International Journal of Environmental Research and Public Health

Research

16 pages, 1297 KiB

Open AccessArticle

Depressive Symptoms in Fathers during the First Postpartum Year: The Influence of Severity of Preterm Birth, Parenting Stress and Partners’ Depression

by Francesca Agostini, Erica Neri, Federica Genova, Elena Trombini, Alessandra Provera, Augusto Biasini and Marcello Stella

Int. J. Environ. Res. Public Health 2022, 19(15), 9478; https://doi.org/10.3390/ijerph19159478 - 2 Aug 2022

Cited by 8 | Viewed by 2617

Abstract

Although preterm birth constitutes a risk factor for postpartum depressive symptomatology, perinatal depression (PND) has not been investigated extensively in fathers of very low (VLBW) and extremely low birth weight (ELBW) infants. This study explored paternal depression levels at 3, 9, and 12 [...] Read more.

Although preterm birth constitutes a risk factor for postpartum depressive symptomatology, perinatal depression (PND) has not been investigated extensively in fathers of very low (VLBW) and extremely low birth weight (ELBW) infants. This study explored paternal depression levels at 3, 9, and 12 months of infant corrected age, investigating also the predictive role played by the severity of prematurity, maternal and paternal PND levels, and parenting stress. We recruited 153 fathers of 33 ELBW, 42 VLBW, and 78 full-term (FT) infants, respectively. Depression was investigated by the Edinburgh Postnatal Depression Scale (EPDS) and distress by the Parenting Stress Index-Short Form-PSI-SF (Total and subscales: Parental Distress, Parent–Child Dysfunctional Interaction, and Difficult Child). ELBW fathers showed a significant decrease (improvement) in EPDS, total PSI-SF, and Parental Distress mean scores after 3 months. Paternal EPDS scores at 12 months were significantly predicted by VLBW and FT infants’ birth weight categories, fathers’ EPDS scores at 3 and 9 months, Parent–Child Dysfunctional Interaction subscale at 3 months, and Difficult Child subscale at 9 months. This study strengthens the relevance of including early routine screening and parenting support for fathers in perinatal health services, with particular attention to fathers who might be more vulnerable to mental health difficulties due to severely preterm birth. Full article

(This article belongs to the Special Issue Screening and Treatment of Perinatal Depression and Anxiety)

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12 pages, 361 KiB

Open AccessArticle

Construct Validity and Responsiveness of Instruments Measuring Depression and Anxiety in Pregnancy: A Comparison of EPDS, HADS-A and CES-D

by Hanna Margaretha Heller, Stasja Draisma and Adriaan Honig

Int. J. Environ. Res. Public Health 2022, 19(13), 7563; https://doi.org/10.3390/ijerph19137563 - 21 Jun 2022

Cited by 14 | Viewed by 2666

Abstract

Depression and anxiety occur frequently in pregnancy and may have unfavourable consequences for mother and child. Therefore, adequate symptom measurement seems important. Commonly used instruments are the Center for Epidemiologic Studies Depression Scale (CES-D), the Edinburgh Postpartum Depression Scale (EPDS), and the Hospital [...] Read more.

Depression and anxiety occur frequently in pregnancy and may have unfavourable consequences for mother and child. Therefore, adequate symptom measurement seems important. Commonly used instruments are the Center for Epidemiologic Studies Depression Scale (CES-D), the Edinburgh Postpartum Depression Scale (EPDS), and the Hospital Anxiety and Depression Scale, anxiety subscale (HADS-A). We compared the (1) structural and (2) longitudinal validity of these instruments. The data originated from a study on the effectiveness of an Internet intervention for pregnant women with affective symptoms. (1) A confirmatory factor analysis was used to estimate the construct validity. The theoretical factorial structure that was defined in earlier studies of the CES-D and the EPDS, but not the HADS-A, could be sufficiently replicated with acceptable CFI and RMSEA values. (2) Since there were two measurements in time, the hypotheses concerning plausible directions of the change scores of subscales that were (un)related to each other could be formulated and tested. In this way, longitudinal validity in the form of responsiveness was estimated. Ten of sixteen hypotheses were confirmed, corroborating the longitudinal validity of all constructs, except anhedonia, probably due to inconsistent conceptualization. The HADS-A seems less suitable to screen for anxiety in pregnancy. Anhedonia needs better conceptualisation to assess the change of symptoms over time with the CES-D and the EPDS. Full article

(This article belongs to the Special Issue Screening and Treatment of Perinatal Depression and Anxiety)

14 pages, 795 KiB

Open AccessArticle

A Comparison of Three Measures to Identify Postnatal Anxiety: Analysis of the 2020 National Maternity Survey in England

by Gracia Fellmeth, Siân Harrison, Maria A. Quigley and Fiona Alderdice

Int. J. Environ. Res. Public Health 2022, 19(11), 6578; https://doi.org/10.3390/ijerph19116578 - 28 May 2022

Cited by 5 | Viewed by 2274

Abstract

Perinatal anxiety affects an estimated 15% of women globally and is associated with poor maternal and infant outcomes. Identifying women with anxiety is essential to prevent these adverse associations, but there are a number of challenges around measurement. We used data from England’s [...] Read more.

Perinatal anxiety affects an estimated 15% of women globally and is associated with poor maternal and infant outcomes. Identifying women with anxiety is essential to prevent these adverse associations, but there are a number of challenges around measurement. We used data from England’s 2020 National Maternity Survey to compare the prevalence of anxiety symptoms at six months postpartum using three different measures: the two-item Generalised Anxiety Disorders Scale (GAD-2), the anxiety subscales of the Edinburgh Postnatal Depression Scale (EPDS-3A) and a direct question. The concordance between each pair of measures was calculated using two-by-two tables. Survey weights were applied to increase the representativeness of the sample and reduce the risk of non-response bias. The prevalence of postnatal anxiety among a total of 4611 women was 15.0% on the GAD-2, 28.8% on the EPDS-3A and 17.1% on the direct question. Concordance between measures ranged between 78.6% (95% CI 77.4–79.8; Kappa 0.40) and 85.2% (95% CI 84.1–86.2; Kappa 0.44). Antenatal anxiety was the strongest predictor of postnatal anxiety across all three measures. Women of Black, Asian or other minority ethnicity were less likely to report self-identified anxiety compared with women of White ethnicity (adjusted odds ratio 0.44; 95% CI 0.30–0.64). Despite some overlap, different anxiety measures identify different groups of women. Certain population characteristics such as women’s ethnicity may determine which type of measure is most likely to identify women experiencing anxiety. Full article

(This article belongs to the Special Issue Screening and Treatment of Perinatal Depression and Anxiety)

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19 pages, 881 KiB

Open AccessArticle

The Childbirth Fear Questionnaire and the Wijma Delivery Expectancy Questionnaire as Screening Tools for Specific Phobia, Fear of Childbirth

by Nichole Fairbrother, Arianne Albert, Fanie Collardeau and Cora Keeney

Int. J. Environ. Res. Public Health 2022, 19(8), 4647; https://doi.org/10.3390/ijerph19084647 - 12 Apr 2022

Cited by 5 | Viewed by 4380

Abstract

Background: Perinatal anxiety and related disorders are common (20%), distressing and impairing. Fear of childbirth (FoB) is a common type of perinatal anxiety associated with negative mental health, obstetrical, childbirth and child outcomes. Screening can facilitate treatment access for those most in need. [...] Read more.

Background: Perinatal anxiety and related disorders are common (20%), distressing and impairing. Fear of childbirth (FoB) is a common type of perinatal anxiety associated with negative mental health, obstetrical, childbirth and child outcomes. Screening can facilitate treatment access for those most in need. Objectives: The purpose of this research was to evaluate the accuracy of the Childbirth Fear Questionnaire (CFQ) and the Wijma Delivery Expectations Questionnaire (W-DEQ) of FoB as screening tools for a specific phobia, FoB. Methods: A total of 659 English-speaking pregnant women living in Canada and over the age of 18 were recruited for the study. Participants completed an online survey of demographic, current pregnancy and reproductive history information, as well as the CFQ and the W-DEQ, and a telephone interview to assess specific phobia FoB. Results: Symptoms meeting full and subclinical diagnostic criteria for a specific phobia, FoB, were reported by 3.3% and 7.1% of participants, respectively. The W-DEQ met or exceeded the criteria for a “good enough” screening tool across several analyses, whereas the CFQ only met these criteria in one analysis and came close in three others. Conclusions: The W-DEQ demonstrated high performance as a screening tool for a specific phobia, FoB, with accuracy superior to that of the CFQ. Additional research to ensure the stability of these findings is needed. Full article

(This article belongs to the Special Issue Screening and Treatment of Perinatal Depression and Anxiety)

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14 pages, 537 KiB

Open AccessArticle

Perinatal Anxiety among Women during the COVID-19 Pandemic—A Cross-Sectional Study

by Grażyna Iwanowicz-Palus, Mariola Mróz, Aleksandra Korda, Agnieszka Marcewicz and Agnieszka Palus

Int. J. Environ. Res. Public Health 2022, 19(5), 2603; https://doi.org/10.3390/ijerph19052603 - 24 Feb 2022

Cited by 7 | Viewed by 2240

Abstract

Introduction: The COVID-19 pandemic has changed the way prenatal education and obstetric care are provided. Pandemic-related anxiety, restrictions, limitations in perinatal care, and the inability to be accompanied by a loved one can have negative psychological consequences for future parents and their child. [...] Read more.

Introduction: The COVID-19 pandemic has changed the way prenatal education and obstetric care are provided. Pandemic-related anxiety, restrictions, limitations in perinatal care, and the inability to be accompanied by a loved one can have negative psychological consequences for future parents and their child. The aim of this study was to analyze the determinants and assess the anxiety of pregnant women in individual trimesters, as well as to learn about the sources of support and medical personnel proceeding methods. Materials and Methods: This research was conducted as a diagnostic survey, using the State-Trait Anxiety Inventory (STAI), Childbirth Anxiety Questionnaire (CAQ), and a standardized interview questionnaire, on 534 pregnant women in Poland. Resultsand Conclusions: The pregnant women, regardless of the trimester of pregnancy, are characterized by: increased anxiety level influenced by the current epidemiological situation, psychophysical condition, previous maternal experiences, participation in classes preparing for childbirth, organization of perinatal care, their relationship with a partner, and the presence of a loved one during childbirth. A negative correlation was shown between the level of childbirth anxiety and maternal experience, as well as the support of a doctor and midwife. Full article

(This article belongs to the Special Issue Screening and Treatment of Perinatal Depression and Anxiety)

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23 pages, 1189 KiB

Open AccessArticle

Screening for Perinatal Anxiety Using the Childbirth Fear Questionnaire: A New Measure of Fear of Childbirth

by Nichole Fairbrother, Fanie Collardeau, Arianne Albert and Kathrin Stoll

Int. J. Environ. Res. Public Health 2022, 19(4), 2223; https://doi.org/10.3390/ijerph19042223 - 16 Feb 2022

Cited by 8 | Viewed by 3821

Abstract

Fear of childbirth affects as many as 20% of pregnant people, and has been associated with pregnancy termination, prolonged labour, increased risk of emergency and elective caesarean delivery, poor maternal mental health, and poor maternal-infant bonding. Currently available measures of fear of childbirth [...] Read more.

Fear of childbirth affects as many as 20% of pregnant people, and has been associated with pregnancy termination, prolonged labour, increased risk of emergency and elective caesarean delivery, poor maternal mental health, and poor maternal-infant bonding. Currently available measures of fear of childbirth fail to fully capture pregnant people’s childbirth-related fears. The purpose of this research was to develop a new measure of fear of childbirth (the Childbirth Fear Questionnaire; CFQ) that would address the limitations of existing measures. The CFQ’s psychometric properties were evaluated through two studies. Participants for Study 1 were 643 pregnant people residing in Canada, the United States, and the United Kingdom, with a mean age of 29.0 (SD = 5.1) years, and 881 pregnant people residing in Canada, with a mean age of 32.9 (SD = 4.3) years for Study 2. In both studies, participants completed a set of questionnaires, including the CFQ, via an online survey. Exploratory factor analysis in Study 1 resulted in a 40-item, 9-factor scale, which was well supported in Study 2. Both studies provided evidence of high internal consistency and convergent and discriminant validity. Study 1 also provided evidence that the CFQ detects group differences between pregnant people across mode of delivery preference and parity. Study 2 added to findings from Study 1 by providing evidence for the dimensional structure of the construct of fear of childbirth, and measurement invariance across parity groups (i.e., the measurement model of the CFQ was generalizable across parity groups). Estimates of the psychometric properties of the CFQ across the two studies provided evidence that the CFQ is psychometrically sound, and currently the most comprehensive measure of fear of childbirth available. The CFQ covers a broad range of domains of fear of childbirth and can serve to identify specific fear domains to be targeted in treatment. Full article

(This article belongs to the Special Issue Screening and Treatment of Perinatal Depression and Anxiety)

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13 pages, 368 KiB

Open AccessArticle

Predictors of Postpartum Depression among Italian Women: A Longitudinal Study

by Sara Molgora, Emanuela Saita, Maurizio Barbieri Carones, Enrico Ferrazzi and Federica Facchin

Int. J. Environ. Res. Public Health 2022, 19(3), 1553; https://doi.org/10.3390/ijerph19031553 - 29 Jan 2022

Cited by 12 | Viewed by 4180

Abstract

Introduction: Postpartum depression is commonly experienced by mothers worldwide and is associated with anxiety disorders, parenting stress, and other forms of distress, which may lead to a complex illness condition. Several studies have investigated the risk factors for this disorder, including biological and [...] Read more.

Introduction: Postpartum depression is commonly experienced by mothers worldwide and is associated with anxiety disorders, parenting stress, and other forms of distress, which may lead to a complex illness condition. Several studies have investigated the risk factors for this disorder, including biological and socio-demographic variables, medical and obstetric factors, and psychological and relational dimensions. The present study aimed to describe the psychological status of mothers up to 12 months postpartum, and to investigate the predictors of depressive symptoms at 12 months postpartum, considering obstetric factors along with psychological and relational variables. Methods: A sample of 137 women completed a questionnaire composed of a sheet on anamnestic and obstetric information and the following scales: Wijma Delivery Experience Questionnaire; State-Trait Anxiety Inventory; Edinburgh Postnatal Depression Scale; Parenting Stress Index (Short Form); Dyadic Adjustment Scale; and Multidimensional Scale of Perceived Social Support. Data were collected at four assessment times: 2–3 days, 3 months, 6 months, and 12 months postpartum. Results: Findings showed that the highest percentage of women with clinically significant symptoms of anxiety (state and trait) and depression was found at 12 months postpartum, which indicated that this was the most critical time. The quality of childbirth experience and trait anxiety at three months postpartum emerged as significant predictors of postpartum depression at 12 months. Conclusion: Our findings highlight the importance of providing stable programs (such as educational programs) to mothers in the first year postpartum. Furthermore, because the quality of the childbirth experience is one of the most important predictors of PPD at 12 months postpartum, effort should be made by healthcare professionals to guarantee a positive experience to all women to reduce possible negative long-term consequences of this experience. Full article

(This article belongs to the Special Issue Screening and Treatment of Perinatal Depression and Anxiety)

14 pages, 452 KiB

Open AccessArticle

The Relevance of Insomnia in the Diagnosis of Perinatal Depression: Validation of the Italian Version of the Insomnia Symptom Questionnaire

by Lavinia De Chiara, Cristina Mazza, Eleonora Ricci, Alexia Emilia Koukopoulos, Georgios D. Kotzalidis, Marco Bonito, Tommaso Callovini, Paolo Roma and Gloria Angeletti

Int. J. Environ. Res. Public Health 2021, 18(23), 12507; https://doi.org/10.3390/ijerph182312507 - 27 Nov 2021

Cited by 7 | Viewed by 2505

Abstract

Background. Sleep disorders are common in perinatal women and may underlie or trigger anxiety and depression. We aimed to translate and validate and evaluate the psychometric properties of the Italian version of the Insomnia Symptom Questionnaire (ISQ), in a sample of women during [...] Read more.

Background. Sleep disorders are common in perinatal women and may underlie or trigger anxiety and depression. We aimed to translate and validate and evaluate the psychometric properties of the Italian version of the Insomnia Symptom Questionnaire (ISQ), in a sample of women during late pregnancy and 6-months postpartum according to the DSM-5 criteria. Methods. The ISQ was administered to 292 women prenatally along with other measures of sleep quality, depression, and anxiety, to examine its construct and convergent validity. Women were readministered the ISQ six months postdelivery to assess test–retest reliability. Women were divided into DSM-5 No-Insomnia (N = 253) and Insomnia (N = 39) groups. Results. The insomnia group had received more psychopharmacotherapy, had more psychiatric family history, increased rates of medically assisted reproduction, of past perinatal psychiatric disorders, and scored higher on almost all TEMPS-A dimensions, on the EPDS, HCL-32, PSQI, and on ISQ prenatally and postnatally. ISQ scores correlated with all scales, indicating adequate convergent and discriminant validity; furthermore, it showed antenatal–postnatal test–retest reliability, 97.5% diagnostic accuracy, 79.5% sensitivity, 94.9% specificity, 70.5% positive predictive power, and 92.8% negative predictive power. Conclusions. The ISQ is useful, valid, and reliable for assessing perinatal insomnia in Italian women. The Italian version showed equivalent properties to the original version. Full article

(This article belongs to the Special Issue Screening and Treatment of Perinatal Depression and Anxiety)

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11 pages, 342 KiB

Open AccessArticle

Pandemic Stress and Its Correlates among Pregnant Women during the Second Wave of COVID-19 in Poland

by Michalina Ilska, Anna Kołodziej-Zaleska, Anna Brandt-Salmeri, Heidi Preis and Marci Lobel

Int. J. Environ. Res. Public Health 2021, 18(21), 11140; https://doi.org/10.3390/ijerph182111140 - 23 Oct 2021

Cited by 12 | Viewed by 3231

Abstract

Background: The ongoing COVID-19 pandemic has created numerous stressful conditions, especially for vulnerable populations such as pregnant women. Pandemic-related pregnancy stress consists of two dimensions: stress associated with feeling unprepared for birth due to the pandemic (Preparedness Stress), and stress related to fears [...] Read more.

Background: The ongoing COVID-19 pandemic has created numerous stressful conditions, especially for vulnerable populations such as pregnant women. Pandemic-related pregnancy stress consists of two dimensions: stress associated with feeling unprepared for birth due to the pandemic (Preparedness Stress), and stress related to fears of perinatal COVID-19 infection (Perinatal Infection Stress). The purpose of our study was to elucidate the association between various factors—sociodemographic, obstetric, pandemic-related, and situational—and pandemic stress in its two dimensions during the second wave of the COVID-19 pandemic in Polish pregnant women. Methods: A cross-sectional study with a total of 1119 pregnant women recruited during the second wave of the COVID-19 pandemic in Poland (between November 2020 and January 2021). Participants were recruited via social media to complete an online study questionnaire that included sociodemographic, obstetric, situational, and COVID-19 pandemic factors, as well as the Pandemic-Related Pregnancy Stress Scale (PREPS). Results: Nearly 38.5% of participants reported high Preparedness Stress; 26% reported high Perinatal Infection Stress. Multivariate analyses indicated that lack of COVID-19 diagnosis, higher compliance with safety rules and restrictions, and limited access to outdoor space were independently associated with moderate to severe levels of Infection Stress. Current emotional or psychiatric problems, nulliparity, limited access to outdoor space, and alterations to obstetric visits were independently associated with moderate to severe Preparedness Stress. Conclusion: Study findings suggest that particular attention should be focused on the groups of pregnant women who are most vulnerable to pandemic-related stress and therefore may be more prone to adverse outcomes associated with prenatal stress. Full article

(This article belongs to the Special Issue Screening and Treatment of Perinatal Depression and Anxiety)

13 pages, 3718 KiB

Open AccessArticle

Factor Structure of the Edinburgh Postnatal Depression Scale in a Sample of Postpartum Slovak Women

by Zuzana Škodová, Ľubica Bánovčinová, Eva Urbanová, Marián Grendár and Martina Bašková

Int. J. Environ. Res. Public Health 2021, 18(12), 6298; https://doi.org/10.3390/ijerph18126298 - 10 Jun 2021

Cited by 6 | Viewed by 2903

Abstract

Background: Postpartum depression has a negative impact on quality of life. The aim of this study was to examine the factor structure and psychometric properties of the Slovak version of the Edinburgh Postnatal Depression Scale (EPDS). Methods: A paper and pencil version of [...] Read more.

Background: Postpartum depression has a negative impact on quality of life. The aim of this study was to examine the factor structure and psychometric properties of the Slovak version of the Edinburgh Postnatal Depression Scale (EPDS). Methods: A paper and pencil version of the 10-item EPDS questionnaire was administered personally to 577 women at baseline during their stay in hospital on the second to fourth day postpartum (age, 30.6 ± 4.9 years; 73.5% vaginal births vs. 26.5% operative births; 59.4% primiparas). A total of 198 women participated in the online follow-up 6–8 weeks postpartum (questionnaire sent via e-mail). Results: The Slovak version of the EPDS had Cronbach’s coefficients of 0.84 and 0.88 at baseline (T1) and follow-up, respectively. The three-dimensional model of the scale offered good fit for both the baseline (χ²_{(df = 28)} = 1339.38, p < 0.001; CFI = 0.99, RMSEA = 0.02, and TLI = 0.99) and follow-up (χ²_{(df = 45)} = 908.06, p < 0.001, CFI = 0.93, RMSEA = 0.09, and TL = 0.90). A risk of major depression (EPDS score ≥ 13) was identified in 6.1% in T1 and 11.6% in the follow-up. Elevated levels of depression symptoms (EPDS score ≥ 10) were identified in 16.7% and 22.7% of the respondents at baseline and follow-up, respectively. Conclusions: The Slovak translation of the EPDS showed good consistency, convergent validity, and model characteristics. The routine use of EPDS can contribute to improving the quality of postnatal health care. Full article

(This article belongs to the Special Issue Screening and Treatment of Perinatal Depression and Anxiety)

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Review

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16 pages, 904 KiB

Open AccessReview

Gender Transformative Interventions for Perinatal Mental Health in Low and Middle Income Countries—A Scoping Review

by Archana Raghavan, Veena A. Satyanarayana, Jane Fisher, Sundarnag Ganjekar, Monica Shrivastav, Sarita Anand, Vani Sethi and Prabha S. Chandra

Int. J. Environ. Res. Public Health 2022, 19(19), 12357; https://doi.org/10.3390/ijerph191912357 - 28 Sep 2022

Cited by 6 | Viewed by 3152

Abstract

Perinatal mental health problems are linked to poor outcomes for mothers, babies and families. In the context of Low and Middle Income Countries (LMIC), a leading risk factor is gender disparity. Addressing gender disparity, by involving fathers, mothers in law and other family [...] Read more.

Perinatal mental health problems are linked to poor outcomes for mothers, babies and families. In the context of Low and Middle Income Countries (LMIC), a leading risk factor is gender disparity. Addressing gender disparity, by involving fathers, mothers in law and other family members can significantly improve perinatal and maternal healthcare, including risk factors for poor perinatal mental health such as domestic violence and poor social support. This highlights the need to develop and implement gender-transformative (GT) interventions that seek to engage with men and reduce or overcome gender-based constraints. This scoping review aimed to highlight existing gender transformative interventions from LMIC that specifically aimed to address perinatal mental health (partner violence, anxiety or depression and partner support) and identify components of the intervention that were found to be useful and acceptable. This review follows the five-stage Arksey and O’Malley framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. Six papers that met the inclusion criteria were included in the review (four from Africa and two from Asia). Common components of gender transformative interventions across studies included couple-based interventions and discussion groups. Gender inequity and related factors are a strong risk for poor perinatal mental health and the dearth of studies highlights the strong need for better evidence of GT interventions in this area. Full article

(This article belongs to the Special Issue Screening and Treatment of Perinatal Depression and Anxiety)

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17 pages, 645 KiB

Open AccessReview

Treatment of Peripartum Depression with Antidepressants and Other Psychotropic Medications: A Synthesis of Clinical Practice Guidelines in Europe

by Sarah Kittel-Schneider, Ethel Felice, Rachel Buhagiar, Mijke Lambregtse-van den Berg, Claire A. Wilson, Visnja Banjac Baljak, Katarina Savic Vujovic, Branislava Medic, Ana Opankovic, Ana Fonseca and Angela Lupattelli

Int. J. Environ. Res. Public Health 2022, 19(4), 1973; https://doi.org/10.3390/ijerph19041973 - 10 Feb 2022

Cited by 15 | Viewed by 6513

Abstract

This study examined (1) the availability and content of national CPGs for treatment of peripartum depression, including comorbid anxiety, with antidepressants and other psychotropics across Europe and (2) antidepressant and other psychotropic utilization data as an indicator of prescribers’ compliance to the guidelines. [...] Read more.

This study examined (1) the availability and content of national CPGs for treatment of peripartum depression, including comorbid anxiety, with antidepressants and other psychotropics across Europe and (2) antidepressant and other psychotropic utilization data as an indicator of prescribers’ compliance to the guidelines. We conducted a search using Medline and the Guidelines International Network database, combined with direct e-mail contact with national Riseup-PPD COST ACTION members and researchers within psychiatry. Of the 48 European countries examined, we screened 41 records and included 14 of them for full-text evaluation. After exclusion of ineligible and duplicate records, we included 12 CPGs. Multiple CPGs recommend antidepressant initiation or continuation based on maternal disease severity, non-response to first-line non-pharmacological interventions, and after risk-benefit assessment. Advice on treatment of comorbid anxiety is largely missing or unspecific. Antidepressant dispensing data suggest general prescribers’ compliance with the preferred substances of the CPG, although country-specific differences were noted. To conclude, there is an urgent need for harmonized, up-to-date CPGs for pharmacological management of peripartum depression and comorbid anxiety in Europe. The recommendations need to be informed by the latest available evidence so that healthcare providers and women can make informed, evidence-based decisions about treatment choices. Full article

(This article belongs to the Special Issue Screening and Treatment of Perinatal Depression and Anxiety)

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Other

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13 pages, 735 KiB

Open AccessStudy Protocol

Online and Offline Intervention for the Prevention of Postpartum Depression among Rural-to-Urban Floating Women: Study Protocol for a Randomized Control Trial

by Xichenhui Qiu, Ting Li, Qiyu Fang, Lingling Huang and Xujuan Zheng

Int. J. Environ. Res. Public Health 2022, 19(13), 7951; https://doi.org/10.3390/ijerph19137951 - 29 Jun 2022

Cited by 2 | Viewed by 2858

Abstract

Background: As a higher-risk group of postpartum depression (PPD), rural to urban floating women urgently require effective and accessible mental health care after childbirth to prevent PPD. Even though there were various interventions, only a small number of women have sought professional help [...] Read more.

Background: As a higher-risk group of postpartum depression (PPD), rural to urban floating women urgently require effective and accessible mental health care after childbirth to prevent PPD. Even though there were various interventions, only a small number of women have sought professional help to reduce their depressive symptoms after childbirth, suggesting the need for an innovative intervention delivery to overcome women’s help-seeking barriers. Online and offline (OTO) interventions, which combine face-to-face and internet-based interventions, provide apparent benefits. As a result, the protocol for a randomized controlled study (RCT) was designed to examine the effectiveness and acceptability of OTO intervention on psychosocial outcomes for Chinese rural-to-urban floating women including the reduction of PPD symptoms and PPD stigma, and the improvement of social support and quality of life. Methods: A double blind, multicenter, RCT will be used and a total of 226 participants will be recruited. The OTO intervention called the “Hi, Mom” program will integrate two face-to-face consulting sessions with online sessions comprising an information module, a communication module, an ask-the-expert module, and a peer story module over a period of three months. The control group will receive routine postpartum care. Outcome measures including PPD symptoms, PPD stigma, social support, quality of life, mother–child bonding, and satisfaction with health care received will be conducted at baseline, postintervention, and three-month follow-up. Results and Discussion: If the intervention is effective, it will provide a convenient and effective intervention program on postpartum mental well-being for rural-to-urban floating women. As the first study to test the effects of an OTO intervention for the prevention of PPD in China, the outcomes gained from this study will provide evidence-based knowledge for clinical practice on PPD prevention based on online and offline health technologies. Moreover, it could be used to plan a culturally appropriate OTO intervention for migrant mothers from different countries. Full article

(This article belongs to the Special Issue Screening and Treatment of Perinatal Depression and Anxiety)

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8 pages, 318 KiB

Open AccessOpinion

Is Validating the Cutoff Score on Perinatal Mental Health Mood Screening Instruments, for Women and Men from Different Cultures or Languages, Really Necessary?

by Stephen Matthey

Int. J. Environ. Res. Public Health 2022, 19(7), 4011; https://doi.org/10.3390/ijerph19074011 - 28 Mar 2022

Cited by 8 | Viewed by 2407

Abstract

Background: The most commonly used mood screening instrument in perinatal health is the Edinburgh Depression Scale. The screen-positive cut-off score on this scale, as for others, has been determined, via validation techniques, for over 20 languages/cultures, and for both women and men. [...] Read more.

Background: The most commonly used mood screening instrument in perinatal health is the Edinburgh Depression Scale. The screen-positive cut-off score on this scale, as for others, has been determined, via validation techniques, for over 20 languages/cultures, and for both women and men. While such validation appears to be considered essential, there are studies that could be interpreted to suggest that this is not an important consideration. Methods: Selective studies have been chosen to indicate these opposing points of view. Results: Examples of studies that support the notion of validating cut-off scores are described, as are examples of studies that appear not to support this point of view. Conclusions: (i) Clinical services and researchers need to be mindful of these opposing points of view, and openly discuss them when using screening cut-off scores for their respective populations. (ii) Researchers and Journals need to be more rigorous in ensuring this issue is correctly reported in studies, and/or openly discussed when relevant. Full article

(This article belongs to the Special Issue Screening and Treatment of Perinatal Depression and Anxiety)

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