Perinatal anxiety and depression: Awareness and attitudes in Australia (original) (raw)
Related papers
National program for depression associated with childbirth: the Australian experience
Best Practice & Research in Clinical Obstetrics & Gynaecology, 2007
Routine screening was introduced as a joint research/public-health initiative across 43 health services in Australia, funded by beyondblue, the National Australian Depression Initiative. This program included assessing risk factors and prevalence of depression in perinatal women. Other objectives included increasing awareness of the condition, training of relevant staff, and assessing the feasibility of a screening program. Women were screened antenatally and postnatally with a demographic questionnaire and the Edinburgh Postnatal Depression Scale. A subgroup of women and health professionals was surveyed. Over 40,000 women participated directly in the program. Data and issues for specific groups are presented. There was a high level of acceptability to women and health professionals involved. Screening is acceptable and feasible as part of the mental-health management of perinatal women. It needs to be supplemented with information for women and education and support for staff.
BMC Public Health, 2010
Background: Whilst the prevalence and correlates of postpartum depression are well established, far less is known about postpartum anxiety. Studies have described the association between socio-demographic factors and postpartum depression, yet few have explored the association between stressors in women's lives around the time of having a baby and maternal psychological morbidity. This study aimed to describe the population prevalence of postpartum depression, anxiety, co-morbid anxiety and depression and social health issues; and to examine the association between postpartum psychological and social health issues experienced in the six months following birth. Methods: Population-based survey of all women who gave birth in Victoria and South Australia in September/ October 2007. Women were mailed the survey questionnaire six months following birth. Anxiety and depression were measured using the Depression Anxiety Stress Scales (DASS-21). Results: Questionnaires were completed by 4,366 women. At six months postpartum the proportion of women scoring above the 'normal' range on the DASS-21 was 12.7% for anxiety,17.4% for depression, and 8.1% for comorbid depression and anxiety. Nearly half the sample reported experiencing stressful life events or social health issues in the six months following birth, with 38.3% reporting one to two and 8.8% reporting three or more social health issues. Women reporting three or more social health issues were significantly more likely to experience postnatal anxiety (Adj OR = 4.12, 95% CI 3.0-5.5) or depression (Adj OR = 5.11, 95% CI = 3.9-6.7) and co-morbid anxiety and depression (Adj OR = 5.41, 95% CI 3.8-7.6) than women who did not report social health issues. Conclusions: Health care providers including midwives, nurses, medical practitioners and community health workers need to be alert to women's social circumstances and life events experienced in the perinatal period and the interplay between social and emotional health. Usual management for postpartum mental health issues including Cognitive Behavioural Therapy and pharmacological approaches may not be effective if social health issues are not addressed. Coordinated and integrated perinatal care that is responsive to women's social health may lead to improvements in women's emotional wellbeing following birth.
Midwifery, 2021
Background: It has been recommended that psychosocial assessment (including depression screening) be integrated into routine antenatal care across Australia, but implementation in the private sector has lagged. Aims: This study aimed to report preliminary outcomes associated with an antenatal psychosocial assessment and depression screening program implemented at an Australian private obstetric hospital setting and to report characteristics and correlates of elevated depression symptoms in this sample. Materials and Methods: A total of 993 pregnant women (mean AE SD gestational age 27.9 AE 6.7 weeks) participated in a structured psychosocial assessment interview and completed the Edinburgh Postnatal Depression Scale (EPDS). Results: Six per cent of participants scored ≥13 on the EPDS. Psychosocial correlates of antenatal depressive symptoms included low income, history of pregnancy termination, poor practical support, lack of confidence and history of depression. Almost 1 in 10 of the total sample was referred for further assessment and clinical support. Conclusions: The prevalence of clinically significant antenatal depressive symptoms in this sample highlights the importance of antenatal depression screening for all women, including those who choose to access private obstetric care.
Australian and New Zealand Journal of Obstetrics and Gynaecology, 2012
Background: Australia is a leader in recognising that perinatal mental health problems are prevalent and constitute a significant burden of disease among women. In 2009, the Australian government launched the National Perinatal Depression Initiative (NPDI) to address this. Aims: To investigate implementation of Australia's NPDI. Materials and Methods: Data were collected by a structured online survey assessing: screening for depression and depression risk in women receiving antenatal and postnatal care; staff training about perinatal depression; barriers and enablers to implementing the NPDI recommendations. All Australian members of Women's Healthcare Australasia (WHA) were invited to complete the survey in March 2011. Results: Of 30 Australian WHA members, 14 (46.6%) completed the survey. The sample included a representative distribution of small, medium and large hospitals. All respondents had introduced some NPDI recommendations. Most (80%) reported using the Edinburgh Postnatal Depression Scale (EPDS) to screen for antenatal depression and for risk of developing depression but at varied gestational ages, and with differing cutoff scores for follow-up or referral. Only one assessed depression status postpartum. Responsibility for screening and feedback was predominantly assigned to midwives, most of whom were offered <4 h training. Implementation barriers included insufficient personnel; per-client time requirements; insufficient clarity about screening protocols; difficulties modifying the medical record; few referral options and a lack of training resources. Conclusions: Implementation of the NPDI is uneven among Australian maternity hospitals. Little is known about perinatal mental health screening practices in the private sector and hospitals with <1000 births annually.
Health professional's knowledge and awareness of perinatal depression: Results of a national survey
Women and Birth, 2006
Introduction: Postnatal depression affects 14% of women, occurring also antenatally, with potential long-term consequences, making it an important disorder to detect and manage early. In this study we sought to examine knowledge and awareness of perinatal depression in health professionals involved in perinatal care throughout Australia prior to the implementation of a comprehensive screening program, aimed at improving detection and access to appropriate management. Methods: A random sample of General Practitioners (GPs) and Maternal Child Health Nurses (MCHNs) and Midwives, in regions throughout Australia to be subsequently targeted by a screening and education program, were invited to participate. Responses to a hypothetical vignette and a knowledge questionnaire, as well as details of experience were completed. Findings: Questionnaires were completed by 246 GPs, 338 MCHNs and 569 midwives, with overall response rates; GP's 23%; MCHN's 55% and midwives 57%. Although knowledge level was similar among professional groups, MCHNs had higher levels of awareness of perinatal depression. Both GPs and MCHNs were more likely than midwives to recognize the need for providing help to women with emotional distress. Depression was more likely to be considered postnatally than antenatally in all groups, with GPs most likely to provide this diagnosis. GPs had a significant propensity to recommend antidepressants, and midwives to select non-specific medications. Conclusions: Health professionals responding to this survey had a high awareness and similar knowledge base. Further education on antenatal depression and the safety risks and alternatives to medication is important for all groups, but particularly important for midwives and GPs. The latter is especially relevant given the preference for women with perinatal depression not to use pharmacological interventions to treat their emotional distress.
Mental health literacy of depression and postnatal depression: A community sample
2014
Objectives: The present experiment aimed to explore the mental health literacy of postnatal depression (PND) in a community sample. Method: Five hundred and twenty Australians (427 females) participated in an experimental study. Participants were randomly presented with one of three vignettes describing a ‘depressive’ episode and then completed an online questionnaire examining mental health literacy and the capacity to recognise PND and its risk factors as well as the ability to source appropriate information. Results: Generally, the ability to recognise PND and the overall mental health literacy of the sample were high. Causation, however, was often misattributed to biological or environmental/social factors. PND recognition was found to be significantly affected by perception of the attachment relationship presented in two of the vignettes. Conclusion: Perception of attachment impacts PND recognition and this may negatively impact help seeking behaviours.
Determinants of antenatal depression and postnatal depression in Australia
BMC psychiatry, 2018
Depression is a leading source of morbidity and health loss in Australian women. This study investigates the determinants of antenatal depressive symptoms and postnatal depressive symptoms in an Australian population, including people from culturally and linguistically diverse (CALD) backgrounds. The study used a retrospective cohort of mothers of all live births in public health facilities in 2014 (N = 17,564) within South Western Sydney Local Health District and Sydney Local Health District in New South Wales, Australia. Prevalence of antenatal and postnatal depressive symptoms were estimated for the cohort. Multivariate logistic regression models were conducted to investigate the sociodemographic, psychological and health service determinants of antenatal and postnatal depressive symptoms, measured using the Edinburgh Postnatal Depression Scale (EPDS). The prevalence of antenatal and postnatal depressive symptoms was 6.2% and 3.3% of the cohort, respectively. Significant risk fac...