Cumulative effects of pre-pandemic vulnerabilities and pandemic-related hardship on psychological distress among pregnant individuals.

OBJECTIVE: Our primary objective was to determine whether pre-existing vulnerabilities and resilience factors combined with objective hardship resulted in cumulative (i.e., additive) effects on psychological distress in pregnant individuals during the COVID-19 pandemic. A secondary objective was to determine whether any of the effects of pandemic-related hardship were compounded (i.e., multiplicative) by pre-existing vulnerabilities. METHOD: Data are from a prospective pregnancy cohort study, the Pregnancy During the COVID-19 Pandemic study (PdP). This cross-sectional report is based upon the initial survey collected at recruitment between April 5, 2020 and April 30, 2021. Logistic regressions were used to evaluate our objectives. RESULTS: Pandemic-related hardship substantially increased the odds of scoring above the clinical cut-off on measures of anxiety and depression symptoms. Pre-existing vulnerabilities had cumulative (i.e., additive) effects on the odds of scoring above the clinical cut-off on measures of anxiety and depression symptoms. There was no evidence of compounding (i.e., multiplicative) effects. Social support had a protective effect on anxiety and depression symptoms, but government financial aid did not. CONCLUSION: Pre-pandemic vulnerability and pandemic-related hardship had cumulative effects on psychological distress during the COVID-19 pandemic. Adequate and equitable responses to pandemics and disasters may require more intensive supports for those with multiple vulnerabilities.

Gender comparison of psychological reaction after miscarriage-a 1-year longitudinal study.

OBJECTIVE: To explore men's psychological reaction and its evolutionary course over 1 year after miscarriage, to compare this reaction with that of their female partners and to investigate the possible correlation of psychological states between partners. DESIGN: Prospective 1-year longitudinal observational study. SETTING: A university-affiliated tertiary referral hospital in Hong Kong. Sample Eighty-three miscarrying couples. METHODS: The psychological reactions of miscarrying women and their male partners were assessed immediately and at 3, 6 and 12 months after miscarriage. MAIN OUTCOME MEASURES: Psychological outcomes were assessed using the 12-item General Health Questionnaire (GHQ-12) and Beck Depression Inventory (BDI). RESULTS: A substantial proportion of men (43.4%) scored high in GHQ-12 and 16.9% scored high in BDI immediately after miscarriage. In men, both psychometric scores decreased sharply within the first 3 months and reached a plateau. When compared with women, men scored significantly lower in GHQ-12 and BDI during the 1-year course after miscarriage. A planned pregnancy was a significant risk factor (P = 0.008) associated with an initial high BDI score in men. There was a significant positive correlation between couples in both GHQ-12 and BDI scores throughout the longitudinal course. CONCLUSIONS: Although the psychological impact of miscarriage on men was less enduring when compared with that on women, a significant proportion of men demonstrated psychological distress after miscarriage. The significant positive correlation in a couple's psychological reaction indicated that psychological morbidity was not confined only to a woman's own experience, but also affected her relationship with her male partner.