Archives of Women's Mental Health最新文献

Purpose

Males and females with First Episode Psychosis (FEP) usually tend to differ in psychopathology, clinical presentation and their longitudinal trajectory. This study aimed to examine the difference of effectiveness of specialized psychosocial and pharmacological treatments for FEP, focusing on various clinical and functioning outcomes across a 2-years follow-up period.

Methods

The assessment included the CAARMS, the HoNOS, the PANSS and the GAF scale and was conducted at baseline and every 12 months.

Results

490 FEP patients (age: 12–35 years) were recruited. Of them, 363 completed the follow-up (132 females and 231 males). At baseline, males showed a higher prevalence rate of schizophrenia diagnosis (56.1% VS 43.8%; p = .008), whereas females a higher prevalence rate of affective psychosis (36.2% VS 23.3%; p = .005). Male participants also showed a more consistent substance abuse (46.9% VS 24.3%; p = .0001), lower years of education (11.26 ± 2.94 VS 11.88 ± 2.68; p = .013), and more striking behavioral manifestations (4.06 ± 2.36 VS 3.39 ± 2.58; p = .003) compared to women. Our 2-year outcome parameter results showed a higher incidence of functional remission over time in females compared to males (49.2% VS 39.0%; p = .028), together with a decreasing trend in new hospitalization rates (17.8% VS 26.9%; p = .089). Independently from sex, our results also showed a statistically significant reduction in the prescription of psychotropic medications and through the increase of all psychosocial interventions, although more evident in males.

Conclusion

These results suggested that specialized interventions for FEP are overall effective in both treated subgroups. Additionally, FEP women specifically showed higher rates of improvement in functional outcome variables over time when compared to males.

Purpose

The prevalence of depression is higher in women than in men. This may be because women are more prone to rumination. However, there is a lack of evidence about which rumination symptoms are most strongly associated with depression in women. According to the network theory of mental disorders, the complex interaction between different subtypes of rumination and depressive symptoms is confusing. We utilized the network analysis method to examine the connection between different subtypes of rumination and depressive symptoms across different gender groups and to investigate gender differences in rumination-depression networks.

Methods

798 Chinese university students (50.5% males and 49.5% females) completed The Rumination Response Scale (RRS) and The Beck Depression Inventory-Second Edition (BDI-II) scales via an online survey platform for this study. The networks were analyzed and built with scale dimensions as nodes.

Results

The line graph indicates that the B (Brooding) and N (Negative attitude) nodes had the highest BEI values in the female group, whereas the R (Reflection) and N nodes had the highest BEI values in the male group.

Conclusion

The findings revealed that males and females in the rumination-depression network had distinct rumination bridge nodes (male: Reflection; female: Brooding) but had a common depression bridge node (Negative attitude). The connection between different types of rumination and depressive symptoms was more pronounced in the female network. The findings enhance comprehension of gender disparities in the co-occurrence of rumination and depression, offering specific subtypes for targeted intervention in rumination.

Purpose

This study aimed to investigate the prevalence, determinants, and care-seeking practices for anxiety and depression among reproductive-aged women in Bangladesh.

Methods

We utilized data from the 2022 Bangladesh Demographic and Health Survey, with a total weighted sample of 20,029 women aged 15–49. Anxiety and depression symptoms were assessed using the Generalized Anxiety Disorder-7 (GAD-7) scale and the Patient Health Questionnaire (PHQ-9) scale, respectively. Prevalence was reported with 95% confidence intervals (CI). Multiple logistic regression was conducted to identify associated factors, and the results were presented as adjusted odds ratios (AOR) with 95% CI.

Results

Among women, 4% (95% CI: 3.9%, 4.9%) had symptoms of moderate to severe anxiety, and 5% had moderate to severe depression. The prevalence of both symptoms was significantly higher (p < 0.05) in Khulna, Rangpur, and Sylhet. Older women (45–49 years) (anxiety: AOR: 2.33, 95% CI: 1.55, 3.50; depression: AOR: 1.63, 95% CI: 1.15, 2.31) and women who made all major household decisions (anxiety: AOR: 1.30, 95% CI: 1.00, 1.69; depression: AOR: 1.41, 95% CI: 1.07, 1.80) were more likely to experience moderate to severe anxiety and depression. Among women with symptoms of moderate to severe anxiety or depression, 22% (95% CI: 19.9%, 25.0%) sought care, and 8% (95% CI: 6.6%, 10.1%) used medication.

Conclusion

The findings highlight a significant burden of anxiety and depression among women in Bangladesh, with notable regional disparities. These insights underscore the need for targeted interventions to address regional disparities, support vulnerable groups such as older women and those involved in household decision-making, and integrate mental health services into primary healthcare for better mental well-being among women in Bangladesh.

Article highlights

• In Bangladesh, 4% and 5% of reproductive-aged women experienced moderate to severe symptoms of anxiety and depression respectively.

• Highest prevalence of anxiety and depression was in Khulna, Rangpur, and Sylhet.

• Women with older age and higher decision-making autonomy are associated with anxiety and depression.

• 22% of women with symptoms of anxiety and depression sought care from a healthcare provider and 8% took medication.

Purpose

Perinatal mood and anxiety disorders (PMADs) include depressive and anxiety disorders during pregnancy or postpartum and can have significant consequences for the parent, child, and family. When severe, these conditions can lead to suicide. Despite numerous policy efforts to improve screening, education, and referral structures, disparities in PMAD diagnosis and treatment still exists, particularly among racial and ethnic minorities. Computer Adaptive Testing (CAT) has been shown to improve the efficiency of screening by significantly reducing test length. This study evaluates whether applying CAT to the Edinburgh Postnatal Depression Scale (EPDS) maintains diagnostic accuracy while ensuring these methods do not exacerbate racial disparities in PMAD screening outcomes.

Methods

Using real data simulation, we assessed three CAT-based short-form versions of the EPDS, derived from one-, two-, and three-factor item response theory models. We evaluated their diagnostic precision and examined potential racial disparities in false negative rates compared to the full-length EPDS.

Results

We demonstrate that estimated scores from three short versions of the EPDS administered through CAT—assuming one, two, and three-factor item response theory models—are more highly correlated with the full-length EPDS measure traditionally used to make clinical decisions (r’s between 0.96 and 0.97) than the major depressive disorder subtest (CAT-MDD) from CAT-Mental Health (CAT-MH^®) (r =.82), as previously reported. Importantly, the false negative rates of the CAT-implied diagnoses did not significantly vary between racial groups, indicating no evidence of racial bias in diagnostic accuracy.

Conclusion

The CAT-based versions of the EPDS offers a promising solution for improving the efficiency of PMAD screening without sacrificing diagnostic precision or exacerbating racial groups. By reducing evaluation time, these tools could facilitate more widespread and equitable screening, enabling earlier diagnosis and treatment of PMADs across diverse populations.

Purpose

Mother-Infant Interaction (MII) is the first dynamic relationship that focuses on both mother-infant involvement and dyadic coordination and is associated with infant development. The main objective of this review is to summarize the evidence on the quality of MII in mothers with Severe Mental Illness (SMI).

Method

A systematic search for cross sectional, cohort or case control studies has been carried out in PubMed, Web of Science, PsycINFO and Scopus to extract studies addressing the relationship between the quality of MII and SMI.

Results

A total of 15 studies with a sample of 992 women were included. Studies showed worst outcomes for MII in mothers with psychotic disorder and bipolar disorder. The impairments were more pronounced in psychotic disorders.

Conclusions

There is evidence of impaired MII in SMI. Social cognition (SC) is essential for understanding and responding to infant cues, so it could partially explain the associations between SMI and interaction outcomes. The current evidence is limited due to substantial heterogeneity and methodological limitations in the studies. Therefore, such findings should be interpreted with caution.

Purpose

This study aimed to investigate the correlation between prenatal smoking and postpartum depression (PPD) in order to determine if smoking cigarettes is associated with an increased risk of PPD, a prevalent emotional distress in women across various cultures.

Methods

A systematic review was conducted to find suitable literature following PRISMA guidelines. Authors searched PubMed and Web of Science databases using specific search terms related to depression and smoking. Articles published in English between November 2019 and November 2023 were screened. Titles and abstracts were reviewed for relevance, and eligible papers underwent detailed full-text analysis.

Results

334 records were screened, of which 32 met the eligibility criteria, and 10 were included in this review.

Conclusion

Our review provides proof that smoking before and during pregnancy increases the risk of postpartum depression, especially for women who smoke heavily. A more detailed examination of the specific mechanisms linking smoking to postpartum depression is essential and could be a crucial topic for future research.

Article Highlights

This study highlights the importance of addressing smoking cessation interventions for pregnant women to potentially reduce the incidence of PPD.

Purpose

Maternal filicide is a deeply distressing and potentially preventable phenomenon that demands priority attention. This study aims toshed light on the psychological, social and systemic factors contributing to maternal filicide. It calls for robust early intervention strategies and the establishment of comprehensive mental health support systems to mitigate the risk and prevent the occurence of such tragedies..

Methods

A detailed evaluation of a mother who committed filicide was undertaken The assessments included in-depth psychiatric evaluations, interviews with family members, review of the individual's medical history, prior social circumstances, and existing legal records. This comprehensive approach allowed for the identification of potential warning signs and gaps in intervention. Additionally, a review of existing literature and national frameworks related to maternal mental health was undertaken to contextualize the findings within the broader socio-cultural and healthcare landscape of India.

Results

The case highlights a complex interplay of untreated mental health disorders, social stigma, lack of accessible mental health services, and a failure to recognize warning signs by family members and professionals. The analysis reveals missed opportunities for intervention that might have prevented the act of filicide. Key contributing factors included postpartum mental health issues, socio-economic stressors, and inadequate social and legal support for the mother. This case underscores the need for systemic changes, including improved mental health screening during the perinatal period and the establishment of crisis intervention services.

Conclusion

Maternal filicide is not solely a legal issue but also a multifaceted public health and social problem that warrants a multidisciplinary response. The findings emphasize the need for an integrated approach involving healthcare professionals, social workers, and law enforcement agencies to address the mental health challenges faced by mothers in distress. Early identification of at-risk individuals, destigmatization of mental health care, and the provision of timely interventions are pivotal in preventing such tragedies. This study underscores the urgency of implementing mental health policies that prioritize maternal mental health, enhance public awareness, and ensure the availability of accessible, culturally sensitive support systems for at-risk families.