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To adapt an evidence-based psychological intervention for pregnant women experiencing depressive symptoms and intimate partner violence (IPV) in rural Ethiopia. We conducted a desk review of contextual factors in Sodo, Ethiopia, followed by qualitative interviews with 16 pregnant women and 12 antenatal care (ANC) providers. We engaged stakeholders through participatory theory of change (ToC) workshops, to select the intervention and articulate a programme theory. We used "ADAPT" guidance to adapt the intervention to the context, before mapping potential harms in a "dark logic model". Brief problem-solving therapy developed for South Africa was the most contextually relevant model. We adapted the delivery format (participants prioritised confidentiality and brevity) and training and supervision (addressing IPV). Consensus long-term outcomes in our ToC were ANC providers skilled in detecting and responding to emotional difficulties and IPV, women receiving appropriate support, and emotional difficulties improving. Our dark logic model highlighted the risk of more severe IPV and mental health symptoms not being referred appropriately. Although intervention adaptation is recommended, the process is rarely reported in depth. We comprehensively describe how contextual considerations, stakeholder engagement, programme theory, and adaptation can tailor psychological interventions for the target population in a low-income, rural setting. [ABSTRACT FROM AUTHOR]

This article discusses the importance of addressing paternal perinatal depression, which refers to depression experienced by fathers during the perinatal period (from conception to 1 year after birth). While the mental health of perinatal women is receiving attention, the mental health of new fathers is often underassessed due to the absence of clinical guidelines. Paternal perinatal depression can manifest as difficulties in balancing work and home life, financial strain, and relationship difficulties. Men may be less likely than women to seek help for perinatal depression, but it is important to address their mental health as it can have negative effects on both the father and the child. General practice is an accessible setting where men can receive support and treatment for paternal perinatal depression, and healthcare professionals should be aware of the potential impact on personal and social functioning. Health visitors can also play a role in identifying and supporting paternal mental health, but there are limitations in accessing male partners' electronic care records. It is recommended that healthcare professionals ask about depression prior to the birth of a child as well as around the birth, as the support fathers require may vary. Treatment options for paternal perinatal depression include guided self-help, talking therapy, exercise, mindfulness, counseling, and pharmacological therapy if necessary. Challenges include limited record sharing and stigma surrounding fathers' mental health, but there are opportunities to improve practice through screening, father-specific support, and psychoeducation. Collecting and recording mental health assessment data for male parents in shared health [Extracted from the article]

Aims and Method: Functional neurological disorder (FND) most often presents in women of childbearing age, but little is known about its course and outcomes during pregnancy, labour and postpartum (the perinatal period). We searched MEDLINE, PsycInfo and Embase combining search terms for FND and the perinatal period. We extracted data on patient demographics, subtype of FND, timing of symptom onset, comorbidities, medications, type of delivery, investigations, treatment, pregnancy outcomes and FND symptoms at follow-up., Results: We included 36 studies (34 case reports and 2 case series) describing 43 patients. Six subtypes of FND were identified: functional (dissociative) seizures, motor weakness, movement disorder, dissociative amnesia, speech disorders and visual symptoms. New onset of perinatal FND was more common in the third trimester and onwards. Some women with functional seizures were exposed to unnecessary anti-seizure prescriptions and intensive care admissions., Clinical Implications: Prospective studies are urgently needed to explore how FND interacts with women's health in the perinatal period.

Aims and Method: Our team of core and higher psychiatry trainees aimed to improve secondary mental health service detection of and response to gender-based violence (GBV) in South East London. We audited home treatment team (HTT), drug and alcohol (D&A) service and in-patient ward clinical records ( n = 90) for female and non-binary patients. We implemented brief, cost-neutral staff engagement and education interventions at service, borough and trust levels before re-auditing ( n = 86), completing a plan-do-study-act cycle., Results: Documented enquiry about exposure to GBV increased by 30% (HTT), 15% (ward) and 7% (D&A), post-intervention. We identified staff training needs and support for improving GBV care. Up to 56% of records identified psychiatric symptoms related to GBV exposure., Clinical Implications: Moves to make mental healthcare more trauma-informed rely on services first being supportive environments for enquiry, disclosure and response to traumatic stressors. Our collaborative approach across clinical services increased GBV enquiry and documentation. The quality of response is more difficult to measure and requires concerted attention.