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The literature reports that teenage pregnancy is considered a risk factor for anxiety disorders (ADs). However, research on this topic is limited. This study aimed to investigate if pregnant adolescents presented a greater likelihood of having ADs by comparing two samples of pregnant women in a southern city of Brazil. We also observed the prevalence rates of antenatal ADs among adolescents and adult women.In this cross-sectional study, we evaluated 1852 women from two different studies: 995 pregnant adolescents attending prenatal care in the public health system (convenience sample) and 857 pregnant women from a population-based study. We used the Mini International Neuropsychiatric Interview (MINI Plus) to assess antenatal ADs, using the Social Anxiety Disorder (SAD) and Generalized Anxiety Disorder (GAD) modules. The primary aim of this study was tested through multivariate analysis using Poisson regression.The prevalence of ADs was 11.0 % among pregnant adolescents and 13.8 % among adult pregnant women. Both samples presented similar rates of ADs (p = 0.065). In the adjusted analysis, maternal age did not predict antenatal ADs (PR = 0.97; p = 0.853).Considering the particularities of each study where the samples came from, it was not possible to include other ADs such as panic disorder or phobias.Our findings suggest that pregnancy in adolescence does not increase the likelihood of antenatal ADs. However, we emphasize the importance of an adequate psychological screening and care in pregnancy in order to prevent possible psychiatric disorders.

Resumo Objetivos: explorar um conjunto de fatores associados ao menor apego materno-fetal (AMF) em gestantes. Métodos: trata-se de um estudo transversal, correspondente à segunda fase de um estudo de coorte com uma amostra de base populacional de gestantes no sul do Brasil. Foi utilizada a Escala de Apego Materno-Fetal (EAMF) para medir o AMF. A análise bivariada foi realizada através do teste t e ANOVA. As variáveis que apresentaram p

Trata-se de uma revisão narrativa da literatura que teve como objetivo explorar os possíveis fatores associados à descontinuação do processo de Aleitamento Materno Exclusivo (AME), bem como a prevalência do mesmo, até seis meses de vida dos bebês. A busca de dados foi realizada na base de dados eletrônica PubMed, no mês de outubro de 2020, através de uma estratégia de busca que utilizou indexadores selecionados segundo os Descritores em Ciência da Saúde (DeCS/MeSH). Dos 14 artigos incluídos na presente revisão, foram identificados 18 fatores associados que corroboram com a descontinuação do processo de AME. Dentre estes, encontram-se características sociodemográficas e comportamentais da díade mãe-bebê, aspectos sobre o histórico gestacional e do parto, adversidades ao praticar o AME e a falta de informações relacionadas a este processo, além de crenças atreladas a cultura. O fator associado mais prevalente foi a atividade laboral materna. Seguido da baixa escolaridade da mulher, depressão pós-parto e menor número de consultas pré-natais realizadas. Ressalta-se a necessidade de um olhar cuidadoso sob a perspectiva multiprofissional, ofertando os cuidados necessários. A licença à maternidade e a amamentação durante os horários de trabalho devem ser continuamente estimuladas e respeitadas, já que por muitas vezes há tabus envolvidos. As orientações sobre o AME necessitam ser realizadas desde os primeiros contatos com a gestante, de uma forma didática, facilitando a compreensão das mulheres. Assim, corroborando com o possível aumento das taxas de AME, beneficiando a saúde da díade mãe-bebê.

This study aimed to verify the course of maternal anxiety disorders and its impact on child development of toddlers. This is a cohort study that followed 497 pregnant adolescents who received anten...

Genetic alterations related to oxytocin system seem to influence the neurobiology of attention-deficit hyperactivity disorder and anxiety problems leading to greater functional, social and emotional impairment. Here, we analyzed the association of OXTR rs2254298 and CD38 rs6449182 variants with attention/hyperactivity problems and anxiety problems in children. The study enrolled 292 children and adjusted regression model revealed OXTR rs2254298 AA genotype as a risk factor for attention deficit/hyperactivity problems (PR: 2.37; P

Highlights • Brief CBT in pregnancy was effective in preventing PPD. • CBT improved interpersonal relationships and understanding of social status (OQ-45). • Education, among the risk factors for PPD, was decisive in the effectiveness of CBT., Background Postpartum depression (PPD) affects a high number of women, often the first manifestation of a mood disorder that will occur later in life, bringing serious consequences for the patient and her offspring. Depression today is the leading cause of disability worldwide. The aim of this study was to evaluate the effectiveness of a preventive cognitive behavioral therapy (CBT) for PPD. Methods Pre-post therapy study, as part of a population-based cohort study. Pregnant women without a diagnosis of depression participated, who were divided into two groups: risk of depression (CBT) and a control group (without therapy). The preventive therapy consisted of six sessions of CBT, administered weekly. The Outcome Questionnaire (OQ-45) was used in all sessions. The Mini International Neuropsychiatric Interview and Beck Depression Inventory-II were used on three occasions. The final statistical analyses were performed by Poisson regression. Results The prevalence of PPD in the risk group was 5.5% and in the control group 2.2%, with no difference between the groups (PR 1.66 95% CI 0.44-6.18). The OQ-45 averages gradually reduced during the therapy sessions, indicating therapeutic progress. Schooling was an associated factor, both with the manifestation of PPD and with the greater effectiveness of the therapy. Limitations Rate of 40.5% refusal to preventive treatment and absence of a group with similar characteristics in another therapy model. Conclusions Brief cognitive behavioral therapy applied by mental health professionals with basic training was effective in preventing the manifestation of PPD.

Given the importance that love has in individuals’ lives, and considering that more specific studies about the relationship between depression and the way people love are lacking, the aim of the current study was to evaluate the effect of major depressive disorder (MDD) on “love styles.” This study was nested in a cohort of adolescent mothers. Women were assessed for MDD at each point of assessment: during pregnancy (T1), at between 30 and 60 postpartum days (T2), and at approximately 30 postpartum months (T3), by using the Mini International Neuropsychiatric Interview (MINI PLUS) tool. The Love Attitudes Scale (LAS) was administered to assess the six love styles at T3. Logistic regression analyses were carried out to express the strength of depression on love styles. We found that chronic major depression had the largest effect on the love styles (low Eros, high Mania, and high Agape), followed by current major depression. However, the same association was not observed in the perinatal period. Thus, the assessment of love style is relevant as it seems that an MDD-related injury in maternal life is related to their attitudes about love and there could be possible harmful consequences of these attitudes to the mother and the whole family.

Adults with childhood maltreatment history can face a difficult experience in transitioning to parenthood. Women with a history of emotional neglect in childhood tend to experience problematic attachment. The study's aim was to evaluate the relationship between childhood trauma and maternal-fetal attachment in pregnant women in a population-based study in Southern Brazil. This is a longitudinal study with pregnant women who were interviewed in two moments: before 24-weeks of pregnancy and 60 days after the first interview. We used the Childhood Trauma Questionnaire and the Maternal-Fetal Attachment Scale. The mean of maternal-fetal attachment in the general sample was 99.8 (± 10.8). The mean of emotional neglect was 8.9 (± 4.7); physical neglect 6.7 (± 2.8); sexual abuse 5.9 (± 3.0); physical abuse 6.8 (± 3.1) and emotional abuse 8.0 (± 4.1). After adjusted analysis, we found that pregnant women who suffered emotional neglect had 0.4 points less on the average on the maternal-fetal attachment, β = -0.4, CI 95% [-0.6, -0.2], and pregnant women who suffered emotional abuse had 0.2 points less on the average on the maternal-fetal attachment, β = -0.2, CI 95% [-0.5, -0.0]. Only emotional neglect and emotional abuse were associated with maternal-fetal attachment. This study showed that a history of childhood trauma can have a negative impact during the prenatal period, and can impair maternal-fetal attachment. The data found can assist health professionals in identifying factors that can protect and contribute to pregnant women who were victims of childhood trauma to face the transition to parenthood in the best possible way.

The aim of the study is to verify the association between GAD, the severity of depressive symptoms and stressors in pregnant women between the first and second trimester. Cross-sectional study, part of a cohort that followed 980 women during the gestational period of a city in southern Brazil. We performed bivariate analysis using the t-test and chi-square. The variables that presented p ≤ 0.20 were taken for multivariate analysis, through logistic regression, in order to control possible confounding factors. The Mini International Neuropsychiatric Interview Plus was used to evaluate GAD, the severity of depressive symptoms was investigated through the Beck Inventory of Depression II, and stress events according to the Social Readjustment Assessment Scale of Holmes e Rahe. The sample consisted of 980 women. Women with mild depression symptoms had 9.8 (IC95% 4.6;21.0) times more GAD, those with moderate symptoms had 27.5 (IC95% 12.5;60.0) times more GAD, and those with severe symptoms had 52.9 (IC95% 19.1;146.5) times more GAD when compared to pregnant women with no symptoms or minimal symptoms. Regarding the stressful events, the pregnant women who presented GAD had an increase of 1.0 (IC95% 1.0;1.1) point in the mean of occurrence of stressor events when compared to those without GAD. These findings highlight the need for prevention strategies and interventions to promote maternal mental health, which benefit the development of infants in the long term.

The COVID-19 pandemic has changed individuals and families, causing adverse psychological effects, especially in young adults, women, and parents. This study aimed to verify the prevalence of current major depressive episode (CMDE) in mothers of preschoolers (up to five years old) and its associated stressors during the COVID-19 pandemic in a municipality in the Southern Brazil. This is a cross-sectional, population-based study with mothers. All mothers were interviewed by telephone call during the COVID-19 pandemic. We used the Mini-International Neuropsychiatric Interview (M.I.N.I. Plus) to assess the presence of CMDE. Statistical analysis was conducted using the chi-square test and a multivariate logistic regression. We evaluated 666 mothers. The prevalence of CMDE was 12.3%. Mothers with financial losses had 2.1 (95%CI: 1.3-3.4) more odds of presenting CMDE than those financially stable. We observed that financial losses were determinant for the higher prevalence of depression in mothers.

To evaluate the efficacy of brief psychotherapeutic interventions of cognitive behavioral therapy to treat antenatal depression and verify the association between interventions and motor development of infants at 3 and 18 months of age.Pre-post-intervention study nested a randomized clinical trial, both of which are extracts from a population-based cohort study of a southern Brazilian city. The major depressive episode was measured through Mini Plus, the severity of depressive symptoms by BDI-II and motor development using Bayley-III and AIMS. The follow-ups occurred during the gestational period (T2) and at 3 (T3) and 18 months (T4) after delivery.Data were analyzed from 336 women in the control group (not intervened) and 108 from the group of depressed women who received intervention for antenatal depression. The effectiveness of the interventions for a major depressive episode was around 80% for both models in the two follow-up stages (3 and 18 months postpartum). In addition, the children whose mothers received intervention presented 3.7 (95% CI 0.7-6.6) points higher in Bayley-III at 3 months old when compared to the children in the control group (p = 0.01). There was no difference between the two psychotherapy models tested, both being equally effective (p 0.05).We found that the brief psychotherapeutic interventions of cognitive behavioral therapy for gestational depression were effective in causing remission of the condition both in the short and long term, besides indirectly causing benefits also to the children, with regard to their motor development.

This study aimed to investigate the association between child maltreatment and depressive symptomatology during gestation in adolescents. This was a cross-sectional study with pregnant adolescents aged 12 to 19 years. Data were collected with the Beck Depression Inventory, Childhood Trauma Questionnaire, and Mini International Neuropsychiatric Interview. Compared to adolescents who did not experience each type of neglect or abuse, experiencing them was associated with a higher proportion of depressive symptoms: emotional neglect PR = 1.4 (95% CI 1.1; 1.8); physical neglect PR = 1.7 (95% CI 1.3; 1.7); emotional abuse PR = 1.8 (95% CI 1.4; 2.2); and physical abuse PR = 1.3 (95% CI 1.1; 1.7). This study demonstrates the association between childhood experiences and mental health in adolescence, especially in vulnerable samples, such as pregnant adolescents. This finding reveals the importance of studying early trauma in life and enabling preventive help, especially in adolescents. High-quality evidence of perinatal mental health problems should be generated to make pregnancy safer for women in low- and middle-income countries.

Background: Family members tend to modify their routine by assisting or participating in the patient’s rituals. These behaviors have been identified as family accommodation (FA). Aims: The aim of this study was to describe the relationship between family accommodation of relatives of Obsessive-Compulsive Disorder (OCD) patients and their perceptions about the obsessions and compulsions of the patient. Method: This was a cross-sectional study with family members of Obsessive-Compulsive Disorder in a Southern Brazilian city. The family perception of the OCD symptoms and their accommodation were assessed through the Family Accommodation Scale for Obsessive-Compulsive Disorder – Interviewer-Rated (FAS-IR). Results: The level of family accommodation was higher in those family members who lived with the patient when compared to those who did not live with them ( p = .011). The obsessions associated with higher levels of family accommodation were: contamination ( p Conclusion: The family accommodation is present in family members of Obsessive-Compulsive Disorder patients, regardless of the type of obsessive/compulsive symptom perceived.

Suicide associated with severe psychiatric illnesses is considered the leading cause of maternal deaths. We aimed to assess the suicide risk in women who experienced depressive or mixed episodes of mood change during the postpartum period and to determine which disorder is more related to suicide risk in the same period. We conducted a longitudinal study with 706 women whose children were born from April 2007 to May 2008 in a southern city in Brazil, and received prenatal care by the Brazilian National System of Public Health. The first assessment occurred during the prenatal period and the second within 30 to 60 days postpartum. The incidence of suicide risk was 10.9%. The odds of postpartum suicide risk were 6.50 (95% CI: 2.73; 15.48) higher in mothers with postpartum depression and 41.50 (95% CI: 12.11; 142.16) higher in those with mixed episodes than those who did not suffer from any mood disorder. Women with chronic episodes (who had depressive or mixed episodes during pregnancy and postpartum) were at increased odds of 4.94 (95% CI: 1.46; 16.69) of a postpartum suicide risk. The postpartum seems to be a critical period in the women’s mental health. The impact of mental disorders in this period, especially mixed episodes, can increase the odds of a suicide risk onset. A good psychiatric evaluation and support during the prenatal and postpartum care may prevent the subsequent risk of suicide.

Objective To verify the association between mood and anxiety disorders, and suicide risk during pregnancy and their relationship with premature birth in a population of pregnant adolescents attending prenatal care in the public health system of Pelotas, a southern city in Brazil. Methods This was a cohort study with all pregnant adolescents attending antenatal public services in the urban area of Pelotas between October 2009 and May 2011. The first assessment occurred between the 20th and 22 nd week of pregnancy and the second occurred one month after delivery. We used the Mini International Neuropsychiatric Interview (MINI) to assess mood and anxiety disorders and suicide risk. Results A total of 645 pregnant women aged between 12 and 19 years old were interviewed. An anxiety disorder was present in 9.1% of the pregnant adolescent, and 28.5% had a mood disorder. The prevalence of suicide risk was 12.6%, and 15.3% of the babies were born premature. A multivariate analysis adjusted for maternal education, number of previous pregnancies and previous preterm birth indicated that adolescents who had suicide risk during pregnancy were approximately twice as likely to give birth prematurely when compared to those who were not diagnosed with suicide risk (PR 1.79; CI 1.06–3.03). Conclusion Our findings suggest that pregnant adolescents who were at risk of suicide during pregnancy were more likely to have premature babies. It is important to pay attention to the mental health of this specific population to prevent obstetric complications and consequently improve the health of the children.

Objetivo: Verificar la relación entre el riesgo de suicidio y el abuso de alcohol y tabaco durante el embarazo. Materiales y métodos: Estudio transversal con mujeres embarazadas entre los dos primeros trimestres gestacionales. La muestra fue elegida por sorteo de 50% (n=244) de los sectores censales en el área urbana de una ciudad en el sur de Brasil. Los instrumentos utilizados fueron la Mini International Neuropsychiatric Interview 5.0.0 (M.I.N.I. Plus), la Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), la Edinburgh Postnatal Depression Scale (EPDS) y la Escala Brasileira de Insegurança Alimentar (EBIA). Esas que estaban en riesgo de suicidio y/o abuso/dependencia del alcohol fueron derivadas al servicio de salud apropiado y aquellas que demostraron abuso/dependencia del tabaco recibieron orientación sobre el daño del uso de esta sustancia durante el embarazo. El proyecto de investigación fue aprobado por el Comité de Ética de Investigación de la Universidad y todas las participantes firmaron un formulario de consentimiento. El estudio está financiado por la Fundación Bill y Melinda Gates. Los análisis univariados se realizaron con frecuencia simple y relativa, media y desviación estándar. Para los análisis bivariados y multivariados, se utilizaron las pruebas de chi-cuadrado, ANOVA y regresión logística, respectivamente. Resultados y conclusiones: Participaron en el estudio 981 mujeres embarazadas. La prevalencia del abuso de alcohol fue de 8.6% (n=84) y el abuso de tabaco fue de 16.2% (n=158). Después de la regresión logística, las mujeres embarazadas con menos educación (OR 7.85; IC95% 2.94-20.92), de clase económica baja (OR 2.80; IC95% 1.44-5.42), con inseguridad alimentaria (OR 1.72; IC95% 1.16-2.55) y con riesgo de suicidio (OR 1.95; IC95% 1.21-3.16) tenían más probabilidades de ser dependientes del tabaco. Este resultado resalta la necesidad de una buena atención prenatal, incluida la atención especial al uso de sustancias y la salud mental de la mujer embarazada.

Background:The parental bonding is influenced by two dimensions: care and control or protection over the child of both parents. The lack of care during childhood may make the individual more susceptible to the onset of psychiatric disorders when adult. These psychiatric disorders when present during pregnancy may have a negative impact on the health of pregnant women and children. The aim of this study was to assess the association between generalized anxiety disorder (GAD) in pregnant adolescents and the perception of parental bonding.Methods:This is a cross-sectional study with 871 pregnant women under the age of 19, receiving prenatal care in 47 Basic Health Units in the one city, Brazil. The generalized anxiety disorder was measured using the Mini International Neuropsychiatric Interview (MINI) and the perception of parental bonding in childhood using the Parental Bonding Instrument (PBI).Results:The prevalence of GAD was 8.5%. Among all the parental bonding dimensions, only a perceived lack of maternal care under 16 years was associated with GAD.Conclusions:The results showed that only the perception of maternal bonding was associated with later GAD. It suggests that an adequate maternal bond is an essential component of psychological health.

Objective: To evaluate the association between abuse of and dependence on different psychoactive substances and the presence of anxiety disorders in a sample of young adults from a city in southern Brazil. Methods: Between 2007 and 2009, we carried out a cross-sectional, population-based study of individuals aged 18-24 years who lived in Pelotas, a city in southern Brazil. We evaluated anxiety disorders using the Mini International Neuropsychiatric Interview 5.0 (MINI), and use of psychoactive substances with the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST 2.0/0MS). We used Fisher’s exact test for univariate analysis, and Poisson regression models with robust variance for multivariable analysis. Results: The sample consisted of 1,560 young adults. The overall prevalence of abuse/dependence was 26.9% for alcohol, 24.9% for tobacco, and 7.3% for illicit substances. Individuals with agoraphobia had a 32% higher prevalence of tobacco abuse/dependence (prevalence ratio [PR] = 1.32 [95%CI 1.01-1.74]). Individuals with posttraumatic stress disorder (PTSD) or generalized anxiety disorder (GAD) had a 2.41-fold (95%CI 1.22-4.77) and 1.76-fold (95%CI 1.00-3.11) higher prevalence of illicit substance abuse/dependence, respectively. Conclusion: In this population-based sample, we found associations between GAD, PTSD, and increased prevalence of illicit substance abuse/dependence. In addition, individuals with agoraphobia seem to have increased tobacco abuse/dependence.

AIM: The aim of this study was to evaluate the prevalence of depressive symptoms and factors associated in the elderly of the city of Pelotas, southern Brazil. METHODS: In this cross-sectional study, the variables of interest were investigated with instruments about the socio-economic profile, aspects of physical and professional activities, eating and sleeping habits. RESULTS: 312 elderly people were interviewed, with a prevalence of depressive symptoms of 30.5%. A higher prevalence of depressive symptoms were found in women, individuals older than 81 years, from the low class, living alone, physically inactive, and retired. In the adjusted analysis, the non-practice of physical activity, low sleep quality, and daily sleeping medication were statistically associated with the outcome. In contradiction to the literature, our results refute the well-established gender roles that preconize that males are more affected by physical impairment, while the females are more affected by psychological and psychiatric disorders. CONCLUSIONS: In conclusion, it is important to identify the prevalence of depressive symptoms in a population commonly affected by other diseases. In addition, characteristics associated with depression were detected, which can help prevent or improve depression in this age group. OBJETIVO: El objetivo de esto estudio fue para evaluar la prevalencia de síntomas depresivos y factores asociados en ancianos de la ciudad de Pelotas, sur de Brasil. MÉTODOS: En este estudio transversal, las variables de interés fueron investigadas con instrumentos sobre perfil socioeconómico, aspectos de las actividades físicas y profesionales, hábitos alimentarios y de sueño.RESULTADOS: Fueron entrevistados 312 ancianos, con prevalencia de síntomas depresivos del 30,5%. Una mayor prevalencia de síntomas depresivos fue encontrada en mujeres, de más de 81 años, de clase baja, viviendo solos, físicamente inactivos y jubilados. En el análisis ajustado, la nula práctica de actividad física, la baja calidad del sueño y la medicación diaria para dormir fueron estadísticamente asociadas al desenlace. En contradicción con la literatura, nuestros resultados refutan papeles de género bien establecidos que preconizan que los hombres son más afectados por el compromiso físico, mientras que las mujeres son más afectadas por disturbios psicológicos y psiquiátricos. CONCLUSIONES: En conclusión, es importante identificar la prevalencia de síntomas depresivos en una población comúnmente afectada por otras enfermedades. Además, las características asociadas a la depresión se han detectado, lo que puede ayudar a prevenir o mejorar la depresión en este grupo de edad. AIM: The aim of this study was to evaluate the prevalence of depressive symptoms and factors associated in the elderly of the city of Pelotas, southern Brazil. METHODS: In this cross-sectional study, the variables of interest were investigated with instruments about the socio-economic profile, aspects of physical and professional activities, eating and sleeping habits. RESULTS: 312 elderly people were interviewed, with a prevalence of depressive symptoms of 30.5%. A higher prevalence of depressive symptoms were found in women, individuals older than 81 years, from the low class, living alone, physically inactive, and retired. In the adjusted analysis, the non-practice of physical activity, low sleep quality, and daily sleeping medication were statistically associated with the outcome. In contradiction to the literature, our results refute the well-established gender roles that preconize that males are more affected by physical impairment, while the females are more affected by psychological and psychiatric disorders. CONCLUSIONS: In conclusion, it is important to identify the prevalence of depressive symptoms in a population commonly affected by other diseases. In addition, characteristics associated with depression were detected, which can help prevent or improve depression in this age group. ***Prevalencia de síntomas depresivos y factores asociados en ancianos de la ciudad de Pelotas-RS***OBJETIVO: O objetivo deste estudo foi avaliar a prevalência de sintomas depressivos e fatores associados em idosos da cidade de Pelotas, sul do Brasil. MÉTODOS: Neste estudo transversal, as variáveis de interesse foram investigadas com instrumentos sobre perfil socioeconômico, aspectos das atividades físicas e profissionais, hábitos alimentares e de sono. RESULTADOS: Foram entrevistados 312 idosos, com prevalência de sintomas depressivos de 30,5%. Uma maior prevalência de sintomas depressivos foi encontrada em mulheres, com mais de 81 anos, de baixa classe, vivendo sozinhos, fisicamente inativos e aposentados. Na análise ajustada, a não prática de atividade física, a baixa qualidade do sono e a medicação diária para dormir foram estatisticamente associadas ao desfecho. Em contradição com a literatura, nossos resultados refutam papéis de gênero bem estabelecidos que preconizam que os homens são mais afetados pelo comprometimento físico, enquanto as mulheres são mais afetadas por distúrbios psicológicos e psiquiátricos. CONCLUSÕES: Em conclusão, é importante identificar a prevalência de sintomas depressivos em uma população comumente afetada por outras doenças. Além disso, características associadas à depressão foram detectadas, o que pode ajudar a prevenir ou melhorar a depressão nessa faixa etária. Descritores: Depressão; Saúde do idoso; Qualidade de vida.

The discussion on the safety of thimerosal-containing vaccines (TCVs) and their impact on child development it́s very relevant.This is a cohort study with mother-child dyads who received prenatal care in the Unified Health System. The domains of motor, cognitive and language development were evaluated in children between 24 and 36 months of age. Data on vaccination were obtained through the child's immunization record. A linear regression analysis was carried out considering possible confounders.In bivariate analyses, motor and language development were associated with TCVs (p 0.05). However, in the multivariate analysis, this association was not maintained (p 0.05). These results indicate that the use of TCVs is not associated with child development. The importance of this study is summarized in transmitting relevant information regarding public health, based on reliable data.

Background The parental bond is characterized by the perception of care and protection received by parental figures throughout human development. During the gestational period, the intensity in which the woman manifests behaviors and feelings for the fetus was denominated maternal-fetal attachment (MFA). In this perspective, the literature indicates that there is association between MFA and the pregnant woman's perception about the bond established with her parents. Aims This study aimed to evaluate the association between MFA and perceived parental bonds of pregnant women in the city of Pelotas/RS (Brazil). Study design This is a cohort study with 839 women during their gestational period. All women answered to the Parental Bonding Instrument to investigate the perceived parental bonds, and the MFA was assessed through the Maternal-Fetal Attachment Scale. Results The main results showed that perceived paternal overprotection was associated with a higher MFA after adjustment (B 2.00 CI95% 0.30; 3.70). Additionally, the pregnant women who were in the first trimester of pregnancy (p, Highlights • Literature suggests an association between maternal-fetal attachment (MFA) and the parental bonding of the pregnant women. • We provide evidence that the overprotection perceived by the women with her paternal figures influences the MFA. • The supportive behaviors provided by the baby's father influence pregnant women's MFA. • Living with a partner also has a positive impact on MFA.

Objective: To evaluate the association between perceived social support and anxiety disorders in pregnant adolescents. Methods: We conducted a cross-sectional study with a sample of 871 pregnant women aged 10 to 19 years who received prenatal care in the national public health care system in the urban area of Pelotas, state of Rio Grande do Sul, southern Brazil. We assessed perceived social support and anxiety disorders using the Medical Outcomes Study Social Support Survey and the Mini International Neuropsychiatric Interview. A self-report questionnaire was used to obtain sociodemographic information. Results: The prevalence of any anxiety disorder was 13.6%. Pregnant adolescents with an anxiety disorder reported less perceived social support in all domains (affectionate, emotional, tangible, informational, and positive social interaction). Older teenagers reported lower perceived support in the emotional, informational, and positive social interaction domains, whereas those with low socioeconomic status reported lower perceived social support in the material domain. Women who did not live with a partner had less perceived social support in the affectionate and positive social interaction domains. Conclusion: Perceived social support seems to be a protective factor against anxiety disorders in pregnant adolescents, with a positive effect on mental health.

Objective: To describe the incidence of suicidal attempts and the prevalence of suicidal ideation in pregnancy; verifying the factors associated with suicidal ideation in pregnant women. Methods: This analysis is a section from a population-based cohort study with pregnant women between the first and second gestational trimester, identified at their homes in the urban area from a southern Brazilian. The Mini International Neuropsychiatric Interview version Plus (MINI PLUS) was used to assess suicidal ideation and behavior. Variables with a p

A large number of children of depressed mothers have one or more mental disorders. This study aimed to evaluate the impact of maternal depression on the mental health of 4–5-year-old children of adolescent mothers, according to the hypotheses generated from the model of accumulation. Between October 2009 and March 2011, all pregnant adolescents who received prenatal care from the public health system in Pelotas (southern Brazil) were invited to participate in the study and have been prospectively followed. Of these individuals, 413 participants were evaluated in the postpartum period and when the child was 2–3 years old and 4–5 years old (current stage). The Strengths and Difficulties Questionnaire was used to assess mental health problems in children, and the Mini International Neuropsychiatric Interview (MINI)-Plus version was used to assess maternal depression. We applied a structured modeling approach to examine the relations between three different hypothesized life course models (accumulation, critical period, and mobility) and maternal depression. After selecting the most appropriate model, we used a logistic regression analysis to assess the effect of depression on mental health problems in 4–5-year-old children of adolescent mothers. We used the Chi square test to estimate the prevalence of mental health problems in 4–5-year-old children. The longer the time of exposure to maternal depression, the greater the probability that the child would present behavioral problems. Investments in strategies to prevent mental disorders beginning in the gestational period are important.

Introduction Depression during pregnancy in adolescents is increasing significantly. However, instruments for early depression screening during prenatal care are scarce. Faced this fact, the objective of this research is to identify the best cutoff points for the Edinburgh Postnatal Depression Scale (EPDS) and Beck Depression Inventory (BDI) in a sample of pregnant adolescents. Method 807 pregnant adolescents, with a mean age of 17 years, met in public antenatal services were evaluated. Two screening scales for depression were analyzed, EPDS and the BDI. These scales had their accuracy measured by AUC of their ROC curve, as well as their respective sensitivity and specificity. Results In the analysis, the best cutoff for the EPDS was≥10, in which the sensitivity was 81.1% and specificity 82.7%. For the BDI, it was with recognized the cutoff ≥11, sensitivity 86.7% and specificity 73.8%. In the analysis of the ROC AUC, values of 0.89 (CI 0.87–0.92) for the EPDS and BDI for 0.87 (CI 0.84–0.89) were identified compared to the MINI. Limitations The sample was composed majority by middle and low income adolescent and the study was performed only with pregnant women in the second trimester. Conclusions The results indicate that both scales have good accuracy in screening of depression in adolescent mothers. However, the EPDS scale shows higher AUC ROC and also better sensitivity and specificity values, the latter being more precise and effective for screening for depression in this population.

Objective: To examine the association between Anxiety Disorders (AD) and cognitive performance in young mothers at 30 months postpartum. Methods: This is a cross-sectional study nested to a follow-up study was conducted with 539 young mothers in the city of Pelotas, in southern Brazil. The ADs were evaluated with the Mini International Neuropsychiatric Interview (MINI PLUS), cognitive performance was screened with the Montreal Cognitive Assessment (MoCA). We used multiple linear regression analysis to explore the association between ADs and cognitive performance. Results: The total MoCA score was associated with the following variables: marital status β= -0.86 (95%CI -1.60;-0.13), education β= 1.22 (95%CI 0.90;1.53), occupation β= 1.03 (95%CI 0.28;1.79), Generalized Anxiety Disorder (GAD) β= -2.28 (95%CI -4.07;-0.50) and at least one AD 30 months postpartum β= -0.10 (95%CI -0.20;-0.00). Together, these variables were responsible for 16% of the variance in the total MoCA score, GAD being the variable with the strongest negative association. Conclusions: The results showed that sociodemographic variables, a GAD diagnosis and the presence of at least one AD were significantly associated with low cognitive performance in young mothers at 30 months postpartum.

OBJECTIVES: To describe the prevalence of Major Depressive Disorder (MDD) during pregnancy in teenage mothers and to assess its association with socio-demographic characteristics, obstetric history and psychosocial variables. METHODS: A cross-sectional study was conducted with a sample of pregnant teenagers enrolled in the national public health system in the urban area of Pelotas, southern Brazil. MDD was assessed with the Mini International Neuropsychiatric Interview, the Abuse Assessment Screen was used to identify physical abuse within the last 12 months and during pregnancy, and social support was assessed with the Medical Outcomes Survey Social Support Scale. RESULTS: Forty-three (4.94%) potential subjects refused to participate, resulting in 828 total participants. The prevalence of MDD was 17.8%, 9.2% reported they had been subjected to violence within the last 12 months, while 5.8% had suffered violence during pregnancy, and the mean (SD) overall social support score was 87.40 (11.75). After adjustment, we found the highest incidence of MDD in adolescents with less than 8 years of education, followed by those with previous episodes of MDD and those with lower overall social support. CONCLUSIONS: MDD is a relatively common condition in pregnant teenagers and appears to be more prevalent in young mothers who are both socioeconomically and psychosocially underprivileged.

Background Suicidal behavior and its correlates remain relatively understudied in pregnant teenagers. Methods A cross-sectional study with a consecutive sample of pregnant teenagers recipient of prenatal medical assistance by the national public health system in the urban area of Pelotas, southern Brazil. Sample size was estimated in 871 participants. Suicidal behavior and psychiatric disorders were assessed with the Mini International Neuropsychiatric Interview; the Abuse Assessment Screen was used to identify physical or sexual abuse; social support was assessed with the Medical Outcomes Survey Social Support Scale; a self-report questionnaire was used to collect socio-demographic, obstetric and other psychosocial data. Results Forty three (4.94%) teenagers refused to participate, resulting in 828 participants. Prevalence of suicidal behavior was 13.3%; lifetime suicide attempts were referred by 7.4%, with 1.3% reporting attempting suicide within the last month. After adjustment, we found significant associations of suicidal behavior with the 18–19 years old subgroup, low education, prior abortion, previous major depression, and physical abuse within the last 12 months. Pregnant teenagers with high social support showed prevalence ratios (PR) 67% lower (PR: 0.33; 95%CI: 0.19–0.56) than those with low social support. Furthermore, a wide range of psychiatric disorders, most notably major depressive disorder (PR: 2.75; 95%CI: 1.34–5.63) and panic disorder (PR: 6.36; 95%CI: 1.61–25.10), remained associated with suicidal behavior after adjustment. Limitations The cross-sectional design precludes causal inferences. Conclusions We found that suicidal behavior is a relatively common feature in pregnant teenagers, frequently associated with psychiatric disorders.

Background Language is one of the most important acquisitions made during childhood. Before verbal language, a child develops a range of skills and behaviours that allow the child to acquire all communication skills. Factors such as environmental factors, socio-economic status and interaction with parents can affect the acquisition of vocabulary in children. Post-partum depression can negatively affect the first interactions with the child and, consequently, the emotional, social and cognitive development of the child. Objective To analyse the effect of the duration of the mother’s depression on the language development of children at 12 months old. Methods This was a longitudinal study. The participants of this study were mothers who had received prenatal care from the Brazilian National System of Public Health in Pelotas city, State of Rio Grande do Sul, Brazil. The mothers were interviewed at two different time points: from 30 to 90 days after delivery and at 12 months after delivery; the children were also evaluated at this later time point. To diagnose maternal depression, we used the Mini International Neuropsychiatric Interview, and to assess child development, we used the language scale of the Bayley Scales of Infant Development III. Results We followed 296 dyads. Maternal depression at both time points (post partum and at 12 months) was significantly associated with the language development of infants at 12 months of age. This impact was accentuated when related to the duration of the disorder. Older women and women with more than two children were more likely to have children with poorer language development, while women who were the primary caregiver had children with higher scores on the language test. Conclusion The findings indicate that maternal age, parity, primary caregiver status and duration of post-partum depression are associated with the language development of the child.

Resumo O objetivo deste artigo é avaliar a relação entre eventos estressores ocorridos no último ano na família de crianças e adolescentes com indicativos de problemas de saúde mental em uma amostra de estudantes de duas escolas de uma cidade no sul do Brasil. Estudo transversal com 1.075 estudantes matriculados em duas escolas públicas de ensino fundamental (uma estadual e outra municipal). Foi utilizado o Strengths and Difficulties Questionnaire para avaliação de fatores emocionais e comportamentais da criança, e a Escala de Avaliação de Reajustamento Social de Holmes e Rahe (1967) para avaliar os eventos estressores. Foram utilizados o teste qui-quadrado e a regressão de Poisson, com ajuste robusto para variância, expressando os resultados em razão de prevalências (RP) e intervalos de confiança de 95%. As chances de apresentar problemas de hiperatividade foram 1,42 (IC 95% 1,10-1,83) vezes maiores no tercil intermediário e 1,37 (IC 95% 1,06-1,78) no tercil superior, quando comparados ao tercil inferior. Quanto aos problemas de relacionamento, as chances foram de 1,49 (IC 95% 1,15-1,93) vezes maiores no tercil superior ao serem comparados com o tercil inferior. Os resultados sugerem que fatores ambientais podem ser fortemente relacionados à etiologia dos transtornos mentais na infância e adolescência. Abstract The scope of this article is to evaluate the relationship between stressor events that occurred last year in the family of children and adolescents that are indicative of mental health problems in a sample of students from two schools in a city in southern Brazil. It involved a cross-sectional study with 1,075 students enrolled in two public elementary schools. The Strengths and Difficulties Questionnaire was used to assess emotional and behavioral factors of the child and the Social Readjustment Rating Scale (SRRS) of Holmes and Rahe (1967) to assess stressor events. The chi-square and Poisson regression test with robust variance adjustment for expressing the results in the prevalence ratio (PR) and confidence intervals of 95% were used. The chances of presenting problems of hyperactivity were 1.42 (95% CI 1.10 to 1.83) times higher in the intermediate tercile and 1.37 (95% CI 1.06-1.78) in the higher tercile compared with the lower tercile. With respect to relationship problems the chances were of 1.49 (95% CI 1.15 to 1.93) times higher in the higher tercile when compared with the lower tercile. The results suggest that environmental factors may be strongly related to the etiology of mental disorders in childhood and adolescence.

Objective: To evaluate the association between social anxiety disorder (SAD) and perceived maternal bonding styles among young women during pregnancy and 30 months after childbirth. Methods: A cohort of young women from the city of Pelotas, Brazil was followed up from pregnancy to 30 months postpartum. The Mini Neuropsychiatric Interview Plus was used to assess SAD and the Parental Bonding Instrument was administered to measure maternal bonding styles. Poisson regression with robust variance was used for multivariable analysis. Results: After adjusting for potential confounding factors, SAD prevalence was 6.39 times higher among young women who perceived their mothers as neglectful (prevalence ratio [PR] 6.39; 95% confidence interval [95%CI] 1.2-32.0), and 5.57 times higher in women who perceived their mothers as affectionless controlling (PR = 5.57; 95%CI 1.5-19.7) when compared with those who received optimal care. Conclusion: Maternal bonding style may have an influence on the development of SAD. Therefore, support and early prevention strategies should be offered to the family.