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Tesfaye W, Ashine B, Tezera H, Asefa T. Postpartum depression and associated factor among mothers attending public health centers of Yeka sub city, addis ababa Ethiopia. Heliyon 2023; 9:e20952. [PMID: 37942166 PMCID: PMC10628654 DOI: 10.1016/j.heliyon.2023.e20952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 10/07/2023] [Accepted: 10/11/2023] [Indexed: 11/10/2023] Open
Abstract
Postpartum depression (PPD) is a major public health concern that affects both the mother's health and the development of the child.Postpartum depression is defined by the American Psychiatric Association (APA) as the development of a Major Depressive Episode (MDE) within four weeks of birth. The rate of postpartum depression statistics is lacking in developing countries. This indicates that the data can be much higher if diagnosed and reported.There for this study assessed the magnitude of postpartum depression and its associated factors among mothers attending selected public health center of Yeka sub city, Addis Ababa, Ethiopia. Method and materials An institutional-based cross-sectional approach was conducted from December 2021 to January 2022 among 454 postpartum women. A single population proportion equations was used to calculate the sample size for this investigation.A multi-stage sampling method was applied based on the health center they are attending.One of the eleven sub-cities in Addis Abeba, Ethiopia, was chosen for this procedure using a simple random selection technique. Furthermore, four health centers from the selected sub-city were chosen using simple random selection.For data collection, structured questioners were utilised.The Edinburgh Postnatal Depression Scale, also known as the EPDS, was used to assess participants' postpartum depression. The data was validated, coded, and entered into Epi-data before being exported to SPSS for analysis. Bivariable and multivariable logistic regression were used. P-values less than 0.05 were deemed statistically significant. Result The overall prevalence of postpartum depression was 23.8 % [95 % CI (20-27.8)].Being single [AOR = 7.4, 95 % CI (4.2-12.9)], having complications during pregnancy [AOR = 2.1, 95 % CI (1.16-3.82)], Bottle feeding immediately after birth [AOR = 0.3, 95 % CI (0.13-0.66)], and having low perceived psycho-social support [AOR = 3.5, 95 % CI (1.4-8.5)] were significantly associated with postpartum depression. Conclusion and recommendation The current study found that post postpartum depression is highly prevalent among women. As a result, we recommend that to have regular screening, follow up and mental health care in postnatal periods of pregnancy. Because the period following childbirth is stressful, especially for new mothers, emotional and psychosocial support should be provided both in the community and in health care settings. Keywords:Postpartum depression, Women, Edinburgh Postnatal Depression Scale (EPDS),Ethiopia.
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Affiliation(s)
- Winta Tesfaye
- Department of Human Physiology, School of Medicine, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Bezawit Ashine
- Department of Reproductive Health,School of Public Health, Sante Medical Collage,Addis Ababa,Ethiopia
| | - Hiwot Tezera
- Department of Bio Chemistry, School of Medicine, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Tseganesh Asefa
- Department of Medical Nursing, School of Nursing, University of Gondar, P. O. Box 196, Gondar, Ethiopia
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Pettman D, O'Mahen H, Blomberg O, Svanberg AS, von Essen L, Woodford J. Effectiveness of cognitive behavioural therapy-based interventions for maternal perinatal depression: a systematic review and meta-analysis. BMC Psychiatry 2023; 23:208. [PMID: 36991389 PMCID: PMC10052839 DOI: 10.1186/s12888-023-04547-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 01/13/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Depression during the perinatal period (during pregnancy and the year after childbirth) is common and associated with a range of negative effects for mothers, infants, family members, and wider society. Although existing evidence suggests cognitive behavioral therapy (CBT) based interventions are effective for perinatal depression, less is known about the effect of CBT-based interventions on important secondary outcomes, and a number of potential clinical and methodological moderators have not been examined. METHODS A systematic review and meta-analysis primarily examined the effectiveness of CBT-based interventions for perinatal depression on symptoms of depression. Secondary aims examined the effectiveness of CBT-based interventions for perinatal depression on symptoms of anxiety, stress, parenting, perceived social support, and perceived parental competence; and explored clinical and methodological moderators potentially associated with effectiveness. A systematic search of electronic databases and other sources was performed up to November 2021. We included randomized controlled trials comparing CBT-based interventions for perinatal depression with control conditions allowing for the isolation of the effects of CBT. RESULTS In total, 31 studies (5291 participants) were included in the systematic review and 26 studies (4658 participants) were included in the meta-analysis. The overall effect size was medium (hedges g = - 0.53 [95% CI - 0.65 to - 0.40]); with high heterogeneity. Significant effects were also found for anxiety, individual stress, and perceived social support, however few studies examined secondary outcomes. Subgroup analysis identified type of control, type of CBT, and type of health professional as significant moderators of the main effect (symptoms of depression). Some concerns of risk of bias were present in the majority of studies and one study had a high risk of bias. CONCLUSIONS CBT-based interventions for depression during the perinatal period appear effective, however results should be interpreted with caution given high levels of heterogeneity and low quality of included studies. There is a need to further investigate possibly important clinical moderators of effect, including the type of health professional delivering interventions. Further, results indicate a need to establish a minimum core data set to improve the consistency of secondary outcome collection across trials and to design and conduct trials with longer-term follow-up periods. TRIAL REGISTRATION CRD42020152254 .
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Affiliation(s)
- Danelle Pettman
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Heather O'Mahen
- Mood Disorders Centre, Department of Psychology, University of Exeter, Exeter, UK
| | - Oscar Blomberg
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Agneta Skoog Svanberg
- Reproductive Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Louise von Essen
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Joanne Woodford
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
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Li X, Yang P, Jiang Y, Gao D. Influence of fear of COVID-19 on depression: The mediating effects of anxiety and the moderating effects of perceived social support and stress perception. Front Psychol 2023; 13:1005909. [PMID: 36698611 PMCID: PMC9869132 DOI: 10.3389/fpsyg.2022.1005909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 12/20/2022] [Indexed: 01/12/2023] Open
Abstract
Objective Explore the influence of fear of COVID-19 on depression, with anxiety as a mediator and perceived social support and stress perception as moderates. Methods From February to March 2020, 1,196 valid data were collected online through questionnaire by cluster sampling method. Fear of COVID-19 Questionnaire, the Patient Health Questionnaire 9-Item Scale (PHQ-9), the Generalized Anxiety Disorder 7-Item Scale (GAD-7), the Perceived Social Support Scale (PSSS) and the10-item Perceived Stress Scale (PSS-10) were used as the survey instrument, and the participants were female undergraduates from a liberal arts college of a Chinese university. Common method bias was assessed using Harman's single-factor test in SPSS and confirmatory factor analysis in AMOS. The levels of participants' anxiety, depression and perceived social support were described using frequency and percentage, Pearson Correlation test was used to measure the correlation between the variables. The PROCESS macro for SPSS (Model 1, Model 4, and Model 21) were applied to examine the mediating effect and moderating effect of the model. Results Fear of COVID-19 can positively influence depression, anxiety plays a mediating role between fear of COVID-19 and depression, perceived social support negatively moderates the relationship between fear of COVID-19 and anxiety, and stress perception positively moderates the relationship between anxiety and depression. These five variables can form a moderated mediating effect model. Conclusion Fear of COVID-19, anxiety and stress perception are risk factors for depression, perceived social support is a protective factor for depression. Reducing the fear of COVID-19, anxiety and stress perception and enhancing perceived social support are beneficial to reduce the level of depression.
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Affiliation(s)
- Xiaoyu Li
- School of Philosophy and Public Administration, Henan University, Kaifeng, China
| | - Pengcheng Yang
- School of Philosophy and Public Administration, Henan University, Kaifeng, China
| | - Yanju Jiang
- Institute of Psychology and Behavior, Henan University, Kaifeng, China
| | - Dongdong Gao
- Institute of Psychology and Behavior, Henan University, Kaifeng, China,*Correspondence: Dongdong Gao, ✉
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Prevalence and risk factors of maternal depression among women who participated in a home visitation program in South Korea. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1167-1178. [PMID: 35044478 DOI: 10.1007/s00127-022-02226-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 01/06/2022] [Indexed: 02/08/2023]
Abstract
PURPOSE The psychosocial health of mother is crucial for healthy prenatal period and early childhood. We investigated the prevalence and risk factors of maternal depression during pregnancy and postpartum among women who participated in a home visitation program in Seoul, South Korea (Seoul Healthy First Step Project, SHFSP). METHODS We analyzed 80,116 women who participated in the SHFSP, which was launched by Seoul metropolitan government in 2013, and defined peripartum depression as a score ≥ 10 on the Korean version of the Edinburgh Postnatal Depression Scale (EPDS). Sociodemographic factors and psychosocial health status were evaluated through a standardized questionnaire completed by participants upon program registration. We calculated the prevalence of women at risk for peripartum depression and evaluated associated factors by multivariable logistic regression analysis. RESULTS Prevalence of women at risk for peripartum depression was 17.7% (prepartum depression: 14.2%, postpartum depression: 24.3%). Younger maternal age, low income (OR 2.40, 95% CI 2.03-2.84), disability (2.61, 1.96-3.47), single parenthood (3.27, 2.69-3.99), and smoking (2.02, 1.44-2.83) increased the peripartum depression risk. Furthermore, experience of stress, change, or loss over the past 12 months (3.36, 3.22-3.50), history of treatment for emotional issues (2.47, 2.27-2.70), experience of child abuse (1.91, 1.74-2.11), and domestic violence (2.25, 1.81-2.80) increased the risk for peripartum depression, whereas having helpers for the baby (0.62, 0.58-0.67), having someone to talk with (0.31, 0.27-0.35), and considering oneself confident (0.30, 0.29-0.31) decreased the risk. CONCLUSIONS Policies to reduce and manage peripartum depression should be strengthened, with a focus on high-risk pregnant and puerperal women.
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Association between social support and postpartum depression. Sci Rep 2022; 12:3128. [PMID: 35210553 PMCID: PMC8873474 DOI: 10.1038/s41598-022-07248-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 02/08/2022] [Indexed: 01/18/2023] Open
Abstract
Postpartum depression is common; however, little is known about its relationship to social support and postpartum depression. This study examined the association between them among South Korean women within one year of childbirth. This study was based on the 2016 Korean Study of Women’s Health-Related Issues (K-Stori), a cross-sectional survey employing nationally-representative random sampling. Participants were 1,654 postpartum women within a year of giving birth. Chi-square test and logistic regression analysis were conducted to analyze the associations between social support (and other covariates) and postpartum depression. Among participants, 266 (16.1%) had postpartum depression. Depending on the level of social support, 6.0%, 53.9%, and 40.1% of them had low, moderate, and high social support, respectively. Women with moderate or low social support were more likely to have postpartum depression (OR = 1.78, 95% CI = 1.26–2.53; OR = 2.76, 95% CI = 1.56–4.89). This trend was observed in participants with multiparity, pregnancy loss, obese body image, and employed women. Social support was associated with a decreased likelihood of postpartum depression, indicating the importance of social support, especially for women experiencing multiparity, pregnancy loss, negative body image, as well as for employed women.
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Iwanowicz-Palus G, Marcewicz A, Bień A. Analysis of determinants of postpartum emotional disorders. BMC Pregnancy Childbirth 2021; 21:517. [PMID: 34284727 PMCID: PMC8293488 DOI: 10.1186/s12884-021-03983-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 07/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The birth of a child entails major changes in a woman's life. In the perinatal period, the woman is particularly susceptible to emotional problems. The objective of the present paper was to investigate the relationship between global orientation to life and its components on the one hand, and socio-demographic factors on the other, with regard to early postpartum emotional disorders. METHODS The study included 643 patients hospitalized in obstetric departments in Lublin, Poland, who had had a spontaneous vaginal delivery. Research instruments included: the Edinburgh Postnatal Depression Scale (EPDS), the Orientation to Life Questionnaire (SOC-29), and the authors' own survey questionnaire to record participants' characteristics. RESULTS The study findings indicate an association between lower levels of postpartum blues and higher levels of global sense of coherence, as well as a stronger sense of meaningfulness, manageability, and comprehensibility. More severe emotional disorders were found in patients who were single. Postpartum blues symptoms were more intense in less educated respondents. CONCLUSIONS Postpartum emotional disorders are associated with a global sense of coherence and its components. Higher levels of SOC reduce the risk of postpartum blues.
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Affiliation(s)
- Grażyna Iwanowicz-Palus
- Chair and Department of Development in Midwifery, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Agnieszka Marcewicz
- Chair and Department of Development in Midwifery, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland.
| | - Agnieszka Bień
- Chair and Department of Development in Midwifery, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
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Mishkin K, Maqsood SS, Ahmed HM. Antenatal Depression Symptoms Among Pregnant Women Seeking Health Services in Erbil, Iraq. Matern Child Health J 2021; 25:1043-1049. [PMID: 33905065 DOI: 10.1007/s10995-021-03142-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Maternal depression, which includes depression in the prenatal and postpartum periods, is estimated to affect between 10 and 20% of women globally but the rate is higher in the Middle East. Research focused on maternal depression in Iraq is limited to one study focused on postpartum depression. This paper identifies the prevalence and factors associated with antenatal depression among pregnant Iraqi women. METHODS Women seeking maternal health services at primary health centers were invited to participate. Data were collected by trained midwifery students in Erbil, Iraq. Responses to the PHQ-2 PRIME-MD depression questions were used to identify depressive symptoms. Chi-square and logistic regression analyses were used to analyze findings. RESULTS Of the 179 participants, 86 (48%) reported depressive symptoms. In bivariate analysis, antenatal depression was associated with gestational age (p = 0.03), first prenatal visit in the second trimester (p = 0.003), loss of appetite (p = 0.003), not having help at home (p = 0.03), and use of prenatal vitamins (p = 0.002). Gravida approached significance (p = 0.07). In adjusted analysis, women reporting loss of appetite were more likely to report depressive symptoms (OR = 3.09, 95% CI: 1.47-6.51). DISCUSSION Consistent with other research from the region, nearly half the women reported depressive symptoms. Because lack of appetite is associated with depressive symptoms, women reporting loss of appetite should be prioritized for depression screening in time-constrained settings.
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Affiliation(s)
- Kathryn Mishkin
- Department of Health Policy, Management, Behavior, University at Albany, Albany, NY, USA.
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Li D, Zou L, Zhang Z, Zhang P, Zhang J, Fu W, Mao J, Cao S. The Psychological Effect of COVID-19 on Home-Quarantined Nursing Students in China. Front Psychiatry 2021; 12:652296. [PMID: 33897502 PMCID: PMC8061631 DOI: 10.3389/fpsyt.2021.652296] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/03/2021] [Indexed: 12/18/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) has significantly caused socioeconomic impacts. However, little is known about the psychological effect of COVID-19 on home-quarantined nursing students. The present study aimed to identify the prevalence and major determinants of anxiety, depression and post-traumatic stress symptoms (PTSS) in Chinese nursing students during the COVID-19 pandemic quarantine period. An online survey was conducted on a sample of 6,348 home-quarantined nursing students. Mental health status was assessed by the Generalized Anxiety Disorder 7-Item Scale (GAD-7), the Patient Health Questionnaire 9-Item Scale (PHQ-9) and the Post Traumatic Stress Disorder Check List-Civilian version (PCL-C), respectively. Logistic regression analyses were performed to identify risk factors of anxiety, depression and PTSS. The overall prevalence of anxiety was 34.97%, and the rates of "mild," "moderate," and "severe" anxiety were 26.24, 7.04, and 1.69%, respectively. Depression was detected in 40.22% of the nursing students, and the prevalence of "mild," "moderate," "moderately severe," and "severe" depression was 27.87, 7.18, 4.08, and 1.09%, respectively. The overall prevalence of PTSS was 14.97%, with the prevalence of "mild" and "moderate-to-severe" PTSS reported at 7.04 and 7.93%, respectively. Male gender and insufficient social support were common risk factors for anxiety, depression and PTSS. In conclusion, about one-third, two-fifths, and one-seventh of Chinese nursing students had anxiety, depression and PTSS during the period of home quarantine, respectively. Timely and appropriate psychological interventions for nursing students should be implemented to reduce the psychological harm caused by COVID-19 pandemic.
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Affiliation(s)
- Dandan Li
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Zou
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
- Department of Neurology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Zeyu Zhang
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Pu Zhang
- Department of Cardiology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Jun Zhang
- Department of Endocrinology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Wenning Fu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Emergency and Trauma, Ministry of Education, College of Emergency and Trauma, Hainan Medical University, Haikou, China
| | - Jing Mao
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shiyi Cao
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Fu W, Yan S, Zong Q, Anderson-Luxford D, Song X, Lv Z, Lv C. Mental health of college students during the COVID-19 epidemic in China. J Affect Disord 2021; 280:7-10. [PMID: 33197782 PMCID: PMC7656159 DOI: 10.1016/j.jad.2020.11.032] [Citation(s) in RCA: 116] [Impact Index Per Article: 38.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 11/04/2020] [Accepted: 11/06/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To assess the psychological status of college students in China during the COVID-19 outbreak, and offer some theoretical evidence for psychological intervention of college students. METHODS An online survey was conducted from May 10, 2020 to June 10, 2020. Anxiety symptoms were measured by the Generalized Anxiety Disorder 7-Item Scale (GAD-7). Categorical data were reported as number and percentage, while continuous data were reported as mean ± SD. Multivariate logistic regression models were used to evaluate the association between different factors and anxiety symptoms. RESULTS A total of 89,588 college students participated in the current study, among which 36,865 students (41.1%) reported anxiety symptoms. Multivariate logistic regression analysis revealed that the risk factors for anxiety symptoms included the age of 26-30 (OR=1.456), sophomore (OR=1.038), junior (OR=1.087) and senior grades (OR=1.161), a higher paternal education level (OR=1.055), low economic status (OR=1.520), and low social support (OR=1.542). CONCLUSIONS About two-fifths of Chinese college students experienced anxiety symptoms during the COVID-19 epidemic. Timely and appropriate psychological interventions for college students should be implemented to reduce the psychological harm caused by COVID-19 epidemic.
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Affiliation(s)
- Wenning Fu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shijiao Yan
- School of public health, Hainan Medical University, Haikou, Hainan, China,Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences (No. 2019RU013), Hainan Medical University, Haikou, Hainan, China,Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, Hainan, China
| | - Qiao Zong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dan Anderson-Luxford
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Victoria, Australia
| | - Xingyue Song
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhiyue Lv
- Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Guangzhou, China,Joint Program of Pathobiology, Fifth Affiliated Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Chuanzhu Lv
- Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences (No. 2019RU013), Hainan Medical University, Haikou, Hainan, China; Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, Hainan, China; Department of Emergency, Hainan Clinical Research Center for Acute and Critical Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou, China; Emergency and Trauma College, Hainan Medical University, Haikou, China.
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Gebregziabher NK, Netsereab TB, Fessaha YG, Alaza FA, Ghebrehiwet NK, Sium AH. Prevalence and associated factors of postpartum depression among postpartum mothers in central region, Eritrea: a health facility based survey. BMC Public Health 2020; 20:1614. [PMID: 33109137 PMCID: PMC7590801 DOI: 10.1186/s12889-020-09676-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 10/12/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Postpartum depression (PPD) is a mood disorder that occurs within the first 12 months after delivery. It affects 20 to 40% of women living in the low-income countries. In resource limited countries discovering the predictors of PPD is important as it allows close follow-up and targeted screening of at risk mothers. The objective of this study was to assess the magnitude and predictors of PPD among recently delivered mothers in Central Region of Eritrea. METHODS This study used analytical cross-sectional study design to evaluate the magnitude of and factors associated with postpartum depression among 380 randomly selected mothers. The study was conducted in four primary health care facilities of Zoba Maekel (Central Region), Eritrea. A structured closed-ended questionnaire was used to capture the socio-demographic and maternity related information of the study participants. The standard Diagnostic and Statistical Manual of Mental Disorders Fifth Edition was used to assess depression. The dependent variable for this study was status of the mother with regard to PPD. The socio-demographic and maternity related variables of the mothers, presumed to influence the likelihood of developing postpartum depression, were the independent variables. RESULTS In this study the prevalence of PPD was found to be 7.4%. Mother's who are housewives were less likely to develop PPD (AOR = 0.24, 95% CI: 0.06-0.97; p = 0.046), whereas, mothers with perceived low economic status (AOR = 13.33, 95% CI: 2.66-66.78; p = 0.002), lack of partner support (AOR = 5.8, 95% CI: 1.33-25.29; p = 0.019), unplanned pregnancy (AOR = 3.39, 95% CI: 1.24-9.28; p = 0.017), maternal illness after delivery (AOR = 7.42, 95% CI: 1.44-34.2; p = 0.016), and reside in Southwest-Asmara (AOR = 6.35, 95% CI: 1.73-23.23; p = 0.05) had statistically significant higher odds of postpartum depression. CONCLUSIONS In the current study setting, factors that associated with PPD are grouped in to two domains; the woman's potential to bear the forthcoming responsibility and the social support they get after delivery. The findings of this study imply the need to introduce an active screening program for PPD the health facilities as part of the postpartum care.
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Affiliation(s)
| | | | | | | | | | - Aman Hadish Sium
- School of Public Health, Asmara College of Health Sciences, Asmara, Eritrea
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Leonard KS, Evans MB, Kjerulff KH, Symons Downs D. Postpartum Perceived Stress Explains the Association between Perceived Social Support and Depressive Symptoms. Womens Health Issues 2020; 30:231-239. [PMID: 32527464 PMCID: PMC7347443 DOI: 10.1016/j.whi.2020.05.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 04/15/2020] [Accepted: 05/06/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Limited research has focused on longitudinal interrelations between perceived social support, perceived stress, and depressive symptoms beyond the first postpartum months. This study tested an alternative primary hypothesis within the stress process model examining whether perceived stress mediated the association between perceived social support and depressive symptoms from 1 to 24 months postpartum. Secondary purposes examined whether these factors 1) changed from 1 to 24 months postpartum and 2) predicted depressive symptoms. METHODS Women (N = 1,316) in a longitudinal cohort study completed validated measures of perceived social support, perceived stress, and depressive symptoms at 1, 6, 12, 18, and 24 months postpartum via telephone interviews. Analyses examined changes in psychosocial factors (repeated measures analysis of variance) and the extent to which perceived social support and perceived stress predicted depressive symptoms and supported mediation (linear regression). RESULTS Perceived social support decreased, perceived stress increased, and depressive symptoms remained constant from 1 to 18 months, then increased at 24 months. Low perceived social support predicted 6-month depressive symptoms, whereas perceived stress predicted depressive symptoms at all time points. Perceived stress mediated the association between perceived social support and depressive symptoms across 24 months such that low perceived social support predicted perceived stress, which in turn predicted depressive symptoms. CONCLUSIONS Intervention scientists may want to focus on strengthening perceived social support as a means to manage perceived stress in an effort to prevent a long-term trajectory of depression.
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Affiliation(s)
- Krista S Leonard
- Exercise Psychology Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania
| | - M Blair Evans
- Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania
| | - Kristen H Kjerulff
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania; Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, Pennsylvania
| | - Danielle Symons Downs
- Exercise Psychology Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania; Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, Pennsylvania.
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Pettman D, O'Mahen H, Skoog Svanberg A, von Essen L, Axfors C, Blomberg O, Woodford J. Effectiveness and acceptability of cognitive-behavioural therapy based interventions for maternal peripartum depression: a systematic review, meta-analysis and thematic synthesis protocol. BMJ Open 2019; 9:e032659. [PMID: 31871258 PMCID: PMC6937015 DOI: 10.1136/bmjopen-2019-032659] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 10/30/2019] [Accepted: 11/26/2019] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Peripartum depression is a common mental health difficulty associated with a range of negative impacts for the mother, infant and wider family. This review will examine the effectiveness of cognitive-behavioural therapy (CBT) based interventions for peripartum depression. Secondary aims are to explore the effect of CBT-based interventions targeted at peripartum depression on novel secondary outcomes and moderators potentially associated with effectiveness. To date, there has been little examination of effect on important secondary outcomes (eg, anxiety, stress and parenting), nor clinical and methodological moderators. Further, this review aims to explore the acceptability of CBT-based interventions for women with peripartum depression and examine important adaptations for this population. METHODS AND ANALYSIS Electronic databases (e.g., MEDLINE; ISI Web of Science; CINAHL; CENTRAL; Prospero; EMBASE; ASSIA; PsychINFO; SCOPUS; And Swemed+) will be systematically searched. Database searches will be supplemented by expert contact, reference and citation checking, and grey literature. Primary outcomes of interest will be validated measures of symptoms of depression. A proposed meta-analysis will examine: (1) the overall effectiveness of psychological interventions in improving symptoms of depression (both self-reported and diagnosed major depression) in the peripartum period; (2) the impact of interventions on secondary outcomes (eg, anxiety, stress and parenting); (3) clinical and methodological moderators associated with effectiveness. A thematic synthesis will be conducted on qualitative data exploring the acceptability of CBT-based intervention for postpartum depression including participants' experience and perspectives of the interventions, satisfaction, barriers and facilitators to intervention use, intervention relevance to mothers' situations and suggestions for improvements to tailor interventions to the peripartum client group. ETHICS AND DISSEMINATION Formal ethical approval is not required by the National Ethical Review Board in Sweden as primary data will not be collected. The results will be disseminated through a peer-reviewed publication and inform the development of a new psychological intervention for peripartum depression. This study including protocol development will run from March 2019 to March 2020.
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Affiliation(s)
- Danelle Pettman
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Heather O'Mahen
- Mood Disorders Centre, School of Psychology, University of Exeter, Exeter, UK
| | - Agneta Skoog Svanberg
- Reproductive Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Louise von Essen
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Cathrine Axfors
- Reproductive Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Oscar Blomberg
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Joanne Woodford
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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