147 research outputs found
Timing and chronicity of maternal depression symptoms and children's verbal abilities
ObjectiveTo test the associations between the timing and chronicity of maternal depression symptoms (MDS)and children’s long-term verbal abilities.Study designParticipants were 1073 mother-child pairs from a population-based birth cohort in Canada. MDSwere assessed at ages 5 months, 1.5, 3.5, and 5 years using the Center for Epidemiologic Studies DepressionScale. Verbal abilities were measured at 5, 6, and 10 years using the Peabody Picture Vocabulary Test-Revised(PPVT-R). Multiple linear regression models were used to estimate the association between timing (early: 5 monthsand/or 1.5 years vs late 3.5 and/or 5 years) and chronicity (5 months, 1.5, 3.5, and 5 years) of exposure to el-evated MDS and children’s mean PPVT-R scores.ResultsChildren exposed to chronic MDS had lower PPVT-R scores than children never exposed (mean differ-ence=9.04 [95% CI=2.28-15.80]), exposed early (10.08 [3.33-16.86]) and exposed late (8.69 [1.85-15.53]). Therewere no significant differences between scores of children in the early compared with the late exposure group. Weadjusted for mother-child interactions, family functioning, socioeconomic status, PPVT-R administration language,child’s birth order, and maternal IQ, psychopathology, education, native language, age at birth of child, and par-enting practices. Maternal IQ, (h2=0.028), native language (h2=0.009), and MDS (h2=0.007) were the main pre-dictors of children’s verbal abilities.ConclusionsExposure to chronic MDS in early childhood is associated with lower levels of verbal abilities inmiddle childhood. Further research is needed in larger community samples to test the association between MDSand children’s long-term language skills
Adaptation of the Structured Clinical Interview for DSM-IV Disorders for assessing depression in women during pregnancy and post-partum across countries and cultures
BackgroundTo date, no study has used standardised diagnostic assessment procedures to determine whether rates of perinatal depression vary across cultures.AimsTo adapt the Structured Clinical Interview for DSM–IV Disorders (SCID) for assessing depression and other non-psychotic psychiatric illness perinatally and to pilot the instrument in different centres and cultures.MethodAssessments using the adapted SCID and the Edinburgh Postnatal Depression Scale were conducted during the third trimester of pregnancy and at 6 months postpartum with 296 women from ten sites in eight countries. Point prevalence rates during pregnancy and the postnatal period and adjusted 6-month period prevalence rates were computed for caseness, depression and major depression.ResultsThe third trimester and 6-month point prevalence rates for perinatal depression were 6.9% and 8.0%, respectively. Postnatal 6-month period prevalence rates for perinatal depression ranged from 2.1% to 31.6% across centres and there were significant differences in these rates between centres.ConclusionsStudy findings suggest that the SCID was successfully adapted for this context. Further research on determinants of differences inprevalence of depression across cultures isneeded
Health services research into postnatal depression : results from a preliminary cross-cultural study
Background: Little is known about the
availability and uptake of health and
welfare services by women with postnatal
depression in different countries.
Aims: Within the context of a cross-
cultural research study, to develop and
test methods for undertaking quantitative
health services research in postnatal
depression.
Method: Interviews with service
planners and the collation of key health
indicators were used to obtain a profile of
service availability and provision. A service
use questionnaire was developed and
administered to a pilot sample in a number
of European study centres.
Results: Marked differences in service
access and use were observed between
the centres, including postnatal nursing
care and contacts with primary care
services.Rates of use of specialist services
were generally low.Common barriers to
access to care included perceived service
quality and responsiveness. On the basis of
the pilot work, a postnatal depression
version of the Service Receipt Inventory
was revised and finalised.
Conclusions: This preliminary study
demonstrated the methodological
feasibility of describing and quantifying
service use, highlighted the varied and
often limited use of care in this population,
and indicated the need for an improved
understanding of the resource needs and
implications of postnatal depression
BMJ Open
INTRODUCTION: The prevalence of postnatal depression (PND) is significant: reaching up to 20% in the general population. In mechanistic terms, the risk of PND lies in an interaction between a maternal psychophysiological vulnerability and a chronic environmental context of stress. On the one hand, repetition of stressor during pregnancy mimics a chronic stress model that is relevant to the study of the allostatic load and the adaptive mechanisms. On the other hand, vulnerability factors reflect a psychological profile mirroring mindfulness functioning (psychological quality that involves bringing one's complete and non-judgemental attention to the present experience on a moment-to-moment basis). This psychological resource is linked to protective and resilient psychic functioning. Thus, PND appears to be a relevant model for studying the mechanisms of chronic stress and vulnerability to psychopathologies.In this article, we present the protocol of an ongoing study (started in May 2017). METHODS AND ANALYSIS: The study is being carried out in five maternities and will involve 260 women. We aim to determine the predictive psychobiological factors for PND emergence and to provide a better insight into the mechanisms involved in chronic stress during pregnancy. We use a multidisciplinary approach that encompasses psychological resources and biophysiological and genetic profiles in order to detect relevant vulnerability biomarkers for chronic stress and the development of PND. To do so, each woman will be involved in the study from her first trimester of pregnancy until 12 months postdelivery. ETHICS AND DISSEMINATION: Ethics approval was obtained from the Ile de France III Ethics Committee, France (2016-A00887-44). We aim to disseminate the findings through international conferences and international peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT03088319; Pre-results
Postnatal depression across countries and cultures : a qualitative study
Background: Postnatal depression seems to be a universal condition with
similar rates in different countries. However, anthropologists question the
cross-cultural equivalence of depression,
particularly at a life stage so influenced by
cultural factors.
Aims: To develop a qualitative method to explore whether postnatal depression is universally recognised, attributed and
described and to enquire into people’s
perceptions of remedies and services for
morbid states of unhappiness within the
context of local services.
Method: The study took place in 15 centres in 11 countries and drew on three groups of informants: focus groups with new mothers, interviews with fathers and
grandmothers, and interviews with health
professionals.Textual analysis of these three groups was conducted separately in each centre and emergent themes compared across centres.
Results: All centres described morbid unhappiness after childbirth comparable
to postnatal depression but not all saw this
as an illness remediable by health interventions.
Conclusions: Although the findings of
this study support the universality of a
morbid state of unhappiness following childbirth, they also support concerns
about the cross-cultural equivalence of postnatal depression as an illness requiring the intervention of health professionals;
this has implications for future research
Int J Mol Sci
The placenta is a key organ for fetal and brain development. Its epigenome can be regarded as a biochemical record of the prenatal environment and a potential mechanism of its association with the future health of the fetus. We investigated associations between placental DNA methylation levels and child behavioral and emotional difficulties, assessed at 3 years of age using the Strengths and Difficulties Questionnaire (SDQ) in 441 mother-child dyads from the EDEN cohort. Hypothesis-driven and exploratory analyses (on differentially methylated probes (EWAS) and regions (DMR)) were adjusted for confounders, technical factors, and cell composition estimates, corrected for multiple comparisons, and stratified by child sex. Hypothesis-driven analyses showed an association of cg26703534 () with emotional symptoms, and exploratory analyses identified two probes, cg09126090 (intergenic region) and cg10305789 (), as negatively associated with peer relationship problems, as well as 33 DMRs, mostly positively associated with at least one of the SDQ subscales. Among girls, most associations were seen with emotional difficulties, whereas in boys, DMRs were as much associated with emotional than behavioral difficulties. This study provides the first evidence of associations between placental DNA methylation and child behavioral and emotional difficulties. Our results suggest sex-specific associations and might provide new insights into the mechanisms of neurodevelopment.Exposition prénatale au tabac et à la pollution atmosphérique et effets sur la santé respiratoire et le neurodévelopment de l'enfant: rôle de la méthylation placentaireHorizon 2020 research and innovation programm
Acceptance Mindfulness-Trait as a Protective Factor for Post-Natal Depression: A Preliminary Research
(1) Background: the prevalence of postnatal depression (PND) reaches up to 20%. PND could be based on the interaction between a psychological vulnerability and chronic stress that pregnancy would activate. Vulnerability factors reflect a psychological profile mirroring mindfulness-trait (MT). A high level of MT is associated with an efficient regulation of both physiological and psychological stress, especially negative moods. Interestingly, mindfulness level can be improved by program based on mindfulness meditation. We hypothesize that MT is a protective factor for PND. We also postulate that negative moods increase during the pregnancy for women who develop a PND after delivery (2) Methods: we conducted a multicentric prospective longitudinal study including 85 women during their first trimester of their pregnancy and 72 from the childbirth to the baby’s first birthday”. At the inclusion, presence and acceptance of MT and various variables of personality and of psychological functioning were assessed. Mood evolution was monitored each month during the pregnancy and a delivery trauma risk was evaluated after delivery. PND detection was carried out at 48 h, 2, 6 and 12 months after the delivery with the Edinburgh Postnatal Depression Scale with a screening cut-off >11. (3) Results: high-acceptance MT is a protective factor for PND (OR: 0.79). Women without PND displayed less negative mood during pregnancy (p < 0.05 for Anxiety, Confusion and Anger). (4) Conclusions: these results suggest the value of deploying programs to enhance the level of mindfulness, especially in its acceptance dimension, before, during and after pregnancy, to reduce the risk of PND. © 2022 by the authors. Licensee MDPI, Basel, Switzerland
Pregnancy denial: a complex symptom with life context as a trigger? A prospective case-control study
OBJECTIVE: To identify risk factors for a woman to experience pregnancy denial. DESIGN, SETTING AND POPULATION: A French multicentric prospective case-control study with 71 mother-infant dyads having experienced a pregnancy denial versus a control group of 71 dyads. METHODS: Data were collected in the week after delivery using an observational leaflet and two psychiatric scales (MINI and QSSP). MAIN OUTCOME MEASURES: Statistically significant differences between the two groups regarding social, demographic, medical and psychiatric data. RESULTS: Not being in a stable relationship (odds ratio [OR] 17.18, 95% CI 3.37-87.60]; P < 0.0001), not having a high school diploma (OR 1.11, 95% CI 1.04-1.38]; P < 0.0001) and having a psychiatric history (OR 6.33, 95% CI 1.62-24.76; P = 0.0002) were risk factors to experience pregnancy denial, whereas being older was a protective factor (OR 0.86, 95% CI 0.79-0.93; P = 0.0054) (logistic regression, Wald 95% CI). Other risk factors included late declarations of pregnancy history and past pregnancy denials (case n = 7, 9.7% versus 0% in controls; P = 0.01), past pregnancy denials in the family (case n = 13, 18% versus control n = 4, 5.6%; P = 0.03), and use of a contraceptive method (75% for cases versus 7% in control; P < 0.0001), primarily an oral contraceptive (75%). CONCLUSION: Family or personal history of pregnancy denial should be part of the systematic anamnesis during the first visit of a patient of child-bearing age. Further, our study points out that life context (young age, single status, socio-economic precarity, pill-based contraception) could be a trigger for pregnancy denial in certain women. TWEETABLE ABSTRACT: Life context can be a trigger for pregnancy denial
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Transition to parenthood and mental health in first-time parents
This study aimed to examine the transition to parenthood and mental health in first-time parents in detail and explore any differences in this transition in the context of parental gender and postpartum mental health. Semistructured clinical interviews (Birmingham Interview for Maternal Mental Health) were carried out with 46 women and 40 men, 5 months after birth. Parents were assessed on pre- and postpartum anxiety, depression, and postpartum posttraumatic stress disorder (PTSD), and a range of adjustment and relationship variables. One fourth of the men and women reported anxiety in pregnancy, reducing to 21% of women and 8% of men after birth. Pregnancy and postpartum depression rates were roughly equal, with 11% of women and 8% of men reporting depression. Postpartum PTSD was experienced by 5% of parents. Postpartum mental health problems were significantly associated with postpartum sleep deprivation (odds ratio [OR] = 7.5), complications in labor (OR = 5.1), lack of postpartum partner support (OR = 8.0), feelings of parental unworthiness (OR = 8.3), and anger toward the infant (OR = 4.4). Few gender differences were found for these variables. This study thus highlights the importance of focusing interventions on strengthening the couple's relationship and avoiding postnatal sleep deprivation, and to address parents’ feelings of parental unworthiness and feelings of anger toward their baby
Perceptions of postnatal depression across countries and cultures: from a TransCultural Study of PostNatal Depression (TCS-PND)
Objectives
The qualitative study was conducted within the international
“Transcultural study of postnatal depression (PND)” in 17 centres
located in 13 different countries. The aim was to explore
perceptions of PND by lay and professional key informants,
specifically regarding description of symptoms, awareness of this
pathology and of possible care.
Methods
Broad areas of inquiry and open-ended probes were developed by
the TCS-PND research group during international workshops to
obtain data comparable between countries on perceptions of
PND. A non-random convenience sampling method was used to
recruit postpartum mothers for focus groups, and fathers and
grandmothers for interviews. Influential healthcare planners and
clinicians were interviewed as professional key informants in each
centre. Within sites, transcripts of focus groups and interviews
underwent a process of text analysis in the original language until
exhaustive theme extraction was achieved. Themes (in English)
from all the centres were combined into broader categories and
after consensus discussions these categories were revalidated.
Results and discussion
Qualitative data were supplemented in each centre with sociodemographic
data to address the issues of: (i) whether perceptions
of PND are related to some specific cultural perception of mental
heath and/or of status of parenthood and (ii) how high or low
levels of general care and specificity of health policy relate to
differences in perception of needs for care. Data collected using
the same probes and methodology in different countries and
cultures has enabled a comparative analysis of perceptions of
PND. In addition it has shown that, although not described with
the same words, PND is a well-recognised condition by recent
mothers in all countries in this study. Data on focus groups and
interviews from selected countries are given in the following
abstracts to illustrate some similarities and differences in
perceptions between countries
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