Stepped Care for Maternal Mental Health: A Case Study of the Perinatal Mental Health Project in South Africa

Honikman, Simone; Heyningen, Thandi van; Field, Sally; Baron, Emily; Tomlinson, Mark

doi:10.1371/journal.pmed.1001222

Cited by 141 publications

(162 citation statements)

References 22 publications

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“…Nurses can perform this tracing by means of specific instruments, provide mental health counselling and, if necessary, refer the patient to a psychiatrist for treatment. (9) The prevalence of mental disorders found (12.94%) does not differ much from an interna- tional study performed with pregnant women, which had a prevalence of 17.4%, (10) however, it is far lower than that found in a study conducted in Rio Grande do Sul, which detected a prevalence of 41.7%.…”

Section: Discussioncontrasting

confidence: 52%

Prevalência de transtornos mentais e fatores associados em gestantes

et al. 2015

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Objective: To identify the prevalence of mental disorders and associated factors in pregnant women. Methods: Cross-sectional study with 394 pregnant women, randomly and proportionally selected. Data were collected during home visits, using a semi-structured questionnaire. Bivariate logistic regression was used for the analysis. Results: A total of 51 pregnant women (12.94%) were diagnosed with mental disorder and this number was significantly higher among those between 19 and 30 years of age, unmarried, white skin colored, who were in the second trimester of pregnancy, had a chronic disease associated and had been hospitalized during the current pregnancy. Nine of them were taking psychotropic drugs, and antidepressants were the most commonly used drug. Conclusion: The prevalence of self-reported mental disorders was 12.94% and the associated variables were: age, marital status, skin color, pregnancy trimester, hospitalization during pregnancy and chronic disease. ResumoObjetivo: Identificar a prevalência de transtornos mentais e fatores associados em gestantes. Métodos: Estudo transversal realizado com 394 gestantes, selecionadas de forma aleatória e proporcional. Os dados foram coletados nos domicílios, com aplicação de questionário semiestruturado. Para a análise foi utilizada a regressão logística bivariada. Resultados: Referiram diagnóstico de transtorno mental 51 gestantes (12,94%) e isto foi significativamente maior entre aquelas com idade entre 19 e 30 anos, sem companheiro, de cor branca, que estavam no segundo trimestre de gestação, tinha alguma doença crônica associada e foi internada na gestação atual. Nove delas faziam uso de psicofármacos, sendo os antidepressivos os mais utilizados. Conclusão: A prevalência de transtornos mentais auto-referido foi de 12,94% e as variáveis associadas foram: idade, situação conjugal, cor, trimestre de gestação, internação durante a gestação e doença crônica.

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Section: Discussioncontrasting

confidence: 52%

Prevalência de transtornos mentais e fatores associados em gestantes

et al. 2015

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“…Similar to Kabir et al (2008) and Rochat et al (2013), we defined 4 short and ultra-short versions of the EPDS-10: the 2-item analogue of the Patient Health Questionnaire (EPDS-2) (Lowe et al 2005; Monahan et al 2009), the 3-item anxiety subscale (EPDS-3), an abbreviated 5-item version of the depressive symptoms subscale (EPDS-5) (Rochat et al 2013), and the 7-item depressive symptoms subscale (EPDS-7) (Box 1). Following previous studies in this population, we employed a cutoff score of EPDS-10 ≥13 to define the criterion standard of probable antenatal depression (Honikman et al 2012; Rochat et al 2006; Tomlinson et al 2013). …”

Section: Methodsmentioning

confidence: 99%

Antenatal depression case finding by community health workers in South Africa: feasibility of a mobile phone application

Tsai

Tomlinson

Dewing

et al. 2014

Arch Womens Ment Health

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Purpose Randomised controlled trials conducted in resource-limited settings have shown that once women with depressed mood are evaluated by specialists and referred for treatment, lay health workers can be trained to effectively administer psychological treatments. We sought to determine the extent to which community health workers could also be trained to conduct case finding using short and ultra-short screening instruments programmed into mobile phones. Methods Pregnant, Xhosa-speaking women were recruited independently in two cross-sectional studies (N=1,144 and N=361) conducted in Khayelitsha, South Africa and assessed for antenatal depression. In the smaller study, community health workers with no training in human subjects research were trained to administer the Edinburgh Postnatal Depression Scale (EPDS) during the routine course of their community-based outreach. We compared the operating characteristics of 4 short and ultra-short versions of the EPDS with the criterion standard of probable depression, defined as an EPDS-10 ≥13. Results The prevalence of probable depression (475/1144 [42%] and 165/361 [46%]) was consistent across both samples. The 2-item subscale demonstrated poor internal consistency (Cronbach’s α ranged from 0.55-0.58). All 4 subscales demonstrated excellent discrimination, with area under the receiver operating characteristic curve (AUC) values ranging from 0.91-0.99. Maximal discrimination was observed for the 7-item depressive symptoms subscale: at the conventional screening threshold of ≥10, it had 0.97 sensitivity and 0.76 specificity for detecting probable antenatal depression. Conclusions The comparability of the findings across the two studies suggests that it is feasible to use community health workers to conduct case finding for antenatal depression.

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“…In 1997 and 2002, Postnatal Depression Support Association of South Africa (PNDSA) and Perinatal Mental Health Project (PMHP) were respectively created for the awareness of health professionals and of the community about the disease and to provide appropriate support and treatment to women experiencing PPD as a routine part of their health care [82]. PNDSA works with community health services and professionals, researchers interested in mental health of women, practitioners of ''alternative'' medicine and religious organizations, aiming to break the silence and stigma surrounding perinatal depression [83].…”

Section: Programs and Therapeutic Interventionsmentioning

confidence: 99%

“…Psychiatr Q collaboration with the Ministry of Health addresses pregnant and postnatal women with mental illness [82].…”

Section: Special Populationsmentioning

confidence: 99%

Cross-Cultural Approach of Postpartum Depression: Manifestation, Practices Applied, Risk Factors and Therapeutic Interventions

2015

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It is a well known fact that postpartum depression (PPD) is a global phenomenon that women may experience, regardless of cultural identity and beliefs. This literature review presents the cultural beliefs and postnatal practices around the world, in each continent and people's origins, looking through the extent to which they contribute positively or negatively to the onset of the disease. 106 articles were used in this research, through a systematic electronic search of Pubmed (Medline) and Scopus. Comparison is also made between the prevalence, the risk factors and the different ways of appearance of the disease around the world and among immigrants. Finally, the initiatives and interventions made so far by the governments and institutions with a view to prevent and address this global problem are presented. The results showed (a) that different cultures share the same risk factors towards the disease (b) significant differences in the prevalence of the disease among both Western and non Western cultures and between the cultures themselves (c) more tendencies for somatization of depressive symptoms in non-Western cultures, (d) different postnatal practices between cultures, which are not always effective (e) the more non-West a culture is, the less interventions concern on mental health; the same phenomenon is observed on populations burdened by immigration. The beliefs held by culture should be taken seriously in detecting of PPD, as well as the assessment of the needs of women who have recently given birth.

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Stepped Care for Maternal Mental Health: A Case Study of the Perinatal Mental Health Project in South Africa

Cited by 141 publications

References 22 publications

Prevalência de transtornos mentais e fatores associados em gestantes

Prevalência de transtornos mentais e fatores associados em gestantes

Antenatal depression case finding by community health workers in South Africa: feasibility of a mobile phone application

Cross-Cultural Approach of Postpartum Depression: Manifestation, Practices Applied, Risk Factors and Therapeutic Interventions

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