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The number of parents in China who have lost their only child, referred to as shidu parents, currently exceeds one million and is increasing by approximately 76,000 annually. Shidu parents face a unique challenge in long-term care, primarily stemming from the sudden and tragic loss of their only child, which leads to a substantial decrease in their social support network. A multi-stage, stratified, and cluster sampling method was employed across various economic belts. Linear regression analysis was utilized to examine factors associated with the social support status of shidu and non-shidu parents. The level of social support decreases as the severity of depression increases. Shidu parents with grandchildren tend to have good social support. The city of Hangzhou exhibits relatively high levels of social support. Married individuals typically report higher levels of social support. It is recommended to prioritize shidu parents without grandchildren as a primary focus for government and societal support. Key recommendations include strengthening social skills training and developing social support networks. Drive economic development, particularly in relatively underdeveloped regions. Strengthen social organizations and community development. Enhancing access to support services, leveraging technology, and encouraging volunteerism for non-married parents.
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BACKGROUND: The COVID-19 pandemic represents a significant psychological burden for many people; however, especially during the first wave of the pandemic in Germany, little acute professional help was available for people in need. OBJECTIVE: In southern Germany, a telephone hotline for psychological first aid for COVID-19-related burdens was set up under the lead of the Baden-Wuerttemberg Ministry of Social Affairs and Integration, opened to the entire population and evaluated in April 2020. MATERIAL AND METHODS: In the period from 22 April to 24 July 2020, 753 volunteer psychotherapeutically trained counselors from different professional groups answered a total of 8096 calls. RESULTS: Depression symptoms (36%), anxiety symptoms (18%) and psychotic symptoms (19%) were most frequently reported. Every second call was related to a previous mental illness. During the counseling sessions, which lasted 25â¯min on average, a variety of psychological acute interventions were conducted. In the presence of unclear symptoms, psychotic symptoms or severe personality disorder symptoms, the counselors were able to help significantly less compared to the remaining calls in which other clearly defined symptoms were present. CONCLUSION: The results point to both the benefits and limitations of hotline services. The major benefits relate to the fast availability and effective professional help for people with clearly characterized symptoms. In the case of unclear or complex symptoms, immediate help by telephone seems to be possible only to a limited extent, but it could initiate access to further help offers. Overall, the results of this study provide a first indication that hotline services for psychological first aid are feasible under pandemic conditions.
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COVID-19 , Pandemias , Primeros Auxilios , Alemania , Líneas Directas , Humanos , Salud Mental , Primeros Auxilios Psicológicos , SARS-CoV-2RESUMEN
Somatoparaphrenia lacka ownership of a paralyzed limb, i.e., the illusion that one's limbs belong to someone else. Somatoparaphrenia is one of the many forms of body misperceptions. We report a case of somatoparaphrenia with misoplegia, characterized by the absence of anosognosia for hemiplegia and personal neglect, following a surgical operation for left parietal meningioma. The patient received a novel multidisciplinary treatment, including motor rehabilitation training, traditional physiotherapy and robotic rehabilitation using the Hunova Movendo Technology and psychological counseling. At the end of the training, the patient improved in global cognitive functioning, mood, motor abilities, and the perception of herself and her body, reducing the sense of estrangement and repulsion in the lower right limb. Our result showed the importance of a specific neuropsychological assessment in patients with parietal brain lesions and the usefulness of an integrated psychological and motor approach in rehabilitating patients with somatoparaphrenia, primarily when associated with misoplegia.
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Imagen Corporal , Rehabilitación Neurológica , Lóbulo Parietal/patología , Lóbulo Parietal/fisiopatología , Trastornos de la Percepción/rehabilitación , Terapia Combinada , Consejo , Femenino , Humanos , Persona de Mediana Edad , Trastornos de la Percepción/patología , Trastornos de la Percepción/fisiopatología , Proyectos Piloto , Psicoterapia , RobóticaRESUMEN
OBJECTIVE: To investigate the clinical effect of tadalafil combined with behavioral therapy and psychological counseling in the treatment of erectile dysfunction (ED). METHODS: We collected the clinical data on 338 cases of ED treated in our andrology clinic with tadalafil combined with behavioral therapy and psychological counseling (the trial group, n = 159) or with tadalafil alone (the control group, n = 179) from January to December 2019. Using chief complaints scores as the main observation indexes, we evaluated the subjective feelings and objective symptoms of the patients during their sexual life. RESULTS: After treatment, the patients in the trial group, compared with the controls, showed significantly lower chief complaints scores (1.96 ± 1.38 vs 2.73 ± 1.80, P < 0.01) and higher satisfaction with the therapeutic effect (67.9% vs 47.5%, P < 0.01). No statistically significant difference was observed in the IIEF-5 scores between the two groups before and after treatment. CONCLUSIONS: Tadalafil combined with behavior therapy and psychological counseling is superior to oral tadalafil alone in the treatment of ED, which affords greater satisfaction with the therapeutic effect, higher quality of sexual life, and better relationship between the partners.
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Disfunción Eréctil , Terapia Conductista , Terapia Combinada , Consejo , Disfunción Eréctil/tratamiento farmacológico , Disfunción Eréctil/terapia , Humanos , Masculino , Tadalafilo/uso terapéuticoRESUMEN
OBJECTIVE: To observe the clinical effect of priligy (dapoxetine hydrochloride) combined with behavioral therapy and psychological counseling in the treatment of primary premature ejaculation (PPE). METHODS: A total of 202 PPE patients diagnosed from 2017 to 2018 were randomized into a control (n = 100) and an experimental group (n = 102), the former treated with oral priligy at 30 mg 1ï¼3 hours before anticipated sexual activity, and the latter by the same medication combined with 30-minute behavioral therapy and psychological counseling once a month for two times. The therapeutic effects were evaluated according to the Premature Ejaculation Profile (PEP) scores of the patients at 1 and 2 months of treatment. RESULTS: After 1 month of treatment, both groups of the patients showed significant improvement, as compared with the baseline, in the PEP scores on personal distress related to ejaculation (P < 0 05), interpersonal difficulty related to ejaculation (P < 0.05) and satisfaction with sexual intercourse (P < 0.05) but not on perceived control over ejaculation (P > 0.05). At 2 months, however, the patients' scores on all the four PEP items were dramatically improved, even more significantly in the experimental than in the control group, as on perceived control over ejaculation (2.73 ± 0.95 vs 2.22 ± 0.68, P < 0.05), personal distress related to ejaculation (2.97 ± 1.07 vs 2.57 ± 0.69, P < 0.05), interpersonal difficulty related to ejaculation (3.19 ± 1.03 vs 2.77 ± 0.69, P < 0 05) and satisfaction with sexual intercourse (2.85 ± 0.99 vs 2.35 ± 0.63, P < 0.05). There was no statistically significant difference in the incidence rate of adverse events between the experimental and control groups (21.6% vs 20.0%, P > 0.05), and all the symptoms were relieved within 24 hours. CONCLUSIONS: Priligy combined with behavioral therapy and psychological counseling is more effective than priligy alone in improving the sexual function of PPE patients, raise their interest in sexual life and increase the intimacy between the partners, and can even achieve clinical cure in some patients.
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Bencilaminas/uso terapéutico , Terapia Cognitivo-Conductual , Naftalenos/uso terapéutico , Eyaculación Prematura , Psicoterapia , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéutico , Humanos , Masculino , Eyaculación Prematura/terapia , Resultado del TratamientoRESUMEN
BACKGROUND: The aim was to assess the effects of a training program inclusive of contact sports and counseling on school dropout, quality of life (QoL) and psychopathologic symptoms in the youth with a history of school dropout and psychopathic personality traits. METHODS: The Experimental Group (EG) consisted of 32 subjects (male 90.6%; age 19.6±4.3 years); the Control Group (CG) consisted of an equal number matched for gender and age with the same psychological features. At the beginning of the experimental Training Program (T0), both cohorts were assessed by a diagnostic psychiatric interview (SCID ANTAS), the Short Form Health Survey (SF-12) to evaluate QoL, the Psychopathy Checklist - Revised (PCL-R) for the assessment of psychopathic traits, the Self Reporting Questionnaire (SRQ) to measure general psychopathology. At the end of the program (T1), the coorths were evaluated by SF-12 and SRQ. RESULTS: Twenty-seven subjects in the EG (84.4%) completed the course and underwent the evaluation at T1. The SF-12 score significantly increased from T0 to T1 in both groups, albeit this was more evident in the EG than in the CG, owing to an interaction between time and group. SRQ score significantly decreased in the EG from T0 to T1, while in the CG it did not, although the interaction between time and group was not significant. CONCLUSION: The experimental training program was effective in improving QoL and countering school dropout in young citizens with psychopathic traits. Further studies are needed to clarify if such results are due to a relationship between the practical tasks approach including contact sports and an improvement in mentalization processes.
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BACKGROUND: Although integrative medicine is gaining increasing attention and is claiming more and more its place in modern health care, it still plays a marginal role in conventional maternity care. The present study aims to examine the patterns of Complementary and Alternative Medicine (CAM) use and the demand for integrative therapies, including CAM, relaxation therapies, nutritional counseling, and psychological assistance, among women in pregnancy and childbed. METHODS: The survey was conducted from April 2017 to July 2017 by means of a pseudo-anonymous 38-item questionnaire at the Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University of Munich. Eligible participants were women hospitalized due to pregnancy related complications and women in childbed. Descriptive statistics were generated to determine patterns of CAM use and demand for integrative therapeutic approaches. Univariate analysis was used to detect associations between patients' characteristics and their interest in the different integrative therapies. Furthermore, binary logistic regression was used to estimate the odds ratio of demand for CAM. RESULTS: A total of 394 out of 503 patients participated in the survey (78%). 60% declared using CAM in general, 45% specifically in relation to their pregnancy or childbed. Most commonly used modalities were vitamins (31% of all patients), yoga (24%), and herbal supplements (23%). Most popular sources of recommendation of CAM use were midwives and gynecologists. Integrative therapy options patients would have wanted alongside conventional maternity care were CAM (64%), relaxation therapies (44%), dietary counseling (28%), and psychological counseling (15%). Furthermore, associations between patients' sociodemographic characteristics and their demand for integrative therapies were identified. CONCLUSIONS: The results of this study demonstrate that there is a considerable demand for integrative medicine and widespread use of CAM among women during pregnancy and childbed in Germany. Maternity health care providers should be aware of these findings in order to be able to better address patients' needs and wishes. Our study findings should be interpreted with regard to patients in an hospital setting.
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Terapias Complementarias/estadística & datos numéricos , Necesidades y Demandas de Servicios de Salud/estadística & datos numéricos , Medicina Integrativa/estadística & datos numéricos , Embarazo/estadística & datos numéricos , Adolescente , Adulto , Estudios Transversales , Femenino , Alemania/epidemiología , Encuestas de Atención de la Salud , Humanos , Persona de Mediana Edad , Periodo Posparto , Adulto JovenRESUMEN
Young cancer patients are increasingly interested in preserving their fertility prior to undergoing gonadotoxic therapies. Although the medical safety and treatment protocols for fertility preservation have been well documented, limited research has addressed the emotional issues that arise in fertility preservation patients. We briefly review the literature on the psychosocial issues in adult female fertility preservation treatment and describe our experiences within this patient population. Our findings suggest that several important issues to be addressed during the psychological counseling of adult female fertility preservation patients include: (1) preexisting psychological distress in patients undergoing treatment, (2) choice of fertility preservation strategy in the face of an uncertain relationship future, (3) decision making regarding use of third-party reproduction (e.g., sperm/egg donation, gestational surrogacy), (4) treatment expectations regarding pregnancy and miscarriage, (5) ethical issues related to treatment including the creation, cryopreservation, and disposition of embryos/oocytes, and (6) decision regret from patients who declined fertility preservation.
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Consejo , Preservación de la Fertilidad/psicología , Neoplasias/terapia , Adulto , Conducta de Elección , Femenino , Humanos , Neoplasias/psicologíaRESUMEN
BACKGROUND: In recent years, artificial intelligence (AI) technology has been continuously advancing and finding extensive applications, with one of its core technologies, machine learning, being increasingly utilized in the field of healthcare. OBJECTIVE: This research aims to explore the role of Artificial Intelligence (AI) technology in psychological counseling and utilize machine learning algorithms to predict counseling outcomes. METHODS: Firstly, by employing natural language processing techniques to analyze user conversations with AI chatbots, researchers can gain insights into the psychological states and needs of users during the counseling process. This involves detailed analysis using text analysis, sentiment analysis, and other relevant techniques. Subsequently, machine learning algorithms are used to establish predictive models that forecast counseling outcomes and user satisfaction based on data such as user language, emotions, and behavior. These predictive results can assist counselors or AI chatbots in adjusting counseling strategies, thereby enhancing counseling effectiveness and user experience. Additionally, this study explores the potential and prospects of AI technology in the field of psychological counseling. RESULTS: The research findings indicate that the designed machine learning models achieve an accuracy rate of approximately 89% in analyzing psychological conditions. This demonstrates significant innovation and breakthroughs in AI technology. Consequently, AI technology will gradually become a highly important tool and method in the field of psychological counseling. CONCLUSION: In the future, AI chatbots will become more intelligent and personalized, providing users with precise, efficient, and convenient psychological counseling services. The results of this research provide valuable technical insights for further improving AI-supported psychological counseling, contributing positively to the application and development of AI technology.
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Academic burnout is a condition characterized by exhaustion, cynicism, a distant attitude toward studying, and diminished self-efficacy in academic activities. Preliminary scientific findings indicate that interventions designed to alleviate work burnout also hold promise for mitigating academic burnout, however clear evidence based on randomized controlled trials is still missing. This research protocol describes a randomized controlled trial aimed at evaluating the efficacy of an online group psychological intervention to contrast academic burnout. Participants with high levels of burnout will be assigned to a psychological counseling group or a waiting list control group. The research comprises several phases: (T0) Screening, Recruitment, and Randomization; (T1) Baseline assessment (pre-intervention); (T2) Outcome Assessment (post-intervention); and (T3) Follow-up Assessment (3 months post-intervention). The primary outcomes include burnout symptoms, general wellbeing, and academic achievement. Additionally, secondary variables such as effort-reward imbalances, satisfaction/frustration of basic psychological needs, intrapersonal and interpersonal emotion regulation, coping strategies, and social support will be examined. The psychological intervention strategies will encompass psychoeducation, self-awareness enhancement, cognitive restructuring, and promotion of social support. This research protocol is an initial step toward evidence-based psychological interventions to treat academic burnout.
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Introduction: The COVID-19 pandemic brought about unprecedented problems for contemporary society. Among the numerous challenges faced following the spread of the virus, the need to provide assessment tools and remote psychological assistance certainly deserves particular attention. Indeed, this profound paradigm shift in psychological assessment and care occurred during a period of fragility for people already suffering from the restrictions imposed to stem the spread of the virus. One population particularly affected by the pandemic was students, including university students. The latter faced the pandemic in a particularly critical formative period. Methods: For these reasons, our systematic review has two main objectives: (i) identify the assessment tools and psychological dimensions most used/investigated during the pandemic in Italian university students; (ii) systematize and deepen our knowledge about the impact of the pandemic on the psychological wellbeing of Italian university students. Our search used PRISMA 2020 guidelines on Web of Science, Pubmed, Scopus, and EBSCOHost. Results: The results indicated that the psychological dimensions most investigated in university students during the pandemic were anxiety and depression. At the same time, the most used assessment instruments were the State-Trait Anxiety Inventory (STAI-Y) and the Beck Depression Inventory-II (BDI-II). Furthermore, it is clear from the results that the pandemic has harmed the psychological wellbeing of university students. Finally, we dedicated a section to discuss the interventions implemented by university counseling services during the pandemic. Discussion: This review could improve the work of university counseling services in this post-pandemic period and contribute to developing specific screening and assessment programs for future emergencies.
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BACKGROUND: Nutritional support for patients hospitalized in the intensive care unit (ICU) is an important part of clinical treatment and care, but there are significant implementation difficulties. AIM: To introduce a modified nutritional support management system for ICU patients based on closed-loop information management and psychological counseling. METHODS: The division of functions, personnel training, system construction, development of an intelligent decision-making software system, quality control, and improvement of the whole process were carried out to systematically manage nutritional support for ICU patients. RESULTS: Following the implementation of the whole process management system, the scores of ICU medical staff's knowledge, attitudes/beliefs, and practices regarding nutritional support were comprehensively enhanced. The proportion of hospital bed-days of total enteral nutrition (EN) in ICU patients increased from 5.58% to 11.46%, and the proportion of EN plus parenteral nutrition increased from 42.71% to 47.07%. The rate of EN initiation within 48 h of ICU admission increased from 37.50% to 48.28%, and the EN compliance rate within 72 h elevated from 20.59% to 31.72%. After the implementation of the project, the Self-rating Anxiety Scale score decreased from 61.07 ± 9.91 points to 52.03 ± 9.02 points, the Self-rating Depression Scale score reduced from 62.47 ± 10.50 points to 56.34 ± 9.83 points, and the ICU stay decreased from 5.76 ± 2.77 d to 5.10 ± 2.12 d. CONCLUSION: The nutritional support management system based on closed-loop information management and psychological counseling achieved remarkable results in clinical applications in ICU patients.
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Individuals with disabilities are more vulnerable to depression development than the general population. This study sought to map the evidence on current knowledge of depression, intervention strategies, and assessment tools among people with disabilities. This review was conducted following Arksey and O'Malley's scoping review methodology framework. An electronic search was performed on four English databases: PubMed, Cochrane Library, PsycINFO, and Web of Science. The original search returned 1802 results, with 1,116 from Web of Science, 626 from PubMed, 25 from Cochrane, and 35 from PsycINFO. After removing duplicates, 786 articles were chosen for the title and abstract screening processes. Finally, 112 full-text publications were deemed eligible, with 41 papers being included in this scoping review for analysis. A large proportion (32; 78.04%) of the studies chosen were cross-sectional, 14 (34.14%) of them reported general disability, 12 (29.26%) used a patient health questionnaire (PHQ-9) to measure depression, and 14 (34.14%) had interventions, including cognitive behavioral therapy, psychological counseling, social support, and physical activity. All interventions successfully reduced the severity of the depression. Cognitive behavioral therapies and psychological counseling were widely used interventions that had a significant impact on reducing depression. More randomized controlled trials are required, and they should focus on individuals with specific disabilities to provide disability-specific care that can improve the quality of life for disabled individuals.
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Depresión , Personas con Discapacidad , Humanos , Personas con Discapacidad/psicología , Apoyo Social , Terapia Cognitivo-ConductualRESUMEN
In 2020, COVID-19 became a global pandemic. The Chinese government's quarantine measures tend to cause anxiety, tension and depression among the quarantined people. This article constructs a differential game model of self-regulation, government guidance and social forces guidance. Then, the psychological benefits of the masses and the benefits of the whole society under the three modes are obtained, and the applicable conditions of various connection modes are compared. The research results show that: compared with social power channeling, the public under the government channeling mode can obtain more psychological benefits. However, with the increase of guidance, the difference between the psychological benefits of different ways of guidance first decreases and then tends to be stable. Under the guidance mode, the social benefits of the government decrease, and the more guidance, the smaller the social benefits. Therefore, both the government and social forces should make use of limited resources to conduct appropriate psychological counseling for the isolated population.
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Recent years have seen a marked rise in the number of students accessing University Psychological Counseling (UPC) services, and their concerns have been increasingly severe. This study aimed to examine the impact of cumulative adverse childhood experiences (ACEs) on mental health in students who had approached counseling services (N = 121) and students who had no experience with counseling services (N = 255). Participants completed an anonymous online self-report questionnaire measuring exposure to adverse childhood experiences (ACE-Q), psychological distress (General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9), personality traits (PID-5), and coping strategies. We found that students who approached UPC services scored higher on cumulative ACEs than the non-counseling group. While ACE-Q score was a direct positive predictor of PHQ-9 (p < 0.001), it did not predict GAD-7. Moreover, the results supported the existence of a mediation effect of avoidance coping, detachment, and psychoticism on the indirect effects of ACE-Q score on PHQ-9 or GAD-7. These results underlined the importance of screening for ACEs in a UPC setting because it can help identify students at higher risk for developing mental and physical health problems and provide them with early interventions and support.
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Experiencias Adversas de la Infancia , Salud Mental , Humanos , Estudiantes/psicología , Adaptación Psicológica , ConsejoRESUMEN
University counseling services (UCSs) are actively involved in mental health assessment and in supplying interventions aimed at preventing, facing and possibly overcoming psychological problems. However, we do not have a global overview of psychological counseling among universities. This systematic review aims at reviewing the literature on university psychological counseling, including articles documenting: (1) mental health and attitudes regarding help-seeking behaviors and UCSs among university students or counselors, (2) the description of protocols/services among UCSs, (3) the efficacy of psychological counseling/interventions among university students (both face-to-face and internet-delivered interventions). The study followed PRISMA guidelines and was registered on PROSPERO. After defining inclusion and exclusion criteria, a literature search was conducted, identifying 7085 records. Finally, 152 articles met the review eligibility criteria and were included in the qualitative synthesis. Results are divided into seven thematic topics that emerged during the analysis of the literature. The results mainly showed that face-to-face and web-based counseling/psychological interventions improve university students' mental health. Cross-sectional studies showed that many biases exist toward help-seeking behaviors, especially among international students. Both students and counselors must strive to overcome cultural barriers. Available resources for UCSs are scarce and need to be strengthened, as well as efficacy studies through randomized clinical trials.
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Objective: The aim of this study was to explore the psychological counseling intention of college students, the attitude of seeking psychological help, and the related factors of shame so as to promote the psychological health of college students. Methods: In 4 comprehensive colleges with sound psychological counseling centers, students of different grades were selected and divided into an active help-seeking group (n = 216) and a help-refusal group (n = 270). Students' shame behaviors were evaluated using the Self-Stigma of Seeking Help (SSOSH) scale and Self-Stigma Scale (SSS). The intention of psychological counseling was measured by the General Help-Seeking Questionnaire. The Inventory of Attitudes Toward Seeking Mental Health Services was used to evaluate the psychological status. Data from the above scales were compared through the t-test. Additionally, multiple linear regression analysis was performed to explore the impact of shame on the intention of psychological counseling. Results: The study found that the active help-seeking group scored lower on SSOSH scale compared to those in the help-refusal group (total score: 41.2 ± 9.1 vs. 37.9 ± 8.7, P = .0017). Meanwhile, the help-refusal group had higher scores on the shame dimension of the SSS (16.2 ± 3.9 vs. 5.3 ± 1.1, P = .00085). After adjusting for age, gender, and other variables, multiple linear regression analysis indicated a negative correlation between shame and intention of psychological help and counseling, revealing a significant impact of shame on professional psychological counseling (P < .05). Conclusion: Our study findings suggest that shame has a negative impact on the intention of seeking psychological help and counseling among college students, highlighting the importance of addressing shame-related factors to promote psychological health and encourage the utilization of professional psychological counseling services.
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Objective: Postpartum women can develop post-traumatic stress disorder (PTSD) in response to complicated, traumatic childbirth; prevalence of these events remains high in the U.S. Currently, there is no recommended treatment approach in routine peripartum care for preventing maternal childbirth-related PTSD (CB-PTSD) and lessening its severity. Here, we provide a systematic review of available clinical trials testing interventions for the prevention and indication of CB-PTSD. Data Sources: We conducted a systematic review of PsycInfo, PsycArticles, PubMed (MEDLINE), ClinicalTrials.gov, CINAHL, ProQuest, Sociological Abstracts, Google Scholar, Embase, Web of Science, ScienceDirect, and Scopus through December 2022 to identify clinical trials involving CB-PTSD prevention and treatment. Study Eligibility Criteria: Trials were included if they were interventional, evaluated CB-PTSD preventive strategies or treatments, and reported outcomes assessing CB-PTSD symptoms. Duplicate studies, case reports, protocols, active clinical trials, and studies of CB-PTSD following stillbirth were excluded. Study Appraisal and Synthesis Methods: Two independent coders evaluated trials using a modified Downs and Black methodological quality assessment checklist. Sample characteristics and related intervention information were extracted via an Excel-based form. Results: A total of 33 studies, including 25 randomized controlled trials (RCTs) and 8 non-RCTs, were included. Trial quality ranged from Poor to Excellent. Trials tested psychological therapies most often delivered as secondary prevention against CB-PTSD onset (n=21); some examined primary (n=3) and tertiary (n=9) therapies. Positive treatment effects were found for early interventions employing conventional trauma-focused therapies, psychological counseling, and mother-infant dyadic focused strategies. Therapies' utility to aid women with severe acute traumatic stress symptoms or reduce incidence of CB-PTSD diagnosis is unclear, as is whether they are effective as tertiary intervention. Educational birth plan-focused interventions during pregnancy may improve maternal health outcomes, but studies remain scarce. Conclusions: An array of early psychological therapies delivered in response to traumatic childbirth, rather than universally, in the first postpartum days and weeks, may potentially buffer CB-PTSD development. Rather than one treatment being suitable for all, effective therapy should consider individual-specific factors. As additional RCTs generate critical information and guide recommendations for first-line preventive treatments for CB-PTSD, the psychiatric consequences associated with traumatic childbirth could be lessened.
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Background: We assessed the feasibility of implementing psychological counseling services (PCS) for mothers of children with autism spectrum disorders (ASD) integrated within special education settings in urban Bangladesh. Method: In two special education schools for ASD in Dhaka City, trained female psychologists screened mothers using the Patient Health Questionnaire (PHQ-9). PCS was administered to all the mothers irrespective of a diagnosis of depression. Mothers with a PHQ-9 score >4 who met criteria for a major depressive episode (MDE) based on the DSM-IV Structured Interview Axis I Disorders (SCID-I) were also administered skill-building training through monthly home visits to support ASD care. The level of depression was assessed by the Depression Measurement Scale (DMS), and quality of life (QoL) was measured by Visual Analogue Scale (VAS) of EQ5D5L scale before and after PCS. Result: Among 188 mothers enrolled in the study, 81 (43%) received PCS, and 27.1% (22) had MDE. In the first month, 73 sessions were scheduled and 60 completed (85%). In the last month, 53 sessions were scheduled and 52 completed (98%). The mean DMS score decreased from 79.5 ± 23 to 60 ± 20 (p = 0.004), and DMS scores were significantly higher among mothers with MDE (97.8 ± 12.1 v. 69.9 ± 22.1; p < 0.001) compared to those without MDE (72.7 ± 22.6 v. 56.1 ± 18.1; p = 0.003). The mean VAS score improved from 70.3 ± 14.1 to 80.2 ± 13.3 (p = 0.001) between the first and the last session. Changes in DMS were negatively correlated with changes in VAS scores (ß: -0.213, 95% CI 0.370 to -0.056). Conclusion: Within special education schools for ASD in urban Bangladesh, it was feasible to administer an integrated program of PCS for mothers of children with ASD by trained psychologists who were able to screen and intervene to reduce their level of depression and improve their quality of life.