Archives of women's mental health
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Arch Womens Ment Health · Dec 2015
Using the Patient Health Questionnaire (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS) to assess suicidal ideation among pregnant women in Lima, Peru.
We sought to examine the concordance of two suicidal ideation items from the Patient Health Questionnaire-9 (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS), to evaluate the prevalence of suicidal ideation among pregnant women, and to assess the co-occurrence of suicidal ideation with antepartum depressive symptoms. A cross-sectional study was conducted among 1,517 pregnant women attending prenatal care clinics in Lima, Peru. Item 9 of the PHQ-9 assesses suicidal ideation over the last 14 days while item 10 of the EPDS assesses suicidal ideation in the past 7 days. ⋯ Assessed by the PHQ-9, 51 % of participants with suicidal ideation had probable depression. In prenatal care clinics, screening for suicidal ideation is needed for women with and without depressive symptoms. Future studies are needed to identify additional predictors of antepartum suicidality, determine the appropriate duration of reporting period for suicidal ideation screening, and assess the percentage of individuals with positive responses to the two suicidal ideation items at high risk of planning and attempting suicide.
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Arch Womens Ment Health · Dec 2015
Randomized Controlled TrialHealth services utilization of women following a traumatic birth.
This cohort study compared 262 women with high childbirth distress to 138 non-distressed women. At 12 months, high distress women had lower health-related quality of life compared to non-distressed women (EuroQol five-dimensional (EQ-5D) scale 0.90 vs. 0.93, p = 0.008), more visits to general practitioners (3.5 vs. 2.6, p = 0.002) and utilized more additional services (e.g. maternal health clinics), with no differences for infants. Childbirth distress has lasting adverse health effects for mothers and increases health-care utilization.
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Arch Womens Ment Health · Aug 2015
Intimate partner violence and suicidal ideation in pregnant women.
Intimate partner violence (IPV) during pregnancy is a major public health issue with significant implications for maternal mental health. Less studied is the association between IPV during pregnancy and suicidal ideation. This study reports the prevalence and correlates of suicidal ideation among low-income pregnant women receiving prenatal care at a university obstetrical clinic from February 2009 to March 2010. ⋯ In the fully adjusted model, antenatal depressive symptomatology (OR = 17.04; 95 % CI 2.10-38.27) and experiencing IPV (OR = 9.37; 95 % CI 3.41-25.75) were significantly associated with an increased risk of antenatal suicidal ideation. The prevalence of antenatal suicidal ideation in the current study was higher than other population-based samples though this sample was predominantly single, low-income, and 19 % experienced IPV during pregnancy. Given the strong association of antenatal suicidal ideation, depressive symptomatology, and IPV, health care providers are urged to identify those women at risk so that antenatal care can be tailored to best support optimal maternal and neonatal outcomes.
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Postpartum depression (PPD) is a common childbirth complication, affecting 10-15 % of newly delivered mothers. This study aims to assess the association between personality factors and PPD. All pregnant women during the period September 2009 to September 2010, undergoing a routine ultrasound at Uppsala University Hospital, were invited to participate in the BASIC study, a prospective study designed to investigate maternal well-being. ⋯ Somatic trait anxiety and psychic trait anxiety were associated with increased risk for PPDS at 6 weeks (aOR = 2.1, 95 % CI 1.2-3.5 and aOR = 1.9, 95 % CI 1.1-3.1), while high scores of mistrust were associated with a twofold increased risk for PPDS at 6 months postpartum (aOR 1.9, 95 % CI 1.1-3.4). Non-depressed pregnant women with high neuroticism scores have an almost fourfold increased risk to develop depressive symptoms postpartum, and the association remains robust even after controlling for most known confounders. Clinically, this could be of importance for health care professionals working with pregnant and newly delivered women.
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Arch Womens Ment Health · Jun 2015
Randomized Controlled TrialMaternal thoughts of harm in response to infant crying: an experimental analysis.
Ninety-eight mothers of healthy firstborn infants 0 to 6 months old were randomly assigned to listen to 10-min of infant crying or infant cooing while continuously rating subjective feelings of frustration. Participants completed pre-test measures of depressed mood, empathy, and trait anger and post-test measures of infant-related harm thoughts, negative and positive emotions, and urge to comfort and to flee. Twenty-three (23.5 %) participants endorsed unwanted thoughts of active harm (e.g., throwing, yelling at, shaking the infant). ⋯ Women in the cry condition who endorsed thoughts of harm reported higher frustration levels over the 10 min of crying, higher levels of post-test negative emotions, and stronger urges to flee the infant but not stronger urges to comfort the infant. Trait anger and personal distress empathy predicted the occurrence of unwanted thoughts of infant harm, whereas negative mood did not. Unwanted, intrusive, infant-related thoughts of harm may be triggered by prolonged infant crying, are predicted by personal distress empathy and a tendency to experience anger, and are associated with higher frustration, negative emotions, and the urge to escape the infant.