Background Although much is known about the risk factors for postpartum depression (PPD), the role of giving birth to a preterm or low-birth-weight infant has not been reviewed systematically.Objective To review systematically the prevalence and risk factors for PPD among women with preterm infants.Search strategy Medline, CINAHL, EMBASE, PsycINFO and the Cochrane Library were searched from their start dates to August 2008 using keywords relevant to depression and prematurity.Selection criteria Peer-reviewed articles were eligible for inclusion if a standardised assessment of depression was administered between delivery and 52 weeks postpartum to mothers of preterm infants.Data collection and analysis Data on either the prevalence of PPD or mean depression score in the target population and available comparison groups were extracted from the 26 articles included in the review. Risk factors for PPD were also extracted where reported. Main resultsThe rates of PPD were as high as 40% in the early postpartum period among women with premature infants. Sustained depression was associated with earlier gestational age, lower birth weight, ongoing infant illness/disability and perceived lack of social support. The main limitation was that most studies failed to consider depression in pregnancy as a confounding variable.Author's conclusions Mothers of preterm infants are at higher risk of depression than mothers of term infants in the immediate postpartum period, with continued risk throughout the first postpartum year for mothers of very-low-birth-weight infants. Targeted clinical interventions to identify and prevent PPD in this vulnerable obstetric population are warranted.

Background This study examines the prevalence, correlates, and psychiatric disorders of adults with history of child sexual abuse (CSA). Methods Data were derived from a large national sample of the U.S. population. More that 34,000 adults aged 18 years and older residing in households were face-to-face interviewed in a survey conducted during the 2004–2005 period. Diagnoses were based on the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV version. Weighted means, frequencies, and odds ratios of sociodemographic correlates and prevalence of psychiatric disorders were computed. Logistic regression models were used to examine the strength of associations between child sexual abuse and psychiatric disorders, adjusted for sociodemographic characteristics, risk factors and other axis I psychiatric disorders. Results The prevalence of child sexual abuse was 10.14% (24.8% in men, and 75.2% in women). Child physical abuse, maltreatment, and neglect was more prevalent among individuals with CSA than among those without it. Adults with child sexual abuse history had significantly higher rates of any Axis I disorder and suicide attempts. The frequency, type and number of CSA were significantly correlated with psychopathology. Conclusions The high correlation rates of CSA with psychopathology and increased risk for suicide attempts in adulthood suggest the need for a systematic assessment of psychiatric disorders and suicide risk in these individuals. The risk factors for CSA emphasize the need for health care initiatives geared towards increasing recognition and development of treatment approaches for the emotional sequelae CSA as well as early preventive approaches.

Longitudinal studies with clearly defined "rural" and "comparison" groups are needed to determine whether rural residence is associated with increased risk for PPD. The results can inform prevention and treatment programs tailored to serve rural women.

Introduction Previous research on postpartum sexuality has primarily focused on the impact of physical factors on the resumption and frequency of sexual intercourse; fewer studies have focused on the impact of psychological factors on women’s sexual functioning. Aim The aim of this study is to assess current sexual functioning and sexual behavior in women with and without symptoms of postpartum depression using validated measures of postpartum depression and sexual functioning. Methods Women attending postpartum appointments were consecutively recruited over a 12-month period and completed questionnaires assessing sexual functioning, current sexual behavior, and mental health. Main Outcome Measures The Female Sexual Function Index (FSFI), the Edinburgh Postnatal Depression Scale (EPDS), and items assessing current sexual behaviors. Results A total of 77 women returned completed questionnaire packages (mean postpartum weeks: 13, range 3–24). Of these, 57 women (74%) had engaged in sexual activity with a partner in the 4 weeks prior to completing the questionnaire. The mean FSFI score was 23.0 (range 6–34), with 37 women (65%) scoring in the range associated with clinical sexual dysfunction. Women with elevated EPDS scores had significantly lower total FSFI, arousal, orgasm, and satisfaction FSFI subscale scores (all P values <0.005) than nondepressed women, suggesting more problematic sexual functioning. Desire, lubrication, and pain FSFI subscale scores were not significantly associated with depression status. Conclusions A substantial proportion of women experience sexual problems in the postpartum period; these problems are particularly pronounced among women with symptoms of postpartum depression. Longitudinal research is needed to better understand the relationship between sexual dysfunction and depression among postpartum women, and to identify implications for prevention and treatment of both conditions.

Sexual violence can cause acute and persistent negative psychological outcomes among children and adults in a community. Previous studies have frequently reported high prevalence of prior child and adolescent sexual abuse among adult victims of sexual violence. This raises uncertainty over the specific contribution of sexual victimization in adulthood to the adverse psychological outcomes. The present study draws on a large nationally representative sample of adults without history of childhood sexual abuse, and applies diagnostic criteria of DSM-IV, in order to investigate the risk factors and psychiatric comorbidities correlated with sexual victimization in adulthood. In a large representative sample of U.S. adults without history of childhood sexual abuse, 2.5% reported sexual victimization in adulthood. Female gender, living alone, economic disadvantage, and a history of childhood adversities and parental psychopathology were identified as risk factors. Adult sexual victimization increased the risk of developing a variety of psychiatric disorders, especially PTSD (HR = 3.43, 95% CI [2.67, 4.41]) and drug abuse (HR = 3.38, 95% CI [2.49, 4.58]). Conversely, pre-existing psychiatric psychopathology, particularly PTSD (HR = 3.99, 95% CI [2.68, 5.94]) and dysthymia (HR = 2.26, 95% CI [1.42, 3.59]), increased the likelihood of sexual victimization in adulthood. Childhood experience and adulthood sociodemographic characteristics are important in affecting the risk of being sexually victimized in adulthood. Psychiatric disorders can act as both risk factors and outcomes of adult sexual victimization.