A prevalence study of antenatal depression among Chinese women

BACKGROUND: There has thus far been no empirical research on the occurrence of antenatal psychiatric morbidity in Chinese population. Epidemiological studies in western societies generally show that depressive episodes occur in 10-20% of pregnant women. Longitudinal studies have demonstrated that antenatal depression is one of the most powerful predictors of postnatal depression. There is also a growing literature that shows that antenatal psychological distress can adversely affect maternal and foetal well being. METHODS: At 38 weeks of pregnancy, 238 consecutive women were invited to return for psychiatric assessment. The participants were interviewed using the non-patient version of the Structured Clinical Interview for DSM-IV (SCID-NP). RESULTS: Seventy women (29%) declined to participate, and another 11 (5%) defaulted the SCID interview. Among the 157 women interviewed, the 1-month prevalence of antenatal depression was 4.4%. The 1-month prevalence of all psychiatric diagnoses was 6.4%. The prevalence of antenatal depression and all psychiatric diagnoses for the entire pregnancy was 6.4% and 8.3%, respectively. LIMITATIONS: About a third of eligible subjects did not participate in the study. CONCLUSIONS: A significant proportion of Chinese women suffer from psychiatric morbidity during pregnancy. Depressive disorders are by far the commonest morbidity in the study population. Given the scope of the morbidity and the potential impact on obstetric and neonatal outcomes, early screening and treatment are warranted.     

安徽省农村老年人抑郁的现况调查

老年人抑郁症状严重危害老年人的心身健康,影响老年人的生活质量[1]。本研究探讨安徽农村老年人抑郁症状及相关因素。1对象与方法1.1对象2009年12月-2010年3月,在安徽省16个地市41个县,每个县随机选取2个乡镇,每个乡镇随机选取2~3个自然村,调查10~15户老年人家庭(入选条件为家庭内有至少1名60岁以上老人,且有子女健在),每个家庭调查1名60岁以上老人,共调查了992户家庭,其中有17户家庭老     

Incidence and factors associated with medication nonadherence in patients with mental illness: A cross-sectional study

Background:

In spite of the progress made in the treatment of psychiatric disorders during the last few decades, nonadherence continues to be a frequent phenomenon, often associated with potentially severe clinical consequences and increased health-care costs. There are numerous factors associated with medication nonadherence in patients with mental illness. The aim of the study was to determine the incidence and factors associated with medication nonadherence among psychiatric outpatients.

Materials and Methods:

A cross-sectional study was carried out in the outpatient psychiatric department of an Indian tertiary care private hospital over a period of 1 year. Patients aged 18 years and above who presented with mental illness as diagnosed by the International Classification of Diseases (ICD)-10 and who were receiving at least one psychotropic medication for at least 1 month were included in the study. Medication adherence was assessed using the Medication Adherence Rating Scale (MARS).

Results:

Of the 400 patients, 172 (43%) were nonadherent to their prescribed medications. There is a statistically significant association between the education (P = 0.001), number of drugs (P = 0.002), family income (P = 0.013), and nonadherence. Among the 172 patients, 33.5 % were nonadherent to their therapy due to patient-related factors followed by drug-related factors (32%) and disease-related factors (31%).

Conclusion:

The overall incidence of medication nonadherence in patients with mental illness was 43%. Numerous factors contributed to medication nonadherence. Strategies need to be developed and implemented to enhance medication adherence, and thereby achieve a better therapeutic outcome in patients with mental illness.KEY WORDS: Factors, incidence, mental illness, nonadherence, outpatients     

Identification of factors associated with delayed antenatal care

Research has shown that women who do not obtain adequate prenatal care significantly reduce their chances of a favorable pregnancy outcome. Because interventions aimed at circumventing unfavorable pregnancy outcomes, such as low birthweight, are most effective during prenatal care, the need to identify sociodemographic characteristics associated with a delay in the onset of such care is reinforced. In this study of 284 women seeking services at selected public clinics in Detroit, regression analysis was used to examine the simultaneous effects of change in income, insurance status, household members, age, and other variables on the prevalence of delayed prenatal care. Delayed care was found to be associated with a lack of insurance and an education of fewer than 12 years. Insurance status and household members (serving as an adjunct indicator of marital status) were found to be important predictors of late entry. Other variables such as age and race appeared to have no influence on the decision to delay care.     

Burnout Syndrome and associated factors among medical students: a cross-sectional study

OBJECTIVES:

To assess the prevalence and levels of burnout syndrome among medical students at the Universidade Federal de Sergipe-Brazil and to identify associated factors.

METHODS:

A cross-sectional study was performed with randomly selected students in 2009. The Maslach Burnout Inventory/Student Survey (MBI-SS) and a structured questionnaire on socio-demographic characteristics, the educational process, and individual aspects were used. Statistical evaluation of multiple variables was performed through backward stepwise logistic regression analysis.

RESULTS:

The prevalence of burnout was 10.3% (n = 369). The prevalence was higher among those who did not have confidence in their clinical skills (Odds Ratio–OR = 6.47), those who felt uncomfortable with course activities (OR = 5.76), and those who did not see the coursework as a source of pleasure (OR = 4.68).

CONCLUSION:

There was a significant prevalence of burnout among the medical students studied. Three variables, in particular, were associated with burnout and were directly related to the medical education process. Preventive and intervention measures must be adopted, and longitudinal studies should be conducted.     

Infertility and associated factors in three hospitals in Douala,Cameroon: a cross-sectional study

AimWe determined the prevalence and factors associated with couple infertility in three hospitals in Douala, Cameroon.MethodsWe conducted a cross-sectional study from December 18th 2015 to March 18th 2016 in three public hospitals in Douala. Three hundred and sixty participants were studied prospectively for associated factors using a multivariate logistic regression model and 4732 files were studied retrospectively for the prevalence of infertility. Statistical significance was set at p < 0.05.ResultsThe prevalence of couple infertility was 19.2%. In logistic models, the factors which independently increased the risk of couple infertility were a history of reproductive tract infection/STI, a history of uterine fibroids, a history of dysmenorrhea and abortion for the females while for males it was a history of mumps, erectile dysfunction and exposure to chemicals/toxic substances/pesticides.ConclusionOne in every five couples in this study was infertile. Several factors affect the risks associated with couple infertility. The identification of these factors could help detect subgroups of couples at high risk of infertility. Reproductive health education, screening programmes for STI''s that may lead to infertility should be offered to couples.     

Multicentre prospective study of perinatal depression in Japan: incidence and correlates of antenatal and postnatal depression

Summary A multicentre study on the epidemiology of perinatal depression was conducted among Japanese women expecting the first baby (N = 290). The incidence rate of the onset of the DSM-III-R Major Depressive Episode during pregnancy (antenatal depression) and within 3 months after delivery (postnatal depression) were 5.6% and 5.0%, respectively. Women with antenatal depression were characterised by young age and negative attitude towards the current pregnancy, whereas women with postnatal depression were characterised by poor accommodation, dissatisfaction with sex of the newborn baby and with the emotional undermining. Antenatal depression was a major risk factor for postnatal depression.     

A review of longitudinal studies on antenatal and postnatal depression

Antenatal depression is a known risk factor for postnatal depression; both are common disorders associated with negative impacts on child development. Few studies have followed up women from pregnancy and through the postnatal period to explore how rates of depression change. This review evaluates recent evidence on depression during pregnancy and after childbirth. A search of Embase, PsychINFO, MEDLINE and Cochrane Reviews was carried out to identify longitudinal studies on antenatal and postnatal depression. Studies that measured depression during pregnancy and up to 1 year after childbirth were evaluated against a set of criteria (e.g. less than 50 % attrition). Of the initial 523 studies identified, 16 studies met the final inclusion criteria with a total of 35,419 women. The average rate of antenatal depression across these studies was 17 and 13 % postnatal depression. The longitudinal nature of the studies revealed that on average 39 % of those who experienced antenatal depression went on to have postnatal depression. Similarly, on average, 47 % of those with postnatal depression had also experienced antenatal depression. On average, almost 7 % of women reported significant depressive symptoms in pregnancy that persisted after childbirth. The review provided evidence that rates of depression tend to be higher during pregnancy than in the first year following childbirth. Furthermore, the longitudinal data show that there is much movement between the groups categorised as depressed or not depressed. There is evidence that postnatal depression is often a continuation of existing antenatal depression.     

Virologic suppression and associated factors in HIV infected Ugandan female sex workers: a cross-sectional study

IntroductionKey populations have disproportionately higher HIV prevalence rates than the general population.ObjectiveTo determine the level of virologic suppression and associated factors in female Commercial Sex Workers (CSW) who completed six months of ART and compare with the female general population (GP).MethodsClinical records of CSW and GPs who initiated ART between December 2014 to December 2016 from seven urban clinics were analyzed to determine virologic suppression (viral load < 1000 copies/ml) and associated factors.ResultsWe identified 218 CSW and 182 female GPs. CSW had median age of 28 (IQR 25–31) vs 31 (IQR 26–37); median baseline CD4 446 (IQR 308–696) vs 352 (IQR 164–493) cells/microL; and optimal ART adherence levels at 70.6% vs 92.8% respectively, compared to GP. Virologic suppression in CSW and GPs was 85.7% and 89.6% respectively, P=0.28. Overall virologic suppression in CSW was 55% while Retention in care after 6 months of ART was 77.5%. Immediate ART initiation (<2weeks) and tuberculosis independently predicted virologic suppression in CSW with adjusted odds ratios 0.07 (95% C.I. 0.01–0.55, P=0.01) and 0.09 (95% C.I. 0.01–0.96, P=0.046) respectively.ConclusionVirologic suppression in both groups is similar, however, intensified follow-up is needed to improve treatment outcomes     

产后抑郁发病因素的综合研究

目的:研究产后抑郁可能的心理社会因素,为提高围产保健水平提供一些理论与实践的依据.方法:自拟一般资料调查表等4种表格收集有关的心理、社会、环境因素及产科因素;用Edinburgh(EPDS)抑郁量表分≥10分为界,筛查产后抑郁,共298例完成了产后第3天评定,127例完成了产后第42天的评定.测定38名产妇临产前与产后72小时的雌二醇、孕酮及催乳素水平.结果:产后抑郁的发病率为23.15%,家庭支持等社会心理因素以及雌二醇的变化幅度和产后抑郁密切相关.结论:产后抑郁的发生具有一定的心理、社会与生物学因素,妊娠、分娩与产褥期良好的社会、家庭支持是减少产后抑郁障碍的有力措施.     

Gender preferences among antenatal women: a cross-sectional study from coastal South India

Background

A balanced sex ratio is essential for a stable society.

Objective

The main objective of the present research was to study the perceptions of women attending the antenatal care (ANC) facility regarding their gender preferences and family composition.

Method

In this cross-sectional study 132 antenatal women were interviewed in their preferred language using a predesigned semi-structured questionnaire. The collected information was analyzed using SPSS version 11.5.

Results

The mean age of the study participants was 27.2 ± 4.1 years. The majority of the antenatal women (60.6%, n=80) did not have any gender preferences. Among those who had a gender preference (39.4%, n=52), male and female preference was reported by 55.7% (n=29) and 44.3% (n=23) of the participants respectively. The overall son preference index was observed to be 1.3. No consistent relationship could be established between the socio-demographic factors and the preference for gender. The mean preferred family size in our study was 1.85±0.531 and more than half of the participants had a balanced gender preference. The majority of the participants were aware that the adverse sex ratio can lead to fall in the number of brides and that it would bring about a social imbalance.

Conclusion

As a developed society we need to ensure that both the genders get equal respect and are free from any sort of preferences and prejudices. To achieve this, more and more people need to be made aware of the consequences of gender imbalance and adverse sex ratio in a society.     

Psychosocial factors associated with depression severity in pregnant adolescents

Adolescent depression during pregnancy is associated with increased morbidity for the teen and her infant. This cross-sectional study explored the relationships among the independent histories of alcohol use, drug use, depression, and abuse (physical or sexual) on depression severity in a diverse group of 116 pregnant adolescents (mean age?=?16) who attended an urban prenatal clinic. Ever having had an alcoholic drink was a significant predictor of higher depressive scores on Children's Depression Rating Scale-Revised, β?=?3.3 (0.8, 5.7); p?相似文献   

Obesity,antenatal depression,diet and gestational weight gain in a population cohort study

Purpose

The aims of this paper are to examine: (1) the relationship between high pre-pregnancy BMI and antenatal depression; (2) whether BMI and antenatal depression interact to predict diet and gestational weight gain (GWG).

Methods

Data came from the Avon Longitudinal Study of Parents and Children (ALSPAC). Underweight women were excluded. Pre-pregnancy BMI was self-reported and antenatal depression was assessed using the Edinburgh Postnatal Depression Scale at 18 and 32 weeks’ gestation to identify persistently elevated depressive symptoms (EPDS>12). Dietary patterns were calculated from food frequency questionnaires at 32 weeks’ gestation. GWG was categorised using the USA Institute of Medicine guidelines.

Results

This study included 13,314 pregnant women. Obese women had significantly higher odds of antenatal depression than normal weight controls after adjusting for socio-demographics and health behaviours (aOR 1.39, 95%CI 1.05–1.84). Every unit increase in pre-pregnancy BMI was associated with approximately 3% higher odds of antenatal depression (aOR 1.03, 95%CI 1.01-1.05). Antenatal depression was not meaningfully associated with dietary patterns after adjusting for confounders and was not associated with inadequate or excessive GWG. There was no evidence for an interaction of depression and BMI on either diet or GWG.

Conclusions

Healthcare professionals should be aware of the dose-response relationship between high pre-pregnancy BMI and antenatal depression.

     

新疆克拉玛依地区酒精滥用者焦虑、抑郁症状及自杀风险调查

目的:调查新疆克拉玛依地区酒精滥用者的抑郁、焦虑症状及其自杀风险,为此类精神卫生问题的预防和早期干预提供参考依据。方法:采用PPS抽样调查对1992例社区居民进行调查和统计分析,用酒精使用障碍筛查量表(AUDIT)筛查酒精滥用,初级保健精神障碍患者健康问卷中的抑郁分量表(PHQ-9)和焦虑分量表(PHQ GAD-7)筛查抑郁症状和焦虑症状,简明国际神经精神访谈(MINI)自杀筛选问卷筛查自杀风险。结果:筛查出酒精滥用阳性者298例,酒精滥用比为15.1%。酒精滥用者抑郁症状阳性比53.4%、焦虑阳症状性比35.9%、自杀风险比5.7%,均高于非滥用者(阳性比分别是42.3%、27%、3.2%,均P0.05)。结论:本研究提示,在酒精滥用筛查时要注意对相关精神卫生问题的评估和诊断,以便采取及时、有效的干预措施。