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1.
Nurs Clin North Am ; 54(4): 561-567, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31703781

RESUMO

Postpartum depression (PPD) affects10% to 20% of women within the first year after birth and 25% beyond the first year. PPD, despite advances in diagnosis and treatment, remains underdiagnosed and misunderstood. Women do not always display signs of PPD while in care for delivery of the infant and may not discuss mood changes to their primary care provider at discharge and first post-delivery appointment. Identifying screening and treatment options for non-mental health providers was the purpose of this article.


Assuntos
Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/terapia , Programas de Rastreamento , Papel do Profissional de Enfermagem/psicologia , Depressão Pós-Parto/epidemiologia , Tratamento Farmacológico , Feminino , Humanos , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Fatores de Risco
2.
Artigo em Inglês | MEDLINE | ID: mdl-31635045

RESUMO

Women's partners may act as facilitators of professional help-seeking for mental health problems in the postpartum period. This study aimed to examine the sociodemographic and clinical correlates of men's intentions to recommend professional help-seeking to their partners if they display postpartum mood and anxiety disorders and to explore the relationship between gender-role conflict and the intention to recommend help-seeking. A cross-sectional study included 214 adult men in a heterosexual relationship with a partner within the reproductive age. Men presented a high intention to recommend professional help to their partners. All dimensions of gender-role conflict were directly associated with the intention to recommend professional help-seeking (p < 0.05). High levels of gender-role conflict (dimensions success, power and competition, and restricted emotionality) were found to lead to increased levels of stigma and lower levels of intention to seek professional help, which, in turn, translated into lower intention to recommend help-seeking. These results emphasize the importance of developing universal awareness-raising and education campaigns directed at men aiming to reduce levels of gender-role conflict and stigma, and normalize the use of mental health services, to increase men's intentions to recommend professional help-seeking to their partners.


Assuntos
Depressão Pós-Parto/terapia , Intenção , Serviços de Saúde Mental/organização & administração , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Parceiros Sexuais/psicologia , Adolescente , Adulto , Conscientização , Conflito de Interesses , Estudos Transversais , Feminino , Identidade de Gênero , Humanos , Masculino , Pessoa de Meia-Idade , Estigma Social , Inquéritos e Questionários , Adulto Jovem
3.
BMC Pregnancy Childbirth ; 19(1): 256, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31331292

RESUMO

BACKGROUND: Perinatal depression, the most common pregnancy complication, is associated with negative maternal-offspring outcomes. Despite existence of effective treatments, it is under-recognized and under-treated. Professional organizations recommend universal screening, yet multi-level barriers exist to ensuring effective diagnosis, treatment, and follow-up. Integrating mental health and obstetric care holds significant promise for addressing perinatal depression. The overall study goal is to compare the effectiveness of two active interventions: (1) the Massachusetts Child Psychiatry Access Program (MCPAP) for Moms, a state-wide, population-based program, and (2) the PRogram In Support of Moms (PRISM) which includes MCPAP for Moms plus a proactive, multifaceted, practice-level intervention with intensive implementation support. METHODS: This study is conducted in two phases: (1) a run-in phase which has been completed and involved practice and patient participant recruitment to demonstrate feasibility for the second phase, and (2) a cluster randomized controlled trial (RCT), which is ongoing, and will compare two active interventions 1:1 with ten Ob/Gyn practices as the unit of randomization. In phase 1, rates of depressive symptoms and other demographic and clinical features among patients were examined to inform practice randomization. Patient participants to be recruited in phase 2 will be followed longitudinally until 13 months postpartum; they will have 3-5 total study visits depending on whether their initial recruitment and interview was at 4-24 or 32-40 weeks gestation, or 1-3 months postpartum. Sampling throughout pregnancy and postpartum will ensure participants with different depressive symptom onset times. Differences in depression symptomatology and treatment participation will be compared between patient participants by intervention arm. DISCUSSION: This manuscript describes the full two-phase study protocol. The study design is innovative because it combines effectiveness with implementation research designs and integrates critical components of participatory action research. Our approach assesses the feasibility, acceptance, efficacy, and sustainability of integrating a stepped-care approach to perinatal depression care into ambulatory obstetric settings; an approach that is flexible and can be tailored and adapted to fit unique workflows of real-world practices. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02760004, registered prospectively on May 3, 2016.


Assuntos
Depressão Pós-Parto , Depressão , Assistência Perinatal/métodos , Complicações na Gravidez , Técnicas Psicológicas , Sistemas de Apoio Psicossocial , Adulto , Análise por Conglomerados , Depressão/diagnóstico , Depressão/etiologia , Depressão/terapia , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/terapia , Feminino , Humanos , Saúde Mental , Participação do Paciente , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/psicologia , Complicações na Gravidez/terapia , Projetos de Pesquisa
4.
Ceska Gynekol ; 84(1): 68-72, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31213061

RESUMO

OBJECTIVE: To bring actual summary of knowledge about diagnostics and modern trends in therapy of postpartum depression. DESIGN: Review. SETTING: National Institute of Mental Health, Klecany. METHODS: Narrative review. RESULTS: First assessment of depressive symptoms among puerperal women can be done by screening instruments. Baby blues and postpartum psychosis must be kept in mind during the differential diagnostics of postpartum depression. Both nonpharmacological and pharmacological interventions can be used for postpartum depression treatment. As for nonpharmacological interventions, cognitive behavioral therapy is the most evidence based one. Antidepressants from the selective serotonin reuptake inhibitor group (SSRI) are the first choice from pharmacological interventions. Parenting support is also an important component of modern care of women with postpartum depression. CONCLUSION: Systematic cooperation between psychiatrist and gynecologists-obstetricians is a precondition of the effective postpartum depression treatment. The therapeutic intervention is chosen according to severity of depressive symptoms.


Assuntos
Antidepressivos/uso terapêutico , Terapia Cognitivo-Comportamental , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/terapia , Depressão Pós-Parto/psicologia , Feminino , Humanos , Período Pós-Parto , Transtornos Puerperais , Resultado do Tratamento
6.
Arts Health ; 11(1): 38-53, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-31038038

RESUMO

BACKGROUND: This article is a process evaluation of a three-arm randomised controlled trial (RCT) comparing the effects of creative interventions on symptoms of postnatal depression (PND) in new mothers. METHODS: Analyses of quantitative evaluation data from 91 participants and qualitative interviews and focus groups with 80 participants and 3 members of staff. RESULTS: Key assumptions of the RCT, including how the delivery of the intervention was achieved and what the intervention involved, are explored. Data suggest that the intervention was delivered as planned with a high level of fidelity. Key uncertainties surrounding the project, in particular unanticipated challenges that had to be overcome during the RCT, are also discussed and simple recommendations for improvement are made. CONCLUSION: This process evaluation aims to illuminate the outcome and mechanisms data from the RCT and enable organisations or individuals to ascertain the feasibility of establishing their own creative classes for women with symptoms of PND.


Assuntos
Criatividade , Depressão Pós-Parto/terapia , Mães/psicologia , Adulto , Feminino , Grupos Focais , Humanos , Relações Interpessoais , Entrevistas como Assunto , Jogos e Brinquedos , Ensaios Clínicos Controlados Aleatórios como Assunto , Canto
7.
Biomed Res Int ; 2019: 6597503, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31016194

RESUMO

Background: Previous studies have demonstrated that acupuncture was an effective alternative for treating major depressive disorders. However, the use of acupuncture for the treatment of postpartum depression remains controversial. This review summarizes the most significant studies in the area of acupuncture treatment for postpartum depression and provides a detailed overview of the efficacy of acupuncture for the treatment of postpartum depression. Methods: We undertook a systematic review of publicly available electronic databases to identify studies that evaluated acupuncture for the treatment of postpartum depression. Our meta-analysis selected randomized controlled trials (RCTs) and quasi-RCTs that reported on the treatment effect of acupuncture on postpartum depression. Results: Eight prospective trials reporting data on postpartum depression were included in our meta-analysis. The results demonstrated that acupuncture treatment could significantly reduce HAMD scores (SMD: -1.08; 95%CI: -2.11 to -0.05; P=0.040). However, with regard to EPDS, clinical response, and serum estradiol levels, pooled analysis suggested no beneficial effects of acupuncture for postpartum women in EPDS (RR: 1.23; 95%CI: 0.90 to 1.67; P=0.195); clinical response (RR: 1.00; 95%CI: 0.89 to 1.12; P=0.969); and the levels of serum estradiol (SMD: 1.96; 95%CI: -0.01 to 3.93; P=0.051). Limitations: First, there was relatively high heterogeneity among the studies, except for clinical response. In order to identify the sources of heterogeneity, we divided the studies into subgroups by way of controls. However, heterogeneity still existed, which suggested that it arose from participants rather than controls. Second, the sample size of the studies was small, causing the power of summary results to be low. This may result in over- or underestimating the interpretation of the results. Third, our analysis used pooled data, which restricted us from performing a more detailed analysis. Conclusions: Our meta-analysis suggested that acupuncture treatment may reduce HAMD scores, while no significant effects on EPDS, clinical response, and serum estradiol levels were observed.


Assuntos
Depressão Pós-Parto/terapia , Acupuntura/métodos , Terapia por Acupuntura/métodos , Transtorno Depressivo Maior/terapia , Feminino , Humanos , Período Pós-Parto/fisiologia , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto
8.
Am J Clin Hypn ; 61(4): 322-334, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31017547

RESUMO

Hypnosis and biofeedback techniques are evidence-based psychophysiological therapies that can be applied with a wide variety of medical and mental health disorders. Research shows efficacy for anxiety, depression, post-traumatic stress disorder (PTDS), chronic pain, hypertension, fibromyalgia, and a host of other disorders. Hypnosis and biofeedback can also augment the effectiveness of psychotherapy. The author utilizes the case narrative of a 36-year-old woman, presenting with postpartum depression and dissociative features, to illustrate the integration of biofeedback training, physiological monitoring, self-hypnosis, hypnotic age regression, and affective journaling into dynamic psychotherapy. The hypnotic techniques and the affective journaling assisted in the retrieval of critical traumatic events during the patient's adolescence, and a combination of breath training, self-hypnosis, and biofeedback aided the patient in self-calming.


Assuntos
Biorretroalimentação Psicológica/métodos , Depressão Pós-Parto/terapia , Transtornos Dissociativos/terapia , Hipnose/métodos , Adulto , Feminino , Humanos
9.
Neuron ; 102(1): 13-16, 2019 04 03.
Artigo em Inglês | MEDLINE | ID: mdl-30946818

RESUMO

Perinatal depression (PND) is a heterogeneous disorder with differences in timing of onset of depression, which influences symptomology, severity, and treatment efficacy. Researchers must embrace the heterogeneity to bring fruition to a precision medicine approach for women in reproductive mental health care.


Assuntos
Depressão Pós-Parto/metabolismo , Transtorno Depressivo Maior/metabolismo , Complicações na Gravidez/metabolismo , Animais , Ansiedade/psicologia , Comportamento Compulsivo/psicologia , Depressão Pós-Parto/psicologia , Depressão Pós-Parto/terapia , Transtorno Depressivo Maior/psicologia , Transtorno Depressivo Maior/terapia , Modelos Animais de Doenças , Feminino , Humanos , Comportamento Obsessivo/psicologia , Medicina de Precisão , Gravidez , Complicações na Gravidez/psicologia , Complicações na Gravidez/terapia
10.
Emerg Med Clin North Am ; 37(2): 277-286, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30940372

RESUMO

The period just after delivery is a high-risk period for women with associated morbidity and even mortality. There are large variations in complication rates across various groups in the United States. This article covers complications commonly encountered in the emergency department in late pregnancy and the early postpartum period. It specifically addresses postpartum depression, peripartum cardiomyopathy, and the late pregnant or postpartum patient presenting with headache or neurologic complaints. Emergency physicians should be well versed in common and life-threatening postpartum pathologies.


Assuntos
Complicações na Gravidez/diagnóstico , Terceiro Trimestre da Gravidez , Transtornos Puerperais/diagnóstico , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/terapia , Serviço Hospitalar de Emergência , Feminino , Cefaleia/complicações , Cefaleia/diagnóstico , Cefaleia/terapia , Humanos , Período Pós-Parto , Gravidez , Complicações na Gravidez/terapia , Transtornos Puerperais/terapia
12.
BMC Psychiatry ; 19(1): 94, 2019 03 21.
Artigo em Inglês | MEDLINE | ID: mdl-30898103

RESUMO

BACKGROUND: Unwanted, intrusive thoughts of harm-related to the infant are reported by the vast majority of new mothers, with half of all new mothers reporting unwanted, intrusive thoughts of harming their infant on purpose. Thoughts of intentional harm, in particular, are distressing to women, their partners and the people who care for them. While maternal, unwanted and intrusive thoughts of infant-related harm are known to be associated with obsessive compulsive disorder (OCD) and depression, preliminary evidence suggests that they are not associated with an increased risk of harm to infants. Perinatal care providers and policy makers, as well as new mothers and their partners require evidence-based information in order to respond appropriately to these types of thoughts. The purpose of this research is to address important gaps regarding the (a) prevalence and characteristics of intrusive, unwanted thoughts of baby-related harm, (b) their association (or lack thereof) with child abuse, and (c) the prevalence and course of obsessive-compulsive disorder and depression in the perinatal period. METHODS: Participant were 763 English-speaking women and recruited during pregnancy. In this province-wide study in British Columbia, participants were recruited proportionally from hospitals, city centers and rural communities between January 23, 2014 and September 09, 2016. Participants were administered online questionnaires and diagnostic interviews over the phone at 33-weeks gestation, 7-weeks postpartum and 4-months postpartum. The study assessed intrusive and unwanted thoughts of harm related to the infant, obsessive-compulsive disorder (OCD) and major depressive episode (MDE) disorders and symptomatology, sleep, medical outcomes, parenting attitudes, and infant abuse. DISCUSSION: There is a scarcity of literature concerning maternal unwanted, intrusive, postpartum thoughts of infant-related harm and their relationship to child harming behaviors, OCD and depression. This longitudinal cohort study was designed to build on the existing research base to ensure that policy developers, child protection workers and health-care providers have the guidance they need to respond appropriately to the disclosure of infant-related harm thoughts. Thus, its main goals will be to investigate whether intrusive postpartum thoughts of infant-related harm are a risk factor for child abuse or the development of OCD.


Assuntos
Maus-Tratos Infantis/psicologia , Depressão Pós-Parto/psicologia , Transtorno Depressivo Maior/psicologia , Mães/psicologia , Transtorno Obsessivo-Compulsivo/psicologia , Pensamento , Adulto , Colúmbia Britânica/epidemiologia , Maus-Tratos Infantis/prevenção & controle , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/terapia , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/terapia , Feminino , Humanos , Lactente , Estudos Longitudinais , Masculino , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/terapia , Período Pós-Parto/psicologia , Gravidez , Transtornos Puerperais/diagnóstico , Transtornos Puerperais/psicologia , Transtornos Puerperais/terapia , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
13.
BMJ ; 364: l322, 2019 02 25.
Artigo em Inglês | MEDLINE | ID: mdl-30803997

RESUMO

Perinatal depression is a common disorder that has been associated with serious risks to mother and child. Recently, screening for depression in pregnant and postpartum women has increased, as has the development of new psychotherapy and non-drug treatment modalities. Matching patients to treatments can be challenging, and although research into personalized treatment of major depression in the general population has increased, no published guidelines focus on personalized treatment approaches to perinatal depression. In particular, guidelines on non-drug treatments are lacking. This review summarizes the evidence on personalized non-drug treatment of perinatal depression, how to incorporate patients' preferences, novel treatments under investigation, and the potential role of biomarkers in matching patients to treatment. The review provides recommendations for future research in personalized care of perinatal depression.


Assuntos
Depressão Pós-Parto/psicologia , Assistência Perinatal/métodos , Medicina de Precisão/normas , Biomarcadores/sangue , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/terapia , Feminino , Humanos , Programas de Rastreamento/normas , Preferência do Paciente , Período Pós-Parto/psicologia , Guias de Prática Clínica como Assunto/normas , Gravidez , Complicações na Gravidez/psicologia , Psicoterapia/métodos , Psicoterapia de Grupo/métodos , Higiene do Sono/fisiologia , Estimulação Magnética Transcraniana/métodos
15.
Cell ; 176(1-2): 1, 2019 01 10.
Artigo em Inglês | MEDLINE | ID: mdl-30633900

RESUMO

During the postpartum period, the brain's inhibitory GABAA receptors may not recover in time following their reduced numbers during pregnancy. This is likely the cause of postpartum depression prevalent in ∼12% of childbearing women. A new therapy for this condition consists of administering a synthetic neurosteroid during the postpartum period to alleviate the mood disorder. To view this Bench to Bedside, open or download the PDF.


Assuntos
Depressão Pós-Parto/terapia , Pregnanolona/farmacologia , Receptores de GABA-A/metabolismo , beta-Ciclodextrinas/farmacologia , Adulto , Depressão Pós-Parto/metabolismo , Transtorno Depressivo Maior/metabolismo , Transtorno Depressivo Maior/terapia , Combinação de Medicamentos , Feminino , Humanos , Transtornos do Humor , Neurotransmissores/farmacologia , Período Pós-Parto/metabolismo , Gravidez , Prevalência , Receptores de GABA-A/fisiologia
16.
Annu Rev Med ; 70: 183-196, 2019 01 27.
Artigo em Inglês | MEDLINE | ID: mdl-30691372

RESUMO

Postpartum depression (PPD) is common, disabling, and treatable. The strongest risk factor is a history of mood or anxiety disorder, especially having active symptoms during pregnancy. As PPD is one of the most common complications of childbirth, it is vital to identify best treatments for optimal maternal, infant, and family outcomes. New understanding of PPD pathophysiology and emerging therapeutics offer the potential for new ways to add to current medications, somatic treatments, and evidence-based psychotherapy. The benefits and potential harms of treatment, including during breastfeeding, are presented.


Assuntos
Antidepressivos/uso terapêutico , Depressão Pós-Parto/fisiopatologia , Depressão Pós-Parto/terapia , Psicoterapia/métodos , Adulto , Depressão Pós-Parto/epidemiologia , Feminino , Humanos , Incidência , Gravidez , Prognóstico , Medição de Risco , Índice de Gravidade de Doença , Resultado do Tratamento
17.
BMC Womens Health ; 19(1): 21, 2019 01 28.
Artigo em Inglês | MEDLINE | ID: mdl-30691431

RESUMO

BACKGROUND: British Pakistanis are one of the largest ethnic minority groups living in the UK, with high rates of maternal depression being reported in this population. Evidence suggests that culturally-adapted Cognitive Behavioural Therapy (CBT)-based interventions for depression, may improve clinical outcomes and patient satisfaction. This study was conducted to develop and test the feasibility and acceptability of a culturally-adapted, CBT-based, manual-assisted intervention in British Pakistani mothers experiencing maternal depression. METHODS: A mixed-method feasibility study that included qualitative interviews followed by the development of a CBT-based intervention for mothers with mild to moderate depression. Following the qualitative interviews, a CBT-based intervention called the Positive Health Program (PHP) was developed and delivered consisting of 12-weekly sessions. A before and after design was used to explore the feasibility and acceptability of the Positive Health Programme. RESULTS: A culturally-adapted CBT-based group intervention (PHP) was acceptable to this group and improvements were reported in depression and health-related quality of life. The women's understanding of 'depression' as a general consensus was in physical terms, but with an onset triggered by psychosocial causes. The most commonly reported factors contributing to depression were marital disharmony, lack of social support, and financial difficulties. Past help offered was primarily antidepressants, which were not welcomed by most of the women. A lack of availability of culturally sensitive interventions and the limited cultural sensitivity of NHS staff was also reported. CONCLUSION: This study provides preliminary evidence for the feasibility and acceptability of a CBT-based culturally-adapted group psychological intervention for British Pakistani mothers. TRIAL REGISTRATION: Study ethics registration number: 10/H1005/62 (University of Manchester).


Assuntos
Terapia Cognitivo-Comportamental/métodos , Depressão Pós-Parto/etnologia , Depressão Pós-Parto/terapia , Satisfação do Paciente/etnologia , Adulto , Características Culturais , Estudos de Viabilidade , Feminino , Promoção da Saúde , Humanos , Mães/psicologia , Paquistão , Psicoterapia de Grupo/métodos , Qualidade de Vida , Reino Unido
18.
BMC Psychiatry ; 19(1): 48, 2019 01 29.
Artigo em Inglês | MEDLINE | ID: mdl-30696418

RESUMO

INTRODUCTION: Parents are vulnerable to psychological distress symptoms in the postpartum period. It is routine to screen for depressive symptoms, but anxiety, stress, fatigue, irritability and insomnia symptoms are less often assessed despite their prevalence. This study aimed to assess multiple dimensions of psychological distress, and their reliable change and clinically significant change among women admitted to a residential program for assistance with unsettled infant behaviors (UIB). METHOD: Women admitted to a five-night residential early parenting program completed self-report measures: the Depression Anxiety Stress Scale, Irritability Depression Anxiety Scale, Fatigue Severity Scale, and Insomnia Severity Index. A sub-group completed a computerized emotional Go-NoGo (EGNG) task as a measure of emotional impulsivity. RESULTS: Seventy-eight women were recruited (Mage = 34.46, SDage = 4.16). On admission, 48% of women reported clinically elevated depressive symptoms and 97.5% of women not reporting elevated depressive symptoms reported clinical elevations in at least one other form of distress. Upon discharge, all self-report distress symptoms were significantly reduced (all p-values <.001), but reliable and clinically significant change only occurred in a subgroup of women. There were no significant changes in indicators of impulsivity based on the EGNG. CONCLUSIONS: In addition to, and often in the absence of, depressive symptoms, women attending an early parenting program experienced a wide range of psychological distress, including fatigue, insomnia, anxiety and stress. Different forms of distress improved in different magnitudes to the treatment provided. These findings highlight the need for a multi-dimensional approach in the assessment and treatment of postpartum distress.


Assuntos
Depressão Pós-Parto/psicologia , Depressão Pós-Parto/terapia , Educação não Profissionalizante/métodos , Poder Familiar/psicologia , Estresse Psicológico/psicologia , Estresse Psicológico/terapia , Adulto , Depressão Pós-Parto/epidemiologia , Feminino , Humanos , Lactente , Pacientes Internados/psicologia , Período Pós-Parto/psicologia , Prevalência , Distribuição Aleatória , Tratamento Domiciliar/métodos , Estresse Psicológico/epidemiologia , Vitória/epidemiologia
19.
Scand J Caring Sci ; 33(1): 85-92, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30112771

RESUMO

BACKGROUND: In most maternity wards in Norway, early discharge (<48 hour) is the norm. To monitor newborns' and women's health during the first week after delivery, most maternity wards offer early check-ups, where families return to the hospital (standard care). However, a few municipalities offer home visits by midwives (domiciliary care) to ensure seamless services for the family. AIM: The primary aim of this study was to explore whether different follow-up strategies were differently associated with maternal depression and breastfeeding habits, 6 weeks and 6 months postpartum. The secondary aim was to investigate whether families at risk of postpartum depression were included in the home visiting programme in the municipality that offered both follow-up strategies. METHOD: This study draws on data from the 'Little in Norway' (LIN) study, which followed families from pregnancy until the child was 18 months. This study used data from two different well-baby clinics in two municipalities, where one offered standard care (n = 95) and the other domiciliary (n = 64) and standard care (n = 17). The Edinburg Postnatal Depression Scale (EPDS) was used to measure maternal depression. Breastfeeding habits were measured using a self-report questionnaire. The Life Stress subscale of the Parenting Stress Index (PSI) was used to identify women at risk of postpartum depression. RESULTS: There were no differences in maternal depressive symptoms or breastfeeding habits at neither 6 weeks nor 6 months postpartum between women who received standard or domiciliary care in the two municipalities. Within the municipality that offered both follow-up strategies, a higher number of women scoring high on prenatal life stress were included in domiciliary - compared to standard care. CONCLUSION: Differential follow-up strategies in the first week after birth did not impact on maternal depression or breastfeeding habits. However, domiciliary care seems to be regarded as supportive and nonstigmatising for women at risk of postpartum depression.


Assuntos
Aleitamento Materno/psicologia , Aleitamento Materno/estatística & dados numéricos , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/terapia , Hospitalização/estatística & dados numéricos , Visita Domiciliar/estatística & dados numéricos , Mães/psicologia , Adulto , Feminino , Seguimentos , Humanos , Recém-Nascido , Noruega/epidemiologia , Alta do Paciente/estatística & dados numéricos
20.
Women Health ; 59(1): 1-12, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29281589

RESUMO

Attitudes toward seeking mental health treatment are a major predictor of seeking such treatment. Rates of seeking mental health treatment for postpartum depression are low despite contacts with health-care providers and available treatment. This study examined factors associated with four dimensions of attitude toward seeking mental health treatment among Israeli women in the postpartum period. Women (N = 1,059) were recruited (June 2008-February 2009) from a medical center's maternity department within the first two days following delivery and completed a sociodemographic survey and the Attitudes Toward Seeking Professional Psychological Help Scale. Low recognition of need for mental health treatment was associated with having a below average income and no personal and family depression history; low stigma tolerance was associated with being younger, having more children, and defining oneself as ultra-orthodox; low interpersonal openness was associated with having a below average income. Moreover, low confidence in mental health practitioners was associated with being younger and non-ultra-orthodox. Understanding which women are likely to score low on various dimensions of attitude can help target interventions for improving these factors, reducing barriers to receiving mental health treatment among specific groups of women. Research should continue to explore specific attitude dimensions among various populations.


Assuntos
Atitude do Pessoal de Saúde , Depressão Pós-Parto/etnologia , Conhecimentos, Atitudes e Prática em Saúde , Judeus/psicologia , Judaísmo , Mães/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Estigma Social , Adulto , Depressão Pós-Parto/psicologia , Depressão Pós-Parto/terapia , Feminino , Humanos , Israel , Mães/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Período Pós-Parto , Autoimagem , Percepção Social , Estereotipagem , Adulto Jovem
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