Postnatal depression (PND) affects approximately 10-20 % of new mothers in developed countries, with accumulating research documenting its adverse impact on not only the mother but also the wider family. Longitudinal studies assessing potential effects of maternal PND on offspring are mounting, and it is therefore timely to investigate the long-term psychological outcomes for adolescent offspring who were exposed to PND in infancy. PsycINFO, Medline, and Embase databases were searched with key terms for English language abstracts. Papers of 16 were identified that examined associations between PND and internalising problems, externalising problems, psychopathology, psychosocial, and cognitive outcomes of adolescent offspring. Impaired offspring cognitive outcomes reflected some of the most consistent findings. Conflicting evidence was found for an effect of PND on adolescent offspring internalising and externalising problems and overall psychopathology. Psychosocial outcomes in offspring adolescents indicated a specific adverse effect, although based on only two studies. Significant gender differences across outcomes were found. It was concluded that PND possibly increases risk vulnerability in the presence of recurrent, concurrent, and antenatal maternal depression but that these latter factors alone may be the stronger specific predictors. Limitations of the review are discussed as well as implications for future research and clinical practice.
Studies in North America and Europe indicate that the prevalence of blood-borne viruses (BBVs) is elevated in individuals with severe mental illness; there are no comparable data for the UK. We offered routine testing for HIV, and hepatitis B and C in an inner-London in-patient psychiatric unit as a service improvement. Of the patients approached 83% had mental capacity to provide informed consent for testing and 66% of patients offered testing accepted. Although it was not our objective to establish the prevalence of BBVs, 18% of patients had serological evidence of a current or previous BBV infection. We found that offering routine testing in an in-patient psychiatric setting is both practical and acceptable to patients.
The NSPCC is dedicated to perinatal wellbeing and advocating for a preventative model of care that has the potential to improve the mental health for parents, families and communities. Here in the first of two articles, Camilla Sanger, Alice Haynes, Gary Mountain and Naomi Bonett-Healy provide an update of antenatal mental health research and recommended practice, with a specific focus on the role midwives can play in screening and identifying mental health problems.
Mothers from minority ethnic groups are at increased risk of poor mental and physical health outcomes across the perinatal period, and often fail to access existing antenatal support services. There is currently a lack of research about how such families can be supported. The NSPCC has developed and evaluated a group-based perinatal education programme which was designed to meet the needs of a range of disadvantaged parents, including some from minority ethnic backgrounds. In-depth face-to-face interviews were carried out with a sample of 14 minority ethnic parents who had completed the programme. Positive outcomes reported by parents included: increased knowledge about pregnancy and parenting; improved relationships with partners and infants; and, for some, changes in attitudes towards gender roles, corporal punishment and female genital mutilation. The programme was a particularly important source of information and support for parents who were socially isolated. Factors that engaged this group of parents in the programme included: the use of interpreters; cultural competence among practitioners; and practitioners working flexibly by offering additional support and making themselves available to liaise with other agencies on behalf of the parents.
The NSPCC is dedicated to perinatal wellbeing and advocating for a preventive model of care that has the potential to improve the mental health for parents, families and communities. Here in the second of two articles, Camilla Sanger, Alice Haynes, Gary Mountain and Naomi Bonett-Healy describe two evidence-based perinatal NSPCC services facilitated by midwives.
diverse towns in four Australian states (total population 72 000 16e29-year-olds). To date, 27 towns have been randomised (13 intervention, 14 control). Intervention and control towns are similar: baseline chlamydia prevalence (5.8%, 95% CI 4.4 to 7.5% vs 5%, 95% CI 3.9 to 6.3%, individual response rate 63%); past chlamydia testing rate in 16e29-year-olds (6.1%, 95% CI 5.8 to 6.4% vs 5.8%, 5.6 to 6%). After 3 months of the intervention in the first two towns the chlamydia testing rate was 10.9% (95% CI 10.1% to 11.7%; 691 people tested), a 160% increase compared with the testing rate (4.1%) in the year before the intervention.Conclusions Our high recruitment rate shows that Australian GPs are willing to test for chlamydia. The baseline data show a high prevalence of chlamydia among young adults in the study towns. While testing rates are increasing, ongoing work is needed to get coverage up to levels that might reduce prevalence in intervention towns. Results Of the first 100 patients offered a test 83% of patients approached were assessed to have mental capacity to provide informed consent for testing. 69% of patients offered BBV testing, accepted. The prevalence of HIV was found to be 3%. One individual was newly diagnosed with HIV and transferred to specialist care. Overall, 18% of patients tested were found to have a newly diagnosed or previous infection with a BBV. Conclusion It is acceptable to patients to be offered routine BBV screening in a psychiatric setting and the majority have capacity to consent; uptake rate is comparable to that seen in GUM clinics. HIV prevalence rate was found to be over four times higher than that of the local population. Given the elevated prevalence rates in psychiatric patients, there is a strong case for the wider introduction of routine testing in mental health settings. There is a need to systematically ascertain rates of infection in mental health patients across a range of geographical areas since the prevalence of BBVs appears to be higher than that in the local population.
O10SHOULD Background In 2008, a schools-based HPV vaccination programme was introduced for girls aged 12e13, with an accelerated catch up programme for those aged 14e18. A significant impact on cervical cancer rates requires 80% uptake of three vaccinations, however in England the completion rate was 58% in 2009/10.
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