Archives of Women's Mental Health最新文献

Purpose

Women in Mozambique are noted to be at heightened risk of poor mental health. Yet, studies have not examined how their experiences of Intimate Partner Violence (IPV) may be associated with mental health outcomes. Our study, therefore, aimed to examine the association between probable depression and symptoms of anxiety with women’s experiences of IPV in Mozambique.

Methods

We used nationally representative data from the 2022-23 Mozambique Demographic and Health Survey. Using STATA 17, we applied logistic regression analysis to our analytical sample of 4,454 ever-married women aged 15 to 49 who answered questions related to their experience of emotional, sexual, and physical IPV.

Results

The prevalence of probable depression and symptoms of anxiety were 12% and 13%, respectively. Compared to women who have never experienced any form of IPV, those who had been victims of physical IPV (OR = 2.27, 95% CI = 1.59, 3.23; OR = 2.60, 95% CI = 1.88, 3.58), sexual IPV (OR = 2.38, 95% CI = 1.48, 3.80; OR = 2.16, 95% CI = 1.37, 3.43) and emotional IPV (OR = 3.27, 95% CI = 2.41, 4.44; OR = 3.90, 95% CI = 2.87, 5.29) were all more likely to report depression and symptoms of anxiety, respectively. In addition, we also found the protective effect of higher household wealth and employment against the risk of depression and anxiety among women. Finally, we observed that religious affiliation is associated with depression and anxiety.

Conclusions

We suggest the urgent need to strategize and design a holistic mental health policy in Mozambique which prioritizes eradicating IPV among women. Increasing public awareness about the devastating impact of IPV on women while strengthening the laws that criminalize it will be helpful in this regard.

Purpose

To evaluate the quality of life (QOL) of postmenopausal women during the COVID-19 pandemic in Thailand and the associated factors.

Methods

A cross-sectional study using a validated Thai version of the WHOQOL-BREF questionnaire to assess QOL was conducted.

Results

A total of 453 postmenopausal women participated in the study, with a median age of 58 years (ranging from 41 to 65). These women, residing in urban areas of Thailand such as Bangkok, Nonthaburi, Nakhon Pathom, Pathum Thani, Samut Prakan, and Samut Sakhon, completed a survey questionnaire with the assistance of health volunteers during the COVID-19 pandemic, between October 2021 and April 2022. The study revealed that 55.85% of participants reported experiencing poor quality of life (QOL) during the pandemic. Stepwise logistic regression analysis identified several significant associations with QOL. Factors linked to a poorer QOL included lower levels of well-being index (odds ratio [OR] 7.89, 95% confidence interval [CI] 3.16–19.75, P < 0.01), reduced physical activity (OR 2.72, 95% CI 1.62–4.54, P < 0.01), and the severity of menopausal symptoms (OR 1.94, 95% CI 1.42–2.66, P < 0.01). Conversely, higher education (OR 0.28, 95% CI 0.10–0.75, P < 0.01), an earlier onset of menopause (OR 0.55, 95% CI 0.39–0.78, P < 0.01), and occasional social alcohol consumption (OR 0.56, 95% CI 0.33–0.94, P = 0.03) were identified as protective factors for QOL.

Conclusion

These findings highlight the importance of comprehensive menopausal care, addressing both physical and mental well-being, and providing specific care for menopausal symptoms during challenging times of the COVID-19 pandemic.

Background

Age at menarche may influence the onset of depression later in life. We aim to assess the association between early/late menarche and depressive outcomes in females by updating a systematic review and meta-analysis.

Methods

The search of the original systematic review was updated for studies published in PubMed, Embase, and Cochrane Library from 2013 to 2023. The early/late and on-time menarche divisions were generally based on each study. Depression or depressive symptoms could be measured through various validated tools and diagnostic criteria. We assessed the quality of the evidence using the GRADE approach and performed a random-effect meta-analysis with age at menarche and the cases of depression as outcomes.

Results

We included eight cohort and three cross-sectional studies (138,819 participants). Females with early menarche were more likely to have depression later in life compared with those who had on-time menarche (early vs. on-time menarche: odds ratio (OR) = 1.11; 95% confidence interval (CI): 1.03, 1.20; I² = 44.5%). We found a null association between late menarche and depression for females (late vs. on-time menarche: odds ratio (OR) = 1.00; 95% confidence interval (CI): 0.87, 1.15; I² = 73.2%). Sensitivity analyses showed that the results were robust. The quality of the available evidence was rated as very low.

Conclusions

Existing evidence suggests that early menarche may be associated with an increased risk of depression in females. But it remains unclear about late menarche. More high-quality studies are warranted.

Purpose

The objective of this study was to determine the independent effects of maternal mental health difficulties (MHD) during the preconception, prenatal, and postnatal periods on well-baby visit (WBV) attendance in a population-wide sample through retrospective analysis of Pregnancy Risk Assessment Monitoring System (PRAMS) data.

Methods

This secondary analysis utilized data from the 2016 − 2021 New Jersey PRAMS, yielding 6,699 participants (mean age = 30.8 years). Survey-weighted means, confidence intervals, and percentages were used to describe sociodemographic, mental health, and WBV variables across all participants. Logistic regression with complex survey weights and multiple imputation of missing data was implemented to test associations between sociodemographic factors, maternal MHDs, and WBV attendance.

Results

The weighted prevalence of missing the 1-week checkup or having never attended a WBV during the first six months postpartum was 4.3% (95% CI: 3.8% − 5.0%; n = 260) and 1.4% (1.1% − 2.0%; n = 98), respectively. Preconception depression (n = 553; 7.7%, 7.0% − 8.0%), prenatal depression (n = 481; 6.5%, 5.9% − 7.0%;), preconception anxiety (n = 1,007; 15.2%, 14.2% − 16.0%), and prenatal anxiety (n = 570; 8.44%, 7.7% − 9.0%) were not associated with 1-week checkup attendance. However, women with preconception depression were more than twice as likely to have never attended a WBV (OR = 2.43, 1.01 − 5.82). Multiple social determinants and demographic variables were associated with greater odds of missing WBVs, including middle household income, receiving government-issued health insurance or being uninsured, Hispanic ethnicity, and Spanish as a primary language.

Conclusions

Preconception depression, middle household income, receiving government-issued health insurance, being uninsured, Hispanic ethnicity, and Spanish as a primary language may decrease attendance of WBVs, and the mediating role of preconception depression in infant health outcomes warrants further investigation.

This manuscript highlights the mental health challenges faced by pregnant women in Gaza amidst ongoing conflict and a collapsing healthcare system. Limited access to prenatal care and psychological support and the destruction of healthcare infrastructure has worsened mental health issues like anxiety and depression. Pregnant women in Gaza are at higher risk of miscarriage, stillbirth, and birth defects, further impacting their mental well-being. This study calls for urgent interventions, including vaccination, nutrition campaigns, and improved sanitation to control infectious diseases. It emphasizes the need for 24-hour mental health centers and trained professionals to provide care. Additionally, digital health solutions such as telemedicine and Geographic Information Systems (GIS) can be crucial in diagnosing and managing health conditions in conflict zones.

Background

Depression during pregnancy and postpartum can severely impact psychological and physical well-being, with significant consequences for the child and family. This systematic review and meta-analysis aimed to evaluate the effectiveness of online interventions during pregnancy in reducing postpartum depressive symptoms and enhancing well-being.

Methods

Randomized controlled trials (RCTs) published in English involving pregnant women over 18 years old who participated in online interventions, with or without the support of a health worker, were included. Studies were required to use validated measures for depression and well-being assessed during pregnancy and postpartum. Exclusion criteria comprised literature reviews, meta-analyses, theses, self-help groups and assessment of symptomatology during the period concurrent with maternity blues. A search was conducted using PubMed and EBSCOhost databases, concluding on July 29, 2024. The risk of bias was assessed using RoB 2.

Results

Eighteen studies with a total of 9,565 participants met the inclusion criteria. Of these, 38.8% involved clinical populations. Variability was noted in theoretical models, gestational age, professional involvement, and intervention activities. The overall effect size was significant (Cohen’s d = 0.37; 95% CI: 0.08 to 0.66; p = 0.0114) with greater efficacy observed in studies using treatment as usual (TAU) as a control and those incorporating relaxation and physical activity.

Discussion

Limitations include the absence of standardized protocols and uncertainties regarding long-term efficacy. Although the findings suggest potential effectiveness of online interventions in reducing depressive symptoms, further research is required to address gaps in the existing evidence.

Other

The study received no funding and was registered in PROSPERO (CRD42023420999).

Purpose

Women with a history of sexual trauma (ST) have heightened risk for postpartum psychopathology. Although ST increases risk for traumatic delivery and maternal psychopathology, knowledge of the functional connections among various psychiatric symptoms and complicated delivery remains limited.

Methods

We used regularized partial correlation networks to examine connections between symptoms of childbirth-related PTSD (CB-PTSD), depression, anxiety, somatization, obsessive-compulsive disorder, and complicated delivery (e.g., presence of obstetric complications, preterm birth, advanced maternal age) in 1,916 postpartum women. We compared networks of women with and without a history of sexual trauma (n_ST = 958 and n_NST = 958, respectively).

Results

Complicated delivery in both groups connected with three CB-PTSD clusters: reexperiencing, avoidance, and negative alterations in cognition and mood. Network comparison tests revealed a significant difference in global strength invariance, but not network invariance. ST network CB-PTSD nodes were significantly more strongly interconnected as compared to those with no ST (NST). Conversely, stronger connections in the NST network were Mood with Anxiety and Avoidance with Somatic symptoms.

Conclusion

The ST group’s stronger PTSD symptom coactivation may reflect differences in risk for the emergence of CB-PTSD for women with a history of ST.