Trajectory of Perinatal Mental Health In India (original) (raw)
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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.
Archives of Women's Mental Health, 2020
To review the available evidence about the prevalence and determinants of antenatal common mental disorders (antenatal CMDs) among women in India. We searched Ovid Medline, Embase and Psyinfo systematically from date of inception to Oct. 31, 2019 for publications in English language on the prevalence of antenatal CMDs and their determinants among women in India. All study designs were included. Quality was assessed with Standard Quality Assessment Criteria for Evaluating Primary Research Papers. We performed a meta-analysis using a random effects model. Twenty-seven studies involving 7780 women were analysed. There was a high degree of heterogeneity ((I 2 = 97.53%). Publication bias [Egger bias = 0.65 (95% CI: 0.36; .94)] was evident. The overall pooled estimate of the prevalence of antenatal CMDs was 21.87% (95% CI: 17.46; 26.29). Significant risk factors reported in the 18 studies which examined them were negative reaction of husband or in-laws to the dowry, difficult relationship with husband/in-laws, lack of support or experiencing violence perpetrated by an intimate partner and preference for or feeling pressured to have a male child. Protective factors were having more education and being employed, having a supportive husband and opportunities for recreation during pregnancy. Antenatal CMDs are highly prevalent among women in India. There is an urgent need for locally developed policies and programmes for mental health promotion during pregnancy, preventive and early intervention for antenatal CMDs among women to be integrated into maternity care 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.
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.
General Hospital Psychiatry, 2020
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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.
Perinatal depression–knowledge gap among service providers and service utilizers in India
Asian Journal of Psychiatry, 2019
This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
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...
International Journal of Advanced Research, 2020
Pregnant women and their families expect the postpartum period to be a happy time, characterized by the joyful arrival of a new baby. Unfortunately, women in the postpartum period can be vulnerable to complications like postpartum hemorrhage sepsis and psychiatric disorders 1. Because of untreated postpartum psychiatric disorders can have long-term and serious consequences for both the mother and her infant, screening for these disorders must be considered part of standard postpartum care 2. The terms puerperium or puerperal period or immediate postpartum period are commonly used to refer to the first 6 weeks following childbirth 3. Despite mounting evidence of theimpact of maternal mental health on women and children, prevention, and treatment have been slow to enter into maternal and child health (MCH) programs as rightly described as the neglected "m" in MCH programs 4. The WHO's mental health Gap Action Program has recently produced evidence based guidelines for the treatment of depression in the primary health care setting in Low And Middle Income Countries, including in the context of pregnancy and the postnatal period 5. Despite the launch of India's national mental health programme in 1982, maternal mental health is still not a prominent component of the programme. Dedicated maternal mental health services are largely deficient in health-care facilities, and health workers lack mental health training. The availability of mental health specialists is limited or nonexistent in peripheral health-care facilities 6. India is experiencing a steady decline in maternal mortality, which means that the focus of care in the future will shift towards reducing maternal morbidity, including mental health disorders 7. In J&K the data on postpartum psychiatric disorders at community level is limited and inconsistent. There the study is undertaken to assess the prevalence of psychiatric morbidities among women during postopartum period. There are mainly three types of postpartum psychiatric morbidities 8,9 : Postpartum blues: Present with self-limited mild and depressive symptoms such as mood labiality, anxiety insomnia, tearfulness, during the first week after delivery and resolves spontaneously 8,9. Prevalence rate is 30-75%. Its onset and duration is usually in Hours to days. No treatment is required other than reassurance 8,9 .
2021
Background: Poor maternal mental health is a major public health concern since it adversely impacts both maternal and child health outcomes. This study aimed to document the barriers to utilizing perinatal mental health services in Karnataka, India, and to determine its relationship with risk factors of poor maternal mental health in this context. Methods: Qualitative research methods using in-depth interviews were conducted on twenty-one local stakeholders who represented health service providers in various capacities: mental health specialists (n = 4), gynaecologists (n = 2), government officials from the Department of Health and Family Welfare (n = 2), and Department of Women and Child Development (n = 2), senior state consultant to United Nations Children’s Fund (n = 1), and frontline workers (n = 10). Data were analysed using a thematic framework analysis approach. Results: We identified multiple barriers to service utilization operating at the levels of the health system, comm...