Introduction: A deeper understanding of risk factors for postpartum depression (PPD) is essential to better target prevention and screening. An umbrella review was conducted to summarize and synthesize previously published systematic reviews and meta-analyses. Methods: Eight databases were searched in October of 2016, including PubMed, CINAHL, MEDLINE, PsycINFO, Embase, SCOPUS, PsycEX-TRA, and Cochrane. Studies were included if they were reviews examining one or more risk factors for PPD and published between 1996 and 2016. The final sample included 21 articles, which varied in numerous ways, including the scope of risk factors explored and statistical methods. Results: Because of methodological variations between reviews, standardized statistical aggregation was not possible. From this body of literature, 25 statistically significant risk factors emerged with 2 additional risk factors presenting inconclusive findings. The most common risk factors identified were high life stress, lack of social support, current or past abuse, prenatal depression, and marital or partner dissatisfaction. The 2 strongest risk factors for PPD were prenatal depression and current abuse. Discussion: Because untreated PPD leaves women and their children vulnerable to numerous negative short-term and long-term outcomes, a better understanding of PPD risk factors serves to improve maternal and child outcomes by allowing health care providers to better anticipate the needs of affected women.

This multi-method pilot study implemented a relationally-based intervention with mothers of school-aged children receiving treatment for exposure to domestic violence. Grounded in psychodynamic and attachment theories, the short-term intervention consisted of targeted individual and group sessions. Quantitative as well as qualitative data were examined for trends and exemplars of important process outcomes. Improvements were evidenced in a number of key areas including psychiatric symptoms, isolation, defensive avoidance, coping skills, attributional style, and reflective functioning. Results converged to portray improved functioning in critical areas of dysfunction often displayed by these mothers.

Background There is potential to increase the speed of scientific discovery and implement personalized health care by using digitized clinical data collected on the patient care experience. The use of these data in research raises concerns about the privacy and confidentiality of personal health information. This study explored community members’ views on the secondary use of digitized clinical data to (1) recruit participants for clinical studies; (2) recruit family members of persons with an index condition for primary studies; and (3) conduct studies of information related to stored biospecimens. Methods A qualitative descriptive design was used to examine the bioethical issues outlined from the perspective of urban-dwelling community members. Focus groups were used for data collection, and emergent content analysis was employed to organize and interpret the data. Results Thirty community members attended one of four focus groups ranging in size from 4 to 11 participants. Five critical themes emerged from the focus-group material: (1) perceived motivators for research participation; (2) objective or “real-life” barriers to research participation; (3) a psychological component of uncertainty and mistrust; (4) preferred mechanisms for recruitment and participation; and (5) cultural characteristics that can impact understanding and willingness to engage in research. Conclusions The overriding concern of community members regarding research participation and/or secondary clinical and nonclinical use of digitized information was that their involvement would be safe and the outcome would be meaningful to them and to others. According to participants, biospecimens acquired during routine clinical visits or for research are no longer possessions of the participant. Although the loss of privacy was a concern for participants, they preferred that researchers access their personal health information using a digitized clinical file rather than through a paper-based medical record.

Maternal resolution of a child's diagnosis relates to sensitive caregiving and healthy attachment. Failure to resolve is associated with maternal distress, high caregiving burden, and the quality of marital and social support. This study examined maternal resolution of diagnosis in a child psychiatric population utilizing the Reaction to Diagnosis paradigm. Thirty-three mothers of children ages 2–7 years with psychiatric disorders were interviewed using the Reaction to Diagnosis Interview. Slightly over half of the sample was classified as resolved. Associations between maternal resolution status, maternal depression, childrearing stress, and child functioning were examined and a predictive model for maternal resolution status was tested. Specific findings included a significant association between childrearing stress and maternal resolution status with support for some additional predictive power for maternal depression on resolution status. Child functioning was not significantly associated with resolution status, and may exert influence indirectly through its association with childrearing stress. There were no significant associations between maternal or child demographic characteristics and maternal resolution status. Clinical and research implications are discussed.

The current study examined longitudinal associations between mental disorders and all-cause subsequent medical events in a 5% random sample of records in the 2010 national Outcome and Assessment Information Set. Records of older adults (N = 28,475) receiving home health care (HHC) services were examined with respect to mental disorders and medical events, including acute care hospitalization, emergency department admission, and 30-day rehospitalization. Predominant mental disorders were depression and anxiety identified by formal diagnoses, symptom clusters, and/or prescription of related mental health services. Depression intervention use was the strongest risk factor for all three types of medical events. However, 61.6% of patients receiving depression interventions did not screen positive at admission using the Patient Health Questionnaire-2. Moving forward, nurses must closely monitor high-risk older adults throughout the HHC stay using sensitive depression screening tools, as well as receive targeted training in geriatric psychiatry. [Journal of Gerontological Nursing, 42(10), 42-55.].