Chinese Women’s Acceptance and Uptake of Referral after Screening for Perinatal Depression

Abstract

China recently issued a national plan on perinatal depression (PND) screening. Previous studies elsewhere suggested that uptake of referral after screening for PND is suboptimal, but little is known in China. In this cohort study including 1126 women in Hunan, we identified women at a high risk of PND using the Edinburgh Postpartum Depression Scale (EPDS) over multiple time points. We texted them and offered free consultations with a psychiatrist/psychologist. Among 248 screen-positive women, only three expressed interest and one attended the appointment. We surveyed the women about their reasons for declining referrals and preferred means of care. Of the 161 respondents, 128 (79.5%) indicated that they could cope with the condition without professional assistance and 142 (88.2%) chose their families as the preferred source of help. Only 15 (9.3%) chose professionals as their first option. Implementing a referral policy for screen-positive women would mean approximately one-third of women who gave birth in China would be eligible. Our result argues against referring all screen-positive women for professional services at this time. Interventions should instead build upon the tradition of family support in a more engaged response. These considerations are relevant for the implementation of national screening for PND in China.

Experiences and Perceptions of Perinatal Depression Among New Immigrant Chinese Parents: A Qualitative Study

“…The high level of acceptance of mobile health technologies among these Chinese immigrant women and their spouses is similar to other reports 31,39 . Even in 2014, use of mobile services were common practice throughout China, a nation with a many decades' pattern of internal migration and the need for inexpensive long-distance communication.…”

“…Our ndings are consistent with what has been reported previously [26][27][28][29] about attitudes in Chinese culture regarding the shame associated with mental health concerns, and women's reticence to reveal their distress. It also underscores the priority placed on a family-rst approach to resolving problems if they are, in fact, shared at all 30,31 . Perinatal depression screening now is being advocated in China 32 , but there remains insu cient data regarding how best to accomplish effective identi cation and subsequent referrals to care for those women who need it the most.…”

Association Between Dietary Quality and Postpartum Depression in Lactating Women: A Cross-Sectional Survey in Urban China

“…Some researchers suggest the assessment period of postpartum depression should be extended to 12 months postpartum (32). Further, although the National Health Commission (NHC) of China has planned that introducing screening for depression during pregnancy and childbirth to routine antenatal care and postpartum visits, one study has found that the majority of symptom-positive women during the perinatal period do not accept a subsequent referral to mental health services (33). Depressed lactating women who are recommended to take an antidepressant may concern that the drugs have a possible effect on their infants via breast milk (34).…”

States Transitions Inference of Postpartum Depression Based on Multi-State Markov Model

“…However, some limitations of this study can be summarized as follows. First, recognizing the belief of “domestic shame should not be made public” [ 46 ], the percent of women with PPD could be underestimated. Second, women’s lifestyles may change dramatically over such a long period, which could violate the model’s assumption on time homogeneity, and it could lead to biases.…”