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The COVID-19 pandemic affected daily life routines and lifestyles of pregnant and postpartum women and increased their stress and risk of suffering from mental health problems. The aim of this study was to analyse which sociodemographic variables, COVID-19 exposure variables and lifestyles to cope with stress variables predicted anxiety, depression, and PTSD symptoms in pregnant and postpartum women during the COVID-19 pandemic. A cross-sectional design was performed with a sample of 3356 Spanish women participating in the Riseup-PPD-COVID-19 study. These participants completed an online survey composed of measures of anxiety (GAD-7), depression (EPDS), and PTSD related to COVID-19 (Checklist DSM-5), as well as demographics, exposure to COVID-19, and lifestyles to cope with stress. Regarding results, 47.2% showed depression and a third reported anxiety, whereas moderate scores were observed in PTSD symptoms. The most commonly used strategies to cope with stress in the COVID-19 pandemic were talking with friends and family and increasing time with social networks. Better results in mental health were associated with coping strategies such as talking with family and friends or participating in family activities, physical activity, sleeping well at night, eating healthier, and increasing personal care. Furthermore, poor results in mental health were observed in those participants who increased time with screens, ate fast food, reported substance use, and talked more frequently with health professionals. More symptoms were also observed in younger women, primiparous women, and those who reported more exposure to COVID-19. The results underline the need to strengthen the mental health of pregnant and postpartum women. Trial registration: ClinicalTrials.gov Identifier: NCT04595123., Author(s): Diego Gómez-Baya [sup.1] , Irene Gómez-Gómez [sup.2] , Sara Domínguez-Salas [sup.2] , Carmen Rodríguez-Domínguez [sup.2] , Emma Motrico [sup.2] Author Affiliations: (1) grid.18803.32, 0000 0004 1769 8134, Department of [...]

Introduction: The prevalence of depression and anxiety symptoms in pregnant and postpartum women during the COVID‐19 pandemic was assessed by several systematic reviews (SRs) and meta‐analyses which provided contrasting and different results. We aimed to summarize the evidence relating to the global prevalence of anxiety and depression among pregnant and postpartum women during the COVID‐19 pandemic. Material and methods: An umbrella review of SRs and meta‐analyses was performed. Searches were conducted in electronic databases up to April 2023. SRs and meta‐analyses reporting the prevalence of perinatal anxiety and depression during the COVID‐19 pandemic were selected for eligibility. Primary studies extracted from eligible meta‐analyses were included in the quantitative synthesis. The research protocol was registered on PROSPERO (CRD42020173125). Results: A total of 25 SRs (198 primary studies) and 12 meta‐analyses (129 primary studies) were included in the qualitative and quantitative synthesis, respectively. Studies involved data from five continents and 45 countries. The pooled prevalence of antenatal and postpartum depression was 29% (n = 55; 95% CI: 25%–33%) and 26% (n = 54; 95% CI: 23%–30%), respectively. In the case of anxiety, the pooled antenatal and postnatal prevalence was 31% (n = 44; 95% CI: 26%–37%; n = 16; 95% CI: 24%–39%). Differences emerged between continents, with Africa having the highest prevalence of perinatal depression and Oceania and Europe having the highest prevalence of antenatal and postnatal anxiety. The prevalence also varied depending on the assessment tools, especially for antenatal anxiety. A medium‐high quality of the studies was observed. One SR assessed strength‐of‐evidence, reporting very low strength. Conclusions: During the COVID‐19 pandemic, depression and anxiety were common, affecting almost one in three perinatal women globally. A high heterogeneity and a risk of publication bias were found, partially due to the variety of assessment tools and cut‐offs. The results may not be generalized to minorities. Studies on the prevalence of clinical diagnoses are needed. Based on our results it is not possible to firmly affirm that the COVID‐19 pandemic was the main factor that directly increased perinatal depression and anxiety during the past few years. Future studies should study other factors' impact. [ABSTRACT FROM AUTHOR]

Background: Primary health care (PHC) professionals may play a crucial role in improving early diagnosis of depressive disorders. However, only 50% of cases are detected in PHC. The most widely used screening instrument for major depression is the Patient Health Questionnaire (PHQ), including the two-, eight- and nine-item versions. Surprisingly, there is neither enough evidence about the validity of PHQ in PHC patients in Spain nor indications about how to interpret the total scores. This study aimed to gather validity evidence to support the use of the three PHQ versions to screen for major depression in PHC in Spain. Additionally, the present study provided information for helping professionals to choose the best PHQ version according to the context. Methods: The sample was composed of 2579 participants from 22 Spanish PHC centers participating in the EIRA-3 study. The reliability and validity of the three PHQ versions for Spanish PHC patients were assessed based on responses to the questionnaire. Results: The PHQ-8 and PHQ-9 showed high internal consistency. The results obtained confirm the theoretically expected relationship between PHQ results and anxiety, social support and health-related QoL. A single-factor solution was confirmed. Regarding to the level of agreement with the CIDI interview (used as the criterion), our results indicate that the PHQ has a good discrimination power. The optimal cut-off values were: ⩾2 for PHQ-2, ⩾7 for PHQ-8 and ⩾8 for PHQ-9. Conclusions: PHQ is a good and valuable tool for detecting major depression in PHC patients in Spain. [ABSTRACT FROM AUTHOR]

Background: Evidence of post-traumatic stress disorder (PTSD) symptoms related to the COVID-19 pandemic during the perinatal period and the associated risk factors are still limited. Thus, we aimed to investigate the PTSD symptoms associated with the COVID-19 pandemic in a large sample of both pregnant and postpartum women. Methods: A cross-sectional study was conducted on 3319 pregnant and up to 6-month postpartum women from Spain. An online survey was completed between June 2020 and January 2021. The assessment included measures of PTSD symptoms associated with COVID-19 (evaluated with 10 questions from the PTSD checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), pandemic-related concerns and health background (assessed by the Coronavirus Perinatal Experiences—Impact Survey), and demographic characteristics. Results: We found that >40% of women suffered from symptoms of PTSD associated with the COVID-19 pandemic. Difficulty concentrating and irritability were the most common symptoms, showing marked alterations in arousal and reactivity associated with the traumatic event. Being younger, suffering from pandemic concerns and distress, changes due to the pandemic and previous mental health problems were risk factors associated with PTSD symptoms in perinatal women. In addition, whereas being an immigrant (non-Spanish) was a risk factor for pregnant women, having other children and financial problems were risk factors for postpartum women. COVID-19 infection did not appear to be a risk factor for symptoms of PTSD in perinatal women. Conclusions: The increased risk of PTSD in pregnant and postpartum women highlights the importance of early detection and treatment of PTSD for pregnant and postnatal women, both during and beyond the pandemic. Trial Registration: ClinicalTrials.gov Identifier (NCT04595123). [ABSTRACT FROM AUTHOR]

Background: The evidence available on the association between social support and prevention of depression has been basically obtained from observational studies. Aim: We evaluated the effectiveness of social support-based interventions for the prevention of depression in people without clinical depression. Methods: Systematic review and meta-analysis (SR/MA) of randomized controlled trials (RCT), which were searched for in MEDLINE, EMBASE, CENTRAL, WOS, PsycINFO, OpenGrey and other sources from the inception dates to June 8, 2022. We selected RCTs that assessed the effectiveness of social support-based interventions as compared to controls, included subjects without baseline clinical depression, and measured as results a reduction in depressive symptoms and/or the incidence of new cases of depression. Pooled standardized mean differences (SMDs) were calculated from random effects models. Results: Nine RCTs involving 927 patients from North America, Asia and Europe were included. The pooled SMD was −0.43 [95% confidence interval (CI) −0.82 to −0.04; p =.031]. Sensitivity analyses confirmed the robustness of results. Heterogeneity was substantial [ I 2 = 80% (95% CI: 64% to 89%)]. A meta-regression model that included usual care as comparator and the continent (Europe), explained 53% of heterogeneity. Eight RCTs had a moderate overall risk of bias and one had a high risk of bias. Follow-up was ⩾1 year in only three RCTs. There was no statistical evidence of publication bias. The quality of evidence, as measured on GRADE guidelines, was low. Conclusion: Social support-based interventions had a small preventive effect on depression. Longer RCTs with a low risk of bias are necessary. [ABSTRACT FROM AUTHOR]

It is necessary to continue identifying the predictors of anxiety symptoms in men and women undergoing assisted reproductive technology (ART), especially from a psychosocial perspective. For this reason, this study evaluated a mediation model that demonstrates the effect of various stressors related to infertility, as well as the variables of sex, age, social support, and sexist beliefs, on anxiety symptoms. The sample of this cross-sectional study consisted of 215 infertility patients (146 women and 69 men) undergoing ART and residing in Spain. The Inventory of Infertility Problems (FPI) was used, which measures five stressors related to infertility (social, sexual and relationship concerns, rejection of a child-free lifestyle and need for parenthood). The Hospital Anxiety and Depression Scale (HADS) and the Ambivalent Sexism Inventory (ASI) were also used. Being women and perceiving less social support was associated with higher anxiety symptoms, due to the mediated effect of social, sexual and relationships concerns. Higher levels of sexist beliefs were related to greater concern about the relationship, greater rejection of a childless lifestyle and greater need for parenting. This pioneering research in Spain identifies factors predisposing to anxiety in ART patients. This evidence should be considered in infertility research and clinical practice. [ABSTRACT FROM AUTHOR]

Background: The use of online questionnaires to assess common mental disorders such as perinatal anxiety has spread due to the proliferation of Internet-based psychological interventions and research. This study analyses the validity and reliability of the online version of the Generalized Anxiety Disorder-7 (GAD-7) in a sample of pregnant and postpartum Spanish women., Method: A total of 3082 pregnant (n = 1260) and postpartum (n = 1822) women were recruited via the Internet and underwent three follow-up evaluations during a six-month period., Results: A one-factor solution was assigned by Exploratory Factor Analysis and confirmed by Confirmatory Factor Analysis for both pregnant (CFI = 0.998; RMSEA = 0.035) and postpartum (CFI = 0.998; RMSEA = 0.038) women. The one-factor model showed strict invariance across groups. Validity was confirmed by assessing correlations between GAD-7, the Edinburgh Postnatal Depression Scale, and the 10-item Posttraumatic Stress Disorder checklist at three time points. The reliability coefficient was .92 for the two groups., Conclusions: This study shows that the Spanish online GAD-7 version has good psychometric properties and can be used to assess anxiety symptoms during the perinatal period.

Introduction: Maintaining or acquiring healthier health-oriented behaviours and promoting physical and mental health amongst the Spanish population is a significant challenge for Primary Health Care. Although the role of personal aptitudes (characteristics of each individual) in influencing health behaviours is not yet clear, these factors, in conjunction with social determinants such as gender and social class, can create axes of social inequity that affect individuals' opportunities to engage in health-oriented behaviours. Additionally, lack of access to health-related resources and opportunities can further exacerbate the issue for individuals with healthy personal aptitudes. Therefore, it is crucial to investigate the relationship between personal aptitudes and health behaviours, as well as their impact on health equity., Objectives: This paper outlines the development, design and rationale of a descriptive qualitative study that explores in a novel way the views and experiences on the relationship between personal aptitudes (activation, health literacy and personality traits) and their perception of health, health-oriented behaviours, quality of life and current health status., Method and Analysis: This qualitative research is carried out from a phenomenological perspective. Participants will be between 35 and 74 years of age, will be recruited in Primary Health Care Centres throughout Spain from a more extensive study called DESVELA Cohort. Theoretical sampling will be carried out. Data will be collected through video and audio recording of 16 focus groups in total, which are planned to be held in 8 different Autonomous Communities, and finally transcribed for a triangulated thematic analysis supported by the Atlas-ti program., Discussion: We consider it essential to understand the interaction between health-related behaviours as predictors of lifestyles in the population, so this study will delve into a subset of issues related to personality traits, activation and health literacy. Clinical trial registration : ClinicalTrials.gov, identifier NCT04386135., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Young-Silva, Berenguera, Jacques-Aviñó, Gil-Girbau, Arroyo-Uriarte, Chela-Alvarez, Ripoll, Martí-Lluch, Ramos, Elizondo-Alzola, Garcia-Martinez, Méndez-López, Tamayo-Morales, Martínez-Andrés, Motrico, Gómez-Gómez, Fernández-Alvarez, Juvinyà-Canal and the DESVELA Cohort investigators.)