ublic health measures to limit the spread of coronavirus disease 2019 (COVID-19) include requirements not to leave home except for specified purposes, to work from home when practical, to limit proximity to other people, to not visit residential aged care homes, to limit the number of people at social events (weddings, funerals, celebrations), to restrict interstate and international travel, and to accept the enforcement of these restrictions. The mental health consequences of these measures are likely to be unevenly distributed across the community because they also depend on individual social and economic circumstances. A recent position paper 1 summarised international expert opinion on research priorities for mental health during the COVID-19 pandemic. The first recommendation was to gather high quality population level data on its mental health effects. The aim of our study was to assess the mental health of people in Australia during the first month of COVID-19-related restrictions. Our specific objectives were to estimate population prevalence rates of clinically significant symptoms of depression, generalised anxiety, thoughts of being better off dead, increased irritability, and high optimism about the future; to estimate the prevalence of direct experiences of COVID-19, loss of employment caused by COVID-19 restrictions, concern about contracting COVID-19, and major disadvantage because of the restrictions; and to assess associations between these experiences and mental health symptoms. Methods A short, anonymous survey (estimated completion time, 8 minutes) of people living in Australia and aged at least 18 years was available on the Monash University website (https:// www.monash.edu/medic ine/living-with-covid-19-restr ictio nssurvey) from 3 April 2020 (four days after national stage two COVID-19 restrictions were announced by the Prime Minister; phase one restrictions had been gradually introduced during March) until midnight on 2/3 May 2020 (further information: online Supporting Information). Mental health Psychological symptoms experienced during the preceding fortnight were assessed with the Patient Health Questionnaire 9 (PHQ-9) and the Generalised Anxiety Disorder Scale (GAD-7). The PHQ-9 2 is an easily understood scale that asks respondents to rate their experience of nine symptoms from 0 (not experienced) to 3 (experienced nearly every day); a total PHQ-9 score of 10 or more indicates clinically significant (moderate to severe) symptoms, while scores of 5-9 indicate mild symptoms. The GAD-7 3 is an easily understood scale that asks respondents to rate their experience of seven symptoms of anxiety with the same response options as the PHQ-9; a total GAD-7 score of 10 or more indicate clinically significant (moderate to severe) symptoms, while scores of 5-9 indicate mild symptoms. Optimism about the future was assessed with a visual analogue scale (from 0, not at all optimistic, to 10, extremely optimistic).

for the Depression Screening Data (DEPRESSD) PHQ Collaboration IMPORTANCE The Patient Health Questionnaire depression module (PHQ-9) is a 9-item self-administered instrument used for detecting depression and assessing severity of depression. The Patient Health Questionnaire-2 (PHQ-2) consists of the first 2 items of the PHQ-9 (which assess the frequency of depressed mood and anhedonia) and can be used as a first step to identify patients for evaluation with the full PHQ-9.OBJECTIVE To estimate PHQ-2 accuracy alone and combined with the PHQ-9 for detecting major depression.

Australian health policy emphasises prevention, early intervention and improved pathways to treatment for perinatal mental disorders. Primary care is vital to achieving these aims. The aim of this study was to understand the anticipated needs and preferred sources of mental health information and support of men and women expecting their first baby. Nulliparous English-speaking expectant parents attending childbirth education programs in public and private hospitals participated in single sex small group discussions in late pregnancy. Discussions were audio-recorded, transcribed and analysed thematically using the group as the unit of analysis. Eight groups (22 women; 16 men) encompassing diverse socioeconomic circumstances were conducted. Analyses showed idealised fantasies consistently tempered with realistic expectations about adjustment to life with a baby. However, there were diverse and gendered views about whether primary care providers should discuss mental health with parents of infants and willingness to complete written questionnaires or be referred for specialist mental health care. Men regard primary family care as mother not father inclusive. Expectant parents readily anticipate realistic postnatal adjustment and need for emotional support. Increased provision of services that meet men’s needs and public understanding and acceptance of Australian integrated models of primary postnatal mental health care are needed.

No abstract

BackgroundUniversal interventions to prevent postnatal mental disorders in women have had limited success, perhaps because they were insufficiently theorised, not gender-informed and overlooked relevant risk factors. This study aimed to determine whether an innovative brief psycho-educational program for mothers, fathers and first newborns, which addressed salient learning needs about infant behaviour management and adjustment tasks in the intimate partner relationship, prevented postpartum mental health problems in primiparous women.MethodsA before and after controlled study was conducted in primary care in seven local government areas in Victoria, Australia. English-speaking couples with one-week old infants were invited consecutively to participate by the maternal and child health nurse at the universal first home visit. Two groups were recruited and followed sequentially: both completed telephone interviews at four weeks and six months postpartum and received standard health care. Intervention group participants were also invited to attend a half-day program with up to five couples and one month old infants, facilitated by trained, supervised nurses. The main outcome was any Composite International Diagnostic Interview (CIDI) diagnosis of Depression or Anxiety or Adjustment Disorder with Depressed Mood, Anxiety, or Mixed Anxiety and Depressed Mood in the first six months postpartum. Factors associated with the outcome were established by logistic regression controlling for potential confounders and analysis was by intention to treat.ResultsIn total 399/646 (62%) women were recruited; 210 received only standard care and 189 were also offered the intervention; 364 (91%) were retained at follow up six months postpartum. In women without a psychiatric history (232/364; 64%), 36/125 (29%) were diagnosed with Depression or Anxiety or Adjustment Disorder with Depressed Mood, Anxiety, or Mixed Anxiety and Depressed Mood in the control group, compared with 16/107 (15%) in the intervention group. In those without a psychiatric history, the adjusted odds ratio for diagnosis of a common postpartum mental disorder was 0.43 (95% CI 0.21, 0.89) in the intervention group compared to the control group.ConclusionsA universal, brief psycho-educational group program for English-speaking first time parents and babies in primary care reduces de novo postpartum mental disorders in women. A universal approach supplemented by an additional program may improve effectiveness for women with a psychiatric history.Trial registrationACTRN 12605000567628.

No abstract

No abstract

The aim was to identify from empirical research that used quantitative or qualitative methods the reasons women give for having an abortion. A search was conducted of peer-reviewed, English language publications indexed in eight computerized databases with publication date 1996-2008, using keywords 'abortion' and 'reason' (Medline: 'induced abortion' OR 'termination of pregnancy' OR 'elective abortion' and 'reason'). Inclusion criteria were empirical research on humans that identified women's reasons for undergoing an abortion, conducted in 'high-income' countries. 19 eligible papers were found. Despite variation in methods of generating, collecting, and analysing reasons, and the inadequacy of methodological detail in some papers, all contributed to a consistent picture of the reasons women give for having an abortion, with three main categories ('Woman-focused', 'Other-focused', and 'Material') identified. Ambivalence was often evident in women's awareness of reasons for continuing the pregnancy, but abortion was chosen because continuing with the pregnancy was assessed as having adverse effects on the life of the woman and significant others. Women's reasons were complex and contingent, taking into account their own needs, a sense of responsibility to existing children and the potential child, and the contribution of significant others, including the genetic father.