Perinatal mental health: a review of progress and challenges

Howard, Louise M.; Khalifeh, Hind

doi:10.1002/wps.20769

Cited by 525 publications

(469 citation statements)

References 200 publications

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“…Safety concerns include not only the sense of safeness regarding medical treatments (e.g., psychotropics) but also structural inequalities and disadvantages that impact women’s well-being (such as insecure employment, domestic violence, poverty, insecure immigrant status, etc. ), all of which are well-known vulnerability factors for the development of emotional disorders in general and in the peripartum period in particular [ 47 ]. The perception of emotional, instrumental, and informational support includes the access and the availability of formal and informal parenting support (both for mothers and fathers); this is closely associated with perceived loneliness and is another protective factor for the development of perinatal depression and stress [ 48 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers

Pacheco

Sobral

Guiomar

et al. 2021

Behavioral Sciences

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The COVID-19 pandemic has altered the normal course of life, with measures to reduce the virus spread impacting motherhood expectations and, in particular, breastfeeding practices. This study aimed to review evidence regarding the impact of COVID-19 on breastfeeding plans and how these relate to women’s psychological outcomes. Searches were conducted on PubMed and Web of Science for studies in English, Spanish, and Portuguese between January 2020 and January 2021. All study designs and pre-prints were considered. Twelve studies were included. Reports suggest that COVID-19 impacts differently on breastfeeding plans, which in turn leads to distinctive mental health outcomes. Positive breastfeeding experiences have been observed when mothers perceive that they have more time for motherhood, which may be associated with better mental health outcomes. Negative breastfeeding experiences have been observed when mothers are separated from their newborns, when mothers struggle with breastfeeding, or when mothers perceive decreased family and professional support, which seems to be associated with worse mental health outcomes. These preliminary results highlight the need for further research into the association between COVID-19, breastfeeding expectations, and maternal mental health. Filling this gap will foster the development of guidelines and interventions to better support mothers experiencing the obstacles of COVID-19 pandemic.

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Section: Discussionmentioning

confidence: 99%

Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers

Pacheco

Sobral

Guiomar

et al. 2021

Behavioral Sciences

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“…The ICD‐11 approach was adopted to reflect the diagnostic practices of obstetricians and other health care providers, whose primary clinical focus tends to be on the woman’s pregnancy, childbirth, delivery and postpartum care, and who tend to make diagnoses such as “postpartum depression” and “postpartum psychosis” 92 . For mental health specialists, the psychiatric presentation is of primary importance, and the fact that its onset is during pregnancy or postpartum is more commonly thought of as a course qualifier.…”

Section: Harmonization At the Disorder Levelmentioning

confidence: 99%

An organization‐ and category‐level comparison of diagnostic requirements for mental disorders in ICD‐11 and DSM‐5

et al. 2021

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In 2013, the American Psychiatric Association (APA) published the 5th edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM‐5). In 2019, the World Health Assembly approved the 11th revision of the International Classification of Diseases (ICD‐11). It has often been suggested that the field would benefit from a single, unified classification of mental disorders, although the priorities and constituencies of the two sponsoring organizations are quite different. During the development of the ICD‐11 and DSM‐5, the World Health Organization (WHO) and the APA made efforts toward harmonizing the two systems, including the appointment of an ICD‐DSM Harmonization Group. This paper evaluates the success of these harmonization efforts and provides a guide for practitioners, researchers and policy makers describing the differences between the two systems at both the organizational and the disorder level. The organization of the two classifications of mental disorders is substantially similar. There are nineteen ICD‐11 disorder categories that do not appear in DSM‐5, and seven DSM‐5 disorder categories that do not appear in the ICD‐11. We compared the Essential Features section of the ICD‐11 Clinical Descriptions and Diagnostic Guidelines (CDDG) with the DSM‐5 criteria sets for 103 diagnostic entities that appear in both systems. We rated 20 disorders (19.4%) as having major differences, 42 disorders (40.8%) as having minor definitional differences, 10 disorders (9.7%) as having minor differences due to greater degree of specification in DSM‐5, and 31 disorders (30.1%) as essentially identical. Detailed descriptions of the major differences and some of the most important minor differences, with their rationale and related evidence, are provided. The ICD and DSM are now closer than at any time since the ICD‐8 and DSM‐II. Differences are largely based on the differing priorities and uses of the two diagnostic systems and on differing interpretations of the evidence. Substantively divergent approaches allow for empirical comparisons of validity and utility and can contribute to advances in the field.

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“…Perinatal period is a challenging time of substantial emotional, physiological, social, familial, and role changes[ 1 , 2 ]. These changes may affect psychological and physical resources, resulting in increased susceptibility of psychological problems, including depression, anxiety, and stress[ 3 ]. A systematic review observed that depression, anxiety, and stress symptoms co-existed in the perinatal period[ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Perinatal mental disorders during pregnancy and postpartum period are associated with considerable maternal, infant, and child morbidity and mortality[ 8 - 10 ]. In addition, they lead to huge economic burden on health and social care[ 3 ]. Therefore, effective intervention is imperative.…”

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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Perinatal mental health: a review of progress and challenges

Cited by 525 publications

References 200 publications

Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers

Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers

An organization‐ and category‐level comparison of diagnostic requirements for mental disorders in ICD‐11 and DSM‐5

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

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