Effectiveness of a brief psychoeducational intervention on postnatal depression in the slums, Nairobi: a longitudinal study

Kariuki, Esther; Kuria, Mary Wangari; Were, Fredrick; Ndetei, David M.

doi:10.1007/s00737-020-01085-1

Cited by 7 publications

(26 citation statements)

References 47 publications

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“…Five studies were cluster RCTs ( 73 , 78 – 81 ) with group assignment at the level of the healthcare center, two were classified as quasi-cluster RCTs ( 75 , 76 ), and thirteen were individual RCTs ( 62 – 72 , 74 , 77 ).…”

Section: Resultsmentioning

confidence: 99%

“…The sample populations included women in all three trimesters of pregnancy and the postpartum period. Most studies (75%) focused on women in the antepartum period ( 63 – 65 , 67 – 69 , 71 , 73 – 75 , 77 – 81 ), while five studies (25%) focused on women in the postpartum period ( 62 , 66 , 70 , 72 , 76 ). More than half of the studies focused on illness prevention rather than treatment of women with active diagnoses or positive screening for depression or anxiety.…”

Section: Resultsmentioning

confidence: 99%

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A Systematic Review of Interventions That Integrate Perinatal Mental Health Care Into Routine Maternal Care in Low- and Middle-Income Countries

et al. 2022

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BackgroundWomen in low- and middle-income countries (LMICs) are disproportionally affected by perinatal depression and anxiety and lack access to mental health care. Integrating perinatal mental health care into routine maternal care is recommended to address gaps in access to mental health care in such under-resourced settings. Understanding the effectiveness of interventions that integrate perinatal mental health care into routine maternal care in LMICs is critical to inform ongoing intervention development, implementation, and scale-up. This systematic review aims to assess the effectiveness of interventions that integrate perinatal mental health care into routine maternal care to improve maternal mental health and infant health outcomes in LMICs.MethodIn accordance with the PRISMA guidelines, an electronic database search was conducted seeking publications of controlled trials examining interventions that aimed to integrate perinatal mental health care into routine maternal care in LMICs. Abstracts and full text articles were independently reviewed by two authors for inclusion utilizing Covidence Review Software. Data was extracted and narrative synthesis was conducted.FindingsTwenty studies met eligibility criteria from the initial search results of 2,382 unique citations. There was substantial heterogeneity between the study samples, intervention designs, and outcome assessments. Less than half of the studies focused on women with active depression or anxiety. Most studies (85%) implemented single intervention designs involving psychological, psychosocial, psychoeducational, or adjuvant emotion/stress management. There were few interventions utilizing multicomponent approaches, pharmacotherapy, or referral to mental health specialists. Outcome measures and assessment timing were highly variable. Eighteen studies demonstrated significantly greater improvement on depression and/or anxiety measures in the intervention group(s) as compared to control.ConclusionIntegrated interventions can be effective in LMICs. The findings provide a critical understanding of current interventions design gaps. This includes the lack of comprehensive intervention designs that incorporate increasing intensity of treatment for more severe illness, pharmacotherapy, mental health specialist referrals, and non-mental health professional training and supervision. The findings also provide strategies to overcome design and implementation barriers in LMICs. Study findings provide a foundation for future evidence-based adaptation, implementation, and scale-up of interventions that integrate perinatal mental health care into routine maternal care in LMICs.Systematic Review Registration[https://www.crd.york.ac.uk/prospero/display_ record.php?ID=CRD42021259092], identifier [CRD42021259092].

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Interventions That Integrate Perinatal Mental Health Care Into Routine Maternal Care in Low- and Middle-Income Countries

et al. 2022

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“…This paper is a cross-sectional design and is a part of a longitudinal study (34) and investigated hypothesized risk factors for PND. Data was collected from Lang'ata and Riruta Health Centres-MCH clinics.…”

Section: Participants and Proceduresmentioning

confidence: 99%

“…Mothers were recruited as they brought their infants for the rst MCH clinic visit through continuous purposive sampling until the required sample was achieved(567 participants). The sampling method is published elsewhere (34). Informed consenting mothers lled up a self-administered Social-Demographic Questionnaire (SDQ) and an English version of the original (1961) Becks Depression Inventory (BDI).…”

Section: Participants and Proceduresmentioning

confidence: 99%

Predictors of Postnatal Depression in the Slums Nairobi, Kenya: A Cross-Sectional Study

Kariuki

Kuria

Were

et al. 2021

Preprint

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BackgroundPostnatal depression (PND) is a universal mental health problem that prevents mothers' optimal existence and mothering. Although research has shown high PND prevalence rates in Africa, including Kenya, little research has been conducted to determine the contributing factors, especially in low-resource communities.ObjectiveThis study aimed to investigate the PND risk factors among mothers attending Maternal and Child Health Clinics (MCH) in the slums, Nairobi.MethodsThis study is cross-sectional, which is a part of a larger study. A sample of 567 mothers of 6-10 weeks postnatal from two Maternal and Child Health (MCH) formed the study population. The Depression rate was measured using the original 1961 Beck's Depression Inventory (BDI). In addition, a sociodemographic questionnaire (SDQ) was used to collect hypothesized risk variables. Results The PND prevalence rate was 27.1%. Women with: unplanned pregnancy (AOR=1.87, 95% CI 1.02, 3.43), unemployed (AOR=4.43, 95% CI 1.01, 19.76), dissatisfied with body image (AOR=2.51, 95% CI 1.21, 5.19) and feeling fatigued (AOR=2.02, 95% CI 1.06, 3.85) had higher odds of developing PND. ConclusionThis study builds upon scarce previous studies on PND from low-income countries. Identifying specific PND risk factors may help in devising targeted prophylactic and therapeutic strategies.

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“…Empirical evidence suggests that CBT[ 17 ], mindfulness therapy[ 18 ], problem-solving therapy[ 19 ], stress-reduction therapy[ 20 ], and psychoeducation intervention[ 21 ] using face-to-face approach is effective in improving psychological outcomes among perinatal women. However, traditional face-to-face psychotherapeutic interventions may reduce effectiveness due to structural and psychological barriers[ 22 - 24 ].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of digital psychotherapeutic intervention among perinatal women: A systematic review and meta-analysis of randomized controlled trials

Lau¹,

Cheng²,

Wong³

et al. 2021

WJP

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BACKGROUND The perinatal period is a challenging time of substantial emotional, physiological, social, and relational changes. Depression, anxiety, and stress symptoms are common, and co-exist in the perinatal period. Digital technology continues to grow at an unprecedented pace with wide application, including psychotherapeutic intervention. A growing number of meta-analyses supported the application of digital psychotherapeutic intervention across different populations, but relatively few meta- and meta-regression analyses have concentrated on perinatal women. AIM To evaluate the effectiveness of digital psychotherapeutic intervention on improving psychological outcomes among perinatal women and identify its essential features. METHODS Randomized controlled trials (RCTs) were obtained from eight databases, including Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Embase, Scopus, PsycINFO, PubMed, Web of Science, and ProQuest Dissertation and Theses from inception up until November 24, 2020. Comprehensive Meta-analysis 3.0 software was used to conduct meta- and meta-regression analyses. The Cochrane risk-of-bias tool and the Grading of the Recommendation, Assessment, Development, and Evaluation system were adopted to assess the individual and overall qualities of the evidence, respectively. RESULTS A total of 25 RCTs that included 3239 women were identified. Meta-analyses revealed that intervention significantly improved depression (Hedges’s g = 0.49), anxiety ( g = 0.25), and stress ( g = 0.47) symptoms compared to the control. Subgroup analyses demonstrated that a website platform with ≥ eight therapist-guided sessions using the theoretical principle of cognitive behavioral therapy was more effective than other treatments in improving depression symptoms in postnatal women. Meta-regression analyses observed that the age of perinatal women and the type of psychotherapy also had statistically significant effects on depression symptoms. Egger’s regression asymmetry tests suggested that no publication biases occurred, but the overall quality of the evidence was very low. CONCLUSION This review suggests that digital psychotherapeutic intervention may be a potential solution to reduce psychological problems in perinatal women. Further high-quality RCTs with large sample sizes are needed.

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Effectiveness of a brief psychoeducational intervention on postnatal depression in the slums, Nairobi: a longitudinal study

Cited by 7 publications

References 47 publications

A Systematic Review of Interventions That Integrate Perinatal Mental Health Care Into Routine Maternal Care in Low- and Middle-Income Countries

A Systematic Review of Interventions That Integrate Perinatal Mental Health Care Into Routine Maternal Care in Low- and Middle-Income Countries

Predictors of Postnatal Depression in the Slums Nairobi, Kenya: A Cross-Sectional Study

Effectiveness of digital psychotherapeutic intervention among perinatal women: A systematic review and meta-analysis of randomized controlled trials

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