other tools that assessed social support and COVID-19-risk perception were administered to 620 pregnant women. We found that the percentage of women with moderate or severe anxiety based on GAD -7 was 11.1%. Multivariate analysis showed that higher COVID-19-risk perception, greater antenatal COVID-19 anxiety and lower perceived support significantly predicted moderate and severe generalized anxiety. Greater number of weeks of gestation, lower education, semiurban habitat and lower perceived social support were significant predictors of antenatal COVID-19 anxiety. We conclude that the rates of anxiety in pregnant women though not very high, still warrant attention and specific interventions.
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Affiliation(s)
- Sai Krishna Tikka
- Department of Psychiatry, All India Institute of Medical Sciences, Bibinagar, India
| | | | - Amrit Pattojoshi
- Department of Psychiatry, Hi-Tech Medical college & Hospital, Bhubaneshwar, India
| | | | | | - Deyashini Lahiri
- Department of Clinical Psychology, Post Graduate Institute of Behavioral And Medical Sciences, Raipur, India
| | - Jyoti Jaiswal
- Department of Obstetrics and Gynaecology, Pt. Jawaharlal Nehru Memorial Medical College, Raipur, India
| | - Manju Puri
- Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi, India
| | - Prerna Kukreti
- Department of Psychiatry, Lady Hardinge Medical College, New Delhi, India
| | - Rabindra Nath Behera
- Department of Obstetrics and Gynaecology, Hi-Tech Medical college & Hospital, Bhubaneshwar, India
| | - Sarita Agrawal
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Raipur, India
| | - Shobit Garg
- Department of Psychiatry, Shri Guru Ram Rai Institute of Medical & Health Sciences, Dehradun, India
| | - Surbhi Dubey
- Department of Psychiatry, Pt. Jawaharlal Nehru Memorial Medical College, Raipur, India
| | - Vineeta Gupta
- Department of Obstetrics and Gynaecology, Shri Guru Ram Rai Institute of Medical & Health Sciences, Dehradun, India
| | - Aakash Bajaj
- Department of Biostatistics, National Institute of Mental Health And Neurosciences, Bengaluru, India
| | - Akanksha Agrawal
- Department of Obstetrics and Gynaecology, Pt. Jawaharlal Nehru Memorial Medical College, Raipur, India
| | - Chhaya Singour
- Department of Psychiatry, Shri Guru Ram Rai Institute of Medical & Health Sciences, Dehradun, India
| | - Geetanjali Patel
- Department of Obstetrics and Gynaecology, Pt. Jawaharlal Nehru Memorial Medical College, Raipur, India
| | - Megha Maghade
- Department of Psychiatry, All India Institute of Medical Sciences, Raipur, India
| | - A Purushotham
- Department of Psychiatry, All India Institute of Medical Sciences, Raipur, India
| | - Sanjaya Kumar Pany
- Department of Psychiatry, Hi-Tech Medical college & Hospital, Bhubaneshwar, India
| | - Saurabh
- Department of Psychiatry, Lady Hardinge Medical College, New Delhi, India
| | - Simran Doria
- Department of Psychiatry, Lady Hardinge Medical College, New Delhi, India
| | - Veena Tejan
- Department of Psychiatry, Shri Guru Ram Rai Institute of Medical & Health Sciences, Dehradun, India
| | - Prabha S Chandra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India.
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Al Ghadeer HA, Al Kishi NA, Almubarak DM, Almurayhil Z, Alhafith F, Al Makainah BA, Algurini KH, Aljumah MM, Busaleh MM, Altaweel NA, Alamer MH. Pregnancy-Related Anxiety and Impact of Social Media Among Pregnant Women Attending Primary Health Care. Cureus 2021; 13:e20081. [PMID: 35003947 PMCID: PMC8723695 DOI: 10.7759/cureus.20081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2021] [Indexed: 11/05/2022] Open
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Saad A, Magwood O, Aubry T, Alkhateeb Q, Hashmi SS, Hakim J, Ford L, Kassam A, Tugwell P, Pottie K. Mobile interventions targeting common mental disorders among pregnant and postpartum women: An equity-focused systematic review. PLoS One 2021; 16:e0259474. [PMID: 34714882 PMCID: PMC8555821 DOI: 10.1371/journal.pone.0259474] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 10/19/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Pregnant and postpartum women face major psychological stressors that put them at higher risk of developing common mental disorders, such as depression and anxiety. Yet, their limited access to and uptake of traditional mental health care is inequitable, especially during the COVID-19 pandemic. Mobile interventions emerged as a potential solution to this discontinued healthcare access, but more knowledge is needed about their effectiveness and impact on health equity. This equity-focused systematic review examined the effectiveness and equity impact of mobile interventions targeting common mental disorders among pregnant and postpartum women. METHODS AND RESULTS We systematically searched MEDLINE, EMBASE, PsychINFO and 3 other databases, from date of database inception and until January 2021, for experimental studies on mobile interventions targeting pregnant and postpartum women. We used pooled and narrative synthesis methods to analyze effectiveness and equity data, critically appraised the methodological rigour of included studies using Cochrane tools, and assessed the certainty of evidence using the GRADE approach. Our search identified 6148 records, of which 18 randomized and non-randomized controlled trials were included. Mobile interventions had a clinically important impact on reducing the occurrence of depression (OR = 0.51 [95% CI 0.41 to 0.64]; absolute risk reduction RD: 7.14% [95% CI 4.92 to 9.36]; p<0.001) and preventing its severity perinatally (MD = -3.07; 95% CI -4.68 to -1.46; p<0.001). Mobile cognitive behavioural therapy (CBT) was effective in managing postpartum depression (MD = -6.87; 95% CI -7.92 to -5.82; p<0.001), whereas other support-based interventions had no added benefit. Results on anxiety outcomes and utilization of care were limited. Our equity-focused analyses showed that ethnicity, age, education, and being primiparous were characteristics of influence to the effectiveness of mobile interventions. CONCLUSION As the COVID-19 pandemic has increased the need for virtual mental health care, mobile interventions show promise in preventing and managing common mental disorders among pregnant and postpartum women. Such interventions carry the potential to address health inequity but more rigorous research that examines patients' intersecting social identities is needed.
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Affiliation(s)
- Ammar Saad
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- C.T. Lamont Primary Healthcare Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Olivia Magwood
- C.T. Lamont Primary Healthcare Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Tim Aubry
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
- Centre for Research on Educational and Community Services, University of Ottawa, Ottawa, Ontario, Canada
| | - Qasem Alkhateeb
- Department of Medicine, Schulich School of Medicine, Western University, London, Ontario, Canada
| | | | - Julie Hakim
- Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Dallas, Texas, United States of America
| | - Leanne Ford
- Rebirth Wellness Centre Inc., London, Ontario, Canada
| | - Azaad Kassam
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
- Pinecrest Queensway Community Health Centre, Ottawa, Ontario, Canada
- Ottawa Newcomer Health Centre, Ottawa, Ontario, Canada
| | - Peter Tugwell
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Kevin Pottie
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- C.T. Lamont Primary Healthcare Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Jain A, Sahu KK, Mitra P. Treatment of Patients with Mental Illness Amid A Global COVID-19 Pandemic. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1318:759-771. [PMID: 33973210 DOI: 10.1007/978-3-030-63761-3_42] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
A newly discovered coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the ongoing pandemic of coronavirus disease 2019 (COVID-19), which is not only physically challenging but also has many subtle and overt mental impacts. The concern of being infected, lack of antiviral agents, preventive strategies of social distancing, and home isolation have created unrest in the society. The way of reacting to emergencies varies from individual to individual, and that this variability lies in our unique personality traits. The COVID-19 pandemic is testing the mental stability of all of us, and hence it is crucial to recognize the vulnerable population and support them to prevent or minimize the catastrophe like post-traumatic stress disorder (PTSD), emotional trauma, and suicides. In this context, the role of psychiatrists, psychotherapists, and other mental healthcare providers is indispensable.
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Affiliation(s)
- Ankit Jain
- Department of Psychiatry, Penn State College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Kamal Kant Sahu
- Department of Medicine, Saint Vincent Hospital, Worcester, MA, USA.
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Worcester, MA, USA.
| | - Paroma Mitra
- Department of Psychiatry, Bellevue Hospital Center, New York University School of Medicine, New York, NY, USA
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Fellmeth G, Harrison S, Opondo C, Nair M, Kurinczuk JJ, Alderdice F. Validated screening tools to identify common mental disorders in perinatal and postpartum women in India: a systematic review and meta-analysis. BMC Psychiatry 2021; 21:200. [PMID: 33879130 PMCID: PMC8056564 DOI: 10.1186/s12888-021-03190-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 03/30/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Perinatal common mental disorders are associated with significant adverse outcomes for women and their families, particularly in low- and middle-income settings. Early detection through screening with locally-validated tools can improve outcomes. METHODS We searched MEDLINE, Embase, PsycINFO, Global Health, Cochrane Library, Web of Science and Google Scholar for articles on the validation of screening tools for common mental disorders in perinatal women in India, with no language or date restrictions. Quality was assessed using the QUADAS-2 tool. We used bivariate and hierarchical summary receiver operating characteristic models to calculate pooled summary estimates of sensitivity and specificity. Heterogeneity was assessed by visualising the distance of individual studies from the summary curve. RESULTS Seven studies involving 1003 women were analysed. All studies assessed the validity of the Edinburgh Postnatal Depression Scale (EPDS) in identifying perinatal depression. No validation studies of any other screening tools were identified. Using a common threshold of ≥13 the EPDS had a pooled sensitivity and specificity of 88·9% (95%CI 77·4-94·9) and 93·4 (95%CI 81·5-97·8), respectively. Using optimal thresholds (range ≥ 9 to ≥13) the EPDS had a pooled sensitivity and specificity of 94·4% (95%CI 81·7-98·4) and 90·8 (95%CI 83·7-95·0), respectively. CONCLUSION The EPDS is psychometrically valid in diverse Indian settings and its use in routine maternity care could improve detection of perinatal depression. Further research is required to validate screening tools for other perinatal common mental disorders in India.
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Affiliation(s)
- Gracia Fellmeth
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK.
| | - Siân Harrison
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Charles Opondo
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Manisha Nair
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Jennifer J Kurinczuk
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Fiona Alderdice
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, BT9 7BL, Northern Ireland
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24
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Comorbid anxiety and depression: Prevalence and associated factors among pregnant women in Arba Minch zuria district, Gamo zone, southern Ethiopia. PLoS One 2021; 16:e0248331. [PMID: 33690693 PMCID: PMC7946223 DOI: 10.1371/journal.pone.0248331] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 02/24/2021] [Indexed: 01/08/2023] Open
Abstract
Introduction Prenatal anxiety and depression are major health problems all over the world. The negative sequela of prenatal comorbid anxiety and depression (CAD) has been suggested to be higher than that of anxiety or depression alone. CAD increases the odds of preterm birth, low birth weight, prolonged labor, operative deliveries, postpartum psychiatric disorders and long term cognitive impairment for the newborn. Despite its significant ill consequences, there is a dearth of studies in low-and middle-income countries. So far, to the best of our knowledge, no study assessed the prevalence of CAD in Ethiopia. Hence, the purpose of this study was to assess CAD and associated factors among pregnant women in Arba Minch Zuria district, Gamo zone, southern Ethiopia. Methods A community-based cross-sectional study was conducted among 676 pregnant women from January 01 to November 30, 2019. Patient Health Questionnaire 9-item (PHQ-9) and Generalized Anxiety Disorder 7-item (GAD-7) scales were used to assess depression and anxiety respectively. The data were collected electronically using an open data kit (ODK) collect android application and analyzed using Stata version 15.0. Bivariate and multivariable analyses were carried out to identify factors associated with CAD using binary logistic regression. Statistical significance was set at p-value < 0.05. Results A total of 667 women were involved. The prevalence of CAD was 10.04% [95% confidence interval (CI): 7.76, 12.33]. Being married [adjusted odds ratio (AOR): 0.16, 95% CI: 0.05, 0.56], categorized in the highest wealth quintile [AOR: 2.83, 95% CI: 1.17, 6.84], having medical illness [AOR: 3.56, 95% CI: 1.68, 7.54], encountering pregnancy danger signs [AOR: 2.66, 95% CI: 1.06, 6.67], experiencing life-threatening events [AOR: 2.11, 95% CI: 1.15, 3.92] and household food insecurity [AOR: 3.51, 95% CI: 1.85, 6.64] were significantly associated with CAD. Conclusions In general, one in every ten women faced CAD in the study area. Nutritional interventions, early identification and treatment of pregnancy-related illness and medical ailments, prenatal mental health problems screening and interventions are imperative to minimize the risk of CAD in pregnant women.
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Kalra H, Tran TD, Romero L, Chandra P, Fisher J. Prevalence and determinants of antenatal common mental disorders among women in India: a systematic review and meta-analysis. Arch Womens Ment Health 2021; 24:29-53. [PMID: 32055988 DOI: 10.1007/s00737-020-01024-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 01/26/2020] [Indexed: 02/06/2023]
Abstract
To review the available evidence about the prevalence and determinants of antenatal common mental disorders (antenatal CMDs) among women in India. We searched Ovid Medline, Embase and Psyinfo systematically from date of inception to Oct. 31, 2019 for publications in English language on the prevalence of antenatal CMDs and their determinants among women in India. All study designs were included. Quality was assessed with Standard Quality Assessment Criteria for Evaluating Primary Research Papers. We performed a meta-analysis using a random effects model. Twenty-seven studies involving 7780 women were analysed. There was a high degree of heterogeneity ((I2 = 97.53%). Publication bias [Egger bias = 0.65 (95% CI: 0.36; .94)] was evident. The overall pooled estimate of the prevalence of antenatal CMDs was 21.87% (95% CI: 17.46; 26.29). Significant risk factors reported in the 18 studies which examined them were negative reaction of husband or in-laws to the dowry, difficult relationship with husband/in-laws, lack of support or experiencing violence perpetrated by an intimate partner and preference for or feeling pressured to have a male child. Protective factors were having more education and being employed, having a supportive husband and opportunities for recreation during pregnancy. Antenatal CMDs are highly prevalent among women in India. There is an urgent need for locally developed policies and programmes for mental health promotion during pregnancy, preventive and early intervention for antenatal CMDs among women to be integrated into maternity care in India.
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Affiliation(s)
- Harish Kalra
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, 3004, Melbourne, VIC, Australia. .,Ballarat Rural Clinical School, University of Notre Dame Australia, 01 Drummond St Nth, 3350, Ballarat Central, VIC, Australia. .,Raphael Services, Ballarat, St John of God Health Care Social Outreach, 105 Webster St, 3350, Ballarat Central, VIC, Australia. .,Ballarat Health Services-Mental Health Services, Sturt St, 3350, Ballarat Central, VIC, Australia.
| | - Thach Duc Tran
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, 3004, Melbourne, VIC, Australia
| | - Lorena Romero
- The Ian Potter Library, The Alfred Hospital, 55 Commercial Rd, 3004, Melbourne, VIC, Australia
| | - Prabha Chandra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Hosur Road, Bengaluru, 560029, Karnataka, India
| | - Jane Fisher
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, 3004, Melbourne, VIC, Australia
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Becker-Sadzio J, Gundel F, Kroczek A, Wekenmann S, Rapp A, Fallgatter AJ, Deppermann S. Trauma exposure therapy in a pregnant woman suffering from complex posttraumatic stress disorder after childhood sexual abuse: risk or benefit? Eur J Psychotraumatol 2020; 11:1697581. [PMID: 33343833 PMCID: PMC7734094 DOI: 10.1080/20008198.2019.1697581] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Mental disorders during pregnancy are common and affect the health of mother and child. Despite a relatively high prevalence rate, treatment options have not been investigated systematically. Particularly symptoms of posttraumatic stress disorder (PTSD) may increase significantly during the course of pregnancy. However, proper guidelines for psychotherapeutic treatment of PTSD during pregnancy do not exist. Objective: In this article, we aimed at discussing the effects of untreated PTSD on pregnancy and postpartum mother-child bonding as well as exposure therapy during pregnancy. Method: To do so, we present the case of a pregnant woman with complex PTSD following childhood sexual abuse. At the time of hospitalization, the patient was pregnant in the second trimester and reported intrusive re-experiencing of the traumatic events, nightmares, anxiety and helplessness as well as an impairing level of irritability during social situations. After a careful discussion of the case within our department and at the annual conference of the German Association of Psychiatry, Psychotherapy and Psychosomatics, we decided to treat the patient with dialectical behavior therapy for PTSD (DBT-PTSD) including exposure therapy under the regular observation of a gynecologist. Psychometric measurements (Davidson Trauma Scale (DTS) and Borderline Symptom- List-23 (BSL-23) were used to observe the course of treatment regarding common PTSD-symptoms and disturbances in self-organization (DSO). Results: The intensity of intrusions and hyperarousal increased from the date of admission, reached the maximum when exposure started and decreased below baseline-level at the end of treatment. Avoidance behavior continually decreased from the beginning until the end of therapy. Decreased BSL-23 values show major improvements regarding DSO. To our knowledge, the course of pregnancy was not affected by treatment-induced psychological and physical symptoms.Conclusions: DBT- PTSD is a potential treatment option for patients suffering from PTSD during pregnancy. Yet, further (epigenetic) research in this field is urgently needed.
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Affiliation(s)
- Julia Becker-Sadzio
- Department of Psychiatry and Psychotherapy, University Hospital Tuebingen, Calwerstr. 14, Tuebingen, Germany
| | - Friederike Gundel
- Department of Psychiatry and Psychotherapy, University Hospital Tuebingen, Calwerstr. 14, Tuebingen, Germany
| | - Agnes Kroczek
- Department of Psychiatry and Psychotherapy, University Hospital Tuebingen, Calwerstr. 14, Tuebingen, Germany
| | - Stefanie Wekenmann
- Department of Psychiatry and Psychotherapy, University Hospital Tuebingen, Calwerstr. 14, Tuebingen, Germany
| | - Alexander Rapp
- Department of Psychiatry and Psychotherapy, Klinikum Stuttgart, Stuttgart, Germany
| | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, University Hospital Tuebingen, Calwerstr. 14, Tuebingen, Germany
| | - Saskia Deppermann
- Department of Psychiatry and Psychotherapy, University Hospital Tuebingen, Calwerstr. 14, Tuebingen, Germany
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27
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Sanaeinasab H, Saffari M, Sheykh-Oliya Z, Khalaji K, Laluie A, Al Zaben F, Koenig HG. A spiritual intervention to reduce stress, anxiety and depression in pregnant women: Randomized controlled trial. Health Care Women Int 2020; 42:1340-1357. [PMID: 33180001 DOI: 10.1080/07399332.2020.1836643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We assessed the efficacy of a spiritually-integrated cognitive-behavioral educational group intervention for reducing stress, anxiety, depression, and blood pressure during pregnancy and improving delivery outcomes. A randomized controlled trial was conducted in 84 pregnant women randomly assigned to either the intervention or a control group. Demographic information was collected at baseline, along with measures of religiosity, stress, anxiety, depression, and blood pressure. Our intervention consisted of four 90-minute group sessions over 8 weeks that utilized a spiritually-integrated cognitive-behavioral approach to help participants cope with the stress of pregnancy. Stress, anxiety and depression scores in the intervention group decreased significantly by 41%, 28%, and 41%, respectively, from baseline to 3-month follow-up. There were also significant differences in systolic and diastolic blood pressure between groups at the 3-month follow-up, favoring the intervention group. Between-group differences were also significant for these outcomes. Applying such spiritually-integrated intervention may help to improve the mental and physical health of young, healthy nulliparous pregnant women.
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Affiliation(s)
- Hormoz Sanaeinasab
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Health Education Department, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohsen Saffari
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Health Education Department, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Zarrindokht Sheykh-Oliya
- Health Education Department, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Kazem Khalaji
- Osteoporosis Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Afsaneh Laluie
- Obstetrics and Gynecology Department, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Faten Al Zaben
- Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Harold G Koenig
- Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.,Duke University Medical Center, Durham, North Carolina, USA.,School of Public Health, Ningxia Medical University, Yinchuan, China
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Stocker R, Nguyen T, Tran T, Tran H, Tran T, Hanieh S, Biggs BA, Fisher J. Social and economic development and pregnancy mental health: secondary analyses of data from rural Vietnam. BMC Public Health 2020; 20:1001. [PMID: 32586374 PMCID: PMC7318479 DOI: 10.1186/s12889-020-09067-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 06/05/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND This study aimed to establish whether changes in the socioeconomic context were associated with changes in population-level antenatal mental health indicators in Vietnam. METHODS Social, economic and public policies introduced in Vietnam (1986-2010) were mapped. Secondary analyses of data from two cross-sectional community-based studies conducted in 2006 (n = 134) and 2010 (n = 419), involving women who were ≥ 28 weeks pregnant were completed. Data for these two studies had been collected in structured individual face-to-face interviews, and included indicators of antenatal mental health (mean Edinburgh Postnatal Depression Scale Vietnam-validation (EPDS-V) score), intimate partner relationships (Intimate Bonds Measure Vietnam-validation) and sociodemographic characteristics. Socioeconomic characteristics and mean EPDS-V scores in the two study years were compared and mediation analyses were used to establish whether indicators of social and economic development mediated differences in EPDS-V scores. RESULTS Major policy initiatives for poverty reduction, hunger eradication and making domestic violence a crime were implemented between 2006 and 2010. Characteristics and circumstances of pregnant women in Ha Nam improved significantly. Mean EPDS-V score was lower in 2010, indicating better population-level antenatal mental health. Household wealth and intimate partner controlling behaviours mediated the difference in EPDS-V scores between 2006 and 2010. CONCLUSIONS Changes in the socioeconomic and political context, particularly through policies to improve household wealth and reduce domestic violence, appear to influence women's lives and population-level antenatal mental health. Cross-sectoral policies that reduce social risk factors may be a powerful mechanism to improve antenatal mental health at a population level.
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Affiliation(s)
- Ruby Stocker
- Global and Women's Health, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia
| | - Trang Nguyen
- Global and Women's Health, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia
- Research and Training Centre for Community Development, No 39 Lane 255, Vong Street, Hai Ba Trung District, Hanoi, Vietnam
| | - Thach Tran
- Global and Women's Health, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia
| | - Ha Tran
- Research and Training Centre for Community Development, No 39 Lane 255, Vong Street, Hai Ba Trung District, Hanoi, Vietnam
| | - Tuan Tran
- Research and Training Centre for Community Development, No 39 Lane 255, Vong Street, Hai Ba Trung District, Hanoi, Vietnam
| | - Sarah Hanieh
- Department of Medicine and Victorian Infectious Diseases Services at the Doherty Institute, University of Melbourne, 792 Elizabeth Street, Melbourne, 3000, Australia
| | - Beverley-Ann Biggs
- Department of Medicine and Victorian Infectious Diseases Services at the Doherty Institute, University of Melbourne, 792 Elizabeth Street, Melbourne, 3000, Australia
| | - Jane Fisher
- Global and Women's Health, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia.
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Wajid A, van Zanten SV, Mughal MK, Biringer A, Austin MP, Vermeyden L, Kingston D. Adversity in childhood and depression in pregnancy. Arch Womens Ment Health 2020; 23:169-180. [PMID: 31016472 DOI: 10.1007/s00737-019-00966-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 04/02/2019] [Indexed: 12/19/2022]
Abstract
Adverse childhood experiences (ACEs) have been found to be associated with various health conditions; however, there is dearth of evidence on the relationship between ACEs and prenatal depression. This study was conducted to determine the association between overall ACE score and prenatal depression symptoms, assess the moderating effect of social support and partner support on this relationship, and determine the association between individual ACE scores and prenatal depression. A secondary analysis was conducted of data from an RCT that assessed the feasibility of e-screening for maternal mental health among 636 pregnant women recruited from antenatal clinics. Two logistic regression models were built to reach our objectives. Over 80% of the participants were older than 25 years and had education beyond high school. Eighteen percent of the women had an ACE score of four or more. Univariable analysis found a 2.5-fold increase in the odds of prenatal depression for women with an ACEs score of ≥ 4. When examining the overall ACE score, lack of social support during pregnancy [AOR = 4.16; 95%CI (2.10-10.35)] and partner's relationship [AOR = 2.23; 95%CI (1.12-4.44)] were associated with prenatal depression while among the individual ACE scores, living with a person who went to prison was found to be associated with prenatal depression even when controlled for all variables. No moderating effect was found. These findings suggest for the improvement of partner's relationship and provision of social support before women conceive, in order to mitigate the effect of these adversities.
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Affiliation(s)
- Abdul Wajid
- Faculty of Nursing, University of Calgary, 2500 University Dr. N.W, Calgary, Alberta, T2N 1N4, Canada
| | | | - Muhammad Kashif Mughal
- Faculty of Nursing, University of Calgary, 2500 University Dr. N.W, Calgary, Alberta, T2N 1N4, Canada
| | - Anne Biringer
- Department of Family Medicine, University of Toronto, Toronto, Canada.,Family Medicine Maternity Care, Mount Sinai Hospital, Toronto, Canada
| | - Marie-Paule Austin
- St John of God Chair Perinatal and Women's Mental Health, University of New South Wales, Sydney, Australia
| | - Lydia Vermeyden
- Healthy Outcomes of Pregnancy & Postpartum Experiences (HOPE) Research Program, Faculty of Nursing, University of Calgary, Calgary, Canada
| | - Dawn Kingston
- Faculty of Nursing, University of Calgary, 2500 University Dr. N.W, Calgary, Alberta, T2N 1N4, Canada.
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30
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Fan Q, Long Q, De Silva V, Gunarathna N, Jayathilaka U, Dabrera T, Lynn H, Østbye T. Prevalence and risk factors for postpartum depression in Sri Lanka: A population-based study. Asian J Psychiatr 2020; 47:101855. [PMID: 31733601 DOI: 10.1016/j.ajp.2019.101855] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/21/2019] [Accepted: 10/21/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Previous studies in Sri Lanka have shown a high prevalence of postpartum depression (PPD). Postpartum depression screening using the Edinburgh Postnatal Depression Scale (EPDS) has been validated and included in routine postnatal care in 2012. OBJECTIVES This study aimed to estimate the prevalence of PPD at 10 days and 4 weeks postpartum in 2017 in two medical officer of health (MOH) areas in Sri Lanka, and to assess the association between risk factors and postpartum depression. METHODS An EPDS total score higher than 9 was used to estimate the prevalence of postpartum depression. PPD outcomes were assessed by mothers' responses to the EPDS. Potential risk factors were extracted from routine paper-based medical records. The associations were examined using simple and multivariable linear regression and multivariate logistic regression models. RESULTS A total of 1349 mothers in the two areas, 523 from Dankotuwa and 826 from Bope Poddala, were included. The prevalence of PPD was 15.5% and 7.8% among mothers assessed 10 days postpartum (in Dankotuwa) and 4 weeks postpartum (in Bope Poddala), respectively. EPDS total scores were positively related to delivery age of mothers. Presence of postpartum depression was significantly associated with delivery age over 35, having more than 4 living children and mothers' diseases. Mothers who attended prenatal sessions and whose partners were employed were less likely to report postpartum depression. CONCLUSION The prevalence of PPD in Sri Lanka was 15.5% at 10 days and 7.8% at 4 weeks postpartum. Future studies on the effect of time since delivery on postpartum depression screening outcomes are warranted.
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Affiliation(s)
- Qiping Fan
- Duke University, Durham, North Carolina, United States; Global Health Research Center, Duke Kunshan University, Jiangsu, China.
| | - Qian Long
- Global Health Research Center, Duke Kunshan University, Jiangsu, China.
| | - Vijitha De Silva
- Duke University, Durham, North Carolina, United States; Global Health Research Center, Duke Kunshan University, Jiangsu, China; Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.
| | | | | | - Thushani Dabrera
- Regional Director of Health Service Office, Puttalam, Sri Lanka.
| | - Henry Lynn
- School of Public Health, Fudan University, Shanghai, China.
| | - Truls Østbye
- Duke University, Durham, North Carolina, United States; Global Health Research Center, Duke Kunshan University, Jiangsu, China.
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Aurpibul L, Tongprasert F, Wichasilp U, Tangmunkongvorakul A. Depressive Symptoms Associated with Low Quality of Life Among Pregnant and Postpartum Women Living with HIV in Chiang Mai, Thailand. Int J MCH AIDS 2020; 9:421-429. [PMID: 33163291 PMCID: PMC7604762 DOI: 10.21106/ijma.375] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND OR OBJECTIVES Women living with HIV (WLHIV) are at increased risk of depression. In pregnancy, depression could affect health and pregnancy outcomes, as well as child rearing. We assessed depressive symptoms and quality of life of WLHIV during the perinatal period. METHODS This cross-sectional study was conducted at 15 hospitals in Chiang Mai, Thailand. The Patient Health Questionnaire-9 and the World Health Organization quality of life questionnaire (WHOQOL-BREF_THAI) were used to screen for depressive symptoms and to assess quality of life (QOL), respectively. Statistical analysis was performed by the SPSS. Descriptive statistics were reported. Factors associated with depressive symptoms were assessed by univariate and multivariate analyses. Linear regression analysis was performed to determine association between depressive symptom scores and QOL. Regression coefficient (b) and 95% confidence intervals (CI) were reported. P-values < 0.05 were considered statistically significant. RESULTS One hundred WLHIV were enrolled and the mean age was 29.2 ±7.5 years. The overall prevalence of depressive symptoms was 30 (30%), 95% CI 21-39; specifically, 34 (34%) in pregnant and 27 (27%) in postpartum women. Overall, depressive symptoms were mild in 22 (22%), moderate in 7 (7%), and moderately severe in one (1%). Multivariate logistic regression analysis revealed that verbal abuse by partner (b=4.751 (95% CI=2.306-9.790), p< 0.001) and lifetime alcohol use (b=3.403 (95% CI=1.427-8.115), p=0.006) were associated with depressive symptoms. The overall perception of own health and quality of life of WLHIV in all domains were lower than that of HIV-negative women. WLHIV with depressive symptoms had a significantly lower QOL than those without. CONCLUSION AND GLOBAL HEALTH IMPLICATIONS In this study, the prevalence of depressive symptoms in women living with HIV was similar to that in HIV-negative women. WLHIV with depressive symptoms had a significantly lower QOL than those without. Mental health screening in antenatal and postpartum clinic is warranted.
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Affiliation(s)
- Linda Aurpibul
- Research Institute for Health Sciences, Chiang Mai University, 110 Intavaroros Road,Sri Phum Subdistrict, Muang Chiang Mai District, Chiang Mai 50200, Thailand
| | - Fuanglada Tongprasert
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Sri Phum Subdistrict, Muang Chiang Mai District, Chiang Mai 50200, Thailand
| | - Uraiwan Wichasilp
- Nakornping Hospital, 159 Chotana Road, Don Kaeo Subdistrict, Mae Rim District, Chiang Mai 50180, Thailand
| | - Arunrat Tangmunkongvorakul
- Research Institute for Health Sciences, Chiang Mai University, 110 Intavaroros Road,Sri Phum Subdistrict, Muang Chiang Mai District, Chiang Mai 50200, Thailand
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Noorbala AA, Afzali HM, Abedinia N, Akhbari M, Moravveji SA, Shariat M. Investigation of the effectiveness of psychiatric interventions on the mental health of pregnant women in Kashan City - Iran: A clinical trial study. Asian J Psychiatr 2019; 46:79-86. [PMID: 31639554 DOI: 10.1016/j.ajp.2019.09.036] [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: 08/24/2019] [Revised: 09/29/2019] [Accepted: 09/29/2019] [Indexed: 11/29/2022]
Abstract
AIM Pregnancy is one of the most sensitive periods in a person's life; therefore maternal mental illness during pregnancy increases the risk for adverse developmental outcomes in children (Jha et al., 2018). The aim of this study was to determine the effectiveness of psychiatric interventions in the mental health of pregnant women in Kashan, Iran. METHODS The purpose of this clinical trial was to evaluate an integrated model of mental health during pregnancy over the period of 2015-2018 in Kashan. Subjects consisted in 202 pregnant women (101 in the intervention group and 101 in the control group) who were referred to Kashan Health Centers in the 6th to 10th weeks of pregnancy. The General Health Questionnaire-28, Golombok Rust Inventory of Marital State, an interview on psychiatric symptoms, and a review of the history of the mental health of the mother and first-degree relatives were utilized for data collection. In the intervention group, psychiatric measures and predictive drug treatments were presented. RESULTS Overall, from among 102 pregnant mothers, 39 women (37.14%) were identified as at-risk and high-risk. The highest number of mothers identified as at-risk and high-risk were in the first trimester of pregnancy and in the 6th to 10th weeks of care (64%). With the start of psychiatric interventions in the intervention group, the subscale of physical complaints and anxiety showed a significant decrease compared to the control group (P < 0.01). Mental health improvement was achieved in 95% of expectant mothers through Level I predictive measures, and only 5% of participants required the specialist level of intervention. CONCLUSION By identifying psychiatric disorders in pregnant mothers during the first level of pregnancy care services and taking suitable measures, an integrated model for mental health services in primary health care for pregnant women can help managers, policymakers, and decision-makers to improve health and reduce the costs in the health system in order to achieve the Sustainable Development Goals.
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Affiliation(s)
- Ahmad Ali Noorbala
- Psychosomatic Medicine Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hossein Malek Afzali
- Department of Epidemiology and Statistics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Nasrin Abedinia
- Family Health Research, Maternal, Fetal and Neonatal Health Research Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | - Marzieh Akhbari
- Department of Mental Health, Health Deputy, Kashan University of Medical Science, Kashan, Iran
| | | | - Mamak Shariat
- Department of Pediatrics, Institute of Family Health, Maternal, Fetal and Neonatal Health Research Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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First trimester depression and/or anxiety disorders increase the risk of low birthweight in IVF offspring: a prospective cohort study. Reprod Biomed Online 2019; 39:947-954. [DOI: 10.1016/j.rbmo.2019.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 08/07/2019] [Accepted: 09/05/2019] [Indexed: 01/18/2023]
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Validity and reliability of the Urdu version of the Hospital Anxiety & Depression Scale for assessing antenatal anxiety and depression in Pakistan. Asian J Psychiatr 2019; 45:20-25. [PMID: 31472309 DOI: 10.1016/j.ajp.2019.08.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 08/22/2019] [Accepted: 08/22/2019] [Indexed: 11/20/2022]
Abstract
This study aims to elucidate the appropriate factor structure for Hospital Anxiety & Depression Scale (HADS) for assessment of anxiety and depression symptoms during pregnancy among Pakistani women. This cross-sectional study was conducted during a 5 month period (2014) in four teaching hospitals of Lahore, Pakistan. Convenience sampling was done to recruit pregnant women availing obstetrics and gynecology services for routine prenatal or perinatal care in the respective departments of the four institutes. Trained interviewers interviewed the consenting participants using a pre-tested scale. All data were analyzed using SPSS v.20. Factor structure of the HADS was explored using Principal Axis Factoring (PAF) method. Goodness of fit of the factor structure was assessed using the Confirmatory Factor Analysis (CFA). Cronbach's alpha value for whole scale was good (α = 0.81). Sensitivity analysis involving assessment of Cronbach's alpha value after removal of each item, did not reveal any major deviations in overall internal consistency of the HADS. Parallel analysis suggested one factor solution to be viable. When one factor was extracted as a uni-dimensional measure of anxiety and depression: item 11 (I feel restless as I have to be on the move) and 14 (I can enjoy a good book or radio or TV program) were deemed problematic for having low communalities and factor loading values.
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Nath A, Venkatesh S, Balan S, Metgud CS, Krishna M, Murthy GVS. The prevalence and determinants of pregnancy-related anxiety amongst pregnant women at less than 24 weeks of pregnancy in Bangalore, Southern India. Int J Womens Health 2019; 11:241-248. [PMID: 31114392 PMCID: PMC6489575 DOI: 10.2147/ijwh.s193306] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background: A pregnant woman undergoes physiological as well as psychological changes during this phase of life during which anxiety is a commonly faced mental condition. There is sufficient evidence on the association of pregnancy specific anxiety with adverse pregnancy outcomes. Studies on anxiety during pregnancy from low and middle income countries are limited. Methods: This study included 380 pregnant women, having a confirmed pregnancy of less than 24 weeks without any obstetric complication, who were availing of antenatal care at a public sector hospital in Bangalore city. Pregnancy-related thoughts (PRT) scale was used to screen for anxiety. Details pertaining to sociodemographic data, obstetric history, psychosocial factors including social support, marital discord, domestic violence, consanguinity, history of catastrophic events, history of mental illness, current presence of depression and anxiety was obtained by means of electronic data capture using an Android-based App. Results: Out of 380 pregnant women, 195 (55.7%) were found to have pregnancy-related anxiety. Lower socioeconomic status, low social support and depression emerged as significant determinants of anxiety. Conclusion: The prevalence of anxiety was fairly high in the study population and isp therefore an important public health concern. Pregnancy-related anxiety must be identified early during routine antenatal care to prevent any untoward pregnancy outcomes.
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Affiliation(s)
- Anita Nath
- Indian Institute of Public Health Hyderabad-Bangalore Campus, Public Health Foundation of India, Bangalore, Karnataka, India
| | - Shubhashree Venkatesh
- Indian Institute of Public Health Hyderabad-Bangalore Campus, Public Health Foundation of India, Bangalore, Karnataka, India
| | - Sheeba Balan
- Indian Institute of Public Health Hyderabad-Bangalore Campus, Public Health Foundation of India, Bangalore, Karnataka, India
| | - Chandra S Metgud
- Department of Community Medicine, J.N. Medical College, KLE University, Belgavi, Karnataka, India
| | | | - Gudlavalleti Venkata Satyanarayana Murthy
- Indian Institute of Public Health Hyderabad, Public Health Foundation of India, Hyderabad, Telangana, India
- Department of Clinical Research, International Center for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK
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Tareen RS, Tandon R. A stitch in time saves nine: Untreated perinatal depression hurts future generations. Asian J Psychiatr 2018; 38:A1-A3. [PMID: 30470671 DOI: 10.1016/j.ajp.2018.11.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Ruqiya Shama Tareen
- Western Michigan University School of Medicine, 1000 Oakland Drive, Kalamazoo, MI, 49008, USA.
| | - Rajiv Tandon
- University of Florida College of Medicine, 1600 SW Archer Road, Gainesville, FL, 32669, USA.
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