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Engström M, Lindqvist S, Janson S, Feldman I, Dubowitz H, Lucas S. Validation of the Swedish version of the safe environment for every kid (SEEK) parent screening questionnaire. BMC Public Health 2023; 23:1989. [PMID: 37828478 PMCID: PMC10571478 DOI: 10.1186/s12889-023-16792-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 09/19/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Psychosocial risk factors in the home may impair children's health and development and increase the risk of maltreatment. The Safe Environment for Every Kid (SEEK) model was developed to provide pediatric primary care professionals with a structured way to identify common psychosocial problems. The SEEK model includes use of the Parent Screening Questionnaire (SEEK-PSQ) at routine preventive child health visits, discussion with parents about their responses and, when indicated, referral to relevant services. The SEEK-PSQ has not previously been available in Swedish. The aim of the present study was to evaluate the psychometric properties of an adapted Swedish version of the SEEK-PSQ (PSQ-S). METHODS This study is part of a cluster-randomised controlled trial of SEEK in the Swedish child health services. To validate the PSQ-S, parents (n = 852) with children 0-18 months of age were invited to complete a survey including the PSQ-S as well as evidence-based standardized instruments for the targeted psychosocial risk factors: economic worries, depressive symptoms, parental stress, alcohol misuse and intimate partner violence (IPV). Baseline data from 611 (72%) parents were analysed regarding sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for each risk factor. RESULTS As a whole, the PSQ-S had a sensitivity of 93%, specificity of 52%, PPV of 67% and NPV of 87%. For mothers and fathers combined, sensitivity was 80% for economic worries, 89% for depressive symptoms, 78% for parental stress, 47% for intimate partner violence (IPV) and 70% for alcohol misuse. Specificity was highest for IPV and alcohol misuse (91%) and lowest for depressive symptoms (64%). NPV values were high (81-99%) and PPV values were low to moderate (22-69%) for the targeted problems. Sensitivity was higher for mothers compared to fathers for economic worries, depressive symptoms and IPV. This difference was particularly evident for IPV (52% for mothers, 27% for fathers). CONCLUSION The SEEK-PSQ-S demonstrated good psychometric properties for identifying economic worries, depressive symptoms, parental stress and alcohol misuse but low sensitivity for IPV. The PSQ-S as a whole showed high sensitivity and NPV, indicating that most parents with or without the targeted psychosocial risk factors were correctly identified. TRIAL REGISTRATION ISRCTN registry, study record 14,429,952 ( https://doi.org/10.1186/ISRCTN14429952 ) Registration date 27/05/2020.
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Affiliation(s)
- Maria Engström
- Department of Women's and Children's Health, Uppsala University, SE-751 85, Uppsala, Sweden.
| | - Sara Lindqvist
- Department of Women's and Children's Health, Uppsala University, SE-751 85, Uppsala, Sweden
| | - Staffan Janson
- Division of Public Health Sciences, Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Inna Feldman
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Howard Dubowitz
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Steven Lucas
- Department of Women's and Children's Health, Uppsala University, SE-751 85, Uppsala, Sweden
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Yamakawa Y, Maruta M, Higuchi Y, Tokunaga A, Iwanaga R, Honda S, Imamura A, Tanaka G. Factors influencing postpartum depression among Japanese parents: A prospective longitudinal study. Neuropsychopharmacol Rep 2023. [PMID: 36915226 DOI: 10.1002/npr2.12326] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 02/17/2023] [Accepted: 02/23/2023] [Indexed: 03/16/2023] Open
Abstract
AIM Postpartum depression (PPD) may have negative effects on the parents and lead to impaired cognitive, socioemotional, and behavioral development in their children. The purpose of this study was to examine factors associated with PPD in parents during the first year after delivery. METHODS This study used a self-administered questionnaire. Questionnaires were mailed at 5 days, 3 months, 6 months, and 1 year after delivery, respectively. The particpants were 107 pairs of mothers and fathers. PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS). Data on sense of coherence (SOC), Quality Marriage Index, Social Support Scale, Mother-to-Infant Bonding Scale, and sociodemographic variables were collected. Multiple regression analysis was performed to examine the strength of the association between several variables and the EPDS at each survey period for fathers and mothers, respectively. RESULTS The prevalence of PPD in the first-year postpartum ranged from 12.1%-23.4% to 7.5%-8.4% for fathers and mothers, respectively. SOC had the strongest impact on EPDS scores for both fathers and mothers at all four survey periods. CONCLUSIONS Our findings suggest that stress coping skills are an important factor affecting PPD throughout the first-year postpartum for both fathers and mothers.
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Affiliation(s)
- Yuko Yamakawa
- Department of Occupational Therapy Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Michio Maruta
- Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | - Akiko Tokunaga
- Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ryoichiro Iwanaga
- Department of Occupational Therapy Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Sumihisa Honda
- Department of Nursing Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Akira Imamura
- Department of Occupational Therapy Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Goro Tanaka
- Department of Occupational Therapy Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Xie EB, Freeman M, Penner-Goeke L, Reynolds K, Lebel C, Giesbrecht GF, Rioux C, MacKinnon A, Sauer-Zavala S, Roos LE, Tomfohr-Madsen L. Building Emotional Awareness and Mental Health (BEAM): an open-pilot and feasibility study of a digital mental health and parenting intervention for mothers of infants. Pilot Feasibility Stud 2023; 9:27. [PMID: 36800982 PMCID: PMC9938356 DOI: 10.1186/s40814-023-01245-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 01/13/2023] [Indexed: 02/20/2023] Open
Abstract
BACKGROUND Maternal mental health concerns and parenting stress in the first few years following childbirth are common and pose significant risks to maternal and child well-being. The COVID-19 pandemic has led to increases in maternal depression and anxiety and has presented unique parenting stressors. Although early intervention is crucial, there are significant barriers to accessing care. METHODS To inform a larger randomized controlled trial, the current open-pilot trial investigated initial evidence for the feasibility, acceptability, and efficacy of a newly developed online group therapy and app-based mental health and parenting program (BEAM) for mothers of infants. Forty-six mothers 18 years or older with clinically elevated depression scores, with an infant aged 6-17 months old, and who lived in Manitoba or Alberta were enrolled in the 10-week program (starting in July 2021) and completed self-report surveys. RESULTS The majority of participants engaged in each of the program components at least once and participants indicated relatively high levels of app satisfaction, ease of use, and usefulness. However, there was a high level of attrition (46%). Paired-sample t-tests indicated significant pre- to post-intervention change in maternal depression, anxiety, and parenting stress, and in child internalizing, but not externalizing symptoms. Effect sizes were in the medium to high range, with the largest effect size observed for depressive symptoms (Cohen's d = .93). DISCUSSION This study shows moderate levels of feasibility and strong preliminary efficacy of the BEAM program. Limitations to program design and delivery are being addressed for testing in adequately powered follow-up trials of the BEAM program for mothers of infants. TRIAL REGISTRATION NCT04772677 . Registered on February 26 2021.
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Affiliation(s)
- E. Bailin Xie
- grid.22072.350000 0004 1936 7697Department of Psychology, University of Calgary, Calgary, AB Canada
| | - Makayla Freeman
- grid.17091.3e0000 0001 2288 9830Department of Educational and Counselling Psychology, and Special Education, University of British Columbia, Vancouver, BC Canada
| | - Lara Penner-Goeke
- grid.21613.370000 0004 1936 9609Department of Psychology, University of Manitoba, Winnipeg, MB Canada
| | - Kristin Reynolds
- grid.21613.370000 0004 1936 9609Department of Psychology, University of Manitoba, Winnipeg, MB Canada
| | - Catherine Lebel
- grid.413571.50000 0001 0684 7358Alberta Children’s Hospital Research Institute (ACHRI), Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Department of Radiology, University of Calgary, Calgary, AB Canada
| | - Gerald F. Giesbrecht
- grid.22072.350000 0004 1936 7697Department of Psychology, University of Calgary, Calgary, AB Canada ,grid.413571.50000 0001 0684 7358Alberta Children’s Hospital Research Institute (ACHRI), Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Department of Pediatrics, University of Calgary, Calgary, AB Canada
| | - Charlie Rioux
- grid.266900.b0000 0004 0447 0018Department of Psychology, University of Oklahoma, Norman, OK USA
| | - Anna MacKinnon
- grid.14848.310000 0001 2292 3357Department of Psychiatry and Addictology, Université de Montréal, Montréal, QC Canada ,grid.411418.90000 0001 2173 6322CHU Sainte-Justine Research Center, Montréal, QC Canada
| | - Shannon Sauer-Zavala
- grid.266539.d0000 0004 1936 8438Department of Psychology, University of Kentucky, Lexington, KY USA
| | - Leslie E. Roos
- grid.21613.370000 0004 1936 9609Department of Psychology, University of Manitoba, Winnipeg, MB Canada ,grid.460198.20000 0004 4685 0561Children’s Hospital Research Institute of Manitoba, Winnipeg, MB Canada
| | - Lianne Tomfohr-Madsen
- grid.17091.3e0000 0001 2288 9830Department of Educational and Counselling Psychology, and Special Education, University of British Columbia, Vancouver, BC Canada
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Peltonen K, Kurki M, Reedtz C, Kaiser S, Rasmussen LMP, Merikukka M, Rye M, Laajasalo T, Kyrrestad H, Karjalainen P, Pettersen SD, Eng H, Breivik K, Martinussen M. Psychological tests for expectant parents and young children in the Nordic countries: A review of the evidence. European Journal of Developmental Psychology 2022. [DOI: 10.1080/17405629.2022.2067141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Kirsi Peltonen
- Research Center for Child Psychiatry, University of Turku, Turku, Finland
| | - Marjo Kurki
- Department of Psychology, Itla Children’s Foundation, Helsinki, Finland
| | - Charlotte Reedtz
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sabine Kaiser
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Tromsø, Norway
| | - Lene-Mari P. Rasmussen
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Tromsø, Norway
| | - Marko Merikukka
- Department of Psychology, Itla Children’s Foundation, Helsinki, Finland
| | - Marte Rye
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Tromsø, Norway
| | | | - Henriette Kyrrestad
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Tromsø, Norway
| | - Piia Karjalainen
- Department of Psychology, Itla Children’s Foundation, Helsinki, Finland
| | - Susann Dahl Pettersen
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Tromsø, Norway
| | - Helene Eng
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kyrre Breivik
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
| | - Monica Martinussen
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Tromsø, Norway
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Kachi Y, Ochi M, Kato T, Otsuka M, Takehara K. Factors related to parenting stress among fathers of preschool children in Japan. Pediatr Int 2022; 64:e15132. [PMID: 35411994 DOI: 10.1111/ped.15132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 11/04/2021] [Accepted: 12/15/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND Even though fathers participate in childcare at a higher rate than before, there remains a lack of research on the factors that contribute to parenting stress among fathers. This study explored the socioeconomic and demographic factors associated with parenting stress among fathers of preschool children. METHODS Our study included 17 645 fathers who participated in the 2016 Comprehensive Survey of Living Conditions in Japan. Parenting stress was assessed using a single question. Socioeconomic and demographic factors were predictors. Logistic regression analysis was conducted to estimate the odds ratio (OR) and 95% confidence interval (CI) for parenting stress. RESULTS Overall, 6.6% fathers experienced parenting stress. Fathers with a youngest child aged 0-2 years were more likely to experience parenting stress than those with a youngest child aged 3-6 (OR: 1.45, 95% CI: 1.25-1.68). Compared with fathers who lived in two-parent households without grandparents, those who lived in single-father households (both with and without grandparents) were more likely to experience parenting stress (OR: 12.13, 95% CI: 5.60-26.29 and OR: 4.19, 95% CI: 2.04-8.60, respectively). Furthermore, there was a significant negative association between education and parenting stress. CONCLUSIONS Having a child aged 0-2 years, single fatherhood, and higher education were associated with parenting stress among fathers of preschool children. Healthcare professionals need to be aware of these factors when supporting fathers in raising their children.
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Affiliation(s)
- Yuko Kachi
- Department of Public Health, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.,Department of Social Medicine, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan
| | - Manami Ochi
- Department of Health and Welfare Services, National Institute of Public Health, Wako-shi, Saitama, Japan
| | - Tsuguhiko Kato
- Department of Social Medicine, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan
| | - Miyako Otsuka
- Department of Health Policy, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan
| | - Kenji Takehara
- Department of Health Policy, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan
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Yazdanpanahi Z, Vizheh M, Azizi M, Hajifoghaha M. Paternal Postnatal Depression During COVID-19 Pandemic: The Role of Health Care Providers. J Prim Care Community Health 2022; 13:21501319221110421. [PMID: 35818667 PMCID: PMC9280795 DOI: 10.1177/21501319221110421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background: The fast spread of COVID-19 can cause some psychological disorders for men. One of the psychological disorders is paternal postpartum depression (PPD). The aim of the present research was to review studies that have investigated paternal postpartum depression during the COVID-19 pandemic. Materials and Methods: For this narrative review, databases such as Google Scholar, Scientific Information Databases (SID), Magiran, PubMed, Web of Science, and Scopus were searched for the full texts of published studies in the Persian and English languages in the period of 2019 to 2021. Finally, 3 articles were selected and reviewed in this study. Results: The results of this review study were classified into 3 main categories such as (1) The psychological status of men during the COVID-19 pandemic, (2) The effect of paternal PPD on children’s development and family psychological status during the COVID-19 pandemic, and (3) The role of healthcare providers in the management of paternal PPD. The findings of the studies showed that paternal PPD increases the rate of child maltreatment, maternal depression, and domestic violence. The promotion of the interpersonal skills of healthcare providers with fathers suffering from depression or psychological problems is the determinant factor of successful results. Conclusions: The results showed that paternal PPD has a wide range of consequences in this pandemic. Therefore, it would be recommended that healthcare staff have close contact with families and screen fathers for paternal PPD during the COVID-19 pandemic.
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Affiliation(s)
- Zahra Yazdanpanahi
- Community Based Psychiatric Care Research Center, Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Vizheh
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzieh Azizi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahboubeh Hajifoghaha
- Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Madsen EB, Smith-Nielsen J, Egmose I, Lange T, Vaever MS. The impact of childhood adversity on parenting stress is mediated by adult attachment and depressive symptoms. Scand J Psychol 2021; 63:47-54. [PMID: 34743339 DOI: 10.1111/sjop.12788] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 09/21/2021] [Indexed: 11/29/2022]
Abstract
Adverse childhood experiences can have far-reaching implications for later mental health, including in parenthood. Research suggests that childhood adversity is a risk factor for later parenting stress, yet the underlying mechanisms are only just being uncovered. Uncovering these mechanisms is important to diminish heightened levels of parenting stress and thereby reduce adverse effects of elevated parenting stress on child and parent outcomes. In a cross-sectional study using a sample of mothers of 2-10 month-old infants (N = 367) we first examined depressive symptoms as a mediator, and then, the indirect effect of adult attachment through depressive symptoms between childhood adversity and parenting stress. Results showed that the effect of childhood adversity on parenting stress was mediated by an indirect pathway through depressive symptoms alone, and an indirect pathway of adult attachment through depressive symptoms. The indirect effect of adult attachment through depressive symptoms was found to be stronger than the indirect effect of depressive symptoms alone, supporting the hypothesis that adult attachment insecurity together with depressive symptoms are particularly important risk factors to be considered in this relationship. Results suggest that childhood adversity is a risk factor for parenting stress, and not a determinant of later parenting stress per se. Instead, mediators in this association, adult attachment, and depressive symptoms, were identified as potential targets of intervention to prevent negative effects of childhood adversity on parenting stress. A limitation of the study lies in its cross-sectional design. Future studies should examine these associations longitudinally to allow for interpretation of causality.
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Affiliation(s)
- Eva Back Madsen
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | | | - Ida Egmose
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Theis Lange
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Fricke J, Bolster M, Ludwig-Körner C, Kuchinke L, Schlensog-Schuster F, Vienhues P, Reinhold T, Berghöfer A, Roll S, Keil T. Occurrence and determinants of parental psychosocial stress and mental health disorders in parents and their children in early childhood: rationale, objectives, and design of the population-based SKKIPPI cohort study. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1103-1112. [PMID: 33337512 PMCID: PMC8192328 DOI: 10.1007/s00127-020-02004-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 11/25/2020] [Indexed: 01/09/2023]
Abstract
PURPOSE The postnatal period is a vulnerable time for parents and children but epidemiological and health care utilisation data for Germany on parental mental health during early childhood is scarce. This protocol describes the rationale, aim and study design of a population-based cohort study to assess the occurrence and determinants of psychosocial stress and mental health disorders, as well as the use and cost of health care and social services in early childhood. METHODS As part of the collaborative SKKIPPI project, we will contact a random sample of 30,000 infants listed in the residents' registration offices of three German towns and we expect to include 6,000 mother-child pairs. Both parents are invited to fill out an online screening questionnaire. Mothers with indications of psychosocial stress will be interviewed to assess mental health disorders, regulatory problems of their children, as well as health care and social services utilisation, with a follow-up assessment after 6 months. RESULTS After description of sociodemographic and health data, we will analyse occurrences, patterns, and potential determinants (maternal age, social status, household factors, migration status etc.) of psychosocial stress and mental health disorders in the mothers and their children in early childhood. CONCLUSIONS Our study will identify potential risk and protective factors for postnatal mental health and health care utilization of psychosocially burdened families. This will help to improve prevention and treatment strategies to strengthen the parent-child relationship, to reduce persisting vulnerability of children, and to improve health care and social services. TRIAL REGISTRATION The study has been registered in the German Clinical Trial Registry on February 8th 2019 (DRKS-ID: DRKS00016653).
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Affiliation(s)
- J. Fricke
- grid.6363.00000 0001 2218 4662Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Luisenstr. 57, 10117 Berlin, Germany
| | - M. Bolster
- grid.6363.00000 0001 2218 4662Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Luisenstr. 57, 10117 Berlin, Germany
| | - C. Ludwig-Körner
- grid.461709.d0000 0004 0431 1180International Psychoanalytic University, Berlin, Germany
| | - L. Kuchinke
- grid.461709.d0000 0004 0431 1180International Psychoanalytic University, Berlin, Germany
| | - F. Schlensog-Schuster
- grid.9647.c0000 0004 7669 9786Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, Leipzig, Germany
| | - P. Vienhues
- Department of Psychiatry, Psychosomatics and Psychotherapy, Diakonissenkrankenhaus Flensburg, Flensburg, Germany
| | - T. Reinhold
- grid.6363.00000 0001 2218 4662Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Luisenstr. 57, 10117 Berlin, Germany
| | - A. Berghöfer
- grid.6363.00000 0001 2218 4662Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Luisenstr. 57, 10117 Berlin, Germany
| | - S. Roll
- grid.6363.00000 0001 2218 4662Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Luisenstr. 57, 10117 Berlin, Germany
| | - T. Keil
- grid.6363.00000 0001 2218 4662Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Luisenstr. 57, 10117 Berlin, Germany ,grid.8379.50000 0001 1958 8658Institute of Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany ,State Institute of Health, Bavarian Health and Food Safety Authority, Bad Kissingen, Germany
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Jarneid H, Gjestad K, Røseth I, Dahl B. Fathers' Experiences of Being Present at an Unplanned Out-of-Hospital Birth: A Qualitative Study. J Multidiscip Healthc 2020; 13:1235-1244. [PMID: 33132700 PMCID: PMC7591965 DOI: 10.2147/jmdh.s272021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 09/24/2020] [Indexed: 01/20/2023] Open
Abstract
PURPOSE The purpose of this study was to investigate fathers' experiences of being present at an unplanned birth outside a maternity facility. MATERIALS AND METHODS This was a qualitative interview study with 12 fathers from six of Norway's eleven counties. All had been present at an unplanned out-of-hospital birth in 2015-2020. Data were analyzed using systematic text condensation. RESULTS The data analysis resulted in four themes. The first theme described the fathers' stress and worry and how they managed to keep a cool head and think rationally in a totally unprepared situation. The second theme described the fathers' need for help and the reassuring feeling provided by contact with health professionals. The third theme described how the birth increased the father's attachment to his partner and baby, while the fourth theme described fathers' feelings of exclusion and their reactions following the birth. CONCLUSION Fathers' perceived lack of expertise and their fear of complications led to stress, worry and anxiety, but support from health personnel provided reassurance and control. Many fathers experienced mastery, pride and joy after the birth, but when arriving at hospital, they felt rejected and wished that maternity care staff had approached them to talk about the experience.
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Affiliation(s)
- Henriette Jarneid
- Centre for Women's, Family and Child Health, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg N-3603, Norway
| | - Kristin Gjestad
- Centre for Women's, Family and Child Health, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg N-3603, Norway
| | - Idun Røseth
- Centre for Women's, Family and Child Health, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg N-3603, Norway.,Department of Child and Adolescent Mental Health, Telemark Hospital, Skien, Norway
| | - Bente Dahl
- Centre for Women's, Family and Child Health, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg N-3603, Norway
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Johansson M, Benderix Y, Svensson I. Mothers' and fathers' lived experiences of postpartum depression and parental stress after childbirth: a qualitative study. Int J Qual Stud Health Well-being 2020; 15:1722564. [PMID: 31990637 PMCID: PMC7034451 DOI: 10.1080/17482631.2020.1722564] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Purpose: The study aims are to explore the lived experiences of mothers and fathers of postpartum depression and parental stress after childbirth.Methods: Qualitative interviews conducted, and analysed from an interpretative phenomenological analysis (IPA) perspective.Results: Both mothers and fathers described experiences of inadequacy, although fathers described external requirements, and mothers described internal requirements as the most stressful. Experiences of problems during pregnancy or a traumatic delivery contributed to postpartum depression and anxiety in mothers and affected fathers' well-being. Thus, identifying postpartum depression with the Edinburgh Postnatal Depression Scale, mothers described varying experiences of child health care support. Postpartum depression seemed to affect the spouses' relationships, and both mothers and fathers experienced loneliness and spouse relationship problems. Experiences of emotional problems and troubled upbringing in the parents' family of origin may contribute to vulnerability from previous trauma and to long-term depressive symptoms for mothers.Conclusions: The findings of this study demonstrate the significant impact of postpartum depression and parental stress has in parents' everyday lives and on the spouse relationship. These results support a change from an individual parental focus to couples' transition to parenthood in child health care.
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Affiliation(s)
- Maude Johansson
- Department of Psychology, Linnaeus University, Växjö, Sweden
| | - Ylva Benderix
- Department of Psychology, Linnaeus University, Växjö, Sweden
| | - Idor Svensson
- Department of Psychology, Linnaeus University, Växjö, Sweden
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Chubar V, Luyten P, Goossens L, Bekaert B, Bleys D, Soenens B, Claes S. The link between parental psychological control, depressive symptoms and epigenetic changes in the glucocorticoid receptor gene (NR3C1). Physiol Behav 2020; 227:113170. [PMID: 32956684 DOI: 10.1016/j.physbeh.2020.113170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/20/2020] [Accepted: 09/09/2020] [Indexed: 12/22/2022]
Abstract
AIMS This paper examines the relationship between parental Psychological Control (PC) and depressive symptoms in adolescents and assesses whether this relationship was mediated by DNA methylation, focusing on the glucocorticoid receptor gene (NR3C1), which plays a crucial role in HPA-axis functioning and is linked to environmental stress and depression. This is among the very few studies that looked at the relation between DNA methylation, environmental stress and depression in family trios. METHODS The study cohort consisted of 250 families: father, mother and a biologically related adolescent (adolescents (48.9% boys), mean age: 15.14, SD= 1.9; mean age mothers: 45.83, SD= 4.2; mean age fathers: 47.77, SD= 4.7). Depressive symptoms and PC were measured in adolescents and in both parents. DNA methylation levels in NR3C1 were examined in all participants. RESULTS Depressive symptoms in adolescents were predicted by PC of both mothers and fathers. Moreover, maternal depressive symptoms were associated with maternal PC, and fathers' depressive symptoms and PC. In fathers, only the level of their self-reported PC was associated with their depressive symptoms. There was no relation between adolescents' DNA methylation and depressive symptoms or the level of parental PC. Yet, there was a significant association between maternal depressive symptoms and maternal epigenetic patterns in NR3C1. CONCLUSIONS These findings highlight the need for more research in order to better understand the biological and contextual mechanisms through which parenting and parental emotional well-being is related to the development of psychopathology.
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Affiliation(s)
- V Chubar
- KU Leuven, Mind-Body Research Group, Department of Neuroscience, B-3000 Leuven, Belgium.
| | - P Luyten
- KU Leuven, Faculty of Psychology and Educational Sciences, B-3000 Leuven, Belgium; University College London, Research Department of Clinical, Educational and Health Psychology, London, UK
| | - L Goossens
- KU Leuven, School Psychology and Child and Adolescent Development Research Unit, Faculty of Psychology and Educational Sciences, KU Leuven, B-3000 Leuven, Belgium
| | - B Bekaert
- KU Leuven, University Hospitals Leuven, Department of Forensic Medicine, Laboratory of Forensic Genetics and Molecular Archaeology, B-3000 Leuven, Belgium; KU Leuven, Department of Imaging and Pathology, B-3000 Leuven, Belgium
| | - D Bleys
- KU Leuven, Faculty of Psychology and Educational Sciences, B-3000 Leuven, Belgium
| | - B Soenens
- Ghent university, Department of Developmental, Personality and Social Psychology, Ghent, Belgium
| | - S Claes
- KU Leuven, Mind-Body Research Group, Department of Neuroscience, B-3000 Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, B-3000 Leuven, Belgium
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Goren G, Sarid O, Philippou P, Taylor A. Sense of Coherence Mediates the Links between Job Status Prior to Birth and Postpartum Depression: A Structured Equation Modeling Approach. Int J Environ Res Public Health 2020; 17:E6189. [PMID: 32858960 DOI: 10.3390/ijerph17176189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/20/2020] [Accepted: 08/23/2020] [Indexed: 11/17/2022]
Abstract
Postpartum depression (PPD) has detrimental effects on the health of the mother, child and family. Socio-demographic variables can influence PPD. Sense of coherence (SOC) is a personal resource that mitigates the experience of stressful events. We hypothesized that SOC would have a protective effect against PPD over time. The aim was to investigate the effects of socio-demographic factors and SOC on PPD at birth (T1) and nine months postpartum (T2). A longitudinal study of primiparous women (n = 114; age range 18-47 years) measured PPD, SOC and socio-demographics at T1 and T2. The majority were married, had no economic difficulties and were employed before birth. Results showed that PPD at T1 (15.8%) declined to 6.2% (T2). Job status was positively associated with SOC at T1. The structured equation model accounted for 27% of the variance in PPD (T2). In the first pathway, job status was linked to PPD (T2) via SOC at T1 and T2. In the second, SOC and PPD (T1) and SOC (T2) mediated the link between job status and PPD (T2). Results and clinical implications are discussed in the context of the theory of conservation of resources. An intervention for enhancing SOC is recommended for woman at risk of PPD.
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Wells MB, Kerstis B, Andersson E. Impacted family equality, self‐confidence and loneliness: a cross‐sectional study of first‐time and multi‐time fathers’ satisfaction with prenatal and postnatal father groups in Sweden. Scand J Caring Sci 2020; 35:844-852. [DOI: 10.1111/scs.12900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 06/18/2020] [Accepted: 07/15/2020] [Indexed: 01/01/2023]
Affiliation(s)
- Michael B. Wells
- Department of Women’s and Children’s Health Karolinska Institutet Stockholm Sweden
| | - Birgitta Kerstis
- School of Health, Care and Social Welfare Mälardalen University Vasteras Sweden
| | - Ewa Andersson
- Department of Women’s and Children’s Health Karolinska Institutet Stockholm Sweden
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Abstract
OBJECTIVE Postpartum depression (PPD) is the most common medical complication of childbirth. PPD can be disabling, with potential negative effects on maternal health-related quality-of-life (HRQoL) as well as on children and partners. The objective of this study was to systematically review and summarize recently published literature describing the humanistic burden of PPD on affected women, their children, and partners. METHODS Databases including Embase, MEDLINE, and PsycINFO, as well as conference proceedings were searched for keywords related to PPD. Searches were initially conducted in February 2017 and restricted to the prior 5 years for databases and the prior 2 years for conference proceedings. Searches were updated in February 2018. Two researchers independently reviewed 1154 unique records according to pre-defined inclusion and exclusion screening criteria. RESULTS Forty-eight studies were identified; over 40 studies assessed the effects of PPD on children of affected mothers, with many demonstrating a negative association with elements of parenting and childhood development. Furthermore, five studies that evaluated the effects of PPD symptoms on partners suggested that certain aspects of their relationships were negatively affected. Partners of affected women also experienced greater levels of their own stress, anxiety, and depression compared with partners of women without PPD symptoms. Despite limited data on HRQoL among women with PPD symptoms (four studies), a negative impact on physical and mental sub-scales was observed. CONCLUSIONS Findings suggest that PPD symptoms have a substantial humanistic burden on affected mothers as well as on their children and partners.
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Affiliation(s)
- Tiffany A Moore Simas
- a Departments of Obstetrics & Gynecology , Pediatrics, Psychiatry and Quantitative Health Sciences, University of Massachusetts Medical School/UMass Memorial Health Care , Worcester , MA , USA
| | | | - Cody Patton
- c Analysis Group, Inc. , Menlo Park , CA , USA
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15
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Cooper MC, Kilvert HS, Hodgkins P, Roskell NS, Eldar-Lissai A. Using Matching-Adjusted Indirect Comparisons and Network Meta-analyses to Compare Efficacy of Brexanolone Injection with Selective Serotonin Reuptake Inhibitors for Treating Postpartum Depression. CNS Drugs 2019; 33:1039-52. [PMID: 31642037 DOI: 10.1007/s40263-019-00672-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Brexanolone injection, the first therapy approved by the US FDA for the treatment of postpartum depression (PPD) in adults, has been shown to produce a significantly greater decrease in the Hamilton Rating Scale for Depression (HAM-D) total score than placebo in randomised controlled trials (RCTs) of women with PPD. OBJECTIVES Given the rapid effect of brexanolone injection (within 60 h) sustained throughout the length of the trials (30 days), we sought to compare its efficacy data against selective serotonin reuptake inhibitors (SSRIs), the class of antidepressants most commonly prescribed for PPD, using HAM-D and Edinburgh Postnatal Depression Scale (EPDS) outcomes from currently available RCTs. METHODS We extracted data from 26 studies identified in a systematic literature review of pharmacological and pharmacological/nonpharmacological combination therapies in PPD. Six studies were suitable to form evidence networks through which to perform indirect treatment comparisons (ITCs) of HAM-D and EPDS outcomes between brexanolone and SSRIs. Having assessed the comparability and suitability of the available evidence for analysis, we discovered significant heterogeneity in the study designs, most notably in the placebo arms of the trials. We therefore conducted matching-adjusted indirect comparisons (MAICs) between brexanolone and the placebo arms of comparator studies, subsequently using the MAIC results of brexanolone versus placebo, and results for SSRIs versus placebo, to form ITCs of brexanolone versus SSRIs at three separate time points-day 3, week 4 and last observation. ITCs were calculated as the differences in change from baseline (CFB) in HAM-D and, separately, CFB in EPDS, between treatments, and reported with 95% confidence intervals (CIs). RESULTS For all time points, MAICs showed larger differences in CFB for brexanolone compared with SSRIs. Differences (95% CIs) between brexanolone and SSRIs were 12.79 (8.04-17.53) [day 3], 5.87 (- 1.62 to 13.37) [week 4] and 0.97 (- 6.35 to 8.30) [last observation] for the HAM-D. For the EPDS, the differences in CFB were 7.98 (5.32-10.64) [day 3], 6.35 (3.13-9.57) [week 4] and 4.05 (0.79-7.31) [last observation]. Other analytical approaches are also presented to demonstrate the similarity of results, using a network meta-analysis approach, and the importance of using the MAIC method to control for the important heterogeneity between placebo arms. CONCLUSIONS Acknowledging the limitations of ITCs and this evidence base, when compared with SSRIs, these analyses suggest that brexanolone demonstrated larger differences in CFB for both patient- and clinician-reported PPD outcomes and at all investigated time points after adjusting for differences between placebos in the included studies.
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Abstract
Aims: This report aims to present a concise overview and synthesis of current research findings regarding paternal depression in the perinatal period. Methods: A literature search was conducted, primarily via PubMed and PsychNET, for English-language research studies and meta-analyses using combinations of the terms ‘perinatal’, ‘pregnancy’, ‘postpartum’, ‘depression’ AND ‘fathers’ OR ‘paternal’. Peer-reviewed articles were considered, and a representative sample of literature, with an emphasis on recent publications from a broad range of populations was summarized for each of the following sub-sections: prevalence, risk factors, impact on the infant/child, and healthcare costs. Results: Reported prevalence has ranged from 2.3% to 8.4%, with a significant degree of heterogeneity in rates, due to differences in multiple aspects of the methodology (timing, instruments, etc.). Nevertheless, rates of maternal depression remain higher than paternal depression, and higher rates of one are associated with higher rates of the other. The primary risk factors for paternal depression are maternal depression and the father’s history of severe depression, or symptoms of depression or anxiety prenatally. Biological mechanisms may underlie paternal depression, with changes reported in testosterone, cortisol and prolactin levels during this period. Paternal depression has been related to children’s behavioral, emotional and social function at 36 months and psychiatric disorders at 7 years, adjusting for maternal depression. Healthcare costs may also be impacted by paternal postpartum depression, with higher father–child dyad costs found after controlling for potential confounders. Conclusions: Focusing on fathers’ emotional well-being in the perinatal period is important in itself, as well as for their wives and children. Programs recommending screening for maternal perinatal mood and anxiety disorders should include inquiry regarding the father’s emotional state, and if his distress is reported it should be clarified and followed-up by support and intervention as necessary.
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Affiliation(s)
- S Glasser
- Women and Children’s Health Research Unit, The Gertner Institute for Epidemiology and Health Policy Research, Ltd. Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
| | - L Lerner-Geva
- Women and Children’s Health Research Unit, The Gertner Institute for Epidemiology and Health Policy Research Ltd., Ramat Gan, Israel
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Margareta W, Eva N, John Ö, Birgitta K. Parental stress and depressive symptoms increase the risk of separation among parents with children less than 11 years of age in Sweden. Scand J Public Health 2017; 47:207-214. [PMID: 28803506 DOI: 10.1177/1403494817724312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AIMS Parental separations have become more frequent in recent decades. In Western countries, about 25% of children experience parental separation. There is a need to explore the risk factors for separation to give children an optimal childhood. The objective of the present study was to examine parental stress and depressive symptoms during early parenthood and their association with parental separation. METHODS Four hundred and seven couples completed questionnaires on depressive symptoms for 3 months and parental stress for 18 months after childbirth. Total parental stress and five sub-areas were investigated. To study the separation rate, parents' addresses were recorded 9 to 11 years after childbirth. RESULTS Twenty-nine percent of the parents were separated 9 to 11 years after childbirth. Separation was associated with depressive symptoms at 3 months (mothers p = .002, fathers p = .025) and total parental stress at 18 months after childbirth (mothers p = .010, fathers p = .005). The sub-areas of parental stress, Spouse relationship problems (mothers p = <.001, fathers p = .001) and fathers' Social isolation ( p = .005), were associated with separation. In multivariable regression analyses of the parents' separation rate 9 to 11 years after childbirth, the only significant predictor was mothers' Spouse relationship problems ( p < .001). CONCLUSIONS The knowledge that parental stress and depressive symptoms are risk factors for separation may simplify professional support for parents in early parenting. Courses for new and expectant parents can use this knowledge to increase parents' awareness.
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Affiliation(s)
| | - Nohlert Eva
- 2 Centre for Clinical Research, Uppsala University Västmanland County Hospital, Sweden
| | - Öhrvik John
- 2 Centre for Clinical Research, Uppsala University Västmanland County Hospital, Sweden.,3 Department of Medicine, Karolinska Institutet, Sweden
| | - Kerstis Birgitta
- 1 School of Health, Care and Social Welfare, Mälardalen University, Sweden
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