scholarly journals The Effectiveness of an App-Based Nurse-Moderated Program for New Mothers With Depression and Parenting Problems (eMums Plus): Pragmatic Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Alyssa Sawyer ◽  
Amy Kaim ◽  
Huynh-Nhu Le ◽  
Denise McDonald ◽  
Murthy Mittinty ◽  
...  
Keyword(s):  
Postnatal Depression ◽  
Standard Care ◽  
Intervention Group ◽  
Depression Scale ◽  
Postnatal Period ◽  
Child Assessment ◽  
Care Groups ◽  
Maternal Caregiving ◽  
Online Group ◽  
Over Time

BACKGROUND Postnatal depression and caregiving difficulties adversely affect mothers, infants, and later childhood development. In many countries, resources to help mothers and infants are limited. Online group–based nurse-led interventions have the potential to help address this problem by providing large numbers of mothers with access to professional and peer support during the postnatal period. OBJECTIVE This study tested the effectiveness of a 4-month online group–based nurse-led intervention delivered when infants were aged 2 to 6 months as compared with standard care outcomes. METHODS The study was a block randomized control trial. Mothers were recruited at the time they were contacted for the postnatal health check offered to all mothers in South Australia. Those who agreed to participate were randomly assigned to the intervention or standard care. The overall response rate was 63.3% (133/210). Primary outcomes were the level of maternal depressive symptoms assessed with the Edinburgh Postnatal Depression Scale (EPDS) and quality of maternal caregiving assessed using the Parenting Stress Index (PSI; competence and attachment subscales), the Parenting Sense of Competence Scale (PSCS), and the Nursing Child Assessment Satellite Training Scale. Assessments were completed at baseline (mean child age 4.9 weeks [SD 1.4]) and again when infants were aged 8 and 12 months. RESULTS Outcomes were evaluated using linear generalized estimating equations adjusting for postrandomization group differences in demographic characteristics and the outcome score at baseline. There were no significant differences in the intervention and standard care groups in scores on the PSI competence subscale (P=.69) nor in the PSCS (P=.11). Although the group by time interaction suggested there were differences over time between the EPDS and PSI attachment subscale scores in the intervention and standard care groups (P=.001 and P=.04, respectively), these arose largely because the intervention group had stable scores over time whereas the standard care group showed some improvements between baseline and 12 months. Mothers engaged well with the intervention with at least 60% (43/72) of mothers logging-in once per week during the first 11 weeks of the intervention. The majority of mothers also rated the intervention as helpful and user-friendly. CONCLUSIONS Mothers reported that the intervention was helpful, and the app was described as easy to use. As such, it appears that support for mothers during the postnatal period, provided using mobile phone technology, has the potential to be an important addition to existing services. Possible explanations for the lack of differences in outcomes for the 2 groups in this study are the failure of many mothers to use key components of the intervention and residual differences between the intervention and standard care groups post randomization. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12616001732471; http://www.ANZCTR.org.au/ACTRN12616001732471.aspx (archived on WebCite as http://www.webcitation.org/77zo30GDw)

scholarly journals A pragmatic randomized controlled trial to evaluate the effectiveness of a facilitated exercise intervention as a treatment for postnatal depression: the PAM-PeRS trial

2015 ◽  
Vol 45 (11) ◽  
pp. 2413-2425 ◽  
Author(s):  
A. J. Daley ◽  
R. V. Blamey ◽  
K. Jolly ◽  
A. K. Roalfe ◽  
K. M. Turner ◽  
...  
Keyword(s):  
Usual Care ◽  
Postnatal Depression ◽  
Exercise Intervention ◽  
Controlled Trial ◽  
Intervention Group ◽  
Depression Scale ◽  
International Classification Of Diseases ◽  
Exercise Group ◽  
Mean Difference ◽  
Classification Of Diseases

BackgroundPostnatal depression affects about 10–15% of women in the year after giving birth. Many women and healthcare professionals would like an effective and accessible non-pharmacological treatment for postnatal depression.MethodWomen who fulfilled the International Classification of Diseases (ICD)-10 criteria for major depression in the first 6 months postnatally were randomized to receive usual care plus a facilitated exercise intervention or usual care only. The intervention involved two face-to-face consultations and two telephone support calls with a physical activity facilitator over 6 months to support participants to engage in regular exercise. The primary outcome was symptoms of depression using the Edinburgh Postnatal Depression Scale (EPDS) at 6 months post-randomization. Secondary outcomes included EPDS score as a binary variable (recovered and improved) at 6 and 12 months post-randomization.ResultsA total of 146 women were potentially eligible and 94 were randomized. Of these, 34% reported thoughts of self-harming at baseline. After adjusting for baseline EPDS, analyses revealed a −2.04 mean difference in EPDS score, favouring the exercise group [95% confidence interval (CI) −4.11 to 0.03, p = 0.05]. When also adjusting for pre-specified demographic variables the effect was larger and statistically significant (mean difference = −2.26, 95% CI −4.36 to −0.16, p = 0.03). Based on EPDS score a larger proportion of the intervention group was recovered (46.5% v. 23.8%, p = 0.03) compared with usual care at 6 months follow-up.ConclusionsThis trial shows that an exercise intervention that involved encouragement to exercise and to seek out social support to exercise may be an effective treatment for women with postnatal depression, including those with thoughts of self-harming.

Social Stress and Depression During Pregnancy in Women of a Low Income Country

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
M. Husain ◽  
I.B. Chaudhry ◽  
Q. Saeed ◽  
S. Khan ◽  
Q. Hassan ◽  
...  
Keyword(s):  
Life Events ◽  
Low Income ◽  
Postnatal Depression ◽  
Social Stress ◽  
Depression Scale ◽  
Antenatal Depression ◽  
Postnatal Period ◽  
List Type ◽  
Cross Sectional ◽  
High Positive Correlation

There has been considerable research on postnatal depression (PND), in comparison to antenatal depression (AND). We aimed to study the Prevalence of AND, testing the following hypotheses:a.Depressed pregnant women will have more negative life events than non depressed women.b.Depressed women will have less social support than non-depressed women.Methods:Using a cross sectional study design 1366/1401 women in their 3rd trimester of pregnancy were screened for depression using the Self-Rating Questionnaire (SRQ) and the Edinburgh Postnatal Depression Scale (EPDS). These instruments are validated, available in Urdu and have been used in the pre and postnatal period in Pakistan. The life events checklist was used to measure social stress and the Brief Disability Questionnaire (BDQ) for disability.Results:342 women scored ≥ 12 on the EPDS giving an estimated AND prevalence of 25.6 %. The EPDS and SRQ scores showed a high positive correlation. A significantly higher percentage of depressed women experienced problems in marital relations, work, finances, housing and domestic violence. Depressed women had higher disability scores. 32% of the depressed and 14% of non depressed were unable to perform usual daily activities. 35% of depressed women stayed in bed due to illness as compared to only 16 % of non-depressed.Conclusion:This study confirms a high prevalence of AND in less educated women, experiencing a large number of social difficulties.

scholarly journals Bangla translation, adaptation and piloting of Edinburgh Postnatal Depression Scale

2008 ◽  
Vol 33 (3) ◽  
pp. 81-87 ◽  
Author(s):  
Kaniz Gausia ◽  
Jena D Hamadani ◽  
Md Manirul Islam ◽  
Mohammed Ali ◽  
Sultana Algin ◽  
...  
Keyword(s):  
Postnatal Depression ◽  
Edinburgh Postnatal Depression Scale ◽  
Depression Scale ◽  
Postnatal Period ◽  
Translation Process ◽  
Forward Translation ◽  
Back Translation ◽  
English Speaking ◽  
High Degree ◽  
Lower Educational Attainment

Standardized questionnaires for screening common health problems in the community often need to be translated for use in non-English speaking countries. There is a lack of literature documenting the process of translation of such questionnaire/scale that would enable their application in cross-cultural settings and standardization of the procedure. This paper reports the process of translation into Bangla of the widely used Edinburgh Postnatal Depression Scale (EPDS) for use in Bangladesh. Three methods: forward translation, committee translation, and back translation were used to ensure the equivalence of the translated version. Both the English and Bangla versions were piloted among 10 social science graduates who were proficient in both the languages. The concurrence of each respondent between the two versions showed a correlation coefficient of 0.98 (p<0.01). The Bland-Altman test also showed a high degree of agreement. The piloted version was also tested with 15 women in the postnatal period and found to be suitable for women with lower educational attainment. The documentation of the translation process and the lessons learnt would be helpful in similar settings where screening questionnaires need to be adapted for local use.DOI = 10.3329/bmrcb.v33i3.1138Bangladesh Med Res Counc Bull 2007; 33: 81-87

scholarly journals An Integrative Review of Paternal Depression

2014 ◽  
Vol 9 (1) ◽  
pp. 26-34 ◽  
Author(s):  
Karen-leigh Edward ◽  
David Castle ◽  
Cally Mills ◽  
Leigh Davis ◽  
June Casey
Keyword(s):  
Postnatal Depression ◽  
Edinburgh Postnatal Depression Scale ◽  
Depression Scale ◽  
Antenatal Depression ◽  
Postnatal Period ◽  
Integrative Review ◽  
Inclusion Criteria ◽  
History Of ◽  
History Of Depression ◽  
Review Current

The aim of this project was to review current research regarding postnatal depression in fathers and to present potential screening and referral options. The search was limited to scholarly (peer reviewed) journals and all articles were retrieved with date limits. Initial search parameters were the following: antenatal depression OR pregnancy depression OR postnatal depression OR perinatal depression AND father* OR men OR paternal. The search yielded 311 abstracts returned. With reference to the inclusion criteria and primary and secondary outcomes intended for the focus of this review, N = 63 articles were retrieved and read in full by the researchers. These articles were included in the final integrative review. Depression in fathers following the birth of their child was associated with a personal history of depression and with the existence of depression in their partner during pregnancy and soon after delivery. Based on the review the authors suggest routine screening and assessment of both parents should occur across the pregnancy and postnatal period. The use of the Edinburgh Postnatal Depression Scale for screening of depression in men needs to be linked to referral guidelines for those individuals who require further investigation and care.

scholarly journals Depression in fathers in the postnatal period: Assessment of the Edinburgh Postnatal Depression Scale as a screening measure

2010 ◽  
Vol 125 (1-3) ◽  
pp. 365-368 ◽  
Author(s):  
Olivia J.H. Edmondson ◽  
Lamprini Psychogiou ◽  
Haido Vlachos ◽  
Elena Netsi ◽  
Paul G. Ramchandani
Keyword(s):  
Postnatal Depression ◽  
Edinburgh Postnatal Depression Scale ◽  
Depression Scale ◽  
Postnatal Period ◽  
Screening Measure

scholarly journals Universal prevention of depression in women postnatally: cluster randomized trial evidence in primary care

2010 ◽  
Vol 41 (4) ◽  
pp. 739-748 ◽  
Author(s):  
T. S. Brugha ◽  
C. J. Morrell ◽  
P. Slade ◽  
S. J. Walters
Keyword(s):  
Primary Care ◽  
Postnatal Depression ◽  
Outcome Measure ◽  
Psychological Intervention ◽  
Short Form ◽  
Intervention Group ◽  
Depression Scale ◽  
Cluster Randomized Trial ◽  
Stress Index ◽  
Control Group

BackgroundTo test whether receiving care from a health visitor (HV) trained in identification and psychological intervention methods prevents depression 6–18 months postnatally in women who are not depressed 6 weeks postnatally.MethodThe study was a prospective cluster trial, randomized by GP practice, with follow-up for 18 months in 101 primary care teams in the Trent area of England. The participants were women scoring <12 on the postal Edinburgh Postnatal Depression Scale (EPDS) at 6 weeks postnatally (1474 intervention and 767 control women). Intervention HVs (n=89, 63 clusters) were trained in identifying depressive symptoms using the EPDS and face-to-face clinical assessment and in providing psychologically orientated sessions based on cognitive behavioral or person-centered principles. The control group comprised HVs (n=49, 37 clusters) providing care as usual (CAU). The primary outcome measure was the proportion of women scoring ⩾12 on the EPDS at 6 months postnatally. Secondary outcomes were mean EPDS score, Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE-OM) score, State–Trait Anxiety Inventory (STAI), 12-item Short Form Health Survey (SF-12) and Parenting Stress Index Short Form (PSI-SF) scores at 6, 12 and 18 months.ResultsAfter adjusting for individual-level covariates, living alone, previous postnatal depression (PND), the presence of one or more adverse life events and the 6-week EPDS score, the odds ratio (OR) for EPDS ⩾12 at 6 months was 0.71 [95% confidence interval (CI) 0.53–0.97, p=0.031] for the intervention group (IG) women compared with the control (CAU) group women. Two subgroups were formed by baseline severity: a ‘subthreshold’ subgroup with a 6-week EPDS score of 6–11 (n=999) and a ‘lowest severity’ subgroup with a 6-week EPDS score of 0–5 (n=1242). There was no difference in psychological effectiveness by subgroup (interaction term: z=−0.28, p=0.782).ConclusionsThis study provides new evidence of a universal, enduring preventive effect for depression in women who screen negative for depression postnatally.

scholarly journals Paternal postpartum depression, its relationship to maternal postpartum depression and to insufficient income

2021 ◽  
Author(s):  
Grażyna Gebuza ◽  
Patrycja Kudziełko ◽  
Marzena Kaźmierczak ◽  
Agnieszka Dombrowska-Pali ◽  
Małgorzata Gierszewska ◽  
...  
Keyword(s):  
Postpartum Depression ◽  
Depressive Disorder ◽  
Postnatal Depression ◽  
Previous History ◽  
Depression Scale ◽  
Postnatal Period ◽  
Symptoms Of Depression ◽  
History Of ◽  
Financial Income ◽  
History Of Depression

Introduction: No studies on paternal postnatal depression (PPND) have been performed in Poland. Aim: The aim of the study was to estimate the symptoms of depression in women and men and identify the determinants of mental health of fathers after the birth of their child. Material and methods: Parents (142) participated in the study during the period 1 to 12 months after the birth. Results and discussion: The analyses reveal that 13% of fathers and 18% of mothers after the birth of their child had Edinburgh postnatal depression scale (EPDS) scores of 10 or higher, which indicates possible depression. At score 12 and more, the proportion detected by EPDS decreased to 7% of fathers and 13% of mothers, which is an indicator of major depressive disorder. At EPDS score 12 and more, a probable depressive disorder was indicated in 10% of fathers in the period of 1–3 months, 7% of fathers at 4–7 months and 4% of fathers at 8–12 months. The symptoms of maternal depression at a score of 12 and more were detected in 16% of women at 1–3 months, 12% at 4–7 months 11% at 8–12 months. PPND was significantly associated with depression in mothers OR 5.7, lower education OR 4.3, low financial income OR 6.0, decreased relationship satisfaction OR 3.3, and previous history of depression OR 3.2. Conclusions: Psychosocial factors were strong predictors of PPND up to a year after the birth of the child. The authors suggest the routine screening and assessment of both parents should occur during the woman’s pregnancy and in the postnatal period.

scholarly journals Can the Edinburgh Postnatal Depression Scale-3A be used to screen for anxiety?

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Johanne Smith-Nielsen ◽  
Ida Egmose ◽  
Katrine Isabella Wendelboe ◽  
Pernille Steinmejer ◽  
Theis Lange ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Postnatal Depression ◽  
Edinburgh Postnatal Depression Scale ◽  
Depression Scale ◽  
Target Population ◽  
Postnatal Period ◽  
Operating Characteristics ◽  
New Mothers ◽  
Screening Programs ◽  
Postnatal Mothers

Abstract Background Anxiety in the ante- and postnatal period is prevalent, often co-occurs with depression, and can have adverse consequences for the infant. Therefore, perinatal mental health screening programs should not only focus on depression but also on detecting anxiety. However, in many already implemented perinatal screening programs, adding extra screening instruments is not feasible. We examine the utility of a subscale of the Edinburgh Postnatal Depression Scale (EPDS) consisting of items 3, 4, and 5 (EPDS-3A) for detecting anxiety in new mothers. Methods We used confirmatory factor analysis (CFA) to confirm the presence of the EPDS-3A found in a previous study (n = 320) where exploratory factor analysis (EFA) was used. For the CFA we used a sample of new mothers (n = 442) with children aged 2–11 months recruited from the same population from which mothers for the previous study was recruited. Three models were tested and compared. Receiver operating characteristics of the EPDS-3A were investigated in relation to anxiety caseness status on the combined sample (N = 762). Sample weighing was used to match the dataset to the target population. Cross tabulation was used to investigate the proportion of anxiety cases identified by the EPDS-3A above those identified with the total EPDS. Results The presence of the EPDS-3A was confirmed. An EFA-driven, two-dimensional 7-item model showed the best data fit with one factor representing the anxiety subscale consisting of items 3, 4, and 5. An EPDS-3A score of ≥ 5 was the most optimal for identifying cases of anxiety (sensitivity: 70.9; specificity: 92.2; AUC: 0.926). Further, we found that the EPDS-3A identifies an additional 2.5% of anxiety cases that would not have been identified with the total EPDS. Conclusions The EPDS-3A can be used as a time-efficient screening for possible anxiety in ante- and postnatal mothers. However, adding the EPDS-3A to routine screening with the total EPDS does not lead to a substantial increase in the number of women identified. In line with previous studies, this study confirms that the EPDS identifies anxiety in addition to depression. Therefore, assessment and treatment adjusted to the specific emotional difficulties is imperative.

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