Identifying patients at risk of perinatal mood disorders (original) (raw)
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Perinatal depression and mental health uptake referral rate in an obstetric service
Scientific Reports, 2023
Perinatal depression is an important indicator of mothers' mental health. Studies have been carried out to identify and characterize women at risk of such affective disorder. The aim of this study is to assess mothers' adherence to our perinatal depression screening and eventual follow-up by a multidisciplinary team, including mental health and obstetrics professionals. Ultimately, a risk profile for the uptake rate of referral was described to psychological support. Pregnant women from a maternity of a tertiary center with on-site assessment and treatment (n = 2163) were included in this study. The identification of women at risk for depression was based on a two-question screening and the EPDS scale. Demographic and obstetric data were obtained from medical records. The number of screening evaluations, the uptake referral rate and the compliance to treatment were analyzed. Logistic regression was used to predict a risk profile for adherence. Among 2163 enrolled in the protocol, 10.2% screened positive for depression. Of these, 51.8% accepted referral for mental health assistance. 74.9% were compliant to Psychology appointments and 74.1% to Psychiatry appointments. Women who had a previous history of depression were more likely to accept referral for mental health support. With this study, we were able to understand the behaviour of this population towards the screening protocol we offer. Women with a previous history of depression are more likely to accept mental health assistance. Abbreviations DSM-V Diagnostic and statistical manual of mental disorders V ICD-10 International classification of diseases EPDS Edinburgh postnatal depression scale MHT Mental health team CMIN Centro materno-infantil do Norte Albino Aroso CHUP Centro Hospitalar Universitário do Porto SQ Screening questionnaire Pregnancy is known to be a period of vulnerability in which emotions between astonishment and insecurity may sprout, and it is a challenging period for both physical and mental women's health. Perinatal depression is by far the most common mood disorder, affecting one in every seven women 1. It is defined by the presence of depressive symptoms that occur during pregnancy or until one year after delivery 2. Evaluating perinatal depression can be challenging and efforts have been made to bring up professionals dedicated to maternal health disorders, able to identify perinatal mood and anxiety disorders. Evidence suggests that only 20% of depressed pregnant women receive adequate treatment 3. As we know, untreated depression can result in poor adherence to healthcare, exacerbation of previous physical conditions, substance abuse, suicide and other adverse outcomes 1,3. Therefore, it becomes imperative to standardize a screening protocol for perinatal depression, as well as an appropriate follow-up for these women 1,4 .
Assessment of perinatal mental health problems
2017
Mental health problems in pregnancy and the postnatal period can have long-term negative effects on women and their children. A key barrier to helping women in this period is the low level of identification of mental health problems. Depression has commonly been screened for using the Whooley Questions or Edinburgh Postnatal Depression Scale (EPDS) but women may experience a broad range of symptoms of distress not captured by these measures. The research reported in this dissertation was designed to address several aims. The first strand aimed to explore women’s experiences of postnatal mental health problems and how they conceptualise their symptoms. The focus of the first qualitative study was the lived experience of 17 women who had experienced psychological distress in the first postnatal year, and used interpretative phenomenological analysis. The second qualitative study used thematic analysis with the same sample to explore different symptoms of distress and women’s experienc...
Perinatal mental health screening trial
2020
Background: Pregnancy is a time of great joy and happiness but is also a time of great change, where the woman is at increased risk of onset and relapse of mental health disorders. However, unfortunately many patients go undiagnosed. --- Method: A trial for perinatal mental health screening was set up at Mater Dei Hospital. Mothers under the care of four consultant obstetricians were included in the study. All were asked a series of screening questions to assess necessity of referral to mental health services. If positive for one of the questions, a telephone consultation was carried out by one of the perinatal mental health midwives, giving them the necessary information about the mental health services available. The services offer a multidisciplinary approach with perinatal midwives, a specialised psychiatric team, social worker and psychologists. --- Results: A total of 283 mothers were screened. 105 of which were positive for a screening question, requiring mental health servic...
Perinatal depression: prevalence, outcomes and screening tools - a review of the literature
Journal of Health Technology Assessment in Midwifery
Perinatal depression (PD) is a depressive disorder in women that occurs either during pregnancy and/ or within 12 months after delivery. PD has adverse outcomes not only for mothers, but also for their children and their family/husband. A review of literature was conducted to present a comprehensive review of the available research into depression, its prevalence, risk factors and the screening tools in the context of the perinatal period. The literature will provide the background for understanding perinatal depression and will support the need for the most appropriate perinatal mental health screening-tool, particularly depression in midwifery care.
Perinatal depression: implications for child mental health
Mental health in family medicine, 2010
Perinatal depression is common and primary care holds a crucial role for detecting, treating or, if necessary, providing referrals to mental health care for affected women. Family doctors should be aware of risk factors for peripartum depression, including previous history of depression, life events and interpersonal conflict. Perinatal depression has been associated with many poor outcomes, including maternal, child and family unit challenges. Infants and young children of perinatally depressed mothers are more likely to have a difficult temperament, as well as cognitive and emotional delays. The primary care setting is uniquely poised to be the screening and treatment site for perinatal depression; however, several obstacles, both at patient and systems level, have been identified that interfere with women's treatment engagement. Current published treatment guidelines favour psychotherapy above medicines as first line treatment for mild to moderate perinatal depression, while ...
Screening for perinatal depression: is it enough?
Medical Journal of Australia, 2018
This is the author manuscript accepted for publication and has undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as
A lead for integration of perinatal mental health in maternal and child health services
International Journal Of Community Medicine And Public Health
Life altering moments like pregnancy, birth, and early parenthood can be stressful for women and their partners. As a result, women may undergo a period of poor mental health or witness a worsening of previous mental health or witness a worsening of previous mental health condition. Almost 1 in 5 women will experience a mental health condition during pregnancy or in the year after birth. Among women with perinatal mental health condition, 20% will experience suicidal thoughts or undertake acts of self-harm. Ignoring mental health not only risks women’s overall health and wellbeing, but also impacts infant’s physical and emotional development. This article is based on a comprehensive literature search conducted on 22 February 2023, in the Medline and Cochrane databases, utilizing the medical topic headings (MeSH) and a combination of all available related terms, according to the database. To prevent missing any possible research, a manual search for publications was conducted through...
Perinatal risk assessment of women for psychological problems
IP innovative publication pvt. ltd, 2019
Introduction: Pregnancy is the most beautiful and memorable time in a woman’s life. During pregnancy and even after the birth of a child, women are at an increased risk of experiencing psychological problems. Aim: Screening of antenatal women for risk of psychological illness and following them postnatal period for risk of Post Partum Depression. Materials and Methods: The study has cohort design.150 Antenatal women were screened during their antenatal visit between 24 weeks up till 36weeks of pregnancy by semi structured questionnaire to screen high risk women. These women were followed during Post Natal period between 4-8thday and then 4-8 weeks of postnatal period by Edinburgh Post Natal Depression Scale (EDPS) for assessment of Postnatal Depression. Result: 31% ANC women were screened as high risk 20% had high EDPS scores at 4-8 days and 8.6% at 4-8weeks. By logistic regression antenatal risk factors were statistically analyzed .1) Higher education level there is lesser risk 2) residence from rural area had 3.9 times higher risk. 3) who had supportive mother had 1.3 times lesser risk 4) supportive partner reduced risk by 4.4 times. 5) supportive family reduced risk by1.7 times 6) Previous history of depression of more than 2wks had 5.4 times higher risk 7) history of mental health problem in past had 1.5 times higher risk 8) Antenatal women having psychological illness has 4.29 times higher risk of delivering a neonate with birth weight <2.5kg. Conclusion: Focus also on ante partum psychological risks. It is suggested to integrate mental health to maternal health care services and train health care givers for screening.
Frontiers in Psychology, 2020
BackgroundThe most common mental disorders in women during the perinatal (antenatal and postnatal) period are depressive syndromes and anxiety syndromes. The global prevalence of maternal perinatal depression ranges from 10 to 20%, while the prevalence of perinatal anxiety ranges from 10 to 24%. The comorbidity of mood and anxiety disorders in perinatal women is common, reaching 40%. In Italy, a few studies have been undertaken to evaluate the prevalence of perinatal depression and anxiety, and there is still a scarcity of research and intervention programs regarding primary prevention. Three of the main aims of this study are: (1) to evaluate the prevalence of maternal perinatal depression and anxiety in a large sample of women attending healthcare centers in Italy; (2) to investigate the psychosocial risks and protective factors associated with maternal perinatal depression and anxiety; (3) to evaluate the effectiveness of a manualized psychological intervention (Milgrom et al., 1999) to treat perinatal depression; (4) to evaluate the psychometric properties of both the Edinburgh Postnatal Depression Scale and the Patient Health Questionnaire-9 in detecting perinatal depression; and (5) to evaluate the influence of maternal depression and anxiety on the development of infant temperament.MethodsThis is a prospective cohort study, which merges an observational design and a pre-post intervention design. The study includes a 1-year recruitment period and a one-year follow-up period. The methodological strategy includes: (1) self-report questionnaires on maternal depression, anxiety, health status, quality of life and psychosocial risks; (2) a self-report questionnaire to measure the infant’s temperament; (3) a clinical interview; (4) a structured diagnostic interview; and (5) a psychological intervention.DiscussionThe results of this study may contribute to our knowledge about prevalence of antenatal and postnatal depression and anxiety (during both the trimesters of pregnancy and the first six trimesters after birth) and about the effectiveness of early psychological intervention in the perinatal health services.
Perinatal mental health: a review of progress and challenges
World Psychiatry, 2020
Perinatal mental health has become a significant focus of interest in recent years, with investment in new specialist mental health services in some high‐income countries, and inpatient psychiatric mother and baby units in diverse settings. In this paper, we summarize and critically examine the epidemiology and impact of perinatal mental disorders, including emerging evidence of an increase of their prevalence in young pregnant women. Perinatal mental disorders are among the commonest morbidities of pregnancy, and make an important contribution to maternal mortality, as well as to adverse neonatal, infant and child outcomes. We then review the current evidence base on interventions, including individual level and public health ones, as well as service delivery models. Randomized controlled trials provide evidence on the effectiveness of psychological and psychosocial interventions at the individual level, though it is not yet clear which women with perinatal mental disorders also ne...