scholarly journals Mobile interventions targeting common mental disorders among pregnant and postpartum women: An equity-focused systematic review

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0259474
Author(s):  
Ammar Saad ◽  
Olivia Magwood ◽  
Tim Aubry ◽  
Qasem Alkhateeb ◽  
Syeda Shanza Hashmi ◽  
...  

Introduction Pregnant and postpartum women face major psychological stressors that put them at higher risk of developing common mental disorders, such as depression and anxiety. Yet, their limited access to and uptake of traditional mental health care is inequitable, especially during the COVID-19 pandemic. Mobile interventions emerged as a potential solution to this discontinued healthcare access, but more knowledge is needed about their effectiveness and impact on health equity. This equity-focused systematic review examined the effectiveness and equity impact of mobile interventions targeting common mental disorders among pregnant and postpartum women. Methods and results We systematically searched MEDLINE, EMBASE, PsychINFO and 3 other databases, from date of database inception and until January 2021, for experimental studies on mobile interventions targeting pregnant and postpartum women. We used pooled and narrative synthesis methods to analyze effectiveness and equity data, critically appraised the methodological rigour of included studies using Cochrane tools, and assessed the certainty of evidence using the GRADE approach. Our search identified 6148 records, of which 18 randomized and non-randomized controlled trials were included. Mobile interventions had a clinically important impact on reducing the occurrence of depression (OR = 0.51 [95% CI 0.41 to 0.64]; absolute risk reduction RD: 7.14% [95% CI 4.92 to 9.36]; p<0.001) and preventing its severity perinatally (MD = -3.07; 95% CI -4.68 to -1.46; p<0.001). Mobile cognitive behavioural therapy (CBT) was effective in managing postpartum depression (MD = -6.87; 95% CI -7.92 to -5.82; p<0.001), whereas other support-based interventions had no added benefit. Results on anxiety outcomes and utilization of care were limited. Our equity-focused analyses showed that ethnicity, age, education, and being primiparous were characteristics of influence to the effectiveness of mobile interventions. Conclusion As the COVID-19 pandemic has increased the need for virtual mental health care, mobile interventions show promise in preventing and managing common mental disorders among pregnant and postpartum women. Such interventions carry the potential to address health inequity but more rigorous research that examines patients’ intersecting social identities is needed.

Author(s):  
Marta Estrela ◽  
Maria Teresa Herdeiro ◽  
Pedro Lopes Ferreira ◽  
Fátima Roque

(1) Background: Mental disorders are a growing concern in the 21st century. The most prevalent common mental disorders include depression and anxiety. It is predicted that half of the population will at some point in their lives experience one or more mental disorders. Although common mental disorders are highly prevalent, some of the most significant related problems are the wide treatment gap and the excessive use of antidepressants, anxiolytics and sedatives/hypnotics, especially among older patients. (2) Methods: This study aimed to analyze mental health care in Portugal, with a focus on the consumption of antidepressants, anxiolytics, sedatives and hypnotics among older patients. (3) Results: The use of antidepressants, anxiolytics, sedatives and hypnotics has increased overall across Europe. In Portugal, a downward trend of sedatives and hypnotics consumption can be observed. Anxiolytics and antidepressants, on the other hand, have been increasing. Patients aged ≥60 years old consume more than half of the aforementioned drugs. (4) Conclusions: Mental health policies should be designed to improve the conscientious use of antidepressants, anxiolytics, sedatives and hypnotics, particularly among older adults.


Author(s):  
Roxanne Gaspersz ◽  
Monique H.W. Frings-Dresen ◽  
Judith K. Sluiter

Abstract Objective: The purpose of the study was to assess common mental disorders and the related use and need for mental health care among clinically not yet active and clinically active medical students. Methods: All medical students (n=2266) at one Dutch medical university were approached. Students from study years 1–4 were defined as clinically not yet active and students from study years 5 and 6 as clinically active. An electronic survey was used to detect common mental disorders depression (BSI-DEP), anxiety (BSI-ANG), stress (4DSQ) and post-traumatic stress disorder (IES). The use of mental health services in the past 3 months and the need for mental health services were asked for. The prevalence of common mental disorders, the use and need for mental health services and differences between groups were calculated. Results: The response rate was 52%: 814 clinically not yet active and 316 clinically active students. The prevalence of common mental disorders among clinically not yet active and clinically active students was 54% and 48%, respectively. The use of mental health services was 14% in clinically not yet active and 12% in clinically active students with common mental disorders (n.s.). The need for mental health services by clinically not yet active and clinically active students was 52% and 46%, respectively (n.s.). Conclusions: The prevalence of probable common mental disorders are higher among clinically not yet active than among clinically active students. The need of mental health services exceeds use, but is the same in the two groups of students.


2012 ◽  
Vol 9 (3) ◽  
pp. 213-217
Author(s):  
A Risal

Common mental disorders are a group of distress states manifesting with anxiety, depressive and unexplained somatic symptoms typically encountered in community and primary care settings. Risk factors for these disorders are mainly lower socio-economic status, psychological illnesses, poor reproductive health, gender disadvantage and physical ill-health. WHO has recommended that treatment of all these disorders should be based in primary care to be more effective and accessible to all the community people. The structure of mental health care in primary care is generally understood in terms of the “pathways to care” model and it plays a major role in countries like ours where community-based mental health services do not exist. Both the psychological and pharmacological therapies are found to be equally effective for treating these disorders. Integration of mental health into primary care can be considered as the stepping stone in the way forward to tackle the barriers and problems in effective management of common mental disorders in the community. The acute shortage of mental health professionals and the relatively low levels of awareness about mental disorders make it mandatory that primary health care should remain the single largest sector for mental health care in low and middle income countries like ours.DOI: http://dx.doi.org/10.3126/kumj.v9i3.6308 Kathmandu Univ Med J 2011;9(3):213-7  


2017 ◽  
Vol 41 (S1) ◽  
pp. s787-s787
Author(s):  
A. Hoff

IntroductionSick leave due to common mental disorders (CMD) has major negative influence on society because of the lost productivity, social benefits, and treatment costs, and OECD estimates that the cost is equivalent to 3.4% of the Danish gross domestic product.ObjectivesThe Objective is to examine, whether integrating mental health care with vocational rehabilitation, conveys shorter return to work (RTW) time, compared to treatment as usual, after sick leave due to a CMD such as depression, anxiety, and stress-related disorders.AimsThe aims of the intervention of are to provide the shortest possible RTW time. Primary outcome is RTW time, and secondary outcomes are (a) time from RTW until recurrent sick leave and (b) symptom level a six months.MethodsPatients are included in one of two randomized controlled studies (anxiety or depression in one RCT, and stress-related disorders in another RCT), after referral from the municipality vocational rehabilitation (VR) center, after sick leave for at least four weeks. Patients, in both trials, are randomized into one of three groups, in a ratio of 1:1:1: (a) control group, where they receive treatment as usual in primary care and municipally located VR, (b) intervention group: mental health care (MHC) in the research project, and municipally located VR (not integrated), and (c) intervention group: MHC in the research project, integrated with a special project VR.ResultsWe are currently including, and as of December 2016, more than 300 are included. The total sample will be 1536 patients.Disclosure of interestThe author has not supplied his/her declaration of competing interest.


2018 ◽  
Vol 64 (5) ◽  
pp. 417-426 ◽  
Author(s):  
Kai Sing Sun ◽  
Tai Pong Lam ◽  
Dan Wu

Background: The World Health Organization (WHO) has called for integration of mental health into primary care for a decade. In Western countries, around 15% to 25% of patients with common mental disorders including mood and anxiety disorders seek help from primary care physicians (PCPs). The rate is only about 5% in China. Aims: This article reviews the Chinese findings on the barriers to primary care for common mental disorders and how they compared with Western findings. Methods: A narrative literature review was conducted, focusing on literature published from mid-1990s in English or Chinese. Patient, PCP and health system factors were reviewed. Results: Although Chinese and Western findings show similar themes of barriers, the Chinese have stronger barriers in most aspects, including under-recognition of the need for treatment, stigma on mental illness, somatization, worries about taking psychiatric drugs, uncertainties in the role, competency and legitimacy of PCPs in mental health care and short consultation time. Conclusion: Current policies in China emphasize enhancement of mental health facilities and workforce in the community. Our review suggests that patients’ intention to seek help and PCPs’ competency in mental health care are other fundamental factors to be addressed.


2009 ◽  
Vol 45 (10) ◽  
pp. 989-998 ◽  
Author(s):  
Viviane Kovess-Masfety ◽  
◽  
Anne Dezetter ◽  
Ron de Graaf ◽  
Joseph Maria Haro ◽  
...  

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Stimac Grbic ◽  
I Pavic Simetin ◽  
A Istvanovic

Abstract Issue Care for people with severe mental disorders requires approach that is focused on a person's strengths, not his weaknesses, and is a shift from a deficit model that is often associated with mental illness. Care users and their family members play an important role in this approach. Description of the Problem Mental disorders are the leading group of diseases in Croatia, according to the number of days of hospital treatment. The number of hospitalizations is high, and the rate of hospitalization for depression has tripled in the last twenty years. Such indicators highlight the need for reorientation of mental health care, from hospital-based to community-based, by organizing mobile community intervention teams. Results In Croatia, psychosocial peer teams were established by the NGO Ludruga, financed by local government, to provide peer support to persons with mental disorders. The main activities are: development of a personal recovery plan, home visits and providing psychological support to persons with mental disorders, organizing support groups and education of peer workers. The teams consist of a peer worker, social worker, psychologist, and operate under the supervision of a psychiatrist. The teams have been operating for five years, have had over a hundred users so far and are a significant help to the healthcare system in preventing rehospitalizations. Lessons The goal of therapeutic interventions in mental health care should be recovery. Recovery involves empowering a person to take responsibility for themselves and their health. Peer workers play an important role in the recovery process, providing hope for recovery. Their role must also be recognized by the health system. Key messages People with mental disorders and their families should be co-creators of care and recovery-oriented interventions. Only by comprehensive interventions, tackling all determinants of health, therapeutic goal can be achieved.


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