The prevalence and risk factors of suicidal ideation in women with and without postpartum depression

Shadows of the past - Hierarchical regression analyses on the role of childhood maltreatment experiences for postpartum depression

BACKGROUND

Postpartum depression (PPD) is one of the most common mental disorders in parents after birth. To develop tailored preventive programs, it is necessary to identify risk factors for PPD in parents. This study aimed to examine the impact of parental childhood maltreatment (CM) as a risk factor for PPD.

METHODS

Data from a German study comprising n = 349 mothers and n = 46 fathers were used. Hierarchical regression models were performed to examine CM, educational background, single parenthood, emotion regulation and attachment style as predictors of symptoms of PPD. In exploratory analyses, potential mediators (i.e., parenting stress and emotion regulation) were investigated via a path model.

RESULTS

CM, low level of education, difficulties in emotion regulation, and attachment anxiety were significant predictors for maternal PPD [R2 = 0.52, F (6, 305) = 57.99, p < .001]. For fathers, difficulties in emotion regulation were identified as a predictor [R2 = 0.43, F (6, 24) = 4.78, p < .01]. In exploratory analyses, emotion regulation served as a mediator for the link between CM and PPD as well as for the link between CM and parenting stress.

LIMITATIONS

The study design is cross-sectional and based on self-report questionnaires. Despite our attempts, only few fathers participated in the study, resulting in an underpowered sample for the regression analyses.

CONCLUSIONS

The study confirmed the assumption that CM experiences represent a risk factor for the development of maternal PPD. Emotion regulation might provide a pivotal target for interventions with parents at-risk.

Translation and Validation of the Edinburgh Postnatal Depression Scale for Eritrea: A Screening Tool for Postpartum Depression in Primary Health Care Facilities

Introduction

Postpartum depression (PPD) is a mood disorder characterized by symptoms such as changes in sleep and eating patterns, fatigue, sadness, crying, anxiety, and guilt. The Edinburgh Postnatal Depression Scale (EPDS) was developed to be used as a self-report questionnaire for English-speaking populations to screen for postnatal depression. This study aims to translate, validate, and adapt the EPDS into Eritrean settings.

Methods

This study employed a cross-sectional study design to evaluate the performance of the EPDS as a screening tool by using a sample of 380 mothers from four primary healthcare facilities. The standard Diagnostic and Statistical Manual of Mental Disorders was used as a criterion to assess depression in postpartum women.

Results

Postpartum depression was identified in 28 (7.4%) of the mothers based on the standard Diagnostic and Statistical Manual of Mental Disorders. The translated Tigrinya version EPDS has good internal consistency with Cronbach's alpha of 0.712. The exploratory factor analysis identified three factors, confirming the EPDS's multidimensionality. The area under the receiver operating characteristic curve was 0.87, and optimal sensitivity and specificity combination was found at 10/11 score cut-off points, 85.7% and 88%, respectively.

Conclusion

The Eritrean version of EPDS has proven to be a valid and reliable instrument for the identification of postpartum depression in clinical settings.

Evaluation of depression at 6 and 12 months postpartum by examining depressive symptoms and self-harm ideation during the early postpartum period: Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study

Aim

The aim of this study was to evaluate depression at 6 and 12 months postpartum, using the Edinburgh Postpartum Depression Scale (EPDS) total score and its subitem regarding self-harm ideation (SHI) at 1 month postpartum.

Methods

A sample of 12,358 postpartum women answered the EPDS and questionaries at 1, 6, and 12 months postpartum longitudinally.

Results

For participants with postpartum depression (PPD; EPDS total score ≥9) and SHI (SHI sub-score ≥1) at 1 month postpartum, the risk of depression at 6 and 12 months postpartum (odds ratio [95% confidence interval] at 6 and 12 months postpartum: 20.03 [16.8-23.8] and 14.55 [12.3-17.2], respectively) was higher than for those with PPD but without SHI at 1 month postpartum (OR: 8.57 [7.36-10.0], and 6.24 [5.38-7.24], respectively). Additionally, SHI even without depressive symptoms at 1 month postpartum is also a risk for depression at 6 and 12 months postpartum. To support our longitudinal evaluation of depression at 6 and 12 months postpartum, these related factors were examined: traumatic events or relocations after the Great East Japan Earthquake, employment status, household income, personality traits, sleep status, psychological distress, and social networks. The result showed employment status, low household income and poor social networks were significantly associated with depression at 12 months postpartum but not at 6 months postpartum.

Conclusion

This study showed a high risk of depression at 6 and 12 months postpartum for those who had depressive symptoms with SHI at 1 month postpartum. Our findings may contribute to the precise evaluation of depression at 6 and 12 months postpartum while considering sleep status, psychological distress and social network during pregnancy.

The screening accuracy of the Edinburgh Postnatal Depression Scale (EPDS) to detect perinatal depression with and without the self-harm item in pregnant and postpartum women

BACKGROUND

This study aims to examine whether the Edinburgh Postnatal Depression Scale (EPDS), excluding the self-harm item (EPDS-9), performs as effectively as the full EPDS in identifying depression among perinatal women.

METHODS

A total of 3571 pregnant women and 3850 postpartum women participated in this observational study. Participants who scored ≥ 9 on the EPDS underwent further diagnostic evaluations by a clinical psychologist and/or psychiatrist.

RESULTS

The EPDS-9 and full EPDS demonstrated a near-perfect correlation in both the antepartum (r = 0.996) and postpartum (r = 0.998) cohorts. EPDS-9 showed exceptional precision in identifying depression as screened by the full EPDS at cutoff points ranging 9-14, with areas under the curve ≥0.998. The sensitivity of EPDS-9 and full EPDS to detect depression that requires psychotropic medications was poor. The highest accuracy for both versions was at a cutoff score of 9: sensitivity of 0.579 for the full EPDS and 0.526 for the EPDS-9. At the cutoff point of 9, EPDS-9 performed adequately in predicting the response of the participants to the self-harm item.

CONCLUSION

The EPDS-9 represents a solid and effective replacement for the full EPDS in clinical settings. If the presence of suicidal thoughts needs to be assessed, specialized scales should be used.

Exploring new scientific innovations in combating suicide: a stress detection wristband

There is a silent pandemic of suicides around the world, with an exponential increase in suicidality and chronic suicidal ideations. The exact global estimates cannot be accurately ascertained, but analysis will put it at more than a million annually. With countries like America having almost 50,000 and India alone reaching 200,000, annually. Countries like Bangladesh are nearly chronically suicidal. However, in Africa, Nigeria has a suicide rate of 17.3 per 100,000, which stands above the global 10.5 and Africa's 12.0. The rate of suicide is experiencing an exponential increase. As the world, regions, and countries work towards ways to combat the pandemic, scientists brainstorm on preventive modalities. Our team, "The Mending Mind" (Winners of the 2021 Innovation for Action Global Health Challenge) proposed a suicide-preventing innovation that actively works by pathologic stress level detection. The stress-detecting wristband. This innovation is feasible and the technology needed to invent it is available. Moreso, with the rise in Artificial Intelligence (AI) augmented devices, it can be modified over time to include other healthcare monitoring sequences.

Social Support and Postpartum Depressive Symptoms in Portuguese Women: The Mediating Role of Emotion Regulation Difficulties

Background/Objectives: Postpartum depression (PPD) is a prevalent mental health issue affecting 14% of mothers worldwide, with long-term implications for both maternal and child well-being. Understanding the factors contributing to PPD is essential for developing effective interventions. This study aimed to investigate the relationship between social support and postpartum depression symptoms, with a focus on the mediating role of emotion regulation difficulties. Methods: A sample of 160 postpartum women (M age = 33.57, SD = 4.94) participated in the study. Participants were assessed on their levels of perceived social support, difficulties in emotion regulation, and symptoms of PPD. Results: The results indicated that lower levels of social support were significantly associated with greater difficulties in emotion regulation (effects ranging from -0.10 to 0.07). These difficulties in turn were linked to higher levels of postpartum depression symptoms (effects ranging from -0.29 to 0.78), suggesting a partial mediation effect from emotional awareness (95% CI -0.05, -0.00), non-acceptance of emotions (95% CI -0.04, -0.00), difficulty in goal-directed behavior (95% CI -0.04, -0.00), and limited access to strategies (95% CI -0.12, -0.04). Conclusions: These findings underscore the critical role of both social support and emotion regulation in the development of PPD symptoms. Enhancing emotion regulation skills, particularly for women with limited social support, could be a key target for interventions aimed at reducing the risk and severity of PPD.

Global Overview of Suicidal Behavior and Risk Factors among General Population during the COVID-19 Pandemic: A Systematic Review and a Meta-Regression

The COVID-19 pandemic has significantly impacted mental health worldwide, leading to increased rates of suicidal behavior. This systematic review and meta-regression aim to investigate the global prevalence and risk factors associated with suicidal behaviors in the general population during the pandemic. The study included 202 articles from January 1, 2019, to October 31, 2023, sourced from databases such as Embase, MEDLINE, CINAHL, Web of Science, and Cochrane Library. The meta-analysis revealed a prevalence of 13.5% for suicidal ideation, 10.4% for suicide attempts, and a death rate of 0.5%, translating to 4.52 per 100,000 person-years. Significant risk factors identified include being transgender, young adults (18-44 years), unmarried status, low education, retirement, living alone, low social support, a history of suicide attempts, substance use, depression, anxiety, PTSD, sleep problems, poor perceived physical health, loneliness, quarantine, and residing in the Americas or multiple regions. The findings underscore the urgent need for targeted mental health interventions during pandemics, focusing on high-risk groups such as young adults, transgender individuals, those with low social support, and people with mental health issues. This comprehensive analysis provides valuable insights for policymakers and healthcare providers to develop effective strategies to mitigate the heightened risk of suicide during global health crises.

Digital Training for Nurses and Midwives to Improve Treatment for Women with Postpartum Depression and Protect Neonates: A Dynamic Bibliometric Review Analysis

The high prevalence of postpartum depression makes it necessary for midwives and nurses to implement prenatal interventions for expectant mothers. The current study aims to investigate and highlight the importance of the digital training of nurses in order to help women mitigate the symptoms of postpartum depression and protect infants. To approach this, we conducted a bibliometric analysis to address the study's main objective. Articles were retrieved from the Scopus database for the timeframe 2000-2023. Data analysis was conducted using the statistical programming language R (version R-4.4.) and the bibliometric software VOSviewer (version 1.6.20) and Biblioshiny (version 4.1.4), focused on year, journal, and country. For this investigation, we selected a total of 31 MeSH keywords and sub-headings that exhibited significant frequencies. We consistently used six significant clusters of MeSH keywords. We obtained a total of 585 articles from the Scopus database that were major contributors to the field of PPD, as evidenced by their extensive publication of research articles and their influential role in the domain. The studies included a thorough analysis of depression research, the use of scales for diagnosing and screening PPD, psychological studies related to PPD, and the exploration of causes, mechanisms, outcomes, and genetic factors. Our study's results demonstrate a steady and significant increase in the availability of information on PPD. Importantly, the novelty of the current study lies in highlighting the need for a transition in the ways in which nurses and midwives are trained to mitigate postpartum disease by integrating emerging technologies into their practices. The knowledge provided here has the potential to serve as a foundation for future advancements in obstetric psychology, both presently and in the future.

Common mental disorders and perinatal outcomes in Victoria, Australia: A population-based retrospective cohort study

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.

The Relationship between the Intrapartum Experience and the Risk of Postpartum Depression among Jordanian Women: A Cross-Sectional Study

BACKGROUND

This study seeks to investigate the relationship between birth experience and risk of developing postpartum depression among Jordanian women. Furthermore, it aims to explore the prevalence and risk factors of postpartum depression and raise awareness of it among Jordanians.

MATERIAL AND METHODS

This study was carried out on 214 postpartum Jordanian women at Jordan University Hospital (JUH). A questionnaire was handed to participants which touched on demographics, intrapartum experience, along with the Edinburgh Postnatal Depression Scale (EPDS), and the psychosocial factors affecting them.

RESULTS

Among the 214 respondents, 184 women (86%) had postpartum depression according to EPDS, those with high scores and statistically significant p-values include individuals diagnosed with depression (15.89, p = 0.163), those who had previous consultations with a mental health specialist (16.61, p = 0.037), individuals under 18 (18.75, p = 0.028), those who underwent vaginal delivery (15.12, p = 0.008), underwent episiotomy (15.92, p = 0.023), lacked support from the medical team (13.21, p < 0.001), expressed dissatisfaction with childbirth care (17.03, p < 0.001), experienced body image issues during pregnancy (15.74, p = 0.008) and after birth (16.11, p = 0.001), felt anxiety about motherhood (15.88, p < 0.001), reported insufficient emotional support during pregnancy (17.49, p < 0.001), and after childbirth (17.00, p < 0.001).

CONCLUSION

A significant proportion of Jordanian women are at an increased risk of developing postpartum depression. A maternal age under 18, normal vaginal delivery including episiotomy, and lack of support among others were identified as risk factors for postpartum depression (PPD).