Browsing by Subject "Depression, Postpartum"
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Item Attachment Style, Depression, and Health Outcomes among Antepartum Patients(2015-07-14) Enander, Richard Anthony; Robinson, Richard C.; Evans, Harry M.; Frank, Blake; Bernstein, Ira; Stringer, Claude A.Clear evidence of the impact of psychosocial factors on healthcare utilization continues to grow. An individual's attachment style is hypothesized to be one such important psychosocial factor related to healthcare utilization. Women with high-risk pregnancies treated in antepartum units have been shown to experience higher levels of stress than the general population, which has been hypothesized to activate adaptive and maladaptive patterns of interpersonal relationships. Therefore, the present study investigated the relationship among attachment style, stress, depression, and healthcare utilization in a sample of women with high-risk pregnancies. Stress and depressive symptoms were hypothesized to serve as moderating variables between patients' attachment styles and their healthcare utilization. To the author's knowledge, this was the first study to examine the role of stress in this manner. One hundred seventeen participants from the antepartum unit of Baylor University Medical Center were enrolled. Participants were administered a demographic questionnaire, the Edinburgh Postpartum Depression Scale, the Experiences in Close Relationships Scale - Short Form, the Attachment Style Questionnaire, the Crowne-Marlowe Social Desirability Scale, and the Perceived Stress Scale. Healthcare utilization data was then collected from participants' electronic medical records. Regression analyses determined that while an insecure attachment style was associated with increased depressive symptoms, the strongest association with depressive symptomatology was subjective stress levels (b = .813, t = 11.54, p < .001). Thus, while the moderator analysis was significant overall, stress was most closely associated with depressive symptoms. With regard to healthcare utilization, a MANOVA revealed no association between attachment style and healthcare utilization, although it did reveal that stress scores were significantly associated with emergency room visits in the past twelve months (F(1, 103) = 11.48, p < .001, partial η2 = .093) as well as with pain scores (F(1, 103) = 5.19, p = .025, partial η2 = .044). Thus, although attachment style is related to depression, stress was found to be more strongly associated with depression and several healthcare variables. Further research is warranted to examine the role that attachment style may play in depressive symptoms and healthcare utilization.Item Exploring Partner-Assisted Therapy (PAT) for Perinatal Depression: Are Partner Support and Non-Verbal Communications Associated with Women’s Treatment Response?(2013-01-17) Ceccotti, Nadia Laurence; Wiebe, Deborah J.BACKGROUND: Poor partner support is a risk factor for perinatal depression, a disease with adverse consequences for mother, baby, and partner. This pilot study explored changes in partner verbal/non-verbal supportive behaviors, including overt displays of emotional expression, during interactions between romantic partners and depressed perinatal women participating in Partner-Assisted Therapy (PAT). A novel approach for perinatal depression currently under investigation, PAT includes the partner of a depressed woman as an active participant in her treatment over eight acute sessions and one follow-up. This is the first study to date that investigates psychotherapeutic processes by analyzing the spontaneous display of support and positive affect in romantic partners during their engagement in psychotherapy sessions. METHODS: Eleven couples (females between ≥ 8 weeks pregnant and ≤ 12 weeks postpartum, diagnosed with Major Depressive Disorder) attended eight weekly psychotherapy sessions along with their partners. Two raters coded video recordings from sessions one, four and eight (acute phase). Partner support (positive helping behaviors) was coded using the Social Support Interaction Coding System, marital affect was coded using the Specific Affect Coding System, and warm touch by the male partner to his depressed spouse was recorded by frequency and duration of time. The associations between partner support and the change in the female partner's symptoms of depression were then investigated. RESULTS: Our hypothesis of the inverse correlation between partner support (an increase over time) and treatment outcome was partially supported. The hypotheses that warm touch and positive marital affect would increase over time were not supported in this sample. CONCLUSION: Findings suggest that an increase in partner support over time in treatment is partially associated with a decrease in female depressive symptoms. Future investigations with larger samples would support more confident interpretations and allow meaningful explorations into the processes of partner support and their implication for perinatal depression.Item The Prevalence of Postpartum Depressive Symptoms in Women from a Public Maternity Hospital in Tucumán, Argentina at 4 Weeks Postpartum(2017-03-31) Pham, Diana; Doty, Meitra; Chi, Benjamin; Johnson, AndreaOBJECTIVE: The primary objective of our study is to investigate the prevalence of postpartum depression at 4 weeks postpartum in women from a public hospital in Tucuman, Argentina. Our secondary objective is to determine a relationship between postpartum depression and the associated sociodemographic, medical and obstetric factors. METHODS: We conducted an observational cross-sectional study that was carried out from March 17, 2016 to May 30, 2016 and from June 28, 2016 to July 29, 2016. There were 539 participants. Women were excluded if they: Were less than 18 years old, were located in the intensive care unit (ICU), gave birth to a stillborn or recent newborn that died during delivery, with a multiple gestation, had a recent newborn in the neonatal ICU, had a recent newborn with congenital abnormalities, or gave birth at gestational age less than 28 weeks old. RESULTS: Of the 539 participants, 167 (31.0%) had depressive symptoms. Important risk factors for developing PPD included employment status, education level, positive personal and family history of psychiatric illnesses, perceived social stresses such as poor patient-physician relationship or lack of childcare help, and giving birth to a female newborn. CONCLUSION: The high prevalence of postpartum depression (31.97%) in Tucuman demonstrates that the public sector is twice that of the private sector in Buenos Aires. This study results shows that postpartum depression is a serious public health issue and further study is needed about the cultural acceptance of mental health and how to provide adequate follow-up or treatment in a low-resource setting.