Biological embedding of maternal postpartum depressive symptoms: The potential role of cortisol and telomere length.

Although maternal postpartum depressive symptoms (PDS) are associated with child behavior problems, the underlying biological mechanisms are poorly understood. Thus, the current study focused on 193 healthy mother-child dyads and investigated child cortisol and telomere length as potential mediating factors. At 3 and 6 months postpartum, mothers reported on PDS. At age 6, children provided saliva and buccal swab samples. At age 10, mothers and children reported on child behavior problems. Structural equation modelling revealed (a) no association between PDS and child behavior problems and thus no possibility of mediation, but that (b) lower cortisol forecast more child-reported internalizing problems, and (c) shorter telomere length predicted more child-reported internalizing and externalizing problems. These findings raise mediational questions about the determinants of these biomarkers

SmartMoms – a web application to raise awareness and provide information on postpartum depression

Background Postpartum depression is a major public health concern, which is associated with negative consequences for both mothers and children. Unfortunately, many affected women neither understand the warning signs of postpartum depression nor do they know where to seek help. The aim of this study was to evaluate the feasibility of SmartMoms, a German mobile web application (web app) designed to inform women about postpartum depression, support them, and provide an easily accessible self-screening instrument. Methods After its development, SmartMoms was distributed through healthcare providers and social media. Feasibility was assessed by examining (1) the experience of postpartum women with the web app, (2) user behaviour, and (3) the experience of healthcare providers with the web app and its distribution. A mixed methods approach was used, including online surveys, usage data, and interviews. Results Most women used SmartMoms to prevent postpartum depression and rated the web app as good (on average 4.36 out of 5 stars). The majority of women (62.2%) accessing the self-screening instrument showed a risk for postpartum depression (Edinburgh Postnatal Depression scale score ≥ 12). Most providers (n = 12/13) felt supported through SmartMoms in discussing postpartum depression and considered it a useful offer. Suggestions for improvement were provided. Conclusions SmartMoms meets the needs and expectations of mothers and healthcare providers interested in postpartum depression but should be further adapted to include more specific support options and additional information for professionals

Perinatal mental health literacy: knowledge, attitudes, and help-seeking among perinatal women and the public – a systematic review

Background The perinatal period is a time of increased vulnerability to mental health problems, however, only a small proportion of women seek help. Poor mental health literacy (MHL) is a major barrier to seeking help for mental health problems. This study aimed to collect the existing evidence of MHL associated with perinatal mental health problems (PMHP) among perinatal women and the public. This review analysed which tools were used to assess perinatal MHL as well as the findings concerning individual components of perinatal MHL. Methods Four electronic databases (PubMed, PsycINFO, Web of Science, and CINAHL) were analysed from their inception until September 1, 2020. Not only quantitative studies reporting on components of MHL (knowledge, attitudes, and help-seeking), but also studies reporting overall levels of MHL relating to PMHP were taken into account. Two independent reviewers were involved in the screening and extraction process and data were analysed descriptively. Results Thirty-eight of the 13,676 retrieved articles satisfied the inclusion criteria. The majority of selected studies examined MHL related to PMHP in perinatal women (N = 28). The most frequently examined component of MHL in the selected data set was help-seeking. A lack of uniformity in assessing MHL components was found. The most common focus of these studies was postpartum depression. It was found that the ability to recognize PMHP and to identify relevant symptoms was lacking among both perinatal women and the public. Perinatal women had low intentions of seeking help for PMHP and preferred seeking help from informal sources while reporting a variety of structural and personal barriers to seeking help. Stigmatizing attitudes associated with PMHP were found among the public. Conclusions There is a need for educational campaigns and interventions to improve perinatal MHL in perinatal women and the public as a whole

Perinatal mental health literacy: knowledge, attitudes, and help-seeking among perinatal women and the public – a systematic review

Abstract Background The perinatal period is a time of increased vulnerability to mental health problems, however, only a small proportion of women seek help. Poor mental health literacy (MHL) is a major barrier to seeking help for mental health problems. This study aimed to collect the existing evidence of MHL associated with perinatal mental health problems (PMHP) among perinatal women and the public. This review analysed which tools were used to assess perinatal MHL as well as the findings concerning individual components of perinatal MHL. Methods Four electronic databases (PubMed, PsycINFO, Web of Science, and CINAHL) were analysed from their inception until September 1, 2020. Not only quantitative studies reporting on components of MHL (knowledge, attitudes, and help-seeking), but also studies reporting overall levels of MHL relating to PMHP were taken into account. Two independent reviewers were involved in the screening and extraction process and data were analysed descriptively. Results Thirty-eight of the 13,676 retrieved articles satisfied the inclusion criteria. The majority of selected studies examined MHL related to PMHP in perinatal women (N = 28). The most frequently examined component of MHL in the selected data set was help-seeking. A lack of uniformity in assessing MHL components was found. The most common focus of these studies was postpartum depression. It was found that the ability to recognize PMHP and to identify relevant symptoms was lacking among both perinatal women and the public. Perinatal women had low intentions of seeking help for PMHP and preferred seeking help from informal sources while reporting a variety of structural and personal barriers to seeking help. Stigmatizing attitudes associated with PMHP were found among the public. Conclusions There is a need for educational campaigns and interventions to improve perinatal MHL in perinatal women and the public as a whole

Postpartum depression—who cares? Approaches to care via midwifery, gynaecology, paediatrics and general practice

Hintergrund Die postpartale Depression (PPD) zählt zu den häufigsten psychischen Erkrankungen in der Postpartalzeit. Unbehandelt kann sie teils folgenschwere Auswirkungen auf die Mutter-Kind-Beziehung und die Entwicklung des Kindes haben. Um mögliche negative Auswirkungen verhindern zu können, sind eine frühzeitige Diagnostik betroffener Mütter und eine professionelle Betreuung essenziell. Ziel der Arbeit Der vorliegende Artikel exploriert das Zuständigkeitsgefühl der 4 Primärversorger:innen in der Postpartalzeit: Hebammen, Gynäkolog:innen, Hausärzt:innen und Pädiater:innen, und untersucht den Umgang mit der Erkrankung sowie die Barrieren und Optimierungsmöglichkeiten in der Versorgung. Material und Methoden Die primären Versorger:innen von Frauen nach einer Geburt in Deutschland wurden in 4 voneinander unabhängigen Studien befragt. Mit Hebammen, Gynäkolog:innen und Hausärzt:innen wurden quantitative Befragungen mittels Fragebögen durchgeführt, mit Vertreter:innen des deutschen Berufsverbands der Kinder- und Jugendärzte e. V. (BVKJ) eine qualitative Telefoninterviewbefragung. Es erfolgte eine systematische vergleichende Analyse. Ergebnisse und Diskussion Hebammen und Gynäkolog:innen zeigten ein deutlich höheres Zuständigkeitsgefühl für das Erkennen und die Therapie der PPD als Hausärzt:innen und Pädiater:innen. Als zentrale Voraussetzung für eine Verbesserung der Versorgungssituation in Deutschland wurden von allen 4 Berufsgruppen eine engere interdisziplinäre Zusammenarbeit und somit ein größeres Angebot an Überweisungs- und Therapiemöglichkeiten genannt. Auch eine einheitliche Regelung der finanziellen Vergütung ist für alle Versorger ein wichtiger Aspekt.Background Postpartum depression (PPD) is one of the most common mental illnesses in the postpartum period. If left untreated, it can have serious consequences for the mother–child relationship and the development of the child. In order to prevent possible negative effects, early diagnosis of affected mothers and professional care are essential. Aim of the study This article explores the sense of responsibility of the four primary care providers in the postpartum period—midwives, gynaecologists, general practitioners and paediatricians—and examines how they deal with the disease as well as the barriers and possibilities for optimisation in care. Materials and methods The primary care providers of postpartum women in Germany were interviewed in four independent studies. Quantitative questionnaires were used to interview midwives, gynaecologists and general practitioners, and a qualitative telephone survey was conducted with representatives of the German Association of Paediatricians and Adolescents (BVKJ). A systematic comparative analysis was carried out. Results and discussion Midwives and gynaecologists showed a significantly higher sense of responsibility for the recognition and treatment of PPD than general practitioners and paediatricians. Closer interdisciplinary cooperation and thus a wider range of referral and therapy options were named by all four professional groups as a central prerequisite for improving the care situation in Germany. A uniform regulation of financial remuneration is also an important aspect for all providers