Mental Health Education and Utilization Among Patients with Vestibular Disorders.

To explore the receipt of mental health education, assessment, and referrals, and mental health service use among individuals with vestibular disorders. Patients with vestibular disorders living in the US, Australia, Canada, and the UK were surveyed through social media forums. Questionnaires assessed demographics, anxiety (Generalized Anxiety Disorder-7), depression (Center for Epidemiological Studies Depression-10), dizziness (Dizziness Handicap Inventory), and type of professional providing mental health education, assessment, referral, and treatment. The 226 participants were largely White (90%), educated (67% holding an associate's degree or higher) women (88%) with an average age of 45 who self-identified as having chronic vestibular symptoms (78%), as opposed to episodic ones (22%). Fifty-two percent reported never receiving verbal education, written education (69%), mental health assessment (54%), or referral (72%). Participants were more likely to receive mental health treatment in the past if they had received verbal resources and/or referrals from clinicians. The majority of patients with vestibular disorders report that medical professionals have not provided education, mental health assessment, or a mental health referral.

My Baby, My Move+: feasibility of a community prenatal wellbeing intervention.

BACKGROUND: Excessive gestational weight gain (EGWG), insufficient prenatal physical activity and sleep, and poor psychological wellbeing independently increase risks for adverse maternal and infant outcomes. A novel approach to mitigate these risks is utilizing peer support in a community-based prenatal intervention. This study assessed the feasibility (acceptability, demand, implementation, and practicality) of a remotely delivered prenatal physical activity intervention called My Baby, My Move + (MBMM +) that aims to increase prenatal physical activity, enhance mood and sleep hygiene, and reduce EGWG. METHODS: Participants were recruited through community organizations, local clinics, and social media platforms in the Fall of 2020 and Spring of 2021. Eligible pregnant women were randomized to either the MBMM + intervention or the control group. Each group met over Zoom for 16 sessions (twice weekly for 60 min over 8 weeks) to learn either behavioral change and wellbeing knowledge and skills (MBMM +) or knowledge and skills related to parenting (control group). Multiple methods of evaluation to better understand the feasibility of the intervention were conducted. RESULTS: A total of 49 women (25 MBMM + intervention, 24 control) completed both pre- and post-survey assessments and were included in the analyses. A subsample of 19 (39%) intervention participants completed a combination of semi-structured interviews/surveys to assess acceptability, demand, implementation, and practicality. Participants expressed positive feedback regarding acceptability (satisfaction and intent to continue use) and were extremely likely or likely to recommend the program to a friend (demand). Implementation metrics were assessed by observation and feedback forms completed by peer leaders and demonstrated high-quality control. Findings suggest that the intervention was practical due to remote sessions and cost-effectiveness. CONCLUSION: The MBMM + intervention was deemed to be a feasible intervention with high acceptability, demand, implementation, and practicality. These findings can be used to inform the scalability of the intervention and implementation of a larger efficacy trial. TRIAL REGISTRATION: 19-1366, initial date is on January 23, 2020.

Efficacy of the Crisis Risk Triage Scale in Inpatient Units Within the United States.

ABSTRACT: Patient violence toward others, including doctors and nurses, is a serious concern worldwide. A wealth of literature supports the assertion that violent behavior can be prevented with proper screening and management policies. This project aimed to evaluate the Crisis Triage Rating Scale (CTRS) within a 12-hospital integrated healthcare delivery system located in the southeastern United States. An initial sample of 112,708 unique patient visits between January 2019 and December 2020 was included in this retrospective review of electronic health records. We found that the CTRS harm triage question and risk levels were significant predictors of harm to others. Consistent with previous literature, positive predictive values ranged between 0.025 and 0.070 and negative predictive values ranged between 0.991 and 0.995. Our results support the assertion that clinicians should make balanced judgments about using a positive risk score to allocate safety measures. Variations in practice were evident across our healthcare systems. Improving appropriate assessment procedures may improve the diagnostic tools and risk stratification. When documented correctly, the CTRS performed as expected in an environment where harm to others occurred infrequently.

Evaluating an Online Intervention to Improve Provider Management of Prenatal Depression: A Randomized Controlled Trial.

INTRODUCTION: Prenatal depression is associated with numerous deleterious maternal and child health outcomes. Providers play a significant role in managing (i.e., identifying and treating or referring to care for) prenatal depression. We conducted a randomized controlled trial to test the effects of a brief online training on self-reported provider management practices related to prenatal depression. METHODS: Providers (i.e., physicians, nurses, mental health specialists, and public health educators) were randomized into intervention (i.e., online training) or waitlist control arms. The online training covered guidelines and evidence-based practices related to managing prenatal depression. Changes in providers' knowledge, attitudes, and self-reported practices were assessed by the Management of Maternal Depression Inventory at baseline (T1), 6 weeks after baseline (T2), and 12 weeks after baseline (T3). RESULTS: A total of 108 providers from Colorado and Virginia participated in the trial. Over the three time periods, repeated measures analysis of variance revealed Time × Group relative improvements for the intervention group with respect to satisfaction with working with mental health services, F(1,97) = 10.89, p = .001, partial η2 = 0.10, and increased self-reported screening, counseling, and referral for prenatal depression, F(1,97) = 6.25, p = .014, partial η2 = 0.06. A similar improving pattern was observed for self-efficacy, F(1,99) = 2.48, p = .13, partial η2 = .02. CONCLUSIONS: Findings from our study suggest a brief online training may enhance the likelihood of providers screening, treating, and/or referring at-risk patients for follow-up care for prenatal depression.

Parent-Child Interaction Therapy for Children with Disruptive Behaviors and Autism: A Randomized Clinical Trial.

A relatively large number of children with autism spectrum disorder (ASD) exhibit disruptive behavioral problems. While accumulating data have shown behavioral parent training programs to be efficacious in reducing disruptive behaviors for this population, there is a dearth of literature examining the impact of such programs across the range of ASD severity. To evaluate the effectiveness of Parent-Child Interaction Therapy (PCIT), an evidence-based treatment for children with problem behaviors and their families, in reducing disruptive behaviors among children (4-10 years) with ASD (without intellectual disabilities). Fifty-five children (85.5% male, 7.15 years; SD 1.72) were enrolled from pediatric offices and educational settings into a randomized clinical trial (PCIT: N = 30; Control: N = 25). PCIT families demonstrated a significant reduction in child disruptive behaviors, increase in positive parent-child communication, improvement in child compliance, and reduction in parental stress compared to the control group. Exploratory analyses revealed no differential treatment response based on ASD severity, receptive language, and age. Results are promising for the use of PCIT with children demonstrating disruptive behaviors across the autism spectrum.

Testing a Model of Sexual Minority Orientation in Individuals with Typical Development, the Broad Autism Phenotype, and Autism Spectrum Disorder.

Individuals with Autism Spectrum Disorder (ASD) and the Broad Autism Phenotype (BAP) are more likely than individuals with typical development (TD) to report a sexual minority orientation (e.g., Bejerot and Eriksson, PLoS ONE 9:1-9, 2014; DeWinter et al., Journal of Autism and Developmental Disorders 47:2927-2934, 2017; Qualls et al., Journal of Autism and Developmental Disorders 48:3974-3983, 2018). This study operationalized and tested the fit of an existing model of sexual orientation to examine which factors are associated with increased sexual minority orientation (Worthington et al., The Counseling Psychologist 30:496-531, 2002) in individuals with TD, BAP, and ASD. The model was found to have adequate fit, χ2 (130) = 374.04, p < 0.001; RMSEA = 0.07; CFI = 0.95; SRMR = 0.08. Heterosexism was found to be the only predictor of sexual minority orientation and a significant predictor in the BAP and ASD groups, with increased daily heterosexist experiences predicting greater sexual minority orientation in these groups.

Perinatal Depression Educational Training for Graduate Nursing Students.

The purpose of this study was to implement and assess an educational intervention for nursing students pertaining to perinatal depression (PD) screening and treatment. A single group (n = 59), repeated-measures design (i.e., pre- and post-intervention assessments) was used to assess the impact of an online intervention. Demographics, Theory of Planned Behavior constructs, intention to screen and treat PD, and PD-related knowledge were tested. The intervention resulted in positive gains in PD-related perceived behavioral control (PBC), attitudes, subjective norms, knowledge, intention to screen and treat PD, and perceived importance of screening and treating PD from pre- to post-intervention. PBC demonstrated a small-to-moderate positive association with perceived importance of screening and treating PD at post-intervention. Results from the current study suggest that the PD online educational intervention is effective in improving participants' PD-related PBC, attitudes, subjective norms, knowledge, and intention to screen and treat PD.

Anxiety among fathers during the prenatal and postpartum period: a meta-analysis.

INTRODUCTION: The purpose of this review was to determine the prevalence of anxiety among fathers during the perinatal (pre- and post-natal) period. METHODS: A systematic search was conducted to identify studies published between 1995-2020. One hundred and seventy-two of the records met inclusion criteria and full texts were screened for eligibility. The authors followed PRISMA guidelines to extract the data. RESULTS: A total of 23 studies, representing 40,124 participants, are included in this meta-analysis. The overall random effects estimate of paternal perinatal anxiety was 10.69% (95% confidence interval (CI): 8.14 - 13.91%). Rates of paternal perinatal anxiety demonstrated significant heterogeneity that was large in magnitude (Q = 304,494, p < .001, I2 = 99.93 and τ2 = .5381). Study quality rating did not appear to moderate rates of paternal perinatal anxiety (low: 10.74%; 95% CI: 6.56-17.11%; high: 10.65%; 95% CI: 6.02- 18.15%). DISCUSSION: Paternal perinatal anxiety rates in this meta-analysis are considerably higher than the global WHO regional prevalence rates for anxiety among men suggesting the transition into parenthood may place men at greater risk for anxiety.

Selective use of sternal elevation before substernal dissection in more than 2000 Nuss repairs at a single institution.

BACKGROUND/PURPOSE: Evaluate the safety of sternal elevation (SE) used selectively before creating the substernal tunnel during the Nuss procedure. METHODS: An IRB-approved (01-05-EX-0175-HOSP), single institution, retrospective review was performed (1/1/1997-11/20/2017). Primary and secondary Nuss repairs (i.e., previous Nuss, Ravitch, thoracotomy, or sternotomy) are included. SE use, cardiac injuries, and pectus bar infections are reported. Chi square and Fisher's exact test (FE) were used (critical p < .05). RESULTS: 2037 patients [(80% male; mean age 15.2 years (SD = 4.4, range 3-46); mean Haller index (HI) 5.3 (SD = 5.7, range 1.73-201)] underwent Nuss repair. SE was used before creating the substernal tunnel in 171 (8.4%): 160 (8.2%) of 1949 primary and 11 (12.5%) of 88 secondary repairs. SE use increased significantly [χ2(2) = 118.93; p < .001] over time and with increasing HI [χ2(3) = 59.9; p < .001]. No cardiac injuries occurred in primary repairs but two occurred in patients with previous sternotomy. Infection rates were not different with (2.9%) or without SE (1.8%) [χ2(1) =1.14; p = .285] and not higher with off-label VB (1.5%) versus other SE techniques (3.8%) [FE, p = .65)]. CONCLUSION: Selective use of sternal elevation before substernal dissection during the Nuss procedure is safe but may not prevent cardiac injuries in patients with previous sternotomy. Infection rates were not increased with SE. TYPE OF STUDY: Retrospective review. LEVEL OF EVIDENCE: IV.

Perinatal depression screening rates, correlates, and treatment recommendations in an obstetric population.

INTRODUCTION: The current study aimed to assess perinatal depression (PD) screening and treatment practices of obstetrical health care providers. METHOD: Retrospective record reviews (n = 557) evaluated the PD screening, referral, and treatment practices at an Obstetrician/Gynecology practice. This study assessed the frequency of screening for PD, rates of elevated Edinburgh Postnatal Depression Scale (EPDS) scores, treatment recommendations, demographic correlates, and predictors of elevated EPDS scores. RESULTS: PD screening completion rates were: 60.1% (intake), 35% (glucola test), and 85.5% (6-week follow-up). Rates of clinically elevated EPDS scores were: 18.21% (intake), 17.43% (glucola test), and 13.00% (6-week follow-up). Correlates of clinically elevated EPDS scores at intake and 6-week follow-up were history of depression, history of anxiety, and young age. History of depression and anxiety were associated with an increased likelihood of having a clinically significant EPDS score at intake. Intake EPDS score and history of depression were associated with an increased likelihood of having a clinically significant EPDS score at 6-week follow-up. DISCUSSION: Obstetric/gynecology providers should screen for perinatal depression at every obstetrical appointment. It is important to thoroughly assess history of depression and anxiety. Education and training for health care providers and perinatal women may improve the mental health experience of perinatal women. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Psychometric assessment of the Edinburgh Postnatal Depression Scale in an obstetric population.

The prevalence and negative effects of perinatal depression are well known. The Edinburgh Postnatal Depression Scale (EPDS) is a common screening tool for perinatal depression and it is recommended for use by several professional organizations. The current study tested competing EPDS factor structures and assessed EPDS change from intake to 6-week follow-up, and identified demographic correlates in an outpatient obstetric sample. Using a retrospective observational study design, medical records were coded for demographic, mental health, and EPDS patient data (n = 524). Confirmatory factor analysis, t-tests, and ANOVA were utilized. Findings included: (1) a 3-factor model (i.e. anxiety, depression, anhedonia) of the EPDS displayed the best fit to the current data; (2) small declines in all 3 subscales of the EPDS from intake to 6-week follow-up appointments and; (3) demographic correlates of EPDS subscales included history of depression, history of anxiety, race, and pregnancy status (i.e. first child or not). The 3-factor structure can be used in clinical practice to assess perinatal depression in a nuanced fashion. Given that history of depression and anxiety are risk factors for perinatal depression, a thorough assessment of these items in clinical practice is needed.

Examining the Directionality Between Identity Development and Depressive Symptoms Among Recently Immigrated Hispanic Adolescents.

Although personal identity development has been conceptualized as a source of psychological stability and protective against depressive symptoms among Hispanic immigrants, there remains ambiguity regarding the directional relationship between identity development and depression. To address this limitation, the current study sought to establish directionality between identity development and depressive symptoms. The sample consisted of 302 recent (<5 years) immigrant Hispanic adolescents (53.3% boys; Mage = 14.51 years at baseline; SD = 0.88 years) from Miami and Los Angeles who participated in a longitudinal study. The findings suggested a bidirectional relationship between identity and depressive symptoms such that identity coherence negatively predicted depressive symptoms, yet depressive symptoms also negatively predicted coherence and positively predicted subsequent identity confusion. Findings not only provide further evidence for the protective role of identity development during times of acute cultural transitions, but also emphasize the need for research to examine how depressive symptoms, and psychopathology more broadly, may interfere with establishing a sense of self.

Development and validation of the Pectus Carinatum Body Image Quality of Life (PeCBI-QOL) questionnaire.

INTRODUCTION: While body image disturbances and quality of life in persons with pectus excavatum (PE) have been well documented, very little has been done to systematically measure and document the same in patients with pectus carinatum (PC). Because of this, the current study aimed to develop and validate an instrument to assess body image related quality of life in patients with PC and their parents. METHOD: Participants: Two waves of data collection took place. The development phase enrolled 78 PC patients and 76 matched parents. The validation phase enrolled 50 PC patients and 50 parents. Mean age at the initiation of treatment was 15.14 (SD = 2.54). Participants were mostly boys (85.9%) and White or Caucasian (89.7%). Instrument development, refinement, and validation: A group of 5 experts in chest wall deformities used existing measures of body image disturbances in PE, combined with the broader body image literature, to develop larger item pools for patients and their parents. Item analysis from this phase was used to remove poorly performing or statistically redundant items. In the validation phase, refined patient and parent instruments were examined using exploratory principal components factor analysis (EFA) with parallel analysis for factor retention, followed by Varimax rotation to identify a final factor solution. RESULTS/DISCUSSION: This development and refinement process yielded a final questionnaire for patients (18 items) and parents (15 items). The patient questionnaire includes four subscales, each with good internal consistency: Body Image Disturbance; Treatment Motivation/Engagement; Physical Limitations; and Social Disadvantage. The parent questionnaire includes 3 subscales: Body Image Disturbance; Treatment Motivation/Engagement; Physical Limitations. Patient and parent scales showed moderate correlations. Among patients with measures pre- and posttreatment, there was a significant improvement in overall PeCBI-QOL score. We demonstrate, in this study, that body image and related quality of life can be reliably and validly assessed with the PeCBI-QOL, which has implications for more comprehensively documenting the negative psychological and functional consequences of pectus carinatum. TYPE OF STUDY/LEVEL OF EVIDENCE: Study of diagnostic test/III.

A systematic review of interventions for healthcare professionals to improve screening and referral for perinatal mood and anxiety disorders.

Postpartum depression affects approximately 11% of women. However, screening for perinatal mood and anxiety disorders (PMAD) is rare and inconsistent among healthcare professionals. When healthcare professionals screen, they often rely on clinical judgment, rather than validated screening tools. The objective of the current study is to review the types and effectiveness of interventions for healthcare professionals that have been used to increase the number of women screened and referred for PMAD. Preferred Reporting Items for Systematic Reviews and Meta-Analyses was utilized to guide search and reporting strategies. PubMed/Medline, PsychInfo/PsychArticles, Cumulative Index to Nursing, Allied Health Literature (CINAHL), and Health Source: Nursing/Academic Edition databases were used to find studies that implemented an intervention for healthcare professionals to increase screening and referral for PMAD. Twenty-five studies were included in the review. Based on prior quality assessment tools, the quality of each article was assessed using an assessment tool created by the authors. The four main outcome variables were the following: percentage of women screened, percentage of women referred for services, percentage of women screened positive for PMAD, and provider knowledge, attitudes, and/or skills concerning PMAD. The most common intervention type was educational, with others including changes in electronic medical records and standardized patients for training. Study quality and target audience varied among the studies. Interventions demonstrated moderate positive impacts on screening completion rates, referral rates for PMAD, and patient-provider communication. Studies suggested positive receptivity to screening protocols by mothers and providers. Given the prevalence and negative impacts of PMAD on mothers and children, further interventions to improve screening and referral are needed.

Life After an Autism Spectrum Disorder Diagnosis: A Comparison of Stress and Coping Profiles of African American and Euro-American Caregivers.

The purpose of the present study was to understand how caregiver stress and coping behaviors impact African American and Euro-American families differently when caring for a child with autism. This study used discriminate function analysis to contrast the stress and coping profiles of Euro-American caregivers who are more acculturated with the majority culture with African American caregivers who ascribe to more traditional values. A sample of 103 families was recruited (52 Euro-American, 51 African American). African American families reported significantly more stress and utilizing more varied coping strategies than their Euro-American counterparts. Additional differences were found between the high and low acculturated African American groups such that low acculturated African Americans were more likely to engage in religious coping.

Broad Autism Phenotypic Traits and the Relationship to Sexual Orientation and Sexual Behavior.

Individuals with higher levels of the broad autism phenotype (BAP) have some symptoms of autism spectrum disorder (ASD). Like individuals with ASD, people with higher-BAP may have fewer sexual experiences and may experience more same-sex attraction. This study measured BAP traits, sexual experiences, and sexual orientation in typically developing (TD) individuals to see if patterns of sexual behavior and sexual orientation in higher-BAP resemble those in ASD. Although BAP characteristics did not predict sexual experiences, one BAP measure significantly predicted sexual orientation, ß = 0.22, t = 2.72, p = .007, controlling for demographic variables (R2 change = .04, F = 7.41, p = .007), showing individuals with higher-BAP also reported increased same-sex attraction. This finding supports the hypothesis that individuals with higher-BAP resemble ASD individuals in being more likely than TD individuals to experience same-sex attraction.

Multivariate analysis of risk factors for Nuss bar infections: A single center study.

BACKGROUND/PURPOSE: Our previously published data suggested several risk factors for infection after the Nuss procedure. We aimed to further elucidate these findings. METHODS: An IRB-approved (14-03-WC-0034), single institution, retrospective review was performed to evaluate the incidence of postoperative Nuss bar infections associated with seven variables. These were subjected to bivariate and multivariable analyses. A broad definition of infection was used including cellulitis, superficial infection with drainage, or deep infection occurring at any time postoperatively. RESULTS: Over 7years (4/1/2009-7/31/2016), 25 (3.2%) of 781 patients developed a postoperative infection after primary Nuss repair. Multivariable analyses demonstrated an increased risk of infection with perioperative clindamycin versus cefazolin for all infections (AOR 3.72, p=.017), and specifically deep infections (AOR 5.72, p=.004). The risk of a superficial infection was increased when antibiotic infusion completed >60min prior to incision (AOR 10.4, p=.044) and with the use of peri-incisional subcutaneous catheters (OR 8.98, p=.008). CONCLUSION: Following primary Nuss repair, the rate of deep bar infection increased with the use of perioperative clindamycin rather than cefazolin. The rate of superficial infection increased when perioperative antibiotic infusion was completed more than 60min prior to incision and with the use of peri-incisional subcutaneous catheters. Further studies are needed to better understand these findings. TYPE OF STUDY: Retrospective chart review. LEVEL OF EVIDENCE: Level III treatment study.

Nonoperative management of pectus excavatum with vacuum bell therapy: A single center study.

PURPOSE: The purpose of this study was to determine variables predictive of an excellent correction using vacuum bell therapy for nonoperative treatment of pectus excavatum. METHODS: A single institution, retrospective evaluation (IRB 15-01-WC-0024) of variables associated with an excellent outcome in pectus excavatum patients treated with vacuum bell therapy was performed. An excellent correction was defined as a chest wall depth equal to the mean depth of a reference group of 30 male children without pectus excavatum. RESULTS: Over 4years (11/2012-11/2016) there were 180 patients enrolled with 115 available for analysis in the treatment group. The reference group had a mean chest wall depth of 0.51cm. An excellent correction (depth≤0.51cm) was achieved in 23 (20%) patients. Patient characteristics predictive of an excellent outcome included initial age≤11years (OR=3.3,p=.013), initial chest wall depth≤1.5cm (OR=4.6,p=.003), and chest wall flexibility (OR=14.8,p<.001). Patients that used the vacuum bell over 12 consecutive months were more likely to achieve an excellent correction (OR=3.1,p=.030). Follow-up was 4months to 4years (median 12months). CONCLUSION: Nonoperative management of pectus excavatum with vacuum bell therapy results in an excellent correction in a small percentage of patients. Variables predictive of an excellent outcome include age≤11years, chest wall depth≤1.5cm, chest wall flexibility, and vacuum bell use over 12 consecutive months. TYPE OF STUDY: Retrospective chart review. LEVEL OF EVIDENCE: Level III treatment study.

Selective versus routine patch metal allergy testing to select bar material for the Nuss procedure in 932 patients over 10years.

AIM OF THE STUDY: The aim of the study was to determine the role of patch metal allergy testing to select bar material for the Nuss procedure. METHODS: An IRB-approved (11-04-WC-0098) single institution retrospective, cohort study comparing selective versus routine patch metal allergy testing to select stainless steel or titanium bars for Nuss repair was performed. In Cohort A (9/2004-1/2011), selective patch testing was performed based on clinical risk factors. In Cohort B (2/2011-9/2014), all patients were patch tested. The cohorts were compared for incidence of bar allergy and resultant premature bar loss. Risk factors for stainless steel allergy or positive patch test were evaluated. MAIN RESULTS: Cohort A had 628 patients with 63 (10.0%) selected for patch testing, while all 304 patients in Cohort B were tested. Over 10years, 15 (1.8%) of the 842 stainless steel Nuss repairs resulted in a bar allergy, and 5 had a negative preoperative patch test. The incidence of stainless steel bar allergy (1.8% vs 1.7%, p=0.57) and resultant bar loss (0.5% vs 1.3%, p=0.23) was not statistically different between cohorts. An allergic reaction to a stainless steel bar or a positive patch test was more common in females (OR=2.3, p<0.001) and patients with a personal (OR=24.8, p<0.001) or family history (OR=3.1, p<0.001) of metal sensitivity. CONCLUSION: Stainless steel bar allergies occur at a low incidence with either routine or selective patch metal allergy testing. If selective testing is performed, it is advisable in females and patients with a personal or family history of metal sensitivity. A negative preoperative patch metal allergy test does not preclude the possibility of a postoperative stainless steel bar allergy. LEVEL OF EVIDENCE: Level III Treatment Study and Study of Diagnostic Test.

The course and interrelationship of maternal and paternal perinatal depression.

The aims of the study were to describe course of depression in both mothers and fathers from the third trimester of pregnancy through 6 months postpartum and to examine the relationship between maternal and paternal depression. Hypotheses were as follows: (a) Depressive symptoms would be correlated between parents and (b) earlier depressive symptoms in one parent would predict later increases in depression in the other. Eighty cohabitating primiparous couples were recruited from prenatal OBGYN visits and community agencies and enrolled during pregnancy, between 28-week gestation and delivery. Participants completed measures of depression on four occasions: baseline and 1, 3, and 6 months postpartum. Ninety-eight percent of the enrolled couples (78; 156 individuals) completed the study. For both mothers and fathers, symptom severity ratings and classification as a probable case were stable across time, with prenatal depression persisting through 6 months in 75 % of mothers and 86 % of fathers. Prenatal depression in fathers predicted worsening depressive symptom severity in mothers across the first six postpartum months but not vice versa. In both expecting/new mothers and fathers, depression demonstrates a stable pattern of occurrence and symptom severity between 28-month gestation and 6 months postpartum. Although prenatal maternal depression is not predictive of symptom change in fathers, mothers with prenatally depressed partners showed significant worsening in overall symptom severity during the first six postpartum months.