Changes in perinatal mental healthcare during the COVID-19 pandemic: a protocol for a collaborative research study between the COST actions RISEUP-PPD and DEVOTION

Introduction Significant changes in routine maternity care have been introduced globally in response to the COVID-19 pandemic to reduce infection risk, but also due to lack of medical facilities, staff shortages and the unpredictable nature of the disease. However, it is yet to be established if specialised perinatal mental health (PMH) services have been similarly affected. As a Task Force in PMH and COVID-19 pandemic within Riseup-PPD COST Action, this study aims to identify changes in PMH practices, policies and protocols during the COVID-19 pandemic in Europe. Methods and analysis An online survey of experts in the PMH who are members of the COST Action ‘Riseup-PPD’ and the COST Action ‘’DEVOTION” across 36 European countries will be conducted. A questionnaire on changes in PMH care practices during the COVID-19 Pandemic will be administered. It consists of open-ended questions, checklists and ratings on a 7-point scale addressing seven domains of interest in terms of PMH: (1) policies, guidelines and protocols; (2) PMH care practices at a national level; (3) evidence of best practice; (4) barriers to usual care; (5) resources invested; (6) benefits of investment in the policies and (7) short-term and longterm expectations of the policies. Data will be collected using Qualtrics. Descriptive statistics will be reported and differences between countries will be examined using the χ2 statistic or Student’s t-test. Ethics and dissemination Ethical approval was obtained from The Ethics Committee for Research in Life and Health Sciences of the University of Minho (Portugal) to undertake an anonymous online survey. The findings will be disseminated to professional audience through peerreview publication and presentations and shared widely with stakeholders, policy-makers and service user groups. A position paper will be developed to influence policymaking at a European level to alleviate the adversities caused by COVID-19

Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers

The COVID-19 pandemic has altered the normal course of life, with measures to reduce the virus spread impacting motherhood expectations and, in particular, breastfeeding practices. This study aimed to review evidence regarding the impact of COVID-19 on breastfeeding plans and how these relate to women’s psychological outcomes. Searches were conducted on PubMed and Web of Science for studies in English, Spanish, and Portuguese between January 2020 and January 2021. All study designs and pre-prints were considered. Twelve studies were included. Reports suggest that COVID-19 impacts differently on breastfeeding plans, which in turn leads to distinctive mental health outcomes. Positive breastfeeding experiences have been observed when mothers perceive that they have more time for motherhood, which may be associated with better mental health outcomes. Negative breastfeeding experiences have been observed when mothers are separated from their newborns, when mothers struggle with breastfeeding, or when mothers perceive decreased family and professional support, which seems to be associated with worse mental health outcomes. These preliminary results highlight the need for further research into the association between COVID-19, breastfeeding expectations, and maternal mental health. Filling this gap will foster the development of guidelines and interventions to better support mothers experiencing the obstacles of COVID-19 pandemic

Remotely delivered cognitive therapy for social anxiety disorder in adolescence: Preliminary efficacy evidence based on changes throughout treatment

Cognitive therapy has been established as the frontline treatment for adults with social anxiety disorder (SAD); its efficacy with socially anxious adolescents is incipient but promising. This work investigated change in social anxiety symptoms reported by adolescents and their therapist as they go through remotely delivered 10-session cognitive therapy (i.e., CT@TeenSAD). Participants were 21 adolescents (81% females; Mage = 16.10) diagnosed with SAD. They reported on change on their social anxiety symptoms at the beginning of each session; their therapist reported on how their symptoms had improved at the end of each session. Results, though preliminary, show that sessions had a significant impact on self- and therapist reported change, with consistent and continuous improvement across intervention sessions. Gender did not impact on that change, but therapist did: though the same pattern of change emerged for both therapists, it was more evident for the therapist with the greatest previous clinical experience. Overall, current findings align with the cognitive therapy framework of progressive gains throughout therapy. They also add evidence on the applicability and usefulness of an online cognitive approach to adolescents diagnosed with SAD

Terapia focada na compaixão online para a perturbação de ansiedade social na adolescência (CFT@TeenSAD): Dados preliminares de eficácia ao longo do tratamento

This work investigated the efficacy of Compassion Focused Therapy (CFT) on symptoms of social anxiety disorder (SAD) in adolescence, based on data collected throughout treatment. CFT has contributed to the psychological well-being of various populations, but limited evidence exists on its therapeutic gains for SAD in adolescence. Twenty-one adolescents (57.1% girls; 15-18 years old) presenting with SAD received online treatment. The CFT@TeenSAD intervention was organized into four modules: Our mind according to CFT, Developing the compassionate self and the skills of a compassionate mind, Practicing compassionate behavior, and Last remarks and continuing a compassionate journey. Before each session, adolescents reported on perceived change in symptom severity. At the end of each session, clinicians rated overtime change in that severity. Self-reports (F(1,540) = 32.271, p < .0005, ηp2 = .63) and clinician’s reports (F(1,528) = 24.783, p < .0005, ηp2 = .57) showed that improvement was significantly heightened during treatment, with significant changes across all four intervention modules. Trajectories of change were similar across gender. Though preliminary, findings point to online CFT being a promising approach to treat SAD in adolescent boys and girls, given that it contributes to continuous decrease in severity of social anxiety symptoms.Este trabalho investigou a eficácia da Terapia Focada na Compaixão (TFC) nos sintomas da perturbação de ansiedade social (PAS) na adolescência, com base em dados recolhidos ao longo da intervenção. A TFC contribuiu para o bem-estar psicológico em várias populações, mas é escassa a evidência sobre a sua eficácia no tratamento da PAS em adolescentes. Vinte e um adolescentes (57.1% raparigas; 15-18 anos) com PAS receberam tratamento online. A intervenção CFT@TeenSAD foi organizada em quatro módulos sequenciais: A mente de acordo com a TFC, Promoção do eu-compassivo e de competências para uma mente compassiva, Prática de comportamento compassivo, Últimas notas e continuar numa viagem compassiva. Antes de cada sessão, os adolescentes reportaram mudança percebida na gravidade dos sintomas e os clínicos fizeram essa avaliação no final de cada sessão. Tanto os adolescentes (F (1.540) = 32.271, p<0.0005, ηp2 = 0.63) como os clínicos (F (1.528) = 24.783, p< 0.0005, ηp2= 0.57) relataram melhoria continuada ao longo do tratamento, com mudança significativa ao longo dos quatro módulos. As trajetórias de mudança foram semelhantes para rapazes e raparigas. A TFC surge como uma abordagem promissora na PAS em adolescentes, contribuindo para a diminuição contínua da gravidade dos sintomas