Search

Objective: To examine qualitatively changes occurring in discussions within a time-limited psychotherapy group for mothers with post-natal depression. Method: Discussions occurring in a group that comprised five mothers and a therapist were recorded over the course of six one-hour therapeutic sessions. Participants had been referred or had self-referred to the group on the basis of having post-natal depression. The recorded discussions were transcribed and then analysed in accordance with principles of conversation analysis. Results: Analysis of early and later group discussions showed changes in group members' alignment with the topics that were introduced, in turn-allocation and turn-taking, and in the co-construction of accounts of experience. In contrast to early discussions, in later discussions participants aligned with topics relating to personal emotions, self-selected as next speakers in the discussions, and collaboratively worked up accounts that made sense of their experiences of childbirth and of being diagnosed as having post-natal depression. Conclusions: Interactional changes over the duration of the group point to the benefits for mothers with post-natal depression of participating in a time-limited psychotherapy group. Fine-grained analysis of group discussions potentially offers a way of examining changes over time in psychotherapeutic groups more generally. [ABSTRACT FROM AUTHOR]

Purpose: This pilot study was designed to inform a larger effectiveness trial by: (1) assessing the feasibility of the PRogram In Support of Moms (PRISM) and our study procedures; and, (2) determining the extent to which PRISM as compared to an active comparison group, the Massachusetts Child Access Psychiatry Program (MCPAP) for Moms alone, improves depression among perinatal women.Methods: Four practices were randomized to either PRISM or MCPAP for Moms alone, a state-wide telephonic perinatal psychiatry program. PRISM includes MCPAP for Moms plus implementation assistance with local champions, training, and implementation of office prompts and procedures to enhance depression screening, assessment and treatment. Patients with Edinburgh Postnatal Depression Scales (EPDS) ≥ 10 were recruited during pregnancy, and completed the EPDS and a structured interview at baseline and 3-12 weeks' postpartum.Results: Among MCPAP for Moms alone practices, patients' (n = 9) EPDS scores improved from 15.22 to 10.11 (p = 0.010), whereas in PRISM practices patients' (n = 21) EPDS scores improved from 13.57 to 6.19 (p = 0.001); the between groups difference-of-differences was 2.27 (p = 0.341).Conclusions: PRISM was beneficial for patients, clinicians, and support staff. Both PRISM and MCPAP for Moms alone improve depression symptom severity and the percentage of women with an EPDS >10. The improvement difference between groups was not statistically significant due to limited power associated with small sample size. [ABSTRACT FROM AUTHOR]

Both men and women are known to suffer from post-natal depression. However, there has been little attention paid to the psychodynamic genesis of post-natal depression in fathers. In this paper, I describe case histories of post-natal depression in two first time fathers and offer a formulation for understanding post-natal depression in such cases. I suggest a range of reasons for the failure to recognize this condition; and possible therapeutic interventions. [ABSTRACT FROM AUTHOR]

Objective: Several predictors of postpartum mood have been identified in the literature, but the role of maternal expectations in postpartum mental health remains unclear. The aim of this study was to identify whether maternal expectations during the postpartum hospital stay predict adjustment and depressive symptoms at 6 weeks postpartum. Methods: The sample included 233 first-time mothers recruited from the postpartum unit of a Midwestern hospital. Participants completed measures of maternal expectations and depressive symptoms (EPDS) at Time 1 (2 d postpartum) and completed EPDS and an Emotional Adjustment Scale (BaM-13) at Time 2 (6 weeks postpartum). Results: A conditional relationship between the expectation that an infant's behavior will reflect maternal skill and Time 2 outcomes (BaM-13 and EPDS) was found, such that endorsing this belief predicted increased depression and poorer adjustment in those with higher (but not lower) Time 1 EPDS scores. Time 2 BaM-13 scores were also negatively predicted by expectations of self-sacrifice and positively predicted by expectations that parenthood would be naturally fulfilling. Conclusions: The expectations that new mothers hold about parenting soon after delivery are predictive of emotional adjustment in the early postpartum period, suggesting a role for discussion of expectations in future preventive strategies. [ABSTRACT FROM AUTHOR]

Objective. To estimate the association between common mental disorders (CMD) during pregnancy and risk of low birth weight (LBW) or preterm birth (PTB). Methods. A prospective cohort study was conducted with 831 pregnant women from antenatal clinics in primary healthcare in São Paulo, Brazil. The clinical interview schedule-revised and demographic questionnaires were administered between the 20th and 30th weeks of gestation. Information on infant weight and gestational age at birth were obtained from hospital records. Univariate analyses were used to examine the association between the main exposure and main outcomes. Statistical associations were examined with χ2 tests. Adjusted odds ratios (OR) and 95% confidence intervals (CI) for the main outcomes were obtained using a multivariable logistic regression model. Results. The prevalence of CMD during gestation was 33.6 (95% CI: 30.4-36.9). The follow-up rate was 99.5%. Sixty three (7.6%) newborns were classified as LBW and 56 (6.9%) were classified as PTB. CMD during pregnancy was not associated with risk of PTB (adjusted OR:1.03, 95% CI: 0.57-1.88) or LBW (adjusted OR:1.09, 95% CI: 0.62-1.91). Conclusions. CMD prevalence is high among low-income and low-risk pregnant women attended by public health services in a middle-income country, but not confer an increased risk for adverse obstetric outcome. [ABSTRACT FROM AUTHOR]

The aim of the present study was to analyse whether the Portuguese version of the Postpartum Depression Screening Scale (PDSS) was a valid instrument for screening postpartum depression. For this purpose the following objectives were delineated: (1) to analyse PDSS psychometric properties; (2) to determine PDSS cut-off points and associated conditional probabilities for screening depression according to DSM-IV and ICD-10 criteria; and (3) to compare the performance of PDSS with the Beck Depression Inventory-II (BDI-II) in screening for postpartum depression. Four hundred eighty-six 3-months-postpartum women completed both questionnaires and were interviewed with the Portuguese version of Diagnostic Interview for Genetic Studies (DIGS). The Portuguese version of the operational criteria checklist for psychotic illness (OPCRIT) was used to obtain DSM-IV and ICD-10 diagnoses of depression, our gold standards for caseness. PDSS reliability and validity were very good and equivalent to those reported in other versions, including the original. PDSS was an accurate screening instrument for postpartum depression, showing satisfactory combination of sensitivity and specificity (>80%). Compared to BDI-II it has the advantage of being more specific for the motherhood context. PDSS could be very useful for clinical and epidemiological purposes. [ABSTRACT FROM AUTHOR]

Objectives. To investigate which methods to identify post-natal depression are the most extensively validated, in what setting and in what language. Methods. A systematic search of the literature was undertaken to retrieve English and non-English language articles available until February 2007. This included searching 16 electronic databases, forward citation searching, personal communication with authors and inspection of reference lists. Results. A total of 60 studies (published in 64 articles) met the inclusion criteria. Four PND specific measures and nine generic depression (and sometimes anxiety) measures were found to have been validated against a diagnostic reference standard in pregnant or post-natal populations. The Edinburgh Post-natal Depression Scale (EPDS) was the most frequently validated method to identify women with PND. The EPDS has been translated and validated in 20 different languages. The majority of studies were undertaken at ante-natal clinics ( n=15), after the birth in post-natal wards ( n=12) or during post-natal visits or follow-up clinics ( n=16). Conclusions. The EPDS is the most frequently researched method to identify PND and has been translated and validated in multiple different languages. [ABSTRACT FROM AUTHOR]

Objectives: Research has shown that between 1 and 3% of women may suffer from post-traumatic stress disorder (PTSD) following childbirth. However, the potential effect of childbirth on fathers, and the implications of post-natal symptoms of PTSD for family relationships, have received little attention. The current study therefore examined the potential effects of PTSD symptoms on the couple's relationship and parent-baby bond. Design: Internet-based questionnaire study. Methods: One hundred and fifty-two parents (126 women and 26 men) completed questionnaire measures of PTSD, depression, quality of the couple's relationship, and the parent-baby bond. Results: Symptoms of PTSD and depression were significantly correlated with the couples' relationship and parent-baby bond. Structural equation modelling found the model that best fitted the data was one where PTSD symptoms had a direct effect on the parent-baby bond, but the effect of PTSD on the couples' relationship was mediated by depression. Conclusions: The results indicate the importance of examining the psychological reactions of men and women after birth; and suggest that symptoms of PTSD have an effect on the parent-baby bond. However, methodological considerations mean further research is needed to replicate and extend this study before firm conclusions can be drawn. [ABSTRACT FROM AUTHOR]

This paper illustrates how my work has developed over the years and informed my thinking about, and work with, depressed mothers. It also describes the work of the Parent Infant Foundation in Sydney where pregnant women and mothers with infants and toddlers are seen in groups and individually through home visits. The relevance of the support of a peer group when doing such difficult work is described. The paper draws on a central theme: the depressed mother, returning to her own infant beginnings through pregnancy and birth, confronts a dead mother-dead infant dyad. Trauma from the mother's own infancy is seen to have created an internal, autistic, deadened, psychic space. It is argued that behind this deadness lies the primeval pain of abandonment and loss. The associated rage, previously repressed but now awakened by her alive infant and his powerful primitive demands, invade the mother's psyche. The internal deadness freezes her alive processes as mother to her baby. Unbearable pain is awakened - and she may be in terror and unable to move, or she may experience herself as drowning in something catastrophic. SUMMARY This paper illustrates how my work has developed over the. [ABSTRACT FROM AUTHOR]