Management of perinatal depression with non-drug interventions

Johansen, Sara L.; Robakis, Thalia; Williams, Katherine E.; Rasgon, Natalie

doi:10.1136/bmj.l322

Cited by 20 publications

(16 citation statements)

References 146 publications

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“…Therefore, family members should focus on the psychological and emotional changes of the mother during "doing the month" period, and have more understanding and companionship for the mother. Besides, we should focus on the factors of maternal dissatisfaction, strengthen postpartum social support treatment, properly extend father's paternity leave to increase father's participation in taking care of baby, and reduce the occurrence of PD [27] .…”

Section: Discussionmentioning

confidence: 99%

Maternal Dissatisfaction During the Postpartum Recuperation Period is an Independent Risk Factor for Postpartum Depression after Caesarean Section in China – A Prospective Cohort Study

Chen

You

et al. 2021

Preprint

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Background: Postpartum depression (PD) is a common disorder associated with severe adverse infant and maternal outcomes, which is becoming an important public health problem. However, studies on the clinical relevance of anesthesia and PD are very limited. This study aimed to examine risk factors for PD amongst Chinese parturients of caesarean section from the perspective of anesthesiology, especially during the standard Chinese postpartum recuperation period known as “doing the month”.Methods: Prospective cohort study of 125 women who received caesarean sections aged from 21 to 46 years. The Edinburgh Postnatal Depression Scale were evaluated at the day before caesarean section and 6 weeks postpartum. Demographic, clinical, and treatment, including postoperative prognostic data and conditions during “doing the month”, were recorded and compared between PD and non-PD groups. Univariable and multivariable logistic regression methods were used to explore the risk factors associated with the occurrence of PD. Results: 44 (34.9%) patients were diagnosed PD at 6 weeks postpartum. Occurrence of PD was associated with postoperative pain, pruritus, dissatisfaction with “doing the month”. Multivariate regression analysis showed that lumbago (OR 5.68, 95% CI 1.69-19.06; p=0.005), maternal total dissatisfaction during “doing the month”(OR 6.87, 95% CI 2.48-19.04; p=0.001), and dissatisfaction with mother in-law during “doing the month”(OR 3.22, 95% CI 1.43-16.16; p=0.020) were independent risk factors for PD, while mild activity pain was independent protective factor for PD 6 weeks postpartum (OR 0.018, 95% CI 0.01-0.25; p=0.003). Conclusions: PD was a commonly experienced psychological disorders for women undergoing caesarean section. Postpartum lumbago, maternal total dissatisfaction and dissatisfaction with mother in-law during “doing the month” and mild activity pain were main factors for PD at 6 weeks postpartum.

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Section: Discussionmentioning

confidence: 99%

Maternal Dissatisfaction During the Postpartum Recuperation Period is an Independent Risk Factor for Postpartum Depression after Caesarean Section in China – A Prospective Cohort Study

Chen

You

et al. 2021

Preprint

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“…Zudem sollte immer bedacht werden, dass dabei die betroffenen Mütter von ihrem Alltag separiert werden. Entsprechend muss bei der Rückkehr nach Hause auch die Wiederaufnahme der bisherigen Aufgaben mit eingeübt werden [43].…”

Section: Behandlung Postpartaler Psychischer Störungenunclassified

Postpartale psychische Störungen und ihre Bedeutung für die Wochenbettbetreuung

Weigl¹

2019

Hebamme

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Hebammen sind in der Zeit des Wochenbetts einfühlsame Ansprechpartnerinnen für Frauen mit postpartalen psychischen Störungen. Sie bieten den Müttern die Möglichkeit, vertraulich über schambehaftete Themen, Ängste und unangenehme Erinnerungen an die Geburt zu sprechen. So können sie früh einschätzen, ob eine postpartale psychische Störung vorliegt. Eine wichtige Grundlage, um betroffene Frauen in den ersten Wochen und Monaten nach der Geburt zu motivieren, bei Bedarf die Hilfe anderer Professionen zu suchen und anzunehmen.

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“…A recent review highlighted the need for more personalised therapies to treat perinatal depression, including interpersonal psychotherapy as a plausible treatment option 17. Women in our patient advisory group consultations reported that CBT is ‘too clinical’ and ‘inflexible’ with practitioners not appearing to consider the circumstances of pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Protocol for a feasibility randomised trial of low-intensity interventions for antenatal depression: ADAGIO trial comparing interpersonal counselling with cognitive behavioural therapy

Ingram

Johnson

et al. 2019

BMJ Open

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IntroductionOne in eight women suffer from depression during pregnancy. Currently, low-intensity brief treatment based on cognitive behavioural therapy (CBT) is the only talking treatment widely available in the National Health Service (NHS) for mild and moderate depression. CBT involves identifying and changing unhelpful negative thoughts and behaviours to improve mood. Mothers in our patient advisory groups requested greater treatment choice. Interpersonal counselling (IPC) is a low-intensity version of interpersonal therapy. It may have important advantages during pregnancy over CBT because it targets relationship problems, changes in role and previous losses (eg, miscarriage). We aim to compare CBT and IPC for pregnant women with depression in a feasibility study.Methods and analysisA two-arm non-blinded randomised feasibility study of 60 women will be conducted in two UK localities. Women with depression will be identified through midwife clinics and ultrasound scanning appointments and randomised to receive six sessions of IPC or CBT. In every other way, these women will receive usual care. Women thought to have severe depression will be referred for more intensive treatment. After 12 weeks, we will measure women’s mood, well-being, relationship satisfaction and use of healthcare. Women, their partners and staff providing treatments will be interviewed to understand whether IPC is an acceptable approach and whether changes should be introduced before applying to run a larger trial.Several groups of patients with depression during pregnancy have contributed to our study design. A patient advisory group will meet and advise us during the study.Ethics and disseminationStudy results will inform the design of a larger multicentre randomised controlled trial (RCT). Our findings will be shared through public engagement events, papers and reports to organisations within the NHS. National Research Ethics Service Committee approved the study protocol.Trial registration numberISRCTN11513120.

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Management of perinatal depression with non-drug interventions

Cited by 20 publications

References 146 publications

Maternal Dissatisfaction During the Postpartum Recuperation Period is an Independent Risk Factor for Postpartum Depression after Caesarean Section in China – A Prospective Cohort Study

Maternal Dissatisfaction During the Postpartum Recuperation Period is an Independent Risk Factor for Postpartum Depression after Caesarean Section in China – A Prospective Cohort Study

Postpartale psychische Störungen und ihre Bedeutung für die Wochenbettbetreuung

Protocol for a feasibility randomised trial of low-intensity interventions for antenatal depression: ADAGIO trial comparing interpersonal counselling with cognitive behavioural therapy

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