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Girma B, Sibhat M, Getnet A, Teklehaimanot WZ, Mengstie LA, Gebeyehu MT, Nigussie J. Common mental disorders and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis. BMC Psychiatry 2025; 25:430. [PMID: 40296015 PMCID: PMC12039121 DOI: 10.1186/s12888-025-06880-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 04/17/2025] [Indexed: 04/30/2025] Open
Abstract
BACKGROUND Common mental disorders are the most common public health problems, especially in low and middle-income countries. The burden is high among pregnant women. However, the concern given to this problem is less and isn't assessed during the antenatal period. In Ethiopia, there was no summarized evidence about the problem in this particular population. Therefore, this systematic review and meta-analysis aimed to assess the pooled magnitude of common mental disorders among pregnant mothers and their associated factors in Ethiopia. METHODS We used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines to write this review and meta-analysis. Only primary studies published in English were included. The Egger's test and funnel plot were done to assess the publication bias Heterogeneity was assessed by I2 and subgroup analysis was conducted to identify the source. A random effect model was used to perform the analysis. An association was declared with a pooled adjusted odds ratio with 95% CI. RESULT A total of 11 studies were included and the pooled magnitude of common mental disorders was 27.00 [95% CI: 20.47, 33.53]. Unplanned pregnancy [pooled AOR: 2.82 with 95% CI (2.23, 3.58)], intimate partner violence [pooled AOR: 2.81 with 95% CI (2.29, 3.46), substance use [pooled AOR: 2.97 with 95% CI (2.29, 3.85)], chronic disease [pooled AOR: 3.60; 95% CI (2.19, 5.91)], obstetric complications [pooled AOR: 2.78 with 95% CI (1.89, 4.07)] and family history of psychiatric illness [pooled AOR: 4.03 with 95% (2.58, 6.30)] were significant predictors for common mental disorders. CONCLUSION In this meta-analysis, the pooled magnitude of common mental disorders was high as compared to the global report. Substance use, chronic disease, unplanned pregnancy, intimate partner violence, having a history of obstetric complications, and a family history of psychiatric illness were significantly associated with common mental disorders. The Federal Ministry of Health should design a strategy that helps to assess the mental health of pregnant women during their antenatal care follow-up. Moreover, healthcare providers should focus on and support pregnant women who have the above factors.
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Affiliation(s)
- Bekahegn Girma
- Department of Pediatrics and Child Health Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia.
| | - Migbar Sibhat
- Department of Nursing, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia
| | - Addisu Getnet
- Department of Midwifery, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia
| | - Wegayehu Zeneb Teklehaimanot
- Department of Pediatrics and Child Health Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Leweyehu Alemaw Mengstie
- Department of Pediatrics and Child Health Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Mohammed Tessema Gebeyehu
- Department of Pediatrics and Child Health Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Jemberu Nigussie
- School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Verhees FG, Bendau A, Unger S, Donix KL, Asselmann E, Martini J. Panic disorder during pregnancy and the first three years after delivery: a systematic review. BMC Pregnancy Childbirth 2025; 25:36. [PMID: 39825251 PMCID: PMC11740555 DOI: 10.1186/s12884-024-07127-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Accepted: 12/30/2024] [Indexed: 01/20/2025] Open
Abstract
BACKGROUND Panic disorder (PD) is highly prevalent during the peripartum period. The aim of this systematic review was to summarize evidence on risk factors and course patterns of peripartum PD as well as maternal, infant or dyadic outcomes during the first three years after delivery. METHODS A literature search was conducted according to PRISMA guidelines. Inclusion criteria were: (1) a diagnosis of PD or panic attacks during pregnancy, (2) risk factors and course as well as maternal, infant or dyadic outcomes measured in pregnancy and/or up to 3 years postpartum (3) peer-reviewed articles in English or German published between 1980 and April 2024. After screening of n = 2,740 records, n = 75 records based on n = 64 projects were eligible for this systematic review. RESULTS Overall, n = 47 studies investigated the course of PD during the peripartum period, n = 23 studies examined the associations of PD and obstetric, neonatal or infant outcomes, and n = 5 studies focused on the associations of PD and characteristics of the mother-infant dyad. We found (1) no common trajectory, but heterogeneous courses of maternal PD in the peripartum period, (2) associations of maternal PD with birth complications and subsequent postpartum depression, and (3) evidence for associations of PD with infant and dyadic outcomes. LIMITATIONS Diverse outcome measures in recent original publications did not allow for a meta-analytic approach. CONCLUSION Heterogenous courses and outcomes of peripartum PD require comprehensive monitoring of affected mothers and their infants. There is a need for further longitudinal investigations into familial transmission of anxiety disorders.
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Affiliation(s)
- F Gerrik Verhees
- Department of Psychiatry & Psychotherapy, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Antonia Bendau
- Faculty of Health, HMU Health and Medical University, Potsdam, Germany
| | - Stefanie Unger
- Department of Psychiatry & Psychotherapy, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
- Faculty of Medicine, Institute and Policlinic of Occupational and Social Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Katharina L Donix
- Department of Psychiatry & Psychotherapy, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Eva Asselmann
- Faculty of Health, HMU Health and Medical University, Potsdam, Germany
| | - Julia Martini
- Department of Psychiatry & Psychotherapy, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany.
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
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Nishi D, Imamura K, Watanabe K, Obikane E, Sasaki N, Yasuma N, Sekiya Y, Matsuyama Y, Kawakami N. The preventive effect of internet-based cognitive behavioral therapy for prevention of depression during pregnancy and in the postpartum period (iPDP): a large scale randomized controlled trial. Psychiatry Clin Neurosci 2022; 76:570-578. [PMID: 36114656 PMCID: PMC9826475 DOI: 10.1111/pcn.13458] [Citation(s) in RCA: 6] [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: 05/09/2022] [Revised: 06/30/2022] [Accepted: 07/27/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Prevention of perinatal depression beginning from the antenatal period is essential. Therefore, this study aimed to investigate the effectiveness of recently developed internet-delivered cognitive behavioral therapy (iCBT) for preventing the onset of a major depressive episode (MDE) in the third trimester and at 3 months postpartum. METHODS This is a two-arm, parallel-group, general-information controlled, randomized controlled trial. Participants were 5017 pregnant women at 16-20 weeks' gestation without MDE at baseline. They were randomly assigned to an iCBT (intervention; n = 2509) or general-information (control; n = 2508) group, stratified by psychological distress at baseline. The primary outcomes were the numbers of new MDE onsets, measured using the World Health Organization Composite International Diagnostic Interview 3.0, at 32 weeks' gestation and at 3 months postpartum. RESULTS New MDE onset was reported by 59 participants (2.35%) in the intervention group and 73 (2.91%) in the control group during follow-up. Compared with the control group, the hazard ratio (HR) of MDE in the intervention group was 0.85 (95% CI 0.61-1.20), which was not significantly different. Among participants who scored between 5 and 8 on K6 at baseline, 10 (1.37%) in the intervention group reported new onset of MDE, compared with 28 (3.81%) in the control group, and the HR of MDE was 0.38 (95%CI 0.19-0.79). CONCLUSIONS No intervention effect was found for iCBT in preventing new onset of perinatal MDE. iCBT might prevent perinatal depression only among pregnant women with subthreshold depressive symptoms. TRIAL REGISTRATION UMIN000038190.
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Affiliation(s)
- Daisuke Nishi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Public Mental Health Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kotaro Imamura
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuhiro Watanabe
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
| | - Erika Obikane
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Natsu Sasaki
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Yuki Sekiya
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yutaka Matsuyama
- Department of Biostatistics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Kusumawati Y, Widyawati W, Dewi FST. [Vulnerable to mental health problems: Pregnant women and husband's perception in Surakarta, Indonesia]. ENFERMERIA CLINICA (ENGLISH EDITION) 2022; 32:334-343. [PMID: 36084999 DOI: 10.1016/j.enfcle.2021.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 12/10/2021] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This study aims to explore the perception of women and their husbands on the vulnerability of pregnant women to mental health disorders. METHOD Qualitative study using a phenomenological approach. The inclusion criteria were pregnant women of the second and third-trimester gestation (13-35 weeks). The exclusion criteria were pregnant women with complications and who had a family record of mental disorders. Data was collected using focus group discussion and in-depth interviews at four Primary Health Cares in Surakarta, Indonesia. Then, the data were analyzed through thematic analysis, which was supported by the OpenCode 4.02® software. RESULTS This study uncovered two main topics, firstly the factors that trigger the vulnerability of pregnant women to experience mental disorders and secondly perceived barriers to managing mental health during pregnancy and postpartum. Pregnant women and husbands recognize that they need to get mental health information. CONCLUSION Unstable emotions during pregnancy are considered normal and neglected by their surroundings. Lack of knowledge about mental health in pregnancy justifies the need to increase education in this area in order to prevent prenatal and postpartum depression.
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Affiliation(s)
- Yuli Kusumawati
- Public Health Program, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Central Java, Indonesia.
| | - Widyawati Widyawati
- Department of Pediatric and Maternity Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Fatwa Sari Tetra Dewi
- Department of Health Behavior, Environment and Social Medicine, Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada, Yogyakarta, Indonesia
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Hamidia A, Kheirkhah F, Chehrazi M, Basirat Z, Ghadimi R, Barat S, Cuijpers P, O'Connor E, Mirtabar SM, Faramarzi M. Screening of psychiatric disorders in women with high-risk pregnancy: Accuracy of three psychological tools. Health Sci Rep 2022; 5:e518. [PMID: 35224219 PMCID: PMC8855636 DOI: 10.1002/hsr2.518] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 12/02/2021] [Accepted: 12/09/2021] [Indexed: 01/12/2023] Open
Abstract
PURPOSE This study investigated the optimal cutoff points of three psychological tools for screening psychiatric disorders in women with high-risk pregnancy. DESIGN AND METHODS In this cross-sectional study (N = 155), sensitivity/specificity of the Edinburgh Postnatal Depression Scale (EPDS), the Brief Symptom Inventory 53-items (BSI-53), and the BSI-18 were computed with respect to having a psychiatric diagnosis based on the clinical interview. RESULTS The usual cutoffs (≥13 for EPDS, T-score of 63 for BSI-53) demonstrated poor diagnostic accuracy. The optimal thresholds were computed for EPDS cutoff of 6.5, GSI = 0.47 for BSI-53, and GSI = 0.5 for BSI-18. PRACTICE IMPLICATIONS The use of psychological tools among pregnant women with high-risk pregnancy may need to be modified in order to accurately identify psychiatric disorders.
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Affiliation(s)
- Angela Hamidia
- Social Determinants of Health Research Center, Health Research Institute, Department of PsychiatryBabol University of Medical SciencesBabolIran
| | - Farzan Kheirkhah
- Social Determinants of Health Research Center, Health Research Institute, Department of PsychiatryBabol University of Medical SciencesBabolIran
| | - Mohammad Chehrazi
- Department of Biostatistics and Epidemiology, School of Public HealthBabol University of Medical SciencesBabolIran
| | - Zahra Basirat
- Infertility and Health Reproductive Research Center, Health Research Institute, Department of Obstetrics and GynecologyBabol University of Medical SciencesBabolIran
| | - Reza Ghadimi
- Social Determinants of Health Research Center, Health Research Institute, Social Medicine DepartmentBabol University of Medical SciencesBabolIran
| | - Shahnaz Barat
- Infertility and Health Reproductive Research Center, Health Research Institute, Department of Obstetrics and GynecologyBabol University of Medical SciencesBabolIran
| | - Pim Cuijpers
- Department of Clinical Neuro and Developmental Psychology, Amsterdam Public Health Research InstituteVrije Universiteit AmsterdamAmsterdamNetherlands
| | | | | | - Mahbobeh Faramarzi
- Social Determinants of Health Research Center, Health Research Institute, Department of General CoursesBabol University of Medical SciencesBabolIran
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Kusumawati Y, Widyawati W, Dewi FST. Vulnerable to mental health problems: Pregnant women and husband's perception in Surakarta, Indonesia. ENFERMERIA CLINICA 2022. [DOI: 10.1016/j.enfcli.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Jha S, Salve HR, Goswami K, Sagar R, Kant S. Prevalence of Common Mental Disorders among pregnant women-Evidence from population-based study in rural Haryana, India. J Family Med Prim Care 2021; 10:2319-2324. [PMID: 34322431 PMCID: PMC8284220 DOI: 10.4103/jfmpc.jfmpc_2485_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/21/2021] [Accepted: 03/12/2021] [Indexed: 11/15/2022] Open
Abstract
Background: Mental disorders during pregnancy is one of the major public health problem because of its effect on both mother and child. Objectives: The objective of the study was to assess the burden of common mental disorders (CMDs) among pregnant women in rural Haryana, North India. Methods: A community-based cross-sectional study was conducted in 28 villages of rural Haryana in 2016. Pregnant women in the study area with period of gestation 25–34 weeks were enrolled and assessed for presence of CMDs in two phases. Primary Care Evaluation of Mental Disorders—Patient Health Questionnaire was used for screening and Mini International Neuropsychiatric Interview (MINI) for diagnosis of CMDs. Results: A total of 457 pregnant women were included in the study. Mean age of pregnant women was 23.9 years (SD- 3.9). Prevalence of CMDs was 15.3% (95% CI, 12.0–18.6). Of these, major depression was 2.8% (95% CI, 1.4– 4.4), and Generalized Anxiety Disorder was 15.1% (95% CI, 11.8–18.4) as per MINI. On multivariate analysis, no statistically significant association was found between CMDs during pregnancy with any obstetric, sociodemographic determinants, and child health outcomes. Conclusion: High prevalence of CMDs, especially anxiety, observed among pregnant women in rural area necessitates the need for integration of screening of CMDs during routine antenatal care in India.
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Affiliation(s)
- Shreya Jha
- Centre for Community Medicine, AIIMS, New Delhi, India
| | | | - Kiran Goswami
- Centre for Community Medicine, AIIMS, New Delhi, India
| | - Rajesh Sagar
- Department of Psychiatry, AIIMS, New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, AIIMS, New Delhi, India
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8
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Prevalence and onset of anxiety and related disorders throughout pregnancy: A prospective study in an Australian sample. Psychiatry Res 2021; 297:113721. [PMID: 33493733 DOI: 10.1016/j.psychres.2021.113721] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 01/11/2021] [Indexed: 11/21/2022]
Abstract
The aims of this study were to investigate the prevalence of anxiety and related disorders (e.g., obsessive-compulsive disorder [OCD]) and major depressive disorder (MDD) at any time during pregnancy and during each pregnancy trimester and ascertain the proportions of women with an onset of these disorders during pregnancy. Several questionnaires and the Mini International Neuropsychiatric Interview were administered to 200 women at each pregnancy trimester. Complete data were obtained from 148 participants. The most prevalent anxiety disorder at any time during pregnancy was panic disorder (PD), followed by generalised anxiety disorder (GAD) and OCD. Unlike all the other disorders, the prevalence rates of OCD increased steadily from the first to the third trimester. Approximately one half of women with OCD and about one third of women with PD, GAD and MDD at any time during pregnancy had an onset of these disorders during pregnancy. Pregnancy may be a risk factor for an onset of OCD and to a lesser extent, for an onset of PD, GAD and MDD. Absence of remission of OCD during pregnancy despite treatment may suggest treatment resistance of OCD at this time. These findings have implications for recognition, prevention and treatment of anxiety disorders during pregnancy.
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Takeda S. The current status of and measures against maternal suicide in Japan. HYPERTENSION RESEARCH IN PREGNANCY 2020. [DOI: 10.14390/jsshp.hrp2020-005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Satoru Takeda
- Department of Obstetrics and Gynecology, Faculty of Medicine, Juntendo University
- Aiiku Research Institute
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Yamamoto-Sasaki M, Yoshida S, Takeuchi M, Tanaka-Mizuno S, Kawakami K. Association between antidepressant use during pregnancy and congenital anomalies in children: A retrospective cohort study based on Japanese claims data. Congenit Anom (Kyoto) 2020; 60:180-188. [PMID: 32673440 DOI: 10.1111/cga.12386] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/28/2020] [Accepted: 07/08/2020] [Indexed: 01/27/2023]
Abstract
Certain studies previously pointed out that treating pregnant women with antidepressants may increase risks of congenital anomalies in their children. However, to date, the study results are not conclusive. Furthermore, most studies have been performed using data from Western countries; therefore, we examined this association using Japanese data. This retrospective cohort study was based on claims data of mothers and their children from January 2005 to July 2014, obtained from the JMDC Inc. Information on antidepressant prescriptions was extracted from the database. Children were followed up from birth through July 2014 or until their withdrawal from the database and were identified for obtaining information on their congenital anomalies. We used logistic regression analysis to evaluate the association between maternal antidepressant use during pregnancy and the children's congenital anomalies. Of 53 864 eligible pairs of mothers and children, 53 697 pairs met the study criteria. No increased risk of total congenital anomalies in children whose mothers used antidepressants of any type during the first trimester of pregnancy was found in the analysis (adjusted analysis with confounders, odds ratio: 0.86; 95% confidence interval: 0.52, 1.42). In addition, there was no increased risk of organ specific anomalies in the analysis by type of antidepressant. We found no increased risk of congenital anomalies in children whose mothers used antidepressants during the first trimester of pregnancy compared to that of non-users based on the Japanese claims data. Additional studies are necessary to further clarify the association between antidepressant use during pregnancy and congenital anomalies in children.
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Affiliation(s)
- Madoka Yamamoto-Sasaki
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
| | - Satomi Yoshida
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
| | - Masato Takeuchi
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
| | | | - Koji Kawakami
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
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Jannati N, Mazhari S, Ahmadian L, Mirzaee M. Effectiveness of an app-based cognitive behavioral therapy program for postpartum depression in primary care: A randomized controlled trial. Int J Med Inform 2020; 141:104145. [PMID: 32480319 DOI: 10.1016/j.ijmedinf.2020.104145] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 02/19/2020] [Accepted: 04/13/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The objective of this study was to examine the effect of mobile phone applications (App) based cognitive behavioral therapy (CBT) on postpartum depression. METHOD A non-blinded parallel-group randomized controlled trial was conducted. The study population consisted of women attended to three health care centers in Kerman, Iran. Participants were recruited between September and November 2018, and randomized 1:1 to either the intervention group (mobile application access) or control group (no mobile application access). All participants completed the Edinburgh Postnatal Depression Scale (EPDS) at the baseline and 2 months after baseline. Data were analyzed using inferential statistics including chi-square, independent sample t-test, paired t-test and linear regression. RESULTS A total of 75 women with an average age of 27 years participated in this study. Before the intervention, there was no statistically significant difference between the EPDS score between the two groups (p > 0.001). However, in the intervention group, the average EPDS score after intervention was 8.18 and in the control group was 15.05, which was statistically significant (p < 0.001). CONCLUSION These findings provide proof that providing a CBT program using a mobile application can lead to clinically important improvements in outcomes for mothers who suffer from postpartum depression.
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Affiliation(s)
- Nazanin Jannati
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Shahrzad Mazhari
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Leila Ahmadian
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
| | - Moghaddameh Mirzaee
- Epidemiology and Biostatistics, Kerman University of Medical Sciences, Kerman, Iran
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Antidepressant prescriptions for prenatal and postpartum women in Japan: A health administrative database study. J Affect Disord 2020; 264:295-303. [PMID: 32056764 DOI: 10.1016/j.jad.2020.01.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/16/2019] [Accepted: 01/03/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND The prevalence and pattern of perinatal antidepressant prescriptions in Japan are unknown. METHODS The prevalence of antidepressant prescriptions between 180 days before pregnancy onset and 180 days postpartum was evaluated using a large administrative database. The dates of pregnancy onset and delivery were estimated using developed algorithms. RESULTS Of 33,941 women, at least one antidepressant was prescribed to 451 (133/10,000 deliveries) between 180 days before pregnancy and 180 days postpartum and to 241 (71/10,000 deliveries) during pregnancy. The prevalence of antidepressant prescriptions decreased during the first and second trimesters and increased in the postpartum period. Of 339 women with antidepressant prescriptions before pregnancy, 151 (44.5%) discontinued it during pregnancy. Selective serotonin-reuptake inhibitors were the most frequently prescribed class of antidepressants in the time period studied (356 women, 105/10,000 deliveries), followed by tricyclic/non-tricyclic antidepressants (101 women, 30/10,000 deliveries). Of the 57 women who had at least one record of paroxetine prescription in the first trimester, 13 (22.8%) were prescribed >25 mg/day. Fifty-seven women (17/10,000 deliveries) were concurrently prescribed two or more classes of antidepressants between 180 days before pregnancy and 180 days postpartum. LIMITATIONS It may not always have been the case that the prescribed antidepressants were used. Women whose pregnancy ended in an abortion or stillbirth were not included. CONCLUSIONS Various antidepressants were prescribed to prenatal and postpartum women in Japan. Approximately half of pregnant women discontinued treatment with antidepressants after becoming pregnant. Women of childbearing age should select an appropriate antidepressant considering the risk/benefit profile.
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Fawcett EJ, Fairbrother N, Cox ML, White IR, Fawcett JM. The Prevalence of Anxiety Disorders During Pregnancy and the Postpartum Period: A Multivariate Bayesian Meta-Analysis. J Clin Psychiatry 2019; 80:18r12527. [PMID: 31347796 PMCID: PMC6839961 DOI: 10.4088/jcp.18r12527] [Citation(s) in RCA: 297] [Impact Index Per Article: 49.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 03/08/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To estimate the prevalence of anxiety disorders in pregnant and postpartum women and identify predictors accounting for variability across estimates. DATA SOURCES An electronic search of PsycINFO and PubMed was conducted from inception until July 2016, without date or language restrictions, and supplemented by articles referenced in the obtained sources. A Boolean search phrase utilized a combination of keywords related to pregnancy, postpartum, prevalence, and specific anxiety disorders. STUDY SELECTION Articles reporting the prevalence of 1 or more of 8 common anxiety disorders in pregnant or postpartum women were included. A total of 2,613 records were retrieved, with 26 studies ultimately included. DATA EXTRACTION Anxiety disorder prevalence and potential predictor variables (eg, parity) were extracted from each study. A Bayesian multivariate modeling approach estimated the prevalence and between-study heterogeneity of each disorder and the prevalence of having 1 or more anxiety disorder. RESULTS Individual disorder prevalence estimates ranged from 1.1% for posttraumatic stress disorder to 4.8% for specific phobia, with the prevalence of having at least 1 or more anxiety disorder estimated to be 20.7% (95% highest density interval [16.7% to 25.4%]). Substantial between-study heterogeneity was observed, suggesting that "true" prevalence varies broadly across samples. There was evidence of a small (3.1%) tendency for pregnant women to be more susceptible to anxiety disorders than postpartum women. CONCLUSIONS Peripartum anxiety disorders are more prevalent than previously thought, with 1 in 5 women in a typical sample meeting diagnostic criteria for at least 1 disorder. These findings highlight the need for anxiety screening, education, and referral in obstetrics and gynecology settings.
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Affiliation(s)
- Emily J. Fawcett
- Student Wellness and Counselling Centre, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada
| | - Nichole Fairbrother
- Department of Psychiatry / Island Medical Program, University of British Columbia, Victoria, British Columbia, Canada
| | - Megan L. Cox
- Island Medical Program, University of British Columbia, Victoria, British Columbia, Canada
| | - Ian R. White
- MRC Clinical Trials Unit, University College London, London, UK
| | - Jonathan M. Fawcett
- Department of Psychology, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada
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Fawcett JM, Fairbrother N, Fawcett EJ, White IR. A Bayesian multivariate approach to estimating the prevalence of a superordinate category of disorders. Int J Methods Psychiatr Res 2018; 27:e1742. [PMID: 30216590 PMCID: PMC6383646 DOI: 10.1002/mpr.1742] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 05/17/2018] [Accepted: 07/03/2018] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Epidemiological research plays an important role in public health, facilitated by the meta-analytic aggregation of epidemiological trials into a single, more powerful estimate. This form of aggregation is complicated when estimating the prevalence of a superordinate category of disorders (e.g., "any anxiety disorder," "any cardiac disorder") because epidemiological studies rarely include all of the disorders selected to define the superordinate category. In this paper, we suggest that estimating the prevalence of a superordinate category based on studies with differing operationalization of that category (in the form of different disorders measured) is both common and ill-advised. Our objective is to provide a better approach. METHODS We propose a multivariate method using individual disorder prevalences to produce a fully Bayesian estimate of the probability of having one or more of those disorders. We validate this approach using a recent case study and parameter recovery simulations. RESULTS Our approach produced less biased and more reliable estimates than other common approaches, which were at times highly biased. CONCLUSION Although our approach entails additional effort (e.g., contacting authors for individual participant data), the improved accuracy of the prevalence estimates obtained is significant and therefore recommended.
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Affiliation(s)
- Jonathan M Fawcett
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Nichole Fairbrother
- Department of Psychiatry and the Island Medical Program, University of British Columbia, Vancouver, BC, Canada
| | - Emily J Fawcett
- Student Wellness and Counselling Centre, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Ian R White
- MRC Clinical Trials Unit, University College London, London, UK
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Huang L, Zhao Y, Qiang C, Fan B. Is cognitive behavioral therapy a better choice for women with postnatal depression? A systematic review and meta-analysis. PLoS One 2018; 13:e0205243. [PMID: 30321198 PMCID: PMC6188757 DOI: 10.1371/journal.pone.0205243] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 09/23/2018] [Indexed: 12/27/2022] Open
Abstract
The present study evaluated the combined effectiveness of cognitive behavioral therapy (CBT) for postnatal depression. A systematic search was conducted across databases including PubMed, Embase, and the Cochrane library to identify the randomized controlled trials (RCTs) that assessing CBT versus control for postnatal depression until March 2017. Data was extracted by two reviewers, independently. The Review Manager 5.3 and Stata 11.0 were used to calculate the synthesized effect of CBT on depression, and anxiety. A total of 20 RCTs involving 3623 participants were included. The results of meta-analysis showed that CBT was associated with a better Edinburgh Postnatal Depression Scale (EPDS) than control in short-term (mean difference = -2.86, 95% CI: -4.41--1.31; P<0.05) and long-term (mean difference = -1.68, 95% CI: -1.81-1.56; P<0.05). CBT also improved short-term (mean difference = -6.30, 95% CI: -11.32--1.28; P<0.05) and long-term (mean difference = -4.31, 95% CI: -6.92--1.70; P<0.05) Beck Depression Inventory (BDI). Subgroup analysis based on intervention types showed that in-home and telephone-based therapy exhibited significant reductions in EPDS scores (P<0.05 for all). CBT significantly improved the short-term [odds ratio (OR) = 6.57, 95% CI: 1.84-23.48; P<0.05] and long-term (OR = 2.00, 95% CI: 1.61-2.48; P<0.05) depressive symptomatology as compared to control. CBT also reduced the score of Depression Anxiety Stress Scales (DASS), though without significance. In conclusion, CBT effectively improved the symptoms and progression of postnatal depression.
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Affiliation(s)
- Lili Huang
- Department of Gynaecology and Obstetrics, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yunzhi Zhao
- Department of Gynaecology and Obstetrics, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chunfang Qiang
- Department of Gynaecology and Obstetrics, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bozhen Fan
- Department of Gynaecology and Obstetrics, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- * E-mail:
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Abstract
INTRODUCTION It is important to elucidate the psychologically positive aspects of childbirth for mothers, and not only the negative aspects such as perinatal depression. This study aimed to examine psychological growth after childbirth and its related variables by focussing on five factors of posttraumatic growth: relating to others, new possibilities, personal strength, spiritual change and appreciation of life. METHODS Pregnant women during mid-pregnancy were consecutively recruited at a women's hospital in Japan and followed up 1 month after childbirth. Psychological growth was assessed by the Posttraumatic Growth Inventory. RESULTS Among 177 participants, 117 (66.1%) completed follow-up assessments 1 month after childbirth. Multivariable regression analysis revealed that primipara, higher resilience and less fear at childbirth were associated with posttraumatic growth factors of relating to others and new possibilities. High resilience and less fear at childbirth were also associated with personal strength. On the other hand, being primiparous and high depressive symptoms were associated with greater appreciation of life. No variables were associated with spiritual change. DISCUSSION These findings suggest that giving birth for the first time could be a highly challenging life event as well as an opportunity which leads to PTG, and that giving birth with low fear might lead to mothers' psychological growth. On the other hand, appreciation of life might need attention as it might signify some sorts of coping response. These findings contribute to our understanding of the psychological changes experienced by mothers.
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Affiliation(s)
- Daisuke Nishi
- a Toda Chuo Women's Hospital, Toda, Japan.,b Department of Mental Health Policy and Evaluation , National Institute of Mental Health, National Centre of Neurology and Psychiatry , Kodaira , Japan
| | - Kentaro Usuda
- a Toda Chuo Women's Hospital, Toda, Japan.,b Department of Mental Health Policy and Evaluation , National Institute of Mental Health, National Centre of Neurology and Psychiatry , Kodaira , Japan
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Usuda K, Nishi D, Makino M, Tachimori H, Matsuoka Y, Sano Y, Konishi T, Takeshima T. Erratum to: Prevalence and related factors of common mental disorders during pregnancy in Japan: a cross-sectional study. Biopsychosoc Med 2016; 10:26. [PMID: 27602052 PMCID: PMC5011789 DOI: 10.1186/s13030-016-0077-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 08/23/2016] [Indexed: 11/10/2022] Open
Affiliation(s)
- Kentaro Usuda
- Toda Chuo Women's Hospital, 2-26-3 Kamitoda, Toda, Saitama 335-0022 Japan ; Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023 Japan ; Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8553 Japan
| | - Daisuke Nishi
- Toda Chuo Women's Hospital, 2-26-3 Kamitoda, Toda, Saitama 335-0022 Japan ; Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023 Japan ; Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8553 Japan
| | - Miyuki Makino
- Toda Chuo Women's Hospital, 2-26-3 Kamitoda, Toda, Saitama 335-0022 Japan ; National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8553 Japan
| | - Hisateru Tachimori
- Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8553 Japan
| | - Yutaka Matsuoka
- Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukizi, Chuo-ku, Tokyo 104-0045 Japan
| | - Yo Sano
- Toda Chuo Women's Hospital, 2-26-3 Kamitoda, Toda, Saitama 335-0022 Japan
| | - Takako Konishi
- Musashino University, 3-3-3 Ariake, Koto-ku, Tokyo 135-8181 Japan
| | - Tadashi Takeshima
- Health and Social Welfare Bureau, Kawasaki City Office, 3-16-1 Ida, Nakahara-ku, Kawasaki, Kanagawa 211-0035 Japan
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