Depression In High-risk Women Research Articles

Economic evaluation of Be a Mom, a web-based intervention to prevent postpartum depression in high-risk women alongside a randomized controlled trial

BackgroundPostpartum depression (PPD) poses significant challenges, affecting both mothers and children, with substantial societal and economic implications. Internet-based cognitive behavioral therapy interventions (iCBT) offer promise in addressing PPD, but their economic impact remains unexplored. This study aimed to evaluate the cost-utility of Be a Mom, a self-guided iCBT intervention, compared with a waiting-list control among postpartum women at high risk of PPD. MethodsThis economic evaluation was conducted alongside a 14-month randomized controlled trial adopting a societal perspective. Participants were randomized to Be a Mom (n = 542) or a waitlisted control group (n = 511). Self-report data on healthcare utilization, productivity losses, and quality-adjusted life years (QALYs) were collected at baseline, post-intervention, and 4 and 12 months post-intervention. Incremental cost-effectiveness ratios (ICERs) were calculated, and cost-effectiveness acceptability curves were generated using nonparametric bootstrapping. Sensitivity analyses were conducted to assess result robustness. ResultsOver 14 months, Be a Mom generated a QALY gain of 0.0184 (0.0022, 0.0346), and cost savings of EUR 34.06 (−176.16, 108.04) compared to the control group. At a willingness to pay of EUR 20,000, Be a Mom had a 97.6 % probability of cost-effectiveness. LimitationsResults have limitations due to self-selected sample, potential recall bias in self-reporting, missing data, limited follow-up, and the use of a waiting-list control group. ConclusionsThis study addresses a critical gap by providing evidence on the cost-utility of an iCBT intervention tailored for PPD prevention. Further research is essential to identify scalable and cost-effective interventions for reducing the burden of PPD.

Biopsychosocial risk factors of depression during menopause transition in southeast China

ObjectiveMore than 2 billion women are experiencing menopause transition in China and some of them suffered from depression; while the risk factors of depression during menopause transition were still unclearin China. We aimed to investigate the risk factors in mid-life women in Southeast China.MethodThis study included 1748 Chinese women aged 40–65 years-old who visited gynecology outpatient department of Women’s hospital School of Medicine, Zhejiang University during 2010–2018. Demographic information was collected, and the modified Kupperman Menopausal Index (mKMI) and Hamilton Rating Scale for Depression were assessed. Circulating levels of sex hormones were tested. Ordinal logistic regression analysis was performed to identify risk factors for depression.ResultsThe prevalence of depression symptoms was 47.43%. The majority of women had mild (38.56%) or moderate depressive symptoms (8.00%); only 0.86% had severe depressive symptoms. Compared with perimenopausal women, postmenopausal women had increased risks of more severe depression. The associations between menopausal syndromes and the intensity of depression were strongly positive (OR 6.69, 95% CI 5.39–8.29). Elder age, higher follicle stimulating hormone levels, lower estradiol levels, and fewer parity were positively related with the intensity of depression. Among postmenopausal women, underweight, mKMI > 14, earlier age at menopause, shorter reproductive period, and longer duration after menopause were risk factors for incresed intensity of depression.ConclusionsThe results demonstrated a high proportion of depression in women complaining of menopause. Menopausal symptoms were strongly related to the intensity of depression. In postmenopausal women, estrogen related events are associated with the intensity of depression. Gynecological endocrinologists in China should consider screening for depression in high-risk women.

368. Maternal mental health (mama) trial evaluating short-term estrogen as a strategy to prevent postpartum depression in high-risk women: Protocol for a double-blind, randomized, placebo-controlled trial

Introduction and aims of the study:Perinatal depression affects 10–15% of women postpartum and has a recurrence rate of 40% in subsequent pregnancies. Women who develop perinatal depression are suspected to be more sensitive to the rapid and large fluctuations in sex steroid hormones, particularly estradiol, during pregnancy and postpartum. This trial aims to evaluate the preventive effect of three weeks transdermal estradiol treatment immediately postpartum on depressive episodes in women at high risk for developing postpartum depression.

Short-term oestrogen as a strategy to prevent postpartum depression in high-risk women: protocol for the double-blind, randomised, placebo-controlled MAMA clinical trial

IntroductionPostpartum depression affects 10%–15% of women and has a recurrence rate of 40% in subsequent pregnancies. Women who develop postpartum depression are suspected to be more sensitive to the rapid...

The Effects of Inhalation Aromatherapy with Rose and Lavender at Week 38 and Postpartum Period on Postpartum Depression in High-risk Women Referred to Selected Health Centers of Yazd, Iran in 2015.

Background:Postpartum depression (PPD) is one of the most common problems in women of childbearing age. This study was conducted to evaluate the efficacy of aromatherapy on PPD.Materials and Methods:In this study, 105 pregnant women at 35–37 weeks of pregnancy were enrolled using convenient sampling and randomly assigned to three groups. The intervention group dropped 7 drops of lavender oil and 1 cc rose water at the concentration of 100%, and the placebo group dropped 7 drops of odorless sesame seed oil, with 1 cc of musk willow sweat at the concentration of 100% by dropper on a special cloth. They put the cloths on their mouths and took 10 deep breaths before sleeping and then placed them next to their pillows. The control group only received the routine care. The intervention lasted from 38th week of pregnancy until 6 weeks after delivery. Then depression level was determined before the intervention, 35–37 weeks of pregnancy, 2 and 6 weeks after delivery using Edinburgh questionnaire.Results:The mean of depression score in the intervention group decreased significantly compared to the placebo and control groups, 2 weeks (F = 9.412, p < 0.001) and 6 weeks after delivery (F = 7.813, p < 0.01).Conclusions:This study provides valid evidence for the effect of aromatherapy on PPD. Therefore, the use of aromatherapy can be recommended in high-

Preventing Perinatal Depression in High Risk Women: Moving the Mothers and Babies Course from Clinical Trials to Community Implementation.

A growing research literature highlights the public health need for preventive interventions to reduce symptoms and incidence of perinatal depression among vulnerable populations. The Mothers and Babies (MB) course is a cognitive-behavioral intervention designed to teach mood regulation skills to English- and Spanish-speaking low-income women at high risk for perinatal depression. We describe the development of the MB course and evaluate the extent to which research findings support efficacy, effectiveness, and dissemination based on the Society for Prevention Research Standards Committee's standards of evidence. Our review of research and implementation activities suggests that the MB intervention demonstrates promising evidence for efficacy in reducing depressive symptoms; empirical support for prevention of major depressive episodes is still preliminary. Work is in progress to evaluate program effectiveness and prepare for broad dissemination and implementation. The MB course shows promise as an intervention for low-income women at risk for perinatal mood issues. Spanish and English intervention materials have been developed that can be delivered in different settings (hospitals, home visiting), in different dosages (6, 8, or 12 sessions), and via different modalities (group, individual). Evaluating the MB course against current standards is intended to inform other prevention intervention development research.

The effectiveness of antenatal interventions to prevent postnatal depression in high-risk women

Postnatal depression can have a major impact on the lives of women affected and on those around them. While effective treatments are available, it would be preferable to prevent the condition. The aim of this review was to examine the effectiveness of antenatal interventions designed to prevent postnatal depression in high-risk women. Randomised controlled trials of interventions to prevent postnatal depression delivered to high-risk women in pregnancy were identified through an electronic database search and a reference list search. Information regarding the selection criteria, content and delivery of the interventions was extracted and synthesised. Eleven studies met the review inclusion criteria. Six described interventions that were significantly more effective in reducing the incidence and/or symptoms of postnatal depression than a control condition. Interventions were most likely to be effective when delivered to women who were depressed during pregnancy and when incorporating evidence-based psychological treatments for depression and addressing interpersonal difficulties. It is possible that unpublished trials of antenatal interventions to prevent postnatal depression exist that were not detected. Due to the recognised publication bias, these studies may have been less likely to find a significant effect of antenatal interventions on postnatal depression. There is evidence to suggest that interventions delivered in pregnancy can be effective in preventing postnatal depression. However, these interventions may be better conceptualised as treatment than prevention as they were delivered to women experiencing antenatal depression. There is a need to identify pregnant women experiencing depression and deliver evidence-based psychological interventions.

Patient preference for counselling predicts postpartum depression: a prospective 1-year follow up study in high-risk women

Background Patient preferences have been associated with a positive effect of depression treatment. Little is known about patient preferences in at-risk samples. The aim of this study was to examine the role of patient preference for counselling in the occurrence of postpartum depression in high-risk women. Method We conducted a prospective 1-year follow up study in two hospitals and four midwifery practices in The Netherlands. Participants were 90 pregnant women at high risk for postpartum depression: 45 high-risk women who preferred no counselling, 45 high-risk women who preferred counselling. Both groups received care as usual. The main outcome measure was clinical depression (Research Diagnostic Criteria) at 3, 6, and 12 months postpartum. Results Point-prevalence rates of clinical depression were significantly higher in high-risk women who preferred counselling compared with high-risk women who did not prefer counselling (24% versus 9%, P=0.048; 19% versus 5%, P=0.048, at 3 and 6 months postpartum, respectively) . No significant difference was found at 12 months postpartum. Across the first-year postpartum, high-risk women who preferred counselling were at seven-fold increased risk for clinical depression (OR=7.7, 95% CI 1.7–33.8, P=0.007). Conclusions Patient preference for counselling is an important predictor of postpartum depression in pregnant women at high risk for postpartum depression. Patient preferences may reflect validly a perceived need for intervention in high-risk women. This finding emphasises the need to take patient preference for counselling into account as an important variable to identify a high-risk population.

Can we prevent postnatal depression? A randomized controlled trial to assess the effect of continuity of midwifery care on rates of postnatal depression in high-risk women

Can we prevent postnatal depression? A randomized controlled trial to assess the effect of continuity of midwifery care on rates of postnatal depression in high-risk women

Can we prevent postnatal depression? A randomized controlled trial to assess the effect of continuity of midwifery care on rates of postnatal depression in high-risk women

Objective: To evaluate the effectiveness of continuous midwifery care in reducing rates of postnatal depression in women with histories of depression.Methods: Fifty-one women from a sampleof 98 pregnant women with histories of major depressive disorder were randomly allocated, at antenatal booking, to continuous midwifery care. The remaining 47 women received standard maternity care. A totalof 87 women (44 treatment, 43 control) completed baseline assessments (after randomization) and outcome assessments (at 3 months postpartum).Results: Of the women allocated to continuous midwiferycare, 88% complied in full with their allocated treatment protocol. Forty-nine percent of women had an episode of illness in pregnancy (DSM-III-R case of major or minor depression), 26% developed a newepisode of illness after antenatal booking, and 23% were depressed in the first 3 months postpartum. There were no differences between treatment conditions in total rates, or rates within the context ofsocial adversity, of antenatal depression, depressions which occurred post-booking, postnatal depression, and the duration of depressive episodes.Conclusions: While continuous midwifery carehad no impact on psychiatric outcome, it was highly successful at engaging women in treatment and therefore has an important contribution to make in the care of child-bearing women with mental health problems.