Archives of Women's Mental Health最新文献

Purpose: Pregnant and postpartum mothers with physical disabilities face discrimination in healthcare settings and high rates of maternal and obstetric complications, as well as having higher rates of lifetime depression prior to pregnancy, potentially increasing their likelihood of experiencing postpartum depression (PPD). Some studies have found higher rates of PPD in mothers with physical disabilities than in mothers without physical disabilities, with more disabling symptoms associated with worse PPD systems; however, the literature is sparse and heterogenous. This systematic review and meta-analysis advanced this area of study by evaluating the strength of the association between PPD and physical disability.

Methods: We searched PubMed and PsycInfo, with the primary inclusion criteria being that the studies had an established measure of depression in women during the postpartum period and either a cohort identified as having physical disability or an established measure of physical disability in a general population sample. We aggregated the prevalence of PPD in women with physical disabilities and tested the robustness of our findings to moderators, including region, sample population, and measure type.

Results: Findings from our quantitative meta-analysis (n=14) demonstrated a strong (d=.76, p<.0001) association between PPD and physical disabilities, such that individuals with physical disabilities reported more depression symptoms than individuals without physical disabilities. Moderator analyses were null, revealing that the association between PPD and physical disabilities was robust to several variables. Qualitative results support our conclusion that individuals with physical disabilities are at increased risk of PPD symptoms.

Conclusion: Our findings of a strong association between physical disability and PPD support the need for more research. Additional studies would 1) augment a nuanced understanding of how best to conceptualize PPD in women with physical disabilities and 2) facilitate testing the robustness of the association between PPD and physical disabilities to additional important moderators.

Purpose: Given the lack of available and effective interventions to address the detrimental consequences of perinatal exposure to intimate partner violence (IPV) on maternal mental health, and reported very low access to IPV-related mental health services in Mexico, we examined the feasibility and efficacy of a culturally adapted, virtual, brief group psychosocial intervention designed to improve maternal mental and physical health and reduce IPV revictimization for pregnant women exposed to IPV. In this pilot randomized controlled trial, we evaluated maternal outcomes after participation in the Pregnant Moms' Empowerment Program (PMEP) in Mexico.

Methods: Women were recruited from social service agencies and health centers in the community, as well as social media advertisements that targeted pregnant women living in Mexico. Women were randomized to receive the intervention (n = 43) or a control condition (i.e., referrals to local services; n = 47). Women completed questionnaires at baseline, post-intervention, and 3-months postpartum that assessed their exposure to IPV, depression, posttraumatic stress symptoms (PTSS), physical health symptoms, and resilience, as these were our primary outcomes of interest. Women in the intervention condition participated in ten, 60-minute virtual group sessions. Multilevel models were used to evaluate effects of treatment over time.

Results: On average, women in the intervention condition participated in six treatment sessions. Compared to the control group, intervention participants reported significantly fewer symptoms of depression at both the post-intervention and 3-month postpartum assessments (d = 0.64, d = 0.59, respectively) and fewer physical health symptoms at the post-intervention assessment (d = 0.77). Trend-level improvements in PTSS scores for post-intervention (d = 0.56) and 3-months postpartum (d = 0.56), as well as physical health at 3-months postpartum (d = 0.59), were also observed. There were no group differences in exposure to IPV over time.

Conclusion: The current study adds to the evidence base for the PMEP intervention while also expanding it to a new cultural context by suggesting promise of its clinical utility in targeting Mexican women's perinatal depression, PTSS, and physical health symptoms.

Purpose: Psychosocial risk factors are frequently present in pregnant women and are associated with adverse maternal and neonatal outcomes. Professional guidelines recommend early detection of vulnerability and provision of multidisciplinary care, including an integrated care plan for pregnant women with social factors, such as residing in deprived areas, teenage pregnancy, and psychiatric illness. However, to date, such approach is impeded by lack of data on co-occurrence of vulnerability. Therefore, we aim to describe co-occurrence of psychiatric illness, social factors or substance use during pregnancy.

Methods: A retrospective cohort study of 1002 pregnant women referred for evaluation by a multidisciplinary team because of psychiatric illness, social factors or substance use in a university hospital in a large city in the Netherlands. Data from medical charts between January 2017 and May 2022 were extracted and analyzed by univariate and bivariate analysis.

Results: Multi-domain vulnerability was present in 83% of women and most frequently involved the following patterns: psychiatric illness with social factors and chronic physical illness (24%), psychiatric illness with social factors (14%), social factors with chronic physical illness (13%) and psychiatric illness with chronic physical illness (12%). Single-domain vulnerability was present in 17% of women, involving most frequently social factors (9%) and psychiatric illness (8%).

Conclusion: The majority of women with psychiatric illness, social factors or substance use have multi-domain vulnerability. There is a need for a novel approach to care to address vulnerability in pregnant women.

Purpose: There is limited high-quality evidence about perinatal mental health among women with gestational diabetes. We aimed to assess the risks and longitudinal changes in anxiety, depression, and health-related quality of life comparing women with gestational diabetes and those without among a contemporary cohort of pregnant women.

Methods: Prospective cohort study of participants in the GEMS Trial. Women with a singleton pregnancy were eligible if they had a 75-g diagnostic oral glucose-tolerance test between 24 and 32 weeks' gestation, provided written informed consent, and completed questionnaires about anxiety, depression, and health-related quality of life at the study time points.

Results: There were no differences in risk for anxiety (RR 1.13, 95% CI 0.86, 1.49; p = 0.39) or depression (RR 1.08, 95% CI 0.78, 1.50; p = 0.64) between the two groups at 36 weeks' gestation or 6 months postpartum [anxiety: (RR 1.21, 95% CI 0.90, 1.63; p = 0.21); depression: (RR 0.84, 95% CI 0.55, 1.28; p = 0.43]. However, at 36 weeks' gestation participants with gestational diabetes reported better physical functioning, and at 6 months postpartum, better mental functioning (mean difference (MD) in scores 1.28, 95% CI 0.25, 2.30; p = 0.01) although worse physical functioning (MD -2.99, 95% CI -3.90, -2.07; p = < 0.001) compared to participants without.

Conclusion: The risk for poor mental health during the perinatal period does not differ importantly among women diagnosed and treated for gestational diabetes compared to the general pregnant population.

Purpose: Infertility is common and an increasing number of women go through medically assisted reproduction (fertility treatment) to achieve pregnancy. This may affect mental health. We examined if fertility treatment and the specific fertility treatment method used (in vivo or in vitro) were associated with impaired mental health during or after pregnancy.

Methods: Using self-reported data from the Odense Child Cohort, we assessed prenatal stress by the 10-item Cohen Perceived Stress Scale (PSS-10) during pregnancy at median gestational week 27 and postnatal depressive symptoms by the Edinburgh Postnatal Depression Scale (EPDS) at median postpartum week 15. We compared fertility-treated women overall and by fertility treatment method to women who conceived spontaneously. We conducted linear regression analyses to evaluate the PSS-10 score dimensionally and logistic regression to evaluate EPDS scores above cut-off (≥ 11).

Results: A total of 108 of 820 women (13%) gave birth after fertility treatment. Their prenatal mean stress (PSS-10) score was 11.38 compared to 11.78 for women who conceived spontaneously, leading to an adjusted mean difference of -0.09 points (95% confidence interval (CI): -1.88 to 1.69). In the fertility-treated group, 9.7% had EPDS scores ≥ 11 compared to 10.7% in the spontaneous conception group (adjusted odds ratio of 0.71 (95% CI: 0.26 to 1.91)). The MAR method (in vivo/vitro) did not influence these results.

Conclusion: Women who gave birth after fertility treatment did not report higher levels of prenatal stress or postpartum depressive symptoms than women who conceived spontaneously.

Purpose: The purpose of this study is to investigate the impact of the employment situation on the anxiety levels and research self-efficacy of graduate students, with a particular focus on female graduate students. The study aims to understand how the use of AIGC tools, which has become more frequent among those with lower research self-efficacy, affects anxiety and research resilience. Additionally, the research explores the role of the mentoring relationship in influencing the psychological and academic experiences of female graduate students.

Method: The research involved 1164 female master's and doctoral students and employed a moderated chain mediation model. This model was constructed based on social cognitive theory and Habermas interaction theory to analyze the relationships between research self-efficacy, mobile phone dependence, anxiety, and research resilience. Data was collected and empirically analyzed using SPSS 26.0, a statistical software, to examine the proposed relationships and the moderating effect of the mentoring relationship.

Result: The findings revealed that scientific research self-efficacy positively influences research resilience among female graduate students. Additionally, mobile phone dependence and anxiety were found to play a chain mediating role between self-efficacy and research resilience. The study also discovered that the mentoring relationship negatively moderated the effects of mobile phone dependence and anxiety on these students.

Conclusion: Based on the results, the study concludes that mentors and academic administrators should consider the research capabilities and interests of students when assigning research tasks. It is recommended to establish a flight instructor mentorship system that maximizes the strengths of each mentor to support students, especially those with suboptimal mentor-mentee relationships. This approach could help in providing positive guidance and improving the research resilience of female graduate students who are more susceptible to anxiety and mobile phone dependence.

Purpose: This study investigated whether maternal antenatal attachment (MAA) in the third trimester was associated with self-reported problematic infant crying at eight weeks postnatally and explored links with postnatal depressive symptoms.

Methods: A prospective cohort study was conducted with 1287 pregnant participants in Danish general practice. MAA was measured using the Maternal Antenatal Attachment Scale (MAAS) in the third trimester. Both postnatal depressive symptoms and infant crying problems were assessed eight weeks postnatally, using the Edinburgh Postnatal Depression Scale (EPDS) and maternal reports, respectively.

Results: Low MAAS quality scores in the third trimester were initially associated with a 51% increased risk of reporting problematic infant crying at eight weeks, but this effect disappeared after adjusting for physical and mental health variables (e.g., chronic disease, anxiety, and depression symptoms) during pregnancy. No significant effects were found for MAAS intensity or total score. Low MAAS quality and overall MAAS scores were associated with an increased risk of scoring above cutoff on the EPDS. High levels of postnatal depressive symptoms at eight weeks significantly increased the likelihood of reporting problematic infant crying. Low MAAS scores combined with high levels of postnatal depressive symptoms did not increase the risk of problematic infant crying compared to low levels of depressive symptoms with low MAAS scores.

Conclusions: Our findings highlight the importance of considering maternal mental health when parents report infant crying problems postnatally. Furthermore, our results demonstrate that poor MAA in pregnancy is not necessarily linked with parental report of problematic infant crying after birth.

Purpose: Although many women experience obsessive-compulsive symptoms during the perinatal period, the Yale-Brown Obsessive Compulsive Scale (YBOCS) has not yet been psychometrically evaluated in this population. This study examined the internal consistency, convergent and divergent validity, and factor structure of the YBOCS among pregnant women.

Methods: 256 Women who were 20 to 24 weeks pregnant completed the clinician-administered YBOCS and Mini International Neuropsychiatric Interview (MINI) along with a series of self-report questionnaires including the Edinburgh Postnatal Depression Scale (EPDS), Perinatal Anxiety Screening Scale (PASS) and Obsessive-Compulsive Inventory-Revised (OCI-R).

Results: Internal consistency of the YBOCS was excellent, and there were strong inter-scale correlations between the YBOCS Total Score, YBOCS Obsessions and Compulsions Severity Scales. The YBOCS demonstrated good known-groups validity differentiating women with and without OCD. Convergent validity with the OCI-R was demonstrated while relations with divergent validity were more mixed.

Conclusion: The YBOCS possesses strong psychometric properties in pregnant women.