scholarly journals A Review of the Involvement of Partners and Family Members in Psychosocial Interventions for Supporting Women at Risk of or Experiencing Perinatal Depression and Anxiety

Author(s):  
Maria Noonan ◽  
Julie Jomeen ◽  
Owen Doody

A maternal experience of perinatal mental health conditions can have serious short- and long-term consequences for child development and family relationships. Women with perinatal depression and/or anxiety are primarily supported by their partner/spouse and family. The aim of this review was to synthesise data from studies that have examined the inclusion of partners or family members in psychosocial interventions for women at risk of or experiencing perinatal depression and/or anxiety. A systematic search of five databases was conducted to identify literature published between 2010 and 2020. Nine empirical studies met the eligibility criteria and were independently assessed by two authors using the National Heart, Lung and Blood Institute Quality Assessment Tools and data were extracted and narratively synthesised guided by TIDieR (Template for Intervention Description and Replication) checklist. Eligible studies detailed diverse interventions facilitated by a variety of programme facilitators, with no central model of intervention or study outcome measures evident across the studies. All studies except one reported a significant change in maternal depression and anxiety scores. The interventions had limited evaluation of the woman’s, partner’s or family member’s experiences of involvement in the intervention. Further research is required to firmly establish the effectiveness of co-designed interventions to support the sustainable integration of such interventions into routine perinatal mental health services.

2021 ◽  
Author(s):  
Clare Evans ◽  
Jana Kreppner ◽  
Peter J Lawrence

Background: Perfectionism is an important feature of adult psychopathology. In the absence of a prior review of the role of perfectionism in perinatal psychopathology, we aimed to ascertain whether perfectionism was associated with symptoms of maternal perinatal depression and anxiety. Method: We followed PRISMA guidance (PROSPERO: 42019143369 ), estimated weighted effect sizes and tested possible moderators: timing (pre or post- natal), scales used to measure constructs, infant gender, temperament and age; and rated study quality. Results: 14 studies met eligibility criteria. Perfectionism as a whole, and the perfectionistic concerns dimension, were moderately correlated with common maternal perinatal mental health difficulties r= 0.32 (95% Confidence Interval = 0.23 to 0.41). In sub-group analyses, perfectionistic concerns were associated with depression (r=.35, 95% CI = 0.26 – 0.43). We found no evidence of significant moderation of associations. Limitations: Included studies had methodological and conceptual limitations. Studies inconsistently examined both perfectionistic concerns and strivings, nor anxiety as well as depression. Conclusions: Perfectionism, especially perfectionistic concerns, appears to be an important feature of common maternal perinatal mental health problems. While further research is warranted, screening and identification of perfectionism in the perinatal period may help focus resources for intervention, reducing the prevalence of perinatal mental health difficulties.


2019 ◽  
Vol 27 (3) ◽  
pp. 307-328 ◽  
Author(s):  
Kelly M. Schuppan ◽  
Rachel Roberts ◽  
Rosalind Powrie

Given the prevalence of paternal perinatal mental health concerns, researchers have suggested introducing routine screening. However, little is known about the acceptability of perinatal screening measures in male populations. Furthermore, the need for screening is influenced by men’s perinatal help-seeking behaviors. A thematic analysis of interview data from nine men at risk of paternal perinatal depression and/or anxiety investigated both acceptability of screening and help-seeking behaviors. Themes indicate that routine screening is desired, but acceptability is influenced by perceptions of its intention and possible outcomes. Findings also suggest that barriers to men’s perinatal help-seeking are likely to be minimized by increased awareness and normalization. Future research and clinical practice should account for complexities raised by men’s perceptions of health care services.


2021 ◽  
Vol 4 (4) ◽  
Author(s):  
Rachael Maree Hunter

In 2020 the novel coronavirus outbreak (COVID-19) was declared a global pandemic. Pregnant women have been recognised as a group specifically at risk during this time due to the impact that the COVID-19 infection may have on the health of the birthing person and the unknown impact of vertical transmission to the fetus. Pregnant women also have a recognised risk of perinatal mental health problems including depression and anxiety. The aim of this paper is to summarise the impact of the COVID-19 pandemic and associated infection control measures on perinatal depression and anxiety in England, the cost of the additional impact and the role of English National Health Service (NHS) trusts and maternity services in reducing the impact and cost. Studies including systematic reviews and meta-analyses have found a 3 to 5 fold increase in perinatal depression and anxiety during the COVID-19 pandemic compared to non-pandemic times. This increased prevalence, if also seen in England, is at a potential cost to society of £10.6 billion for depression and £6.9 billion for anxiety, including a cost to the health care sector of £649 million and £1.7 billion respectively. Health care Trusts and maternity services have an important role to play in reducing this cost, not just in providing maternity care, but also in monitoring the health of the population and referring onwards where needed. Modest improvements in the availability of social support including improved partner involvement during pregnancy and labour and support given by health care staff during maternity care have the potential to reduce the risk of perinatal depression and anxiety. Signposting to and provision of perinatal mental health services, particularly for women at risk, is also likely improve outcomes for birthing people and their infants and hence to reduce the total cost to society of perinatal mental health problems.


2019 ◽  
Author(s):  
Jacqueline Anne Boyle ◽  
Suzanne Willey ◽  
Rebecca Blackmore ◽  
Christine East ◽  
Jacqueline McBride ◽  
...  

BACKGROUND Identifying mental health disorders in migrant and refugee women during pregnancy provides an opportunity for interventions that may benefit women and their families. Evidence suggests that perinatal mental health disorders impact mother-infant attachment at critical times, which can affect child development. Postnatal depression resulting in suicide is one of the leading causes of maternal mortality postpartum. Routine screening of perinatal mental health is recommended to improve the identification of depression and anxiety and to facilitate early management. However, screening is poorly implemented into routine practice. This study is the first to investigate routine screening for perinatal mental health in a maternity setting designed for refugee women. This study will determine whether symptoms of depression and anxiety are more likely to be detected by the screening program compared with routine care and will evaluate the screening program’s feasibility and acceptability to women and health care providers (HCPs). OBJECTIVE The objectives of this study are (1) to assess if refugee women are more likely to screen risk-positive for depression and anxiety than nonrefugee women, using the Edinburgh Postnatal Depression Scale (EPDS); (2) to assess if screening in pregnancy using the EPDS enables better detection of symptoms of depression and anxiety in refugee women than current routine care; (3) to determine if a screening program for perinatal mental health in a maternity setting designed for refugee women is acceptable to women; and (4) to evaluate the feasibility and acceptability of the perinatal mental health screening program from the perspective of HCPs (including the barriers and enablers to implementation). METHODS This study uses an internationally recommended screening measure, the EPDS, and a locally developed psychosocial questionnaire, both administered in early pregnancy and again in the third trimester. These measures have been translated into the most common languages used by the women attending the clinic and are administered via an electronic platform (iCOPE). This platform automatically calculates the EPDS score and generates reports for the HCP and woman. A total of 119 refugee women and 155 nonrefugee women have been recruited to evaluate the screening program’s ability to detect depression and anxiety symptoms and will be compared with 34 refugee women receiving routine care. A subsample of women will participate in a qualitative assessment of the screening program’s acceptability and feasibility. Health service staff have been recruited to evaluate the integration of screening into maternity care. RESULTS The recruitment is complete, and data collection and analysis are underway. CONCLUSIONS It is anticipated that screening will increase the identification and management of depression and anxiety symptoms in pregnancy. New information will be generated on how to implement such a program in feasible and acceptable ways that will improve health outcomes for refugee women. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/13271


BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e030208 ◽  
Author(s):  
Billie Lever Taylor ◽  
Jo Billings ◽  
Nicola Morant ◽  
Debra Bick ◽  
Sonia Johnson

ObjectivesPartners and wider family members play a vital role in relation to women’s perinatal mental health. Clinical guidelines in the UK and internationally recommend that services supporting women with perinatal mental health difficulties involve and support their families too. However, little is known about family members’ needs and experiences, or whether they feel included by mental health services. This study set out to explore this.MethodsThis research formed part of a wider study exploring experiences of perinatal mental health care in England. The broader study included semi-structured interviews with 52 women across England who received treatment for a perinatal mental health difficulty, and 32 family members identified by the women as offering them some support. Data from these 84 interviews relating to how services work with partners and families were extracted and analysed thematically.ResultsAnalysis identified three overarching themes: (1) the centrality of women’s families to their perinatal mental health/access to support, (2) experiences of partners and families being excluded by services and (3) ambivalence among women and their families about increasing family involvement/support. We found that partners and families appear to have an important influence on women’s perinatal mental health, access to care and interactions with services, but that services tend to focus on individual women (and babies) with little regard for their wider family context. The complexity of involving and supporting partners and families, coupled with anxiety about this among women and their families, reinforces the tendency to marginalise them.ConclusionInvolving women’s families and providing the support they need is challenging, but important. Experiences of women and their families of services treating perinatal mental health difficulties suggests greater focus is needed on overcoming barriers to family inclusion and on challenging underlying gender roles and expectations, rather than allowing these to shape and guide practice.


2020 ◽  
Vol 2020 ◽  
pp. 1-14
Author(s):  
Yiting Chen ◽  
Zheng Li ◽  
Jian Peng ◽  
Lanjun Shen ◽  
Juan Shi

Background. Psychological symptoms such as depression and anxiety are quite common among stroke survivors and have great negative impacts on patients. Objective. To develop a care bundle through reviewing and integrating care strategies for psychological symptoms after stroke and then improve the bundle by Delphi study. Methods. A structured search of the literature was performed to identify studies evaluating interventions for stroke patients with psychological symptoms such as depression and anxiety. Two trained researchers screened papers through the titles, abstracts, and full-texts independently. All studies complying with the eligibility criteria were appraised using quality assessment tools. Related interventions with evaluated evidence levels formed the preliminary bundle. Afterward, the Delphi study was carried out to improve the bundle, and the experts were contacted by e-mail. Ten clinical experts specialized in stroke and psychological rehabilitation were recruited. The reliability of experts was represented by the effective response rate and authority coefficient (Cr). The consensus was deemed to be reached when the mean score for item importance is all equal or above 3.50 and the coefficient of variation (CV) is all equal or below 0.20. The Kendall coefficient W test was adopted to evaluate the consensus on agreement among the experts as well. Data analysis was performed using SPSS V.22.0. Results. Through a systematic evidence summary and two-round Delphi study, the items that were given high scores and got consensus by experts were chosen for the bundle. The iDAME bundle consisted of five interventions eventually: maintaining Interaction, tailored Diet, Acupressure, mindfulness Meditation, and physical Exercise. Conclusion. The development of an evidence-based and consensus-based iDAME bundle which integrated western and traditional Chinese medicine intervention was described. Evidence summary made the bundle become scientific, while the Delphi study made it more maneuverable. Based on these results, the bundle would be potentially implemented in stroke patients for their psychological symptoms.


Author(s):  
Syeda Beenish Bareeqa ◽  
Syed Ijlal Ahmed ◽  
Syeda Sana Samar ◽  
Waqas Yasin ◽  
Sani Zehra ◽  
...  

Background The novel coronavirus disease which is believed to have initially originated in Wuhan city of China at the end of 2019 was declared as pandemic by March 2020 by WHO. This pandemic significantly impacted the mental health of communities around the globe. This project draws data from available research to quantify COVID-19 mental health issues and its prevalence in China during the early period of the COVID-19 crisis. It is believed that this pooling of data will give fair estimate of the effects of the COVID-19 pandemic on mental health. Methods We conducted this study in accordance with PRISMA guidelines 2009. The protocol for this review is registered and published in PROSPERO (CRD42020182893). The databases used were Pubmed, Medline, Google scholar and Scopus. The studies were extracted according to pre-defined eligibility criteria and risk of bias assessment was conducted. The Meta-analysis was done using OpenMeta [analyst]. Results Total of 62382 participants in nineteen studies fulfilled the eligibility criteria. Stress was the most prevalent (48.1%) mental health consequence of Covid-19 pandemic, followed by depression (26.9%) and anxiety (21.8%). After performing subgroup analysis, prevalence of depression and anxiety in both females and frontline health care workers were high as compared to the prevalence in general Chinese population. Conclusion The prevalence of depression and anxiety is moderately high whereas pooled prevalence of stress was found to be very high in Chinese people during this Covid-19 crisis.


Author(s):  
Emma Carlin ◽  
David Atkinson ◽  
Julia V Marley

Despite high rates of perinatal depression and anxiety, little is known about how Aboriginal women in Australia experience these disorders and the acceptability of current clinical screening tools. In a 2014 study, the Kimberley Mum’s Mood Scale (KMMS) was validated as an acceptable perinatal depression and anxiety screening tool for Aboriginal women in the Kimberley region of Western Australia. In the current study, we explored if it was appropriate to trial and validate the KMMS with Aboriginal women in the Pilbara. Yarning as a methodology was used to guide interviews with 15 Aboriginal women in the Pilbara who had received maternal and child health care within the last three years. Data were analysed thematically, the results revealing that this cohort of participants shared similar experiences of stress and hardship during the perinatal period. Participants valued the KMMS for its narrative-based approach to screening that explored the individual’s risk and protective factors. While support for the KMMS was apparent, particular qualities of the administering health care professional were viewed as critical to the tool being well received and culturally safe. Building on these findings, we will work with our partner health services in the Pilbara to validate the KMMS with Pilbara Aboriginal women.


2016 ◽  
Vol 11 (4) ◽  
pp. 863-876 ◽  
Author(s):  
Anthony P. O’Brien ◽  
Karen A. McNeil ◽  
Richard Fletcher ◽  
Agatha Conrad ◽  
Amanda J. Wilson ◽  
...  

More than 10% of fathers experience depression and anxiety during the perinatal period, but paternal perinatal depression (PPND) and anxiety have received less attention than maternal perinatal mental health problems. Few mainstream treatment options are available for men with PPND and anxiety. The aim of this literature review was to summarize the current understanding of PPND and the treatment programs specifically designed for fathers with perinatal depression. Eight electronic databases were searched using a predefined strategy, and reference lists were also hand searched. PPND and anxiety were identified to have a negative impact on family relationships, as well as the health of mothers and children. Evidence suggests a lack of support and tailored treatment options for men having trouble adjusting to the transition to fatherhood. Of the limited options available, cognitive behavioral therapy, group work, and blended delivery programs, including e-support approaches appear to be most effective in helping fathers with perinatal depression and anxiety. The review findings have important implications for the understanding of PPND and anxiety. Future research is needed to address the adoption of father-inclusive and father-specific models of care to encourage fathers’ help-seeking behavior. Inclusion of male-specific requirements into support and treatment options can improve the ability of services to engage new fathers. Psychotherapeutic intervention could assist to address the cognitive differences and dissonance for men adjusting to the role of father, including male identity and role expectations.


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