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Background: Perinatal depression is often underdiagnosed; consequently, many women suffer perinatal depression without follow-up care. Screening for depressive symptoms during the perinatal period has been recommended in Australia to increase detection and follow-up of women suffering from depressive symptoms. Screening rates have gradually increased over the last decades in Australia. Objective: To explore trends in referrals of women to community mental health services during the perinatal period, and prenatal and postnatal admissions to psychiatric units, among those who gave birth in Queensland between 2009 and 2015. Method: Retrospective analyses of data from three linked state-wide administrative data collections. Trend analyses using adjusted Poisson regression models examined 426,242 births. Outcome variables included referrals to specialised mental health services; women admitted with a mood disorder during the second half of their pregnancy and during the first 3 months of the postnatal period; and women admitted with non-affective psychosis disorders during the second half of their pregnancy and during the first 3 months of the postnatal period. Results: We found an increase in mental health referrals during the perinatal period over time (adjusted incidence rate ratio, 1.07; 95% confidence interval, [1.06, 1.08]) and a decrease in admissions with mood disorders during the first 3 months of the postnatal period (adjusted incidence rate ratio, 0.95; 95% confidence interval, [0.94, 0.98]). We did not find any changes in rates of admission for other outcomes. Conclusion: Since the introduction of universal screening in Queensland, referrals for mental health care during the perinatal period have increased, while admissions for mood disorders in the first 3 months after delivery decreased. [ABSTRACT FROM AUTHOR]

Background: Evidence shows that depressive symptoms during pregnancy increase the risk of an intervention during delivery (induction, the use of forceps or vacuum, and caesarean sections (CS)). Many women with depression during pregnancy are not identified and therefore will not receive appropriate follow up of their symptoms. We hypothesised that routine screening for depressive symptoms during pregnancy could reduce detrimental consequences of depressive symptoms on delivery outcomes. Aim: We explored the association between screening for depressive symptoms during pregnancy and delivery outcomes. Materials and Methods: A cross‐sectional analysis of state‐wide administrative data sets. The population included all women who delivered a singleton in Queensland between the July and December of 2015. Logistic regression analyses were run in 27 501 women (93.1% of the total population) with information in all variables. The following were the main outcomes: onset of labour, CS, instrumental vaginal delivery, and all operative deliveries (including both CS and instrumental vaginal deliveries). Results: Women who completed the screening had increased odds of a spontaneous onset of labour (adjusted odds ratio (aOR) 1.18; 95% CI 1.09–1.27) and decreased odds of an operative delivery (instrumental or CS) (aOR 0.88; 95% CI 0.81–0.96). Among women who had a vaginal delivery, those who completed the screening had decreased odds of having an instrumental delivery (aOR 0.84; 95% CI 0.74–0.97). Sensitivity analyses in women who did not have a formal diagnosis of depression showed similar results. Conclusion: Our findings suggest that screening may decrease interventions during delivery in women with depressive symptoms. [ABSTRACT FROM AUTHOR]

Background To study the associations between maternal smoking during pregnancy and paternal smoking before pregnancy and adult offspring psychiatric disorders. Methods Prospective general population cohort study in Northern Finland, with people from the Northern Finland Birth Cohort 1986: 7259 subjects (77% of the original sample). Data on parental smoking were collected from parents during pregnancy using questionnaires. Outcomes were offspring's register-based diagnoses: any psychiatric disorder, any non-organic psychosis, mood disorder, anxiety disorder and substance use disorder (SUD) until the age of 29–30 years. Maternal smoking during pregnancy and paternal smoking before pregnancy were pooled to three-class variables: (i) none; (ii) 1–9 and (iii) ≥10 cigarettes/day. Information regarding both parents' alcohol use during pregnancy and at offspring age 15–16 years, maternal education level, family structure, parental psychiatric diagnoses and offspring gender, smoking, intoxication frequency and illicit substance use at the age of 15–16 years were investigated as covariates. Results In the multivariable analyses, maternal smoking during pregnancy did not associate with the studied outcomes after adjusting for offspring smoking and other substance use at offspring age 15–16 years and parental psychiatric disorders. However, paternal smoking ≥10 cigarettes/day before pregnancy [hazard ratio (HR) = 5.5, 95% confidence interval (CI) 2.7–11.2, P  <   0.001] and paternal psychiatric disorders (HR = 1.7, 95% CI 1.1–2.8, P  =   0.028) associated with offspring SUD after adjustments. Conclusions Information across the offspring life course is essential in exploring the association between parental smoking and offspring psychiatric disorders. Paternal smoking before pregnancy and paternal psychiatric disorders may act as modifiers in elevating the risk of substance-use-related problems among offspring. [ABSTRACT FROM AUTHOR]

Background: Alcohol and other drug (AOD) use patterns have altered as a result of the coronavirus (COVID-19) pandemic restrictions. This study aimed to: (i) determine the impact of the pandemic on patterns of AOD use among individuals seeking treatment, (ii) identify which mental health and resilience factors were associated with changes in patterns of AOD use and (iii) evaluate changes in the contextual factors (eg, motivations) associated with use. Methods: Cross-sectional surveys were completed by clients (n = 325) who had sought AOD treatment from January 2020 onwards. We measured quantity and frequency of AOD use now compared to before the pandemic, mental health (depression, anxiety, trauma exposure), resilience and contextual factors related to AOD use. Results: Quantity of tobacco and cannabis use increased post-pandemic, while methamphetamine and alcohol did not change. Depression was associated with more frequent alcohol use now compared to before the pandemic, while anxiety and lower resilience were associated with less frequent cannabis use now. Lower resilience was associated changes in methamphetamine use. Depression was associated with using more frequently for enjoyment and to alleviate loneliness following the pandemic, and anxiety was associated with using earlier in the day and to alleviate boredom. Conclusions: The pandemic has led to increased frequency of AOD use for a subset of individuals seeking treatment. Depression, anxiety and resilience are important factors associated with altered AOD use, and changes in the motivations and control surrounding use. Special consideration of this should be considered during AOD treatment through the pandemic. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Alcohol misuse and depressed mood are common during early adolescence, and comorbidity of these conditions in adulthood is associated with poorer health and social outcomes, yet little research has examined the co-occurrence of these problems at early adolescence. This study assessed risky and protective characteristics of pre-teens with concurrent depressed mood/early alcohol use in a large school-based sample.Design and Methods: School children aged 10-14 years (n = 7289) from late primary and early secondary school classes in government, Catholic and independent sectors participated with parental consent in the cross-sectional Healthy Neighbourhoods Study. Key measures included depressed mood, recent alcohol use, school mobility, family relationship quality, school engagement and coping style. Multinomial logistic regression analyses were used to identify school and family-related factors that distinguished those with co-occurring drinking and depressive symptoms from those with either single condition. Gender and school-level interactions for each factor were evaluated.Results: Co-occurring conditions were reported by 5.7% of students [confidence interval (CI)95 5.19, 6.19]. Recent drinkers were more likely than non-drinkers to have symptoms consistent with depression (odds ratio 1.80; CI95 1.58, 2.03). Low school commitment was associated with co-occurring drinking/depressive symptoms (odds ratio 2.86; CI95 2.25, 3.65 compared with null condition). This association appeared to be weaker in the presence of adaptive stress-coping skills (odds ratio 0.18; CI95 0.14, 0.23).Conclusions: We have identified factors that distinguish pre-teens with very early co-occurrence of drinking and depressed mood, and protective factors with potential utility for school-based prevention programmes targeting these conditions. [Salom CL, Kelly AB, Alati R, Williams GM, Patton GC, Williams JW. Individual, school-related and family characteristics distinguish co-occurrence of drinking and depressive symptoms in very young adolescents. Drug Alcohol Rev 2016;35:387-396]. [ABSTRACT FROM AUTHOR]

Aim The co-occurrence of mental health and substance use disorders adds complexity to already-significant health burdens. This study tests whether mental health disorders group differently across substance use disorder types and compares associations of early factors with the development of differing comorbidities. Design Consecutive antenatal clinic attendees were recruited to the longitudinal Mater-University of Queensland Study of Pregnancy (MUSP). Mother/offspring dyads were followed over 21 years. Setting Mater-Misericordiae Public Hospital, Brisbane, Australia. Participants MUSP offspring with maternal baseline information ( n = 7223), offspring behaviour data at 14 ( n = 4815) and psychiatric diagnoses at 21 ( n = 2575). Measurements The Composite International Diagnostic Interview yielded life-time diagnoses of mental health (MH) and substance use (SU) disorders for offspring, then latent class modelling predicted membership of polydisorder groups. We fitted the resulting estimates in multinomial logistic regression models, adjusting for maternal smoking, drinking and mental health, adolescent drinking, smoking and behaviour and mother-child closeness. Findings Fit indices [Bayesian information criterion (BIC) = 12 415; Akaike information criterion (AIC) = 12 234] from LCA supported a four-class solution: low disorder (73.6%), MH/low SU disorder (10.6%), alcohol/cannabis/low MH disorder (12.2%) and poly SU/moderate MH disorder (3.5%). Adolescent drinking predicted poly SU/MH disorders [odds ratio (OR) = 3.34, 95% confidence interval (CI) = 1.42-7.84], while externalizing predicted membership of both SU disorder groups (ORalcohol/cannabis = 2.04, 95% CI = 1.11-3.75; ORpolysubstance = 2.65, 95% CI = 1.1-6.08). Maternal smoking during pregnancy predicted MH (OR = 1.53, 95% CI = 1.06-2.23) and alcohol/cannabis-use disorders (OR = 1.73; 95% CI = 1.22-2.45). Low maternal warmth predicted mental health disorders only (OR = 2.21, 95% CI = 1.32-3.71). Conclusions Mental health disorders are more likely in young adults with polysubstance use disorders than those with alcohol/cannabis use disorders. Predictors of comorbid mental health/polysubstance use disorders differ from those for alcohol/cannabis use disorders, and are detectable during adolescence. [ABSTRACT FROM AUTHOR]

Antenatal depression is the strongest predictor for postpartum depression including psychiatric admission. Universal screening for depressive symptoms during pregnancy may increase the detection of clinical depression and reduce consequent morbidity. We therefore hypothesised that antenatal screening for depressive symptoms could reduce the risk of postpartum psychiatric admissions. We explored the association between antenatal depression screening and postpartum psychiatric admissions using cross-sectional retrospective analysis of state-wide population-based health services administrative data. The analysis included all pregnant women who gave birth to a singleton in Queensland in the second half of 2015 and had information in variables of interest (28,255 women; 95.6% of 29,543 women who gave birth to a singleton during the study period). Women who did not complete antenatal depression screening had increased odds of being admitted to hospital for psychiatric disorders during the first three months after birth (aOR, 2.57; 95% CI, 1.69–3.92), which extended to six months postpartum (aOR, 1.74; 95% CI, 1.10–2.76). We found similar effects for specific psychiatric disorder groups such as mood disorders; schizophrenia, schizotypal and delusional disorders; and mental disorders associated with the puerperium (aOR, 2.65; 95% CI, 1.55–4.54) and mood disorders and puerperal mental disorders (aOR, 3.00; 95% CI, 1.70–5.30). Completion of antenatal depression screening appears to be associated with a decreased risk of psychiatric admission in the first postnatal months. This finding suggests that screening, and associated follow-up interventions, might decrease the severity of depressive symptoms during the perinatal period. [ABSTRACT FROM AUTHOR]