Perceptions and experiences of perinatal mental disorders in rural, predominantly ethnic minority communities in northern Vietnam

Abstract

BackgroundPreliminary research has suggested that perinatal mental disorders (PMDs), including post-partum depression, are prevalent in Vietnam. However the extent to which these disorders are recognized at the community level remains largely undocumented in the literature. PMDs have also never been investigated within Vietnam’s significant ethnic minority populations, who are known to bear a greater burden of maternal and infant health challenges than the ethnic majority.ObjectiveTo investigate knowledge and perceptions of PMDs and their treatments at the community level in a rural, predominantly ethnic minority region of northern Vietnam.MethodsQualitative semi-structured interviews were conducted on the topic of common PMDs. Participant groups were primary health workers (PHWs) working at local community health centers, and pregnant or postpartum women enrolled in a program for maternal and infant health that was not mental health related. Interviews included vignette scenarios that asked respondents to interpret cases of women experiencing PMDs, as well as open-ended questions about mental disorders and their treatments.ResultsTwelve PHWs and 14 perinatal women completed the study. Major themes that emerged from the interviews included (1) Family relationships impact psychological well-being, (2) Nutrition contributes to perinatal mental health, (3) Both traditional and western medicine play roles in perinatal health, (4) There was a lack of personal experience with women experiencing PMDs, (5) Descriptions of mental health symptoms focused on behaviours, and (6) Community care is the primary mental health support.ConclusionsPHWs reported having almost never treated a woman with a PMD. However, anecdotal evidence from the women interviewed suggests that there are incidents of mental disorders during the perinatal period that go largely unaddressed. Willingness to present to primary care appears to be high, and presents an opportunity to address this need by training PHWs in effective screening, treatment, and referral. Such training should account for culturally specific presentations of mental disorders as well as the importance of the patient’s social context. To the best of the author’s knowledge, this research presents the first evidence of a PMD burden within Vietnam’s ethnic minority communities.

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“…In a Japanese study, Ozeki et al [82] observed HLA-A*31:01 was present in 37 of 61 patients with SCARs, significantly higher than in the general population (OR, 10.8; 95% CI, 5.9–19.6). Similarly, McCormack et al found in Europeans that HLA-A*31:01 was associated with all types of CBZ-induced SCARs in SJS (OR, 25.93; 95% CI, 4.93–116.18) and HSS (OR, 12.41; 95% CI, 1.27–121.03) [85]. In contrast, studies in Canada [86], Korea [83] and Taiwan [74], have confirmed HLA-A*31:01 is a genetic risk factor for only non-bullous skin reactions such as HSS and MPE, and not for SJS/TEN [69].…”