scholarly journals A comparison of depression and anxiety symptom trajectories between women who had an abortion and women denied one

2015 ◽  
Vol 45 (10) ◽  
pp. 2073-2082 ◽  
Author(s):  
D. G. Foster ◽  
J. R. Steinberg ◽  
S. C. M. Roberts ◽  
J. Neuhaus ◽  
M. A. Biggs

BackgroundThis study prospectively assesses the mental health outcomes among women seeking abortions, by comparing women having later abortions with women denied abortions, up to 2 years post-abortion seeking.MethodWe present the first 2 years of a 5-year telephone interview study that is following 956 women who sought an abortion from 30 facilities throughout the USA. We use adjusted linear mixed-effects regression analyses to assess whether symptoms of depression and anxiety, as measured by the Brief Symptom Inventory-short form and the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire, differ over time among women denied an abortion due to advanced gestational age, compared with women who received abortions.ResultsBaseline predicted mean depressive symptom scores for women denied abortion (3.07) were similar to women receiving an abortion just below the gestational limit (2.86). Depressive symptoms declined over time, with no difference between groups. Initial predicted mean anxiety symptoms were higher among women denied care (2.59) than among women who had an abortion just below the gestational limit (1.91). Anxiety levels in the two groups declined and converged after 1 year.ConclusionsWomen who received an abortion had similar or lower levels of depression and anxiety than women denied an abortion. Our findings do not support the notion that abortion is a cause of mental health problems.

2021 ◽  
Author(s):  
Shelby L. Levine ◽  
Nassim Tabri ◽  
Marina Milyavskaya

Little is known about how mental health symptoms develop during the transition to university. Most anxiety and depression research fail to consider how symptom development differs over time across different individuals, and how symptom co-occurrence influences the severity of mental heath problems. Students (N = 658) completed online surveys on mental health prior to starting university and every 2 months until April. To better understand mental health problems during this transitional period, latent class growth curve analyses were run to determine how anxiety and depressive symptoms co-develop over time, as well, if self-critical perfectionism was a transdiagnostic risk factor for more severe symptom trajectories in this transition. About 40% of students experienced depression and anxiety symptoms prior to entering/ during the transition to university. There is substantial variation between students in terms of how they experience depression and anxiety symptoms, and research needs to take this heterogeneity into account to properly identify which students might benefit most from resources. Self-critical perfectionism was a transdiagnostic risk factor, such that students higher in this trait experienced more severe anxiety and depressive symptom trajectories during this transition. This research further implicates the importance of understanding and studying individual differences in symptom development.


2021 ◽  
pp. 1-12
Author(s):  
Shelby L. Levine ◽  
Nassim Tabri ◽  
Marina Milyavskaya

Abstract Little is known about how mental health symptoms develop during the transition to university. Most anxiety and depression research fails to consider how symptom development differs over time across different individuals, and how symptom co-occurrence influences the severity of mental health problems. Students (N = 658) completed online surveys on mental health prior to starting university and every 2 months until April. To better understand mental health problems during this transitional period, latent class growth curve analyses were run to determine how anxiety and depressive symptoms co-develop over time, as well, if self-critical perfectionism was a transdiagnostic risk factor for more severe symptom trajectories in this transition. About 40% of students experienced depression and anxiety symptoms prior to entering/during the transition to university. There is substantial variation between students in terms of how they experience depression and anxiety symptoms, and research needs to take this heterogeneity into account to properly identify which students might benefit most from resources. Self-critical perfectionism was a transdiagnostic risk factor, such that students higher in this trait experienced more severe anxiety and depressive symptom trajectories during this transition. This research further implicates the importance of understanding and studying individual differences in symptom development.


10.2196/14284 ◽  
2019 ◽  
Vol 7 (8) ◽  
pp. e14284 ◽  
Author(s):  
Marcos Economides ◽  
Kristian Ranta ◽  
Albert Nazander ◽  
Outi Hilgert ◽  
Philippe R Goldin ◽  
...  

Background Depression is one of the most common mental health disorders and severely impacts one’s physical, psychological, and social functioning. To address access barriers to care, we developed Ascend—a smartphone-delivered, therapist-supported, 8-week intervention based on several evidence-based psychological treatments for depression and anxiety. A previous feasibility study with 102 adults with elevated depression reported that Ascend is associated with a postintervention reduction in depression symptoms. Objective We aimed to examine whether Ascend is associated with a reduction in symptoms of anxiety, and importantly, whether reductions in symptoms of depression and anxiety are maintained up to 12-months postintervention. Methods We assessed whether the previously reported, end-of-treatment improvements seen in the 102 adults with elevated symptoms of depression extended up to 12 months posttreatment for depression symptoms (measured by the Patient Health Questionnaire-9 [PHQ-9]) and up to 6 months posttreatment for anxiety symptoms (added to the intervention later and measured using the Generalized Anxiety Disorder-7 [GAD-7] scale). We used linear mixed effects models with Tukey contrasts to compare time points and reported intention-to-treat statistics with a sensitivity analysis. Results The intervention was associated with reductions in symptoms of depression that were maintained 12 months after the program (6.67-point reduction in PHQ-9 score, 95% CI 5.59-7.75; P<.001; Hedges g=1.14, 95% CI 0.78-1.49). A total of 60% of the participants with PHQ-9 scores above the cutoff for major depression at baseline (PHQ≥10) reported clinically significant improvement at the 12-month follow-up (at least 50% reduction in PHQ-9 score and postprogram score <10). Participants also reported reductions in symptoms of anxiety that were maintained for at least 6 months after the program (4.26-point reduction in GAD-7 score, 95% CI 3.14-5.38; P<.001; Hedges g=0.91, 95% CI 0.54-1.28). Conclusions There is limited evidence on whether outcomes associated with smartphone-based interventions for common mental health problems are maintained posttreatment. Participants who enrolled in Ascend experienced clinically significant reductions in symptoms of depression and anxiety that were maintained for up to 1 year and 6 months after the intervention, respectively. Future randomized trials are warranted to test Ascend as a scalable solution to the treatment of depression and anxiety.


BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e042696
Author(s):  
Karin Hammarberg ◽  
Thach Tran ◽  
Maggie Kirkman ◽  
Jane Fisher

ObjectivesTo identify sex and age differences in clinically significant symptoms of depression and anxiety and the factors associated with these differences among adults in Australia during COVID-19-related restrictions.DesignAnonymous online survey.SettingAustralia.ParticipantsAdults aged over 18 years living in Australia were eligible and 13 829 contributed complete data. Of these, 13 762 identified as female (10 434) or male (3328) and were included in analyses.InterventionsNone.Outcome measuresClinically significant symptoms of depression (≥10 on Patient Health Questionnaire 9) or anxiety (≥10 on Generalized Anxiety Disorder Scale 7 (GAD-7)), and experiences of irritability (GAD-7 item 6).ResultsWomen were more likely than men to have clinically significant symptoms of depression (26.3% (95% CI 25.4 to 27.1) vs 20.1% (95% CI 18.7 to 21.5), p<0.001) and anxiety (21.8% (95% CI 21.0 to 22.6) vs 14.2% (95% CI 13.0 to 15.4), p<0.001) and to have experienced irritability in the previous fortnight (63.1% (95% CI 62.1 to 64.0) vs 51.4% (95% CI 49.7 to 53.2), p<0.001). They were also more likely than men to be doing unpaid work caring for children (22.8% (95% CI 22.0 to 23.6) vs 8.6% (95% CI 7.7 to 9.6), p<0.001) and dependent relatives (9.8% (95% CI 9.2 to 10.3) vs 5.7% (95% CI 4.9 to 6.5), p<0.001) which made significant contributions to the mental health outcomes of interest. Loss of employment, fear of contracting COVID-19 and feeling a severe impact of the restrictions were associated with poorer mental health in women and men of all ages.ConclusionsRates of clinically significant symptoms of depression and anxiety were higher among women than men. Rather than being intrinsically more vulnerable to mental health problems during the COVID-19 pandemic, the higher risk of symptoms of anxiety and depression among women may in part be explained by their disproportionate burden of unpaid caregiving.


2021 ◽  
Author(s):  
Jack L Andrews ◽  
Meiwei Li ◽  
Savannah Minihan ◽  
Annabel Songco ◽  
Elaine Fox ◽  
...  

Individuals vary in their ability to tolerate uncertainty. High intolerance of uncertainty is a known risk factor for mental health problems. In the current study we examined the degree to which intolerance of uncertainty predicted depression and anxiety symptoms and their interrelations across the first year of the COVID-19 pandemic. We examined these associations across three time points (May 2020 – April 2021) in an international sample of adults (N = 2087, Mean age = 41.13) from three countries (UK, USA, Australia) with varying degrees of COVID-19 risk. We found that individuals with high and moderate levels of intolerance of uncertainty reported reductions in depression and anxiety symptoms over time. However, symptom levels remained significantly elevated compared to individuals with low intolerance of uncertainty. Individuals with low intolerance of uncertainty had low and stable levels of depression and anxiety across the course of the study. Network analyses further revealed that the relationships between depression and anxiety symptoms became stronger over time among individuals with high intolerance of uncertainty and identified that feeling afraid showed the strongest association with intolerance of uncertainty. Our findings are consistent with previous work identifying intolerance of uncertainty as an important risk factor for mental health problems, especially in times marked by actual health, economic and social uncertainty. The results highlight the need to explore ways to foster resilience among individuals who struggle to tolerate uncertainty, as ongoing and future geopolitical, climate and health threats will likely lead to continued exposure to significant uncertainty.


2019 ◽  
Author(s):  
Marcos Economides ◽  
Kristian Ranta ◽  
Albert Nazander ◽  
Outi Hilgert ◽  
Philippe R Goldin ◽  
...  

BACKGROUND Depression is one of the most common mental health disorders and severely impacts one’s physical, psychological, and social functioning. To address access barriers to care, we developed Ascend —a smartphone-delivered, therapist-supported, 8-week intervention based on several evidence-based psychological treatments for depression and anxiety. A previous feasibility study with 102 adults with elevated depression reported that Ascend is associated with a postintervention reduction in depression symptoms. OBJECTIVE We aimed to examine whether Ascend is associated with a reduction in symptoms of anxiety, and importantly, whether reductions in symptoms of depression and anxiety are maintained up to 12 months postintervention. METHODS We assessed whether the previously reported, end-of-treatment improvements seen in the 102 adults with elevated symptoms of depression extended up to 12 months posttreatment for depression symptoms (measured by the Patient Health Questionnaire-9 [PHQ-9]) and up to 6 months posttreatment for anxiety symptoms (added to the intervention later and measured using the Generalized Anxiety Disorder-7 [GAD-7] scale). We used linear mixed effects models with Tukey contrasts to compare time points and reported intention-to-treat statistics with a sensitivity analysis. RESULTS The intervention was associated with reductions in symptoms of depression that were maintained 12 months after the program (6.67-point reduction in PHQ-9 score, 95% CI 5.59-7.75; P<.001; Hedges g=1.14, 95% CI 0.78-1.49). A total of 60% of the participants with PHQ-9 scores above the cutoff for major depression at baseline (PHQ≥10) reported clinically significant improvement at the 12-month follow-up (at least 50% reduction in PHQ-9 score and postprogram score <10). Participants also reported reductions in symptoms of anxiety that were maintained for at least 6 months after the program (4.26-point reduction in GAD-7 score, 95% CI 3.14-5.38; P<.001; Hedges g=0.91, 95% CI 0.54-1.28). CONCLUSIONS There is limited evidence on whether outcomes associated with smartphone-based interventions for common mental health problems are maintained posttreatment. Participants who enrolled in Ascend experienced clinically significant reductions in symptoms of depression and anxiety that were maintained for up to 1 year and 6 months after the intervention, respectively. Future randomized trials are warranted to test Ascend as a scalable solution to the treatment of depression and anxiety.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Kleszczewska ◽  
J Mazur ◽  
A Dzielska ◽  
T Gaspar ◽  
M Gaspar de Matos

Abstract Background The project was an answer to the results of the HBSC (Health Behaviour of School-aged Children) study 2013/2014 which indicated an alarming situation regarding the adolescents' mental health. The aim was to investigate mental health problems of Polish and Portuguese youth and to create tools and materials which can be a professional help in this matter. Improve the youth project consisted of two main elements: research and implementation phase. The mixed-method approach was applied in the project. Quantitative and qualitative research methods were used. 2004 pupils (aged 13-19) were surveyed in 89 schools in 2017/ 2018 in Poland. Findings form qualitative study were guidelines for quantitative research. Perception of stress among young people was selected as the leading subject. Short Form Perceived Stress Scale (PSS-4) in a shorter version of 4-statement were used. There were two advisory boards: first - practitioners (psychologists, pedagogists, teachers, social workers) and second - adolescents. Both were consulted to prepare all materials. Results Stress levels are higher in girls than in boys, and they increase with age: between 13 and 19 year of age the increase in the prevalence of high stress level was 5,3% in boys and 12.5% in girls. Family affluence, school achievements and school burden were identified as stress determinants of adolescents. Materials presenting the data and giving practical information and tools on how to support adolescents in coping with stress: guide for adults, guide for youth created by youth and scenario of workshops. 20 workshops for young people run by young people were organised in both countries for about 200 adolescents Results and materials were presented to youth organizations, social institutions and decision makers responsible for youth policy during two 'Improve the Youth' conferences in Poland and in Portugal.


Author(s):  
Rachel A. Fusco ◽  
Yan Yuan ◽  
Hyunji Lee ◽  
Christina E. Newhill

Low-income young adults are more likely to have exposure to trauma, which increases risk for mental health problems. Although adequate sleep promotes good health, people with histories of trauma are more likely to have sleep problems. The current study explored whether poor sleep mediated the relationship between trauma exposure and mental health. A sample of 143 low-income 18–24-year-old young adults completed depression, anxiety, and trauma exposure measures and wore sleep monitors for four nights. Structural equation modeling (SEM) was used to examine both direct and indirect effects of variables. Results showed that higher trauma exposure was associated with depression and anxiety. Mean sleep hours per night was fewer than six, far below recommended guidelines for optimal health and functioning. Fewer sleep hours partially mediated the relationship between both trauma exposure and depression and anxiety, and the direct effect from trauma remained significant after adjusting for the partial mediation from sleep.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 943.1-943
Author(s):  
S. Eulert ◽  
M. Niewerth ◽  
J. Hörstermann ◽  
C. Sengler ◽  
D. Windschall ◽  
...  

Background:Mental disorders often begin in the vulnerable phase of adolescence and young adulthood. Young people with chronic diseases are particularly at risk. Early recognition of mental health problems is necessary in order to be able to support those affected in a timely and adequate manner. By implementing a web-based generic screening tool for mental health in routine care, patients with juvenile idiopathic arthritis (JIA) and mental health conditions can be identified and provided with targeted treatment.Objectives:To investigate the prevalence of mental health conditions in young people with JIA in routine rheumatology care.Methods:Mental health screening is implemented as an add-on module to the National Paediatric Rheumatology Database (NPRD). The current data was gathered over a period of 24 months. Patients complete the screening tool which includes the Patient Health Questionnaire1 (PHQ-9, score 0-27) and the Generalized Anxiety Disorder scale2 (GAD-7, score 0-21) via a web-based questionnaire. The cut-off for critical values in PHQ-9 and GAD-7 were defined as values ≥ 10. Simultaneously, other data, such as sociodemographic data, disease activity (cJADAS10, score 0-30), functional status (CHAQ, score 0-3) were collected as well.Results:The analysis included 245 patients (75% female) with a mean age of 15.7 years and a mean disease duration of 8.8 years. 38.8% of the patients had oligoarthritis (18.0% OA, persistent/20.8% OA, extended) and 23.3% RF negative polyarthritis. At the time of documentation 49 patients (30.6%) had an inactive disease (cJADAS10 ≤ 1) and 120 (49.4%) no functional limitations (CHAQ = 0). In total, 53 patients (21.6%) had screening values in either GAD-7 or PHD-9 ≥10. Patients with critical mental health screening values showed higher disease activity and more frequent functional limitations than inconspicuous patients (cJADAS10 (mean ± SD): 9.3 ± 6 vs. 4.9 ± 4.9; CHAQ: 0.66 ± 0.6 vs. 0.21 ± 0.42). When compared to males, females were significantly more likely to report either depression or anxiety symptoms (11.7% vs. 24.9%, p = 0.031).17.6% of all patients with valid items for these data reported to receive psychological support, meaning psychotherapeutic support (14.5%) and/or drug therapy (8.6%). Among those with a critical mental health screening score, 38.7% received psychological support (psychotherapeutic support (35.5%) and/or drug therapy (16.1%)).Conclusion:Every fifth young person with JIA reported mental health problems, however, not even every second of them stated to receive psychological support. The results show that screening for mental health problems during routine adolescent rheumatology care is necessary to provide appropriate and targeted support services to young people with a high burden of illness.References:[1]Löwe B, Unützer J, Callahan CM, Perkins AJ, Kroenke K. Monitoring depression treatment outcomes with the patient health questionnaire-9. Med Care. 2004 Dec;42(12):1194-201.[2]Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006 May 22; 166(10):1092-7.[3]The screening data were collected as part of COACH (Conditions in Adolescents: Implementation and Evaluation of Patient-centred Collaborative Healthcare), a project supported by the Federal Ministry of Education and Research (FKZ: 01GL1740F).Disclosure of Interests:Sascha Eulert: None declared, Martina Niewerth: None declared, Jana Hörstermann: None declared, Claudia Sengler: None declared, Daniel Windschall: None declared, Tilmann Kallinich: None declared, Jürgen Grulich-Henn: None declared, Frank Weller-Heinemann Consultant of: Pfizer, Abbvie, Sobi, Roche, Novartis, Ivan Foeldvari Consultant of: Gilead, Novartis, Pfizer, Hexal, BMS, Sanofi, MEDAC, Sandra Hansmann: None declared, Harald Baumeister: None declared, Reinhard Holl: None declared, Doris Staab: None declared, Kirsten Minden: None declared


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Qian Wang ◽  
Phoenix K. H. Mo ◽  
Bo Song ◽  
Jiang-Li Di ◽  
Feng-Rong Zhou ◽  
...  

Abstract Background The COVID-19 has caused significant toll over the globe. Pregnant women are at risk of infection. The present study examined the frequency of washing hands with soap and wearing face mask when going out, prevalence of depression and anxiety, and identified their associated factors among pregnant women during the early phase of COVID-19 outbreak in China. Methods A cross-sectional online survey was conducted between 24 February and 3 March 2020. A total of 15 428 pregnant women who were using maternal health care services in China completed a questionnaire which assessed their socio-demographic and pregnancy-related characteristics, contextual, cognitive and social factors related to COVID-19, frequency of washing hands and wearing face masks, and depression and anxiety. Logistics regression analyses were performed to identify the associated factors of preventive behaviours and mental health. Results The prevalence of probable anxiety and depression was 28.2% and 43.6% respectively. 19.8% reported always wearing face mask when going out, and 19.1% reported washing hands with soap for more than 10 times per day. Results from logistic regression analyses showed that older age was associated with lower levels of depression and anxiety (OR = 0.42–0.67) and higher frequency of washing hands (OR = 1.57–3.40). Higher level of education level was associated with probable depression (OR = 1.31–1.45) and higher frequency of wearing face mask (OR = 1.50–1.57). After adjusting for significant socio-demographic and pregnancy-related factors, place of residence being locked down (aOR = 1.10–1.11), being quarantined (aOR = 1.42–1.57), personally knowing someone being infected with COVID-19 (aOR = 1.80–1.92), perception that COVID-19 would pose long term physical harm to human (aOR = 1.25–1.28) were associated with higher levels of depression and anxiety, while the perception that the disease will be under control in the coming month was associated with lower levels of depression and anxiety (aOR = 0.59–0.63) and lower tendency of always wearing face mask (aOR = 0.85). Social support was associated with lower levels of depression and anxiety (aOR = 0.86–0,87) and higher frequency of washing hands (aOR = 1.06). Conclusions The mental health and preventive behaviours of pregnant women during COVID-19 outbreak was associated with a range of socio-demographic, pregnancy-related, contextual, cognitive and social factors. Interventions to mitigate their mental health problems and to promote preventive behaviours are highly warranted.


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