Prevalence and determinants of antenatal common mental disorders among women in India: a systematic review and meta-analysis (original) (raw)
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International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2017
Background: Pregnancy is a major psychological, as well as physiological event; women may find themselves unable to cope with additional demands of pregnancy. Mental illness during pregnancy-whether anxiety, depression or more severe psychiatric disorders-can have a significant negative impact on a mother and her baby. Poor psychological health has been associated with low birth weight, premature birth, perinatal and infant death, postnatal depression, as well as long term behavioural and psychological impacts on the child. Depressive disorders are a common source of disability among women. Mental health problems during pregnancy and postpartum periods are one of the alarming health issue among women. Community-based epidemiological data on antenatal depression from developing countries is scarce. This study was conducted to assess the mental health status of pregnant women attending antenatal clinic of tertiary care hospital, SKIMS, Srinagar (J and K). Methods: A cross sectional study was conducted over a period of six months from 1stSeptember 2016 to 28th February 2017 among randomly selected pregnant women attending antenatal clinic of tertiary care hospital, SKIMS, Srinagar. A total of 200 pregnant women formed the study subjects. Data was collected by interviewing the pregnant women using pre-designed, pre-tested, semi-structured questionnaire. Data was analysed using Statistical Programme for the social science (SPSS) version 19.0. Results: Amongst the study population, prevalence of depressive disorder was 26%. The depression was significantly increasing with advancing pregnancy and advancing age. Socioeconomic status and depression was associated statistically significant (p=0.024). Women with bad relationship with in laws had significantly more depression compared to those who had good relationship with in laws (P=0.0037). The association between parity and depressive disorder was statistically insignificant(P=0,7144). Conclusions: When we care for mother we care for two live and live without psychological consideration is completely materialistic. A depressive symptom occurs commonly during 2nd and 3rd trimester of pregnancy, drawing attention to a need to screen for depression during antenatal care. Maternal health policies, a priority in developing countries, must integrate maternal depression as a disorder of public health importance. Intervention should target women in the early antenatal period.
Indian journal of psychological medicine
Antepartum anxiety and depression are two of the most common risk factors for the development of postpartum depression. Women are at a higher risk of developing depression and suffering from mental disorders during pregnancy and the postnatal period. Psychopathological symptoms during pregnancy have physiological consequences for the fetus, such as impaired blood flow leading to low birth weight, as well as cognitive delay and behavioral problems. To screen antenatal women for common mental health disorders and to determine the factors associated with mental health disorders during pregnancy. A cross-sectional study among 208 pregnant mothers in the third trimester attending the antenatal clinic at a Government Maternity Home in a low-income urban area of Bengaluru was conducted using clinical interview schedule-revised (CIS-R) questionnaire as a screening tool for detecting the presence of mental morbidity. Data collected were analyzed using SPSS version 16. In the study population...
Trajectory of Perinatal Mental Health In India
Indian Journal of Social Psychiatry, 2019
The global burden of psychiatric disorders in women is on the rise, especially in the perinatal period. Despite this, the recognition of the need and delivery of health care in women of reproductive age group is scarce and still met by unscientific treatment modalities. Such a scenario is luring in India as well. We have focused on discussing the impact of culture on the treatment practices, different challenges faced, nosological status, and management principles of different perinatal psychiatric disorders. We mainly employed the Google Scholar search engine to look into articles of all sorts (review articles, case reports, expert opinions, newspaper extracts, and Indian government websites) and reviewed them. We also acknowledged the information extracted from these articles which were highly valuable and enlightening. The perspective of the health‑care delivery in the perinatal group of population has been changing over the years, but still there is lot to change. A holistic, scientific, evidence‑based approach is a definite need toward attaining this goal.
Recommendations for maternal mental health policy in India
Journal of Public Health Policy, 2023
Mental illnesses are a serious concern in India where every seventh person suffers from mental health problems-with women more affected than men. While the burden of perinatal mental illnesses grows, India lacks exclusive policies to address it. The COVID-19 pandemic has had an impact on routine antenatal care and institutional deliveries and has also affected the mental health of pregnant women and mothers. We evaluated existing policies. Policy options were evaluated against criteria like cost-benefit analysis, administrative feasibility, human resources, and equity along with the intended and unintended consequences. We propose three policy options: (1) strengthening and focused implementation of the existing national mental health program (NMHP), (2) integrating mental health in the ongoing Reproductive, Maternal, Newborn, Child and Adolescent Health Program, and (3) including a 'maternal' component in NMHP. We offered policy recommendations to fill the gap in addressing the maternal mental health challenge in India.
PARIPEX INDIAN JOURNAL OF RESEARCH, 2022
Background: Psychiatric disorders have an adverse effect on both maternal as well as fetal well-being. The recognition of antenatal psychiatric disorders is an emerging area of concern in developing countries. Early recognition and interventions can improve the perinatal outcomes significantly. Objective: our objective was to study the sociodemographic and clinical profile of antenatal patients visiting Psychiatric hospital in a tertiary hospital of south Kashmir. Methods: a descriptive, cross-sectional design was employed and was conducted over a period of five months. 62 patients were included as the study sample. The patients were assessed using a semi-structured pro forma and were diagnosed using the ICD-10 diagnostic criteria. Results: our study reported majority of females were in third and fourth decade of life and were unemployed. Depression, followed by generalized anxiety disorder were the most common psychiatric diagnosis with majority of patients presenting in third trimester. Psychiatric illnesses were significantly associated with primiparity and poor social support. Conclusion: our study demonstrated the increasing prevalence of psychiatric illnesses in antenatal period and its adverse perinatal consequences. Hence, it is crucial to emphasize on early detection of mental distress and the need to integrate mental health in antenatal care.
Depression Research and Treatment, 2022
Background. Antenatal depression (AND) is a common mood disorder that affects both the mother and the child. Objective. The current study is aimed at identifying the prevalence of antenatal depression and the risk factors associated with it in South Indian pregnant women. Materials and Methods. The current study was carried out in a tertiary care teaching hospital where pregnancy and postnatal care are offered. In the study, 314 pregnant women who visited the antenatal clinic for their prenatal checkups were included. To diagnose possible depression, Edinburgh Postnatal Depression Scale (EPDS) was used. The chi-square test was applied to determine the association between antenatal depression and various socioeconomic, obstetric, and medical factors. A logistic regression analysis was performed to identify significant confounding variables. Results. Of the total 314 women, 69 (21.98%) were suffering from possible depression with the mean EPDS score being 10:61 ± 7:48. Women of younger age had greater risks for depression than older women (AOR = 2:01; 95% CI: 0.56-7.20). Maternal age (χ 2 = 0:013, p = 0:009) and the presence of health issues during the current pregnancy (χ 2 = 5:18, p = 0:023) were the factors significantly associated with antenatal depression. Conclusions. Clinical efforts should focus on screening antenatal depression, early identification, and effective care, thus preventing progression to postpartum depression and its detrimental effects.
National Journal of Community Medicine, 2017
Introduction: Antenatal depression has often been overlooked and under-diagnosed throughout the world, especially in developing nations like India. The study was conducted to assess the prevalence of antenatal depression among pregnant women in South India and to identify associated risk factors. Methods: A cross sectional study was conducted over seven months on 201 pregnant women in Mangalore. A semi structured questionnaire using Edinburgh Postnatal Depression Scale (EPDS) was used. Data was analyzed using SPSS version 11.5. Results: 201 pregnant ladies were evaluated for antenatal depression. Majority women (52.7%) belonged to the age group of 26-30 years. Using EPDS we found that 10.9% women were progressing towards antenatal depression. The risk of developing antenatal depression was statistically significant among the women (21.1%) who were married before 20 years of age (p= 0.027), who were multi-gravida (p=0.002) and who were facing pressure from in-laws (p<0.05). Conclusion: Need for clinical efforts to focus on early recognition and effectively managing antenatal depression by screening, thus preventing progression to postpartum depression and its ill effects.
BMC Psychiatry, 2021
Background Perinatal common mental disorders are associated with significant adverse outcomes for women and their families, particularly in low- and middle-income settings. Early detection through screening with locally-validated tools can improve outcomes. Methods We searched MEDLINE, Embase, PsycINFO, Global Health, Cochrane Library, Web of Science and Google Scholar for articles on the validation of screening tools for common mental disorders in perinatal women in India, with no language or date restrictions. Quality was assessed using the QUADAS-2 tool. We used bivariate and hierarchical summary receiver operating characteristic models to calculate pooled summary estimates of sensitivity and specificity. Heterogeneity was assessed by visualising the distance of individual studies from the summary curve. Results Seven studies involving 1003 women were analysed. All studies assessed the validity of the Edinburgh Postnatal Depression Scale (EPDS) in identifying perinatal depression...
Indian Journal of Psychological Medicine, 2020
Background: Poor mental health of the mother affects her physical health and the neonate's health and development. Studies from Southern India place different estimates of perinatal mental ill-health. Cultural variables affect health-seeking behaviour and are thus important to study in perinatal women with psychiatric morbidity. Methods: A total of 281 perinatal women were screened on Edinburgh Postnatal Depression Scale (EPDS), Perinatal Anxiety Screening Scale (PASS) and Mini International Neuropsychiatric Interview version 6.0 (MINI), assisted with a clinical interview to identify psychiatric illnesses. The cultural formulation interview (CFI) of DSM-5 was applied on perinatal women having psychiatric illnesses and their caregivers. Results: A psychiatric diagnosis was present in 10.3% of perinatal women. Depression and anxiety disorders were seen in 7.12% and 1.41%, respectively. Marital discord (P < 0.0001), psychosocial stressors (P < 0.0001), and past history of psychiatric disorder (P < 0.001) were significantly higher in perinatal women with a current psychiatric diagnosis. On CFI work-related stress, the gender of the infant, low education and conflict across generations were identified as the negative aspects of the culture associated with psychiatric illness during and after pregnancy. Religion and social support were the major coping strategies, while stigma and financial problems were the major barriers to help-seeking. Conclusion: The high prevalence of psychiatric disorders and the strikingly low help-seeking are noteworthy. These findings can help in planning treatment and prevention programs for timely detection and intervention for perinatal psychiatric disorders.
Background A pregnancy is the most crucial phase of a woman’s life, both physically and mentally. Studies reveals that women with an unintended pregnancy are at an increased risk of depression during pregnancy. As depression, anxiety, or stress during pregnancy can severely affect the health of women and children. This study attempts to scrutinize the association between intention of pregnancy and depressive symptoms among young adolescent girls. Data and methods We used data from Understanding the lives of adolescents and young adults (UDAYA, 2018). The adequate sample size was 5,165 currently married adolescent aged (15–23 years), who were either had a pregnancy with a successful outcome or presently pregnant. Descriptive statistics and bivariate analysis with percentages and chi-square test were used to find the preliminary results. For analyzing the association between unintended pregnancy and depression, the binary logistic regression analysis was conducted. Results Nearly 37% ...