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Caregivers in Utah: More than 336,000 Utahns provide unpaid care to a family member or friend; 99,000 of them support individuals who have dementia. Intimate Partner and Domestic Violence Fatalities: Intimate partner violence is a pattern of abusive behavior between a current or former intimate partner to gain or maintain power and control over the other. This publication also includes: 1) Spotlights: Mental Health Outcomes Following Mistreatment During Childbirth: Utah, 2020; and 2) Monthly Health Indicators Report.

Introduction: Postpartum depression is commonly experienced by mothers worldwide and is associated with anxiety disorders, parenting stress, and other forms of distress, which may lead to a complex illness condition. Several studies have investigated the risk factors for this disorder, including biological and socio-demographic variables, medical and obstetric factors, and psychological and relational dimensions. The present study aimed to describe the psychological status of mothers up to 12 months postpartum, and to investigate the predictors of depressive symptoms at 12 months postpartum, considering obstetric factors along with psychological and relational variables. Methods: A sample of 137 women completed a questionnaire composed of a sheet on anamnestic and obstetric information and the following scales: Wijma Delivery Experience Questionnaire; State-Trait Anxiety Inventory; Edinburgh Postnatal Depression Scale; Parenting Stress Index (Short Form); Dyadic Adjustment Scale; and Multidimensional Scale of Perceived Social Support. Data were collected at four assessment times: 2–3 days, 3 months, 6 months, and 12 months postpartum. Results: Findings showed that the highest percentage of women with clinically significant symptoms of anxiety (state and trait) and depression was found at 12 months postpartum, which indicated that this was the most critical time. The quality of childbirth experience and trait anxiety at three months postpartum emerged as significant predictors of postpartum depression at 12 months. Conclusion: Our findings highlight the importance of providing stable programs (such as educational programs) to mothers in the first year postpartum. Furthermore, because the quality of the childbirth experience is one of the most important predictors of PPD at 12 months postpartum, effort should be made by healthcare professionals to guarantee a positive experience to all women to reduce possible negative long-term consequences of this experience.

Introduction Postpartum depression (PPD) is a multifactor disorder caused by psychological, social, and also biological factors. 5-HTTLPR polymorphism in the promoter region of serotonin transporter gene seems to influence PPD onset. In this study, we examined the effect of 5-HTTLPR polymorphism on prenatal and postnatal symptoms of depression and posttraumatic stress in women. Methods A longitudinal design with three points - time 1 (32-40 weeks gestation); time 2 (2 or 3 weeks after birth), and time 3 (3 months after birth) - was made. A total of 141 women were recruited during childbirth preparation courses. At time 1, women completed the Beck Depression Inventory (BDI) and the Los Angeles Symptoms Checklist (LASC). At time 2, they fulfilled BDI and Edinburgh Postnatal Depression Scale (EDPS), LASC and the Perinatal Posttraumatic stress disorder (PTSD) Questionnaire (PPQ); midwives and nurses collected biological test tubes by blood sampling for the genetic analysis. At time 3, the women were reassessed for BDI, LASC, EDPS, and PPQs. Analysis of variance and moderation analysis were used to correlate genotype and psychological investigations. Results Results showed that, compared with LL/LS genotypes, SS genotype moderated cognitive depressive symptoms onset at T2 and T3. Moreover, this genotype correlated, directly or indirectly, with PTSD postpartum aspects (re-experience, avoidance, and hyperarousal). Discussion Findings revealed that a lower expression of serotonin transporter gene, associated with SS genotype, seems to render women more vulnerable to depressive and PTSD symptoms after childbirth.

Background: Many perinatal mental health risk factor studies report that antenatal depression is a signifcant risk factor for women being depressed postnatally. They often describe the strength of the risk as being ‘strong’ or ‘strongly predictive’ (or similar phrases), though usually without explaining why these terms are used. It is possible that readers of such research may misunderstand these qualitative descriptors. Method: As part of routine teaching regarding risk analyses, we explored participants’ understanding of the conclusion stated in one specific perinatal risk study, which was that antenatal depression “strongly predicts” postnatal depression. Participants were groups of mental health professionals and postgraduate students, in Italy (N = 56) and Australia (N = 34).They completed an Estimate Survey, in which they indicated the actual number of antenatally depressed women they expected would have been depressed postpartum, given the study's conclusion. Results: The majority of survey respondents (~80%) expected that “strongly predicts” meant that a much higher proportion of women with the risk then became depressed than was actually the case. Some participants expressed major concern at the study's conclusion. Limitation: Participants comprised two small convenience samples of health professionals and postgraduate students, and thus may not be representative of the population. Conclusion: Studies that rely on the statistical significance of their analyses to conclude whether antenatal depression is a strong predictor or risk for postnatal depression may not accord with how health professionals interpret the data, once the absolute risk information is clearly provided. Recommendations for improving the reporting of results in such studies are made.

Background: Peripartum common mental disorders (CMD) are highly prevalent in low- and middle-income countries (LMIC) such as South Africa. With limited public mental health resources, task sharing approaches to treatment are showing promise. However, little is known about the feasibility and acceptability of, as well as responses associated with problem-solving therapy (PST) for the treatment of prepartum CMD symptoms in South African public health settings. Aim: To investigate participants’ preliminary responses to a task sharing PST intervention, and to evaluate the feasibility and acceptability of the intervention. Setting: A Midwife and Obstetrics Unit attached to a Community Health Centre in a Western Cape district. Methods: Using mixed methods, 38 participants’ responses to a PST intervention, and their perceptions of its feasibility and acceptability, were explored. Primary outcomes included psychological distress (Self Reporting Questionnaire; SRQ-20) and depression symptoms (Edinborough Postnatal Depression Scale; EPDS). Semi-structured interviews were conducted three after the last session. Six stakeholders were also interviewed. Results: Significant reductions were seen on EPDS (Cohen's d = 0.61; Hedges g = 0.60) and SRQ-20 (Cohen's d = 0.68; Hedges g = 0.67) scores. The intervention's acceptability lay in the opportunity for confidential disclosure of problems; and in relieving staff of the burden of managing of patients’ distress. Barriers included lack of transport and work commitments. Conclusion: Results support task sharing PST to Registered Counsellors to treat antenatal CMDs in perinatal primary health care settings. Research is needed on how such programmes might be integrated into public health settings, incorporating other non-specialists.

Postpartum depression (PPD) affects up to 19% of all women after parturition. The non-apeptide oxytocin (OXT) is involved in adjustment to pregnancy, maternal behavior, and bonding. Our aim was to examine the possible association between plasma OXT during pregnancy and the development of PPD symptoms. A total of 74 healthy, pregnant women were included in this prospective study. During the third trimester of pregnancy and within 2 weeks after parturition, PPD symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Blood samples for plasma OXT assessment were collected in the third trimester. Following the literature, participants with postpartum EPDS scores of 10 or more were regarded as being at risk for PPD development (rPPD group). In a logistic regression analysis, plasma OXT was included as a potential predictor for being at risk for PPD. Results were controlled for prepartal EPDS score, sociodemographic and birth-outcome variables. Plasma OXT concentration in mid-pregnancy significantly predicted PPD symptoms at 2 weeks postpartum. Compared with the no-risk-for-PPD group, the rPPD group was characterized by lower plasma OXT concentrations. To our knowledge, this is the first study to show an association between prepartal plasma OXT concentration and postpartal symptoms of PPD in humans. Assuming a causal relationship, enhancing OXT release during pregnancy could serve as a potential target in prepartum PPD prevention, and help to minimize adverse effects of PPD on the mother-child relationship.

Postpartum depression (PPD) affects up to 19% of all women after parturition. The non-apeptide oxytocin (OXT) is involved in adjustment to pregnancy, maternal behavior, and bonding. Our aim was to examine the possible association between plasma OXT during pregnancy and the development of PPD symptoms. A total of 74 healthy, pregnant women were included in this prospective study. During the third trimester of pregnancy and within 2 weeks after parturition, PPD symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Blood samples for plasma OXT assessment were collected in the third trimester. Following the literature, participants with postpartum EPDS scores of 10 or more were regarded as being at risk for PPD development (rPPD group). In a logistic regression analysis, plasma OXT was included as a potential predictor for being at risk for PPD. Results were controlled for prepartal EPDS score, sociodemographic and birth-outcome variables. Plasma OXT concentration in mid-pregnancy significantly predicted PPD symptoms at 2 weeks postpartum. Compared with the no-risk-for-PPD group, the rPPD group was characterized by lower plasma OXT concentrations. To our knowledge, this is the first study to show an association between prepartal plasma OXT concentration and postpartal symptoms of PPD in humans. Assuming a causal relationship, enhancing OXT release during pregnancy could serve as a potential target in prepartum PPD prevention, and help to minimize adverse effects of PPD on the mother-child relationship.

BACKGROUND: Post-partum depression (PPD) in many low-income countries, including Tanzania, is not well recognized, and the underlying predictors and causes of PPD remain unclear. Results from previous studies suggest that PPD is associated with intimate partner violence (IPV) experienced during the perinatal period. In the present study, we assessed the relationship between IPV and PPD among women attending antenatal services in Tanzania.METHODS: We conducted a prospective cohort study from March 1, 2014 to May 30, 2015, in Kilimanjaro Region, Tanzania, among pregnant women of less than 24 weeks gestation attending antenatal clinics in two primary level health facilities. Women were interviewed at four time points: 1) Socio-demographic and reproductive health characteristics were assessed at recruitment; 2) At 34 weeks gestational age we screened for depression using the Edinburgh Postpartum Depression Scale (EPDS) and self-reported IPV experiences were assessed using structured questions adopted from the WHO's Multi-country Study on Women's Health and Domestic Violence; 3) Assessment for postpartum depression using EPDS was repeated at 40 days post-partum. Data were analyzed using bivariate and multivariate analyses.RESULTS: A total of 1013 women were interviewed, of whom 304 (30.0%) reported being exposed to at least one type of IPV during their pregnancy and 122 (12.0%) had EPDS scores of 13 and more. Exposure to at least one type of IPV increased the odds of PPD more than three times (AOR=3.10; 95% CI: 2.04-4.40) as compared to those women who were not exposed to IPV during their pregnancy. Stratified analyses showed that this risk of PPD was highest among younger women (aged 18-24 years) who were exposed to physical violence (AOR=3.75; 95% CI: 1.21-11.67). Among women exposed to emotional violence, women with no previous history of depression were also at higher risk of developing postpartum depression as compared to women who were having previ

Cesarean delivery rates continue to increase, and surgery is associated with chronic pain, often co-existing with depression. Also, acute pain in the days after surgery is a strong predictor of chronic pain. Here we tested if mode of delivery or acute pain played a role in persistent pain and depression after childbirth. In this multicenter, prospective, longitudinal cohort study, 1288 women hospitalized for cesarean or vaginal delivery were enrolled. Data were obtained from patient interviews and medical record review within 36h postpartum, then via telephone interviews 8 weeks later to assess persistent pain and postpartum depressive symptoms. The impact of delivery mode on acute postpartum pain, persistent pain and depressive symptoms and their interrelationships was assessed using regression analysis with propensity adjustment. The prevalence of severe acute pain within 36h postpartum was 10.9%, while persistent pain and depression at 8 weeks postpartum were 9.8% and 11.2%, respectively. Severity of acute postpartum pain, but not mode of delivery, was independently related to the risk of persistent postpartum pain and depression. Women with severe acute postpartum pain had a 2.5-fold increased risk of persistent pain and a 3.0-fold increased risk of postpartum depression compared to those with mild postpartum pain. In summary, cesarean delivery does not increase the risk of persistent pain and postpartum depression. In contrast, the severity of the acute pain response to childbirth predicts persistent morbidity, suggesting the need to more carefully address pain treatment in the days following childbirth.

by Dominic Tak-Shing Lee., "December 2000.", Thesis (M.D.)--Chinese University of Hong Kong, 2000., Includes bibliographical references (p. 222-245)., Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web., Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web., Mode of access: World Wide Web., http://library.cuhk.edu.hk/record=b6073229, Use of this resource is governed by the terms and conditions of the Creative Commons “Attribution-NonCommercial-NoDerivatives 4.0 International” License (http://creativecommons.org/licenses/by-nc-nd/4.0/)

by Dominic Tak-Shing Lee., "December 2000.", Thesis (M.D.)--Chinese University of Hong Kong, 2000., Includes bibliographical references (p. 222-245)., Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web., Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web., Mode of access: World Wide Web., http://library.cuhk.edu.hk/record=b6073229, Use of this resource is governed by the terms and conditions of the Creative Commons “Attribution-NonCommercial-NoDerivatives 4.0 International” License (http://creativecommons.org/licenses/by-nc-nd/4.0/)