Predictive factors for depression and anxiety in men during the perinatal period: a mixed methods study

The purpose of this study was to identify the risk factors associated with paternal perinatal mental distress in a sample of Australian men. A mixed-methods design was used. The qualitative component (N = 13) using thematic analysis identified maternal depression, marital distress, masculine gender role stress, unplanned pregnancy, work–family conflict, and sleep disturbance as risk factors for paternal perinatal mental distress. The quantitative component (N = 525) expanded on the qualitative findings and examined the associations between the identified risk factors and mental distress of fathers in the perinatal period measured by Edinburgh postnatal depression scale. Hierarchical multiple regression analysis revealed six significant predictors of paternal perinatal mental distress with masculine gender role stress being the most significant risk factor for paternal perinatal mental distress. The results from this study provide an insight into how masculine gender role may affect the expression and experience of mental distress in fathers within the perinatal period. Implications of research findings are discussed

Risk factors for paternal perinatal depression and anxiety: a systematic review and meta-analysis

This article aims to identify the risk factors associated with paternal perinatal depression and anxiety. Studies published between January 1950 and December 2017 that report paternal depression and anxiety in the perinatal period were obtained from 5 different databases. In total, 84 studies were included in the systematic review, and 31,310 participants from 45 studies were included in the final meta-analysis. Risk factors obtained were classified based on the frequency of distribution of factors. Maternal depression is an important risk factor for fathers in the postnatal period (odds ratio [OR] = 3.34, 95% confidence interval [CI; 2.51, 4.46]). Marital distress was also linked to a twofold increase in the likelihood of paternal depression in the postnatal period (OR = 2.16, 95% CI [1.47, 3.19]). Parenting stress as a risk factor was strongly and significantly associated with paternal anxiety in perinatal period (OR = 14.38, 95% CI [7.39, 27.97]). The findings suggest that maternal depression, marital distress, and parental stress are important risk factors for fathers’ mental health in the perinatal period. The current meta-analysis also identifies gender role stress, domestic violence, and mismatched expectancies from pregnancy and childbirth as the risk factors that are unique to fathers only in the perinatal period. Future intervention programs should screen and target fathers with no previous children, or a depressed partner, and aim to enhance relationship satisfaction

Professional quality of life as potential mediators of the association between anxiety and depression among Chinese health-care clinicians

Objective: Building upon the tripartite model of anxiety and depression, the current study aims to examine mechanisms of comorbidity between anxiety and depression using the ProQOL (including the constructs of burnout, secondary traumatic stress and compassion satisfaction) in a sample of Chinese healthcare clinicians. Method: A randomised cross-sectional survey was distributed to 1620 participants who were recruited from eight state-owned hospitals in a city in southern China between January and May 2017. A total of 1562 questionnaires were returned (a response rate of 96.4%). After the cases with more than 10% missing variables and multivariate outliers being removed, 1,423 valid cases remained. Multiple mediator models were used for mediation analysis that was conducted using the PROCESS v3.1 macro for SPSS. Results: The indirect effects of anxiety upon depression through burnout (a1=.601 [95%CI: .552, .650], p < .001; b1 = .137 [95%CI: .101, .174], p < .001) and compassion satisfaction (a3= -.297 [95%CI: -.352, -.241], p < .001; b3 = -.069 [95%CI: -.100, -.039], p < .001) were significant, while there was no evidence that anxiety influenced depression by changing secondary traumatic stress. The indirect effects of depression upon anxiety through secondary traumatic stress (a2=.535 [95%CI: .483, .588], p < .001); b2 = .154 [95%CI: .120, .188], p < .001) was both positive and significant, while there was no evidence that depression influenced anxiety by changing burnout and compassion satisfaction. Conclusions: In the current sample, burnout and compassion satisfaction mediated the effect of anxiety upon depression and secondary traumatic stress mediated the effect of depression upon anxiety. The findings of the current study offer support to the tripartite model

A systematic review and meta-analysis on adverse childhood experiences: Prevalence in youth offenders and their effects on youth recidivism

Background: Adverse childhood experiences (ACEs) have been found to be more prevalent among youth involved with the criminal justice system compared to their counterparts in the general population. The present study aims to systematically review the existing empirical studies to provide a comprehensive understanding of the prevalence of ACEs among youth offenders aged between 10 and 19 years, and the effects of both cumulative ACEs and individual ACE items on youth recidivism. Method: A systematic review approach was employed. Narrative synthesis and meta-analysis were performed to synthesise the data in 31 included studies. Results: The pooled prevalence of cumulative ACEs was 39.4 %. The pooled prevalence of individual ACEs ranged between 13.7 % to 51.4 %. Cumulative ACEs and neglect were positively associated with youth recidivism, with OR = 1.966, 95%CI [1.582, 2.444] and OR = 1.328, 95% CI [1.078, 1.637], respectively. Physical and sexual abuse were not significantly associated with youth recidivism. Regarding the mechanisms underlying the relationship between ACEs and recidivism; moderators included gender, positive childhood experiences, strong social bonds, and empathy. Mediators included child welfare placement, emotional and behavioural problems, drug use, mental health problems, and negative emotionality. Conclusion: Developing programs to youth offenders aiming to address the impact of cumulative and individual ACE exposure, strengthen the protective factors and weaken the risk factors would be useful to reduce youth recidivism

Choosing a screening tool to assess disordered eating in adolescents with type 1 diabetes mellitus

[Extract] Disturbed eating behaviours and insulin omission in adolescents with type 1 diabetes mellitus have concerned diabetes clinicians for decades, yet screening and management protocols using validated tools for this high risk group are lacking. Clinical eating disorders and milder forms of disordered eating can impact negatively on glycaemic control and are associated with serious health consequences (Rydall et al., 1997). Early detection and treatment of disturbed eating thoughts and behaviours is important (Goebel-Fabbri, 2009)

Perceptual Interactions Between Electrodes Using Focused and Monopolar Cochlear Stimulation

In today’s cochlear implant (CI) systems, the monopolar (MP) electrode configuration is the most commonly used stimulation mode, requiring only a single current source. However, with an implant that will allow simultaneous activation of multiple independent current sources, it is possible to implement an all-polar (AP) stimulation mode designed to create a focused electrical field. The goal of this experiment was to study the potential benefits of this all-polar mode for reducing uncontrolled electrode interactions compared with the monopolar mode. The five participants who took part in the study were implanted with a research device that was connected via a percutaneous connector to a benchtop stimulator providing 22 independent current sources. The perceptual effects of the AP mode were tested in three experiments. In Experiment 1, the current level difference between loudness-matched sequential and simultaneous stimuli composed of 2 spatially separated pulse trains was measured as function of the electrode separation. Results indicated a strong current-summation interaction for simultaneous stimuli in the MP mode for separations up to at least 4.8 mm. No significant interaction was found in the AP mode beyond a separation of 2.4 mm. In Experiment 2, a forward-masking paradigm was used with fixed equally loud probes in AP and MP modes, and AP maskers presented on different electrode positions. Results indicated a similar spatial masking pattern between modes. In Experiment 3, subjects were asked to discriminate between across-electrode temporal delays. It was hypothesized that discrimination would decrease with electrode separation faster in AP compared to MP modes. However, results showed no difference between the two modes. Overall, the results indicated that the AP mode produced less current spread than MP mode but did not lead to a significant advantage in terms of spread of neuronal excitation at equally loud levels

Practical aspects of multiaxial classification: A clinically useful biopsychosocial framework for child and adolescent psychiatry

Summary: Multiaxial classification system development (organising important and relevant clinical factors under multiple headings or 'axes') has a long history stretching back to the 1940s. The World Health Organization supported the development of a multiaxial system of classification for children from the 1960s and in the 1990s produced a comprehensive multiaxial system which could be used with ICD-10. Using the multiaxial approach provides for an atheoretical framework that can integrate factors from within the child and the environmental influences on the child. This article presents a variety of ways in which the ICD-10 multiaxial framework can be extended from its classic usage to provide clinicians with valuable tools to assist in a biopsychosocial clinical assessment. Using the multiaxial system in an extended format allows a more comprehensive diagnosis and planning of treatments and is helpful in the training and teaching of juniors. It is also useful in evaluating responses to medication when it is combined with a chronological analysis and can provide other useful ways of integrating information relevant to understanding clinical cases

Mental health first aid in everyday life: collaboration for promoting mental health in higher education in China

Generally speaking, Mental Health First Aid (MHFA) is a program that to train helpers to help a person who is developing a mental health problem and/or experiencing a worsening of an existing mental health problem or in a mental health crisis. The rationale of training helper in traditional MHFA is that many people developing mental disorders do not get professional help or delay getting professional help. They may talk to someone in their social network about their mental health issues. With appropriate mental health first aid skills, this someone (helper) may reduce the risk of the person coming to harm and assist the person to seek professional help. However, in some cultures (e.g., in the Chinese culture), people, in particular young people, may not discuss their mental health issues with someone in their social network because of the stigma of mental health. Considering such a cultural context, providing MHFA in Everyday Life to help people to deal with their mental health issues in their everyday life is as important as MHFA in a mental health crisis. This collaborative project among James Cook University, Taiyuan Psychiatric Hospital, Shanxi University and Shanxi Medical University aims to develop and provide a five-unit training program of MHFA in Everyday Life for university students in China. The topics of the five units are: 1) Mental health conditions across the lifespan; 2) Mental health and wellbeing in the Chinese culture; 3) Psychological resilience; 4) Mindfulness and mental health; and 5) Emotional intelligence

Childhood adversity, allostatic load, and adult mental health: Study protocol using the Avon Longitudinal Study of Parents and Children birth cohort

Introduction: The cumulative burden of chronic stress and life events has been termed allostatic load. Elevated allostatic load indices are associated with different mental health conditions in adulthood. To date, however, the association between elevated allostatic load in childhood and later development of mental health conditions has not been investigated. Methods: Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), we will calculate allostatic load indices using biomarkers representing the cardiovascular, metabolic, immune, and neuroendocrine systems, at the ages of 9 and 17 years. Bivariate and multivariable logistic regression models will be used to investigate the association between allostatic load and psychiatric disorders in adulthood. Furthermore, the role of adverse childhood experiences as a modifier will be investigated. Discussion: This protocol describes a strategy for investigating the association between elevated allostatic load indices in childhood at the age of 9 years old and psychiatric disorders in adulthood at 24 years old

Preschool children perceived by mothers as irregular eaters: physical and psychosocial predictors from a Birth Cohort Study

Objective: Parents often report their children display irregular eating patterns. Our aim is to describe the stability of maternal-perceived irregular eating of their offspring from 6 months to 2-4 years of age and to investigate factors that are associated with maternal perceived irregular eating of their 2-4 year old offspring. Methods: A longitudinal mother-child linked analysis was carried out using 5 year follow-up data from a population-based prospective birth cohort of 5122 mothers who were participants in the Mater-University Study of Pregnancy, Brisbane. Measures included responses to standardized questionnaires, pediatrician review and standardized measures such as the Peabody Picture Vocabulary Test-Revised and the Child Behavior Checklist. Results: 20.2% and 7.6% of mothers respectively stated their 2-4 year old was sometimes or often an irregular eater. Continuity of feeding difficulties from age 6 months was prominent: 48% of 6 month Olds with a feeding problem were 'sometimes' or 'often' irregular eaters at age 2-4 years. From a multivariable analysis, both child-intrinsic factors (chronic physical morbidity, sleeplessness and anxiety-depressive symptoms) and factors that impinge upon the child (poor maternal health and maternal depression and anxiety) independently contributed to irregular eating status at age 2-4 years. Conclusions: We conclude that approximately one third of mothers had some concern with their child's irregular eating, 7.6% of mothers were often concerned. irregular eating children were usually physically well, more likely to have persisting feeding problems, sleeplessness, behavioral problems and lived with mothers with perceived poor physical and mental health. Ontervention strategies should be family orientated and include child, mother and mother-child psychosocial approaches