Archives of women's mental health
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Arch Womens Ment Health · Apr 2013
Factor structure and longitudinal invariance of the Center for Epidemiological Studies Depression Scale (CES-D) in adult women: application in a population-based sample of mothers of children with epilepsy.
The objective of this study was to examine the factor structure and longitudinal measurement invariance of the Center for Epidemiological Studies Depression Scale (CES-D). The population-based sample included 347 adult women who had children participating in the Health-related Quality of Life in Children with Epilepsy Study. Longitudinal confirmatory factor analysis was used to confirm the factor structure and test for measurement invariance. ⋯ Results suggested full measurement invariance over time with the final model demonstrating adequate fit [χ(2) = 2303.92 (df = 1,776); CFI = 0.957; TLI = 0.952; WRMR = 1.149; RMSEA = 0.033, 90% CI, 0.030, 0.038]. We conclude that the four-factor structure of the CES-D is supported for adult women and that the measurement of the scale is longitudinally invariant. Clinicians and researchers can be confident that longitudinal changes in CES-D scores reflect true changes in depressive symptomatology and are not an artifact of changes in the interpretation of items in the scale over time.
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Arch Womens Ment Health · Feb 2013
The impact of subjective birth experiences on post-traumatic stress symptoms: a longitudinal study.
The aim of this prospective study was to examine the etiology of post-traumatic stress symptoms following childbirth within a transactional framework of stress. Participants were women (N = 1,499) from the Akershus Birth Cohort. These women were followed from pregnancy to 8 weeks postpartum. ⋯ A structural equation model showed that subjective birth experiences had the highest association with post-traumatic stress symptoms. Moreover, they mediated the effect of predisposing factors and objective birth experiences. The results suggest that women's subjective birth experiences are the most important factor in the development of post-traumatic stress symptoms following childbirth.
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Arch Womens Ment Health · Feb 2013
A pilot study of heart rate variability biofeedback therapy in the treatment of perinatal depression on a specialized perinatal psychiatry inpatient unit.
Heart rate variability biofeedback (HRVB) therapy may be useful in treating the prominent anxiety features of perinatal depression. We investigated the use of this non-pharmacologic therapy among women hospitalized with severe perinatal depression. Three questionnaires, the State Trait Anxiety Inventory (STAI), Warwick-Edinburgh Mental Well-Being Scale, and Linear Analog Self Assessment, were administered to 15 women in a specialized inpatient perinatal psychiatry unit. ⋯ A majority (81.9 %, n = 9) of women surveyed by telephone also reported continued frequent use at least once per week, and over half (54.6 %, n = 6) described the use of HRVB techniques as very or extremely beneficial. The use of HRVB was associated with statistically significant improvement on all instrument scores, the greatest of which was STAI scores, and most women reported frequent continued use of HRVB techniques after discharge. These results suggest that HRVB may be particularly beneficial in the treatment of the prominent anxiety features of perinatal depression, both in inpatient and outpatient settings.
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Arch Womens Ment Health · Feb 2011
Estimation of desvenlafaxine transfer into milk and infant exposure during its use in lactating women with postnatal depression.
This study characterises the extent of desvenlafaxine transfer into milk and provides data on infant exposure to desvenlafaxine via breast milk in ten women with postnatal depression and their breastfed infants. Desvenlafaxine concentration in milk and plasma was measured chromatographically in milk and in maternal and infant plasma collected at steady state. Theoretic and relative infant doses via milk were estimated and the per cent drug in infant versus mother's plasma was calculated. ⋯ The relative infant dose was similar to that for previous studies using venlafaxine and was supported by a separate exposure measure using the ratio of drug in the infant's plasma relative to that in the mother's plasma. The theoretic infant dose of desvenlafaxine was 41-45% of that for venlafaxine and its metabolite desvenlafaxine in previous studies, reflecting the lower recommended maternal dose for desvenlafaxine. Although our data for desvenlafaxine use in lactation are encouraging and there are supporting data from venlafaxine studies, more patients and their infants need to be studied before the safety of desvenlafaxine as a single therapeutic agent can be fully assessed.
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Arch Womens Ment Health · Feb 2011
Primary care physician's attitudes and practices regarding antidepressant use during pregnancy: a survey of two countries.
Little is known about the practices of primary care physicians regarding the prescribing of antidepressants during pregnancy. An anonymous survey was administered to a group of nonrandomly selected Australian general practitioners (n = 61 out of 77) and randomly selected Canadian family physicians (n = 35 out of 111). Responses to a hypothetical scenario and questions regarding beliefs about the use of antidepressant medication during pregnancy were collected. Physicians from both countries feel strongly that antidepressant use during pregnancy is a decision complicated by conflicting reports of safety and risk.