INTIMATE PARTNER ATTACHMENT STYLE AND ANTENATAL DEPRESSION SYMPTOMS IN NULLIPARAS: RESULTS FROM THE ZRNO STUDY

Background: The purpose of this study was to examine the relationship between the important indicators that define mental health functioning during the first pregnancy: the level of depression, anxiety and fear of childbirth in the context of null intimate pa Subjects and methods: A group of 325 nulliparas in the third trimester of pregnancy were enrolled at the Childbirth preparation Division of Gynaecology and Obstetrics. The following instruments were applied: Experiences in Close Relationships-Revised, The Edinburgh Depression Scale, two aspects of anxiety - Zung Anxiety Scale and a questionnaire regarding fear of childbirth. Attachment anxiety and avoidance scales were recoded into four categories of a prototypical attachment style: secure, fearful, preoccupied and dismissive. Two-way ANOVA and the chi-square test were used for the statistical analysis. Results: All indicators of mental health functioning of our sample of nulliparas differed significantly regarding their partner attachment style. Nulliparas with a fearful, but also with a preoccupied type of attachment, showed less optimal mental health indicators compared to those with a secure/dismissive type of attachment. A significant interactive effect of partner attachment and emotional support from the older generation was found on the level of depression. Partner attachment styles and emotional support from the older generation were found to be statistically dependent. Conclusions:In our sample a secure attachment seems to represent a protective buffer for the level of depression, even when a lower emotional support of the older generation was included. Screening and intervening on intimate attachment style as a protective factor for antenatal depression and different forms of anxiety is proposed

LEVEL OF DEPRESSION, ANXIETY AND IMPAIRMENT OF SOCIAL RELATIONS WITH REGARD TO PAIN INTENSITY IN A NATURALISTIC SAMPLE OF PATIENTS AT THE OUTPATIENT CHRONIC PAIN CLINIC

Background: A high rate of concurrent depression and anxiety has been identified among the patients of pain clinics. Evaluation of own pain can appear as a perception of being negatively impacted by pain-related suffering in social relations. Subjects and methods: A questionnaire with 228 variables was applied to 109 randomly chosen patients at outpatient pain clinic of the Ljubljana University Clinical Centre. Following summative scores were treated as a set of dependent variables in MANOVA, as a set of predictors in discriminant analysis: level of depression (Zung), level of anxiety (Zung), evaluation of the nature of pain and perceptions of negatively impacted social relations. Actual pain has been self-evaluated on a visual-analogue pain scale from 0 to 10 and recorded in subgroups with a low, middle and high intensity of actual pain (criterion variable). Results: The average age of the participants was M=52.7 years (SD 13.9), 70.9 % of them female. Participants with a high intensity of pain were found to have the highest level of depression, the highest level of anxiety and were negatively impacted in their social relations to the greatest extent. Only the first discriminant function was found to be significant (p<0.05). The structure matrix showed a high correlation between anxiety level (0.88) and depression level (0.86), and a low correlation with the perception of negatively impacted social relations (0.57). Conclusions: The results emphasize the connection between pain intensity, anxiety, depression and interpersonal relational issues in the context of patients with chronic pain at an outpatient pain clinic. Anxiety and mood were found to be the best predictors for the perception of pain intensity. The results are preliminary, but significantly support the multidisciplinary collaboration of treatment at a pain clinic with mental health professionals

Anksioznost v peripartalnem obdobju

Nosečnost je za ženske občutljivo obdobje, ki ga spremljajo pomembne fiziološke in duševne spremembe tako na čustveni kot na biološki, tj. hormonski ravni. Anksioznost je v obdobju tako velikih sprememb do neke mere normalen in prilagoditveni odgovor na situacijo. Vendar pa nekatere nosečnice izkusijo visoko raven anksioznosti, ki doseže stopnjo klinično pomembne motnje. Anksiozne motnje, ki se v peripartalnem obdobju najpogosteje pojavljajo, so generalizirana anksiozna motnja, panična motnja, fobije, obsesivno-kompulzivna motnja in posttravmatska stresna motnja. Pretekla anamneza razpoloženjskih in/ali anksioznih motenj je med najmočnejšimi napovedovalci razvoja peripartalne anksioznosti. Čeprav raziskovalno zanimanje za anksiozne motnje v peripartalnem obdobju narašča in vemo več o značilnostih in diagnosticirani ravni, pa so dokazi o klinični obravnavi – tako farmakološki kot nefarmakološki – še vedno omejeni. Tveganje in korist uvedbe farmakološkega zdravljenja vedno individualno pretehtamo. Prepoznavanje in obravnava anksioznosti med nosečnostjo sta bistvenega pomena in delujeta preventivno za psihiatrične motnje po porodu. Poporodna anksioznost matere lahko tudi pomembno ovira proces navezovanja matere in otroka, kar posredno tudi vpliva na razvoj otroka. Pri nosečnicah, ki so v psihiatrično obravnavo že vključene zaradi obravnavane duševne motnje, pa je sledenje, podpora in dobro interdisciplinarno sodelovanje lečečega psihiatra in ginekološke službe nujno potrebno

Self-Rated Health and its Relationship to Health/Life Problems and Coping Strategies in Members of the Professional Slovenian Armed Forces

The aim of this study was to test the association between self-rated health status (i.e. psychological and interpersonal welfare, physical health, coping mechanisms) and absence from work due to illness in the Slovenian armed forces. 390 military personnel were included in the study. Two groups of soldiers, healthy (G1-H) and sick/less healthy (G2-S), were created according to the median value of their annual sick leave. A third group consisted of soldiers on a mission (G3-M). A background questionnaire (demographic data, lifestyle habits, a list of life problems and a list of health problems in the last three years), a Self-Rated Health Scale and the Folkman-Lazarus Ways of Coping Questionnaire were administered. Self-rated physical health was best in group G1-H and worst in G2-S, with differences between the groups being statistically significant. No gender differences were found either between the groups or in the whole sample. The most common coping strategies amongst all the soldiers were found to be problem solving, positive re-evaluation of the situation and self-control. The groups differed only in their use of the distancing strategy. The self-rated health of all the participants was found to be in strong negative correlation with the escape/avoidance coping strategy. In group G2-S, more soldiers assessed their health as poor; the differences between the groups were statistically significant. Strong positive correlations between self-rated health and satisfaction with interpersonal relationships were found. Self-rated health was found to be significantly associated with the quality of interpersonal relationships and the socio-economic and psycho-physical conditions of the soldiers