Previous psychopathology predicted severe COVID-19 concern, anxiety and PTSD symptoms in pregnant women during lockdown in Italy

Italy was the first COVID-19 pandemic epicenter among European countries and established a period of full lockdown, consisting of travel bans, mandatory staying at home and temporary closure of non-essential businesses. Similar measures are known risk factors for psychological disturbances in the general population, still very little is known about their impact on pregnant women's mental health during COVID-19 pandemic. The national survey 'COVID-19 related Anxiety and StreSs in prEgnancy, poSt-partum and breaStfeeding' (COVID-ASSESS) was conducted during the first month of full lockdown in Italy. The questionnaire was specifically developed to examine COVID-19 concerns and included the psychometric tests NSESSS for PTSD and STAI-Y for anxiety. A multivariable logistic regression model was fitted to explore the association of the concern, anxiety and PTSD symptoms with age, gestational weeks, parity, days of lockdown, assisted reproductive technology use, psychopathological history and previous perinatal losses. Out of 1015 pregnant women reached, 737 (72.6%) fully answered the questionnaire; no woman reported a COVID-19 infection. Median age was 34.4 years [quartiles 31.7, 37.2], median days in lockdown were 13.1 [11.0, 17.0], median gestational weeks were 27.8 [19.8, 34.0]. Clinically significant PTSD symptoms were present in 75 women (10.2%, NSESSS cut-off 24) and clinically significant anxiety symptoms were present in 160 women (21.7%, STAI-Y1 cut-off 50). Women were less worried about their own health than the health of their baby and of their elderly relatives. Previous anxiety predicted higher concern and PTSD symptoms; previous depression and anxiety were independently associated with current PTSD symptoms.

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EMDR for Survivors of Life-Threatening Cardiac Events: Results of a Pilot Study

Journal of EMDR Practice and Research ◽

10.1891/1933-3196.5.1.2 ◽

2011 ◽

Vol 5 (1) ◽

pp. 2-13 ◽

Cited By ~ 24

Author(s):

Emanuele Arabia ◽

Maria Luisa Manca ◽

Roger M. Solomon

Keyword(s):

Pilot Study ◽

Cardiac Event ◽

Anxiety Symptoms ◽

Depression And Anxiety ◽

Ptsd Symptoms ◽

Cardiac Events ◽

Life Threatening ◽

Clinically Significant ◽

Better Than

This pilot study evaluated the effectiveness of eye movement desensitization and reprocessing (EMDR) in treating posttraumatic stress disorder (PTSD) symptoms and concomitant depressive and anxiety symptoms in survivors of life-threatening cardiac events. Forty-two patients undergoing cardiac rehabilitation who (a) qualified for the PTSD criterion “A” in relation to a cardiac event and (b) presented clinically significant PTSD symptoms were randomized to a 4-week treatment of EMDR or imaginal exposure (IE). Data were gathered on PTSD, anxiety, and depressive symptoms at pretreatment, posttreatment, and 6-month follow-up. EMDR was effective in reducing PTSD, depressive, and anxiety symptoms and performed significantly better than IE for all variables. These findings provide preliminary support for EMDR as an effective treatment for the symptoms of PTSD, depression, and anxiety that can follow a life-threatening cardiac event.

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Post-traumatic stress symptoms in hematopoietic stem cell transplant (HCT) recipients.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.7505 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. 7505-7505 ◽

Cited By ~ 1

Author(s):

Sarah Griffith ◽

Alyssa L. Fenech ◽

Ashley Nelson ◽

Joseph A. Greer ◽

Jennifer S. Temel ◽

...

Keyword(s):

Traumatic Stress ◽

Anxiety Symptoms ◽

Depression Symptoms ◽

Cell Transplant ◽

Depression And Anxiety ◽

Ptsd Symptoms ◽

Post Traumatic Stress ◽

Hematopoietic Stem ◽

Post Traumatic ◽

Clinically Significant

7505 Background: Patients admitted for HCT, an intensive and potentially curative therapy for hematologic malignancies, experience a prolonged, isolating hospitalization and endure substantial physical and psychological symptom burden. However, data are limited regarding long-term post-traumatic stress (PTSD) in HCT survivors and its risk factors. Methods: We conducted a secondary analysis examining longitudinal data from 250 patients who underwent autologous and allogenic HCT. We used the Post-Traumatic Stress Checklist (PTSD-CL) to assess for PTSD symptoms at six months post-HCT. We used the Functional Assessment of Cancer Therapy—Bone Marrow Transplant (FACT-BMT), and the Hospital Anxiety and Depression Scale to assess quality of life (QOL), depression, and anxiety symptoms at the time of admission for HCT, at week-2 during hospitalization, and at six months post-HCT. We used multivariate regression models to assess factors associated with PTSD symptoms, modeling QOL, depression, and anxiety symptoms separately given their collinearity. Results: The mean age was 56.3 (SD = 13.3). The rate of clinically significant PTSD symptoms at six months post-HCT was 18.9% and these patients experienced hypervigilance (92.3%), avoidance (92.3%), and intrusion (76.9%) symptoms. Among patients without clinically significant PTSD symptoms, 24.5% and 13.7% had clinically significant hypervigilance and avoidance symptoms, respectively. Lower QOL at time of HCT admission (B = -0.04, P = 0.004), and being single (B = -3.35, P = 0.027) were associated with higher PTSD symptoms at six months post-HCT. Higher anxiety at time of HCT admission (B = 1.34, P < 0.001), change in anxiety during HCT hospitalization (B = 0.59, P = 0.006), and being single (B = -3.50, P = 0.017), were associated with higher PTSD symptoms at six months. In a separate model, younger age (B = -0.13, P = 0.017), being single (B = -3.58, P = 0.018), and higher baseline depression symptoms were also associated with higher PTSD symptoms at six months (B = 0.97, P < 0.001). Conclusions: Approximately one fifth of patients undergoing HCT experienced clinically significant PTSD symptoms at six months post-transplant. Patients’ baseline QOL and psychological symptoms emerged as important predictors of their risk for PTSD at six months post-HCT. Thus, interventions to prevent and treat PTSD symptoms in HCT recipients are clearly warranted.

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Study of Possible Relation between Fasting Plasma Glucagon, Gestational Diabetes and Development of Type 2 DM

Current Diabetes Reviews ◽

10.2174/1573399815666190405171907 ◽

2020 ◽

Vol 16 (2) ◽

pp. 148-155 ◽

Cited By ~ 1

Author(s):

Ashraf Okba ◽

Salwa Seddik Hosny ◽

Alyaa Elsherbeny ◽

Manal Mohsin Kamal

Keyword(s):

Gestational Diabetes ◽

Pregnant Women ◽

Post Partum ◽

Plasma Glucagon ◽

Type 2 Dm ◽

Fasting Plasma ◽

Before And After ◽

Two Phases

Background and Aims: Women who develop GDM (gestational diabetes mellitus) have a relative insulin secretion deficiency, the severity of which may be predictive for later development of diabetes. This study aimed to investigate the role of fasting plasma glucagon in the prediction of later development of diabetes in pregnant women with GDM. Materials and Methods: The study was conducted on 150 pregnant women with GDM after giving informed oral and written consents and being approved by the research ethical committee according to the declaration of Helsinki. The study was conducted in two phases, first phase during pregnancy and the second one was 6 months post-partum, as we measured fasting plasma glucagon before and after delivery together with fasting and 2 hour post-prandial plasma sugar. Results: Our findings suggested that glucagon levels significantly increased after delivery in the majority 14/25 (56%) of GDM women who developed type 2 DM within 6 months after delivery compared to 6/20 (30%) patients with impaired fasting plasma glucose (IFG) and only 22/105 (20%) non DM women, as the median glucagon levels were 80,76, 55, respectively. Also, there was a high statistical difference between fasting plasma glucagon post-delivery among diabetic and non-diabetic women (p ≤ 0.001). These results indicated the useful role of assessing fasting plasma glucagon before and after delivery in patients with GDM to predict the possibility of type 2 DM. Conclusion: There is a relatively high glucagon level in GDM patients, which is a significant pathogenic factor in the incidence of subsequent diabetes in women with a history of GDM. This could be important in the design of follow-up programs for women with previous GDM.

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Factors influencing stress, anxiety, and depression among Iranian pregnant women: the role of sexual distress and genital self-image

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03575-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Afsaneh Keramat ◽

Mina Malary ◽

Mahmood Moosazadeh ◽

Nastaran Bagherian ◽

Mohammad-Reza Rajabi-Shakib

Keyword(s):

Pregnant Women ◽

Multivariate Linear Regression Analysis ◽

Depression And Anxiety ◽

Sexual Distress ◽

Self Image ◽

Factors Influencing ◽

Severity Of Depression ◽

The Mean ◽

Distress Scale ◽

In Pregnancy

Abstract Background Pregnancy is a unique period with the increased likelihood of psychological changes and emotional disturbances such as depression, anxiety, and stress. In this study, we investigated the factors influencing depression, anxiety, and stress in pregnancy and identify their associations with Sexual Distress (SD) and Genital Self-Image (GSI). Methods This was a descriptive, correlational, cross-sectional study performed using the two-stage cluster sampling method between September 2019 and January 2020. Overall, 295 pregnant women completed a demographics and obstetric information checklist, Depression Anxiety and Stress Scale-21 (DASS-21), Female Genital Self-Image Scale (FGSI), and Female Sexual Distress Scale-Revised (FSDS-R). Results Analysis of Variance (ANOVA) showed significant differences in the mean scores of SD between the groups with varying degrees of depression, anxiety, and stress (P < 0.001) and in the mean score of GSI between the groups with varying degrees of depression (P = 0.01) and anxiety (P < 0.001). In multivariate linear regression analysis, higher (worse) depression, anxiety, and stress scores were found in women with more advanced age and higher SD scores; however, these scores were lower (better) in those with increased gestational age. Lower depression and anxiety scores were associated with moderate satisfaction with income, moderate satisfaction with BI in pregnancy, and lower stress and depression scores were linked to planned pregnancy. Higher (better) GSI score was a predictor of lower depression score, complication in a previous pregnancy was a predictor of higher stress score, and finally, fear of fetal abortion and being a housewife were predictors of a higher anxiety score. Conclusion Various factors contribute to the development of antenatal depression, anxiety, and stress. A positive correlation was found between SD and the severity of depression, anxiety, and stress, while a negative correlation was noted between GSI and the severity of depression and anxiety. Therefore, raising awareness regarding SD and GSI through screening and counseling sessions can have beneficial effects for mothers and their fetuses.

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Course and predictors of posttraumatic stress-related symptoms among family members of deceased ICU patients during the first year of bereavement

Critical Care ◽

10.1186/s13054-021-03719-x ◽

2021 ◽

Vol 25 (1) ◽

Author(s):

Siew Tzuh Tang ◽

Chung-Chi Huang ◽

Tsung-Hui Hu ◽

Wen-Chi Chou ◽

Li-Pang Chuang ◽

...

Keyword(s):

Social Support ◽

Posttraumatic Stress ◽

End Of Life ◽

End Of Life Care ◽

Family Members ◽

Life Care ◽

Ptsd Symptoms ◽

Icu Patients ◽

Clinically Significant ◽

Bereaved Family

Abstract Background/Objective Death in intensive care units (ICUs) may increase bereaved family members’ risk for posttraumatic stress disorder (PTSD). However, posttraumatic stress-related symptoms (hereafter as PTSD symptoms) and their precipitating factors were seldom examined among bereaved family members and primarily focused on associations between PTSD symptoms and patient/family characteristics. We aimed to investigate the course and predictors of clinically significant PTSD symptoms among family members of deceased ICU patients by focusing on modifiable quality indicators for end-of-life ICU care. Method In this longitudinal observational study, 319 family members of deceased ICU patients were consecutively recruited from medical ICUs from two Taiwanese medical centers. PTSD symptoms were assessed at 1, 3, 6, and 13 months post-loss using the Impact of Event Scale-Revised (IES-R). Family satisfaction with end-of-life care in ICUs was assessed at 1 month post-loss. End-of-life care received in ICUs was documented over the patient’s ICU stay. Predictors for developing clinically significant PTSD symptoms (IES-R score ≥ 33) were identified by multivariate logistic regression with generalized estimating equation modeling. Results The prevalence of clinically significant PTSD symptoms decreased significantly over time (from 11.0% at 1 month to 1.6% at 13 months post-loss). Longer ICU stays (adjusted odds ratio [95% confidence interval] = 1.036 [1.006, 1.066]), financial insufficiency (3.166 [1.159, 8.647]), and reported use of pain medications (3.408 [1.230, 9.441]) by family members were associated with a higher likelihood of clinically significant PTSD symptoms among family members during bereavement. Stronger perceived social support (0.937 [0.911, 0.965]) and having a Do-Not-Resuscitate (DNR) order issued before the patient’s death (0.073 [0.011, 0.490]) were associated with a lower likelihood of clinically significant PTSD symptoms. No significant association was observed for family members’ satisfaction with end-of-life care (0.988 [0.944, 1.034]) or decision-making in ICUs (0.980 [0.944, 1.018]). Conclusions The likelihood of clinically significant PTSD symptoms among family members decreased significantly over the first bereavement year and was lower when a DNR order was issued before death. Enhancing social support and facilitating a DNR order may reduce the trauma of ICU death of a beloved for family members at risk for developing clinically significant PTSD symptoms.

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Mental health and preventive behaviour of pregnant women in China during the early phase of the COVID-19 period

Infectious Diseases of Poverty ◽

10.1186/s40249-021-00825-4 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Qian Wang ◽

Phoenix K. H. Mo ◽

Bo Song ◽

Jiang-Li Di ◽

Feng-Rong Zhou ◽

...

Keyword(s):

Mental Health ◽

Pregnant Women ◽

Social Factors ◽

Early Phase ◽

Associated Factors ◽

Online Survey ◽

Mental Health Problems ◽

Face Mask ◽

Depression And Anxiety ◽

Regression Analyses

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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Physical Activity Advice and Counselling by Healthcare Providers: A Scoping Review

Healthcare ◽

10.3390/healthcare9050609 ◽

2021 ◽

Vol 9 (5) ◽

pp. 609

Author(s):

Uchenna Benedine Okafor ◽

Daniel Ter Goon

Keyword(s):

Physical Activity ◽

Pregnant Women ◽

Scoping Review ◽

Post Partum ◽

Healthcare Providers ◽

Original Research ◽

Eligibility Criteria ◽

Physical Activity Advice ◽

Scoping Reviews ◽

Physical Activity And Exercise

Background: Despite scientific evidence on prenatal physical activity and exercise, synthesized evidence is lacking on the provision of prenatal physical activity and exercise advice and counselling by prenatal healthcare providers. The scoping review seeks to fill this gap by synthesizing available literature on the provision of prenatal physical activity and exercise advice and counselling by prenatal healthcare providers to women during antenatal visits. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) search framework for scoping reviews was applied to retrieve original research articles on the prenatal physical activity and exercise practices of healthcare providers with pregnant women, published between 2010–2020, and available in English. The search databases included Google Scholar, PubMed, Science Direct, Scopus, EMBASE, The Cumulative Index for Nursing and Allied Health Literature (CINAHL), BIOMED Central, Medline and African Journal Online. Studies that fulfilled the eligibility criteria were retrieved for analysis. Results: Out of the 82 articles that were retrieved for review, 13 met the eligibility criteria. Seven of the articles were quantitative, four qualitative, one mixed-method and one controlled, non-randomised study, respectively. Three themes emerged as major findings. Healthcare providers affirmed their responsibility in providing prenatal physical activity advice and counselling to pregnant women; however, they seldom or rarely performed this role. Major barriers to prenatal physical activity and exercise included insufficient time, lack of knowledge and skills, inadequate or insufficient training, and lack of resources. Conclusion: This review highlights salient features constraining the uptake of prenatal physical activity and exercise advice/counselling by prenatal healthcare providers in both community and clinical settings. Prenatal physical activity advice and counselling are key components to the promotion of physical activity adherence during and post-partum pregnancy; this requires adequate knowledge of physical activity prescriptions and recommendations, which are personalised and contextual to environment. Research is needed to examine the prenatal physical activity advice and counselling from prenatal healthcare providers on issues hindering effective delivery of the aforementioned in the context of promoting prenatal physical activity in clinical or community settings.

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Mental Health Challenges and Needs among Sexual and Gender Minority People in Western Kenya

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18031311 ◽

2021 ◽

Vol 18 (3) ◽

pp. 1311

Author(s):

Gary W. Harper ◽

Jessica Crawford ◽

Katherine Lewis ◽

Caroline Rucah Mwochi ◽

Gabriel Johnson ◽

...

Keyword(s):

Mental Health ◽

Sexual Minority ◽

Partner Violence ◽

Intimate Partner ◽

Ptsd Symptoms ◽

Western Kenya ◽

Gender Minority ◽

Sexual And Gender Minority ◽

Clinically Significant ◽

And Gender

Background: Sexual and gender minority (SGM) people in Kenya face pervasive socio-cultural and structural discrimination. Persistent stress stemming from anti-SGM stigma and prejudice may place SGM individuals at increased risk for negative mental health outcomes. This study explored experiences with violence (intimate partner violence and SGM-based violence), mental health outcomes (psychological distress, PTSD symptoms, and depressive symptoms), alcohol and other substance use, and prioritization of community needs among SGM adults in Western Kenya. Methods: This study was conducted by members of a collaborative research partnership between a U.S. academic institution and a Kenyan LGBTQ civil society organization (CSO). A convenience sample of 527 SGM adults (92.7% ages 18–34) was recruited from community venues to complete a cross-sectional survey either on paper or through an online secure platform. Results: For comparative analytic purposes, three sexual orientation and gender identity (SOGI) groups were created: (1) cisgender sexual minority women (SMW; 24.9%), (2) cisgender sexual minority men (SMM; 63.8%), and (3) gender minority individuals (GMI; 11.4%). Overall, 11.7% of participants reported clinically significant levels of psychological distress, 53.2% reported clinically significant levels of post-traumatic stress disorder (PTSD) symptoms, and 26.1% reported clinically significant levels of depressive symptoms. No statistically significant differences in clinical levels of these mental health concerns were detected across SOGI groups. Overall, 76.2% of participants reported ever using alcohol, 45.6% home brew, 43.5% tobacco, 39.1% marijuana, and 27.7% miraa or khat. Statistically significant SOGI group differences on potentially problematic substance use revealed that GMI participants were less likely to use alcohol and tobacco daily; and SMM participants were more likely to use marijuana daily. Lifetime intimate partner violence (IPV) was reported by 42.5% of participants, and lifetime SGM-based violence (SGMV) was reported by 43.4%. GMI participants were more likely than other SOGI groups to have experienced both IPV and SGMV. Participants who experienced SGMV had significantly higher rates of clinically significant depressive and PTSD symptoms. Conclusions: Despite current resilience demonstrated by SGM adults in Kenya, there is an urgent need to develop and deliver culturally appropriate mental health services for this population. Given the pervasiveness of anti-SGM violence, services should be provided using trauma-informed principles, and be sensitive to the lived experiences of SGM adults in Kenya. Community and policy levels interventions are needed to decrease SGM-based stigma and violence, increase SGM visibility and acceptance, and create safe and affirming venues for mental health care. Political prioritization of SGM mental health is needed for sustainable change.

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GAMBARAN PENGETAHUAN, UMUR,DUKUNGAN SUAMI, DAN EKONOMI, PADA IBU HAMIL TENTANG KEPATUHAN PEMERIKSAAN KLINIK PRATAMA SANTA ELISABETH MEDAN

Elisabeth Health Jurnal ◽

10.52317/ehj.v5i02.316 ◽

2020 ◽

Vol 5 (02) ◽

pp. 80-88

Author(s):

Lilis Sumardiani

Keyword(s):

Data Analysis ◽

Antenatal Care ◽

Pregnant Women ◽

Frequency Distribution ◽

Post Partum ◽

Number Of Children ◽

Mothers And Children ◽

Knowledge Age ◽

Husband Support ◽

In Pregnancy

Introduction :antenatal care is an examination of pregnant women both physically and mentally as well as saving mothers and children in pregnancy, childbirth and the puerperium, so that they post partum healthy and normal not only physically but also mentallyMethod : The study was conducted by distributing questionnaires to pregnant women with emesis gravidarum. Data analysis using univariants for frequency distribution. Result : The results showed an overview of knowledge of pregnant women with good knowledge of 13 people (65%), sufficient knowledge of 5 people (25%) and lack of knowledge of 1 person (5%) while lacking knowledge of pregnant women who did not comply did 1 pregnancy check up (5) %). overall obedient pregnant women undergo pregnancy examinations aged <20 years 7 people (35%), 20-30 years there are 7 people (35%) and there are 4 people> 35 years (20%). while those aged <20 years who are not compliant pregnant women do pregnancy examinations 2 people (10%). pregnant women about compliance with antenatal care namely, support from the husband is very good there are 12 people (60%), good 4 people (20%) and enough 4 people (40%). 20%), the middle economy there are 13 people (65%), and the low economy 4 people (20%), while the economy is lacking in pregnant women who do not comply with one pregnancy checkup (5%). parity, shows that the total number of pregnant women regarding compliance with antenatal care is, that has children who live 1 times 4 people (20%), the number of children who live 2-5 times 11 people (55%), and the number of children who live> 5 times 5 people (25%) while parity, in pregnant women who do not comply with pregnancy examination 1 person (5%) Duscussion:From this study it can be concluded that knowledge, age, husband support, economy and parity in pregnant women regarding compliance with antenatal care in the Klinik Pratama Santa Elisabeth Medan is said to be a minority who are disobedient and more who are obedient do ANC visits

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