Edinburgh Scale Research Articles

Depresión posparto: prevalencia y relación con la tipología y función familiar

Introduction: postpartum depression (PPD) is a public health issue. Multiple biological and psychosocial risk factors have been described. In Colombia there are no studies determining its prevalence based on screening scales and diagnostic criteria, as well as its relation to family functioning assessment instruments. Objective: to determine PPD prevalence in in women in the immediate postnatal period and its association with clinical conditions, life-course, and family typology and functioning. Materials and methods: an analytical cross-sectional observational study conducted in the immediate postnatal period (2 to 48 hours after delivery), using the Edinburgh scale (EPDS) and the DSM5 criteria for PPD screening and diagnosis. Sociodemographic variables such as, gynecological-obstetric, and perinatal history, and clinical conditions, were analyzed. Family functioning assessment instruments such as life-course, family typology and family APGAR, were applied. Results: 336 participants with a mean age of 27.3 years, were included. The prevalence of PPD was 5.1%, while prevalent pathologies were preeclampsia (8.3%) and gestational diabetes (6.3%). 58% (p<0.001) had a dysfunctional family to some degree and 88% (p 0.01) belonged to nuclear families. No statistical significance was found for clinical conditions and life-course. Conclusions: PPD is a prevalent mental health issue caused by multiple factors, such as family typology and functioning. Further quantitative and qualitative studies to establish causal relationships, are needed, to better understand this phenomenon.

A 5 years' experience of a parent-baby day unit: impact on baby's development.

Psychiatric Mother-Baby Units are well established in France, United Kingdom, and Australia, mostly in full-time hospitalization. Inpatient units are considered as best practice for improving outcomes for mothers and babies when the mother is experiencing severe mental illness and many studies have showed the effectiveness of care for the mother or the mother-infant relationship. Only a limited number of studies have focused on the day care setting or on the development of the baby. Our parent-baby day unit is the first day care unit in child psychiatry in Belgium. It offers specialized evaluation and therapeutic interventions focused on the baby and involves parents with mild or moderate psychiatric symptoms. The advantages of day care unit is to reduce the rupture with social and family living. The objective of this study is to evaluate the effectiveness of parent-baby day unit in prevention of babies' developmental problems. First, we present the clinical characteristics of the population treated in the day-unit in comparison to the features presented in the literature review about mother-baby units, which usually receive full-time treatment. Then, we will identify the factors that might contribute to a positive evolution of the baby's development. In this study, we retrospectively analyze data of patients admitted between 2015 and 2020 in the day unit. Upon admission, the 3 pillars of perinatal care - babies, parents, and dyadic relationships - have systematically been investigated. All the families have received a standard perinatal medico-psycho-social anamnesis, including data on the pregnancy period. In this unit, all the babies are assessed at entry and at discharge using the diagnostic 0 to 5 scale, a clinical withdrawal risk, and a developmental assessment (Bayley). Parental psychopathology is assessed with the DSM5 diagnostic scale and the Edinburgh scale for depression. Parent-child interactions are categorized according to Axis II of the 0 to 5 scale. We have evaluated the improvement of children symptomatology, the child development and the mother-child relation between the entrance (T1) and the discharge (T2) and we have compared two groups of clinical situations: a group of patients with a successful evolution (considering baby's development and the alliance with the parents) and a group of unsuccessful evolution during hospitalization. We use descriptive statistics to characterize our population. To compare the different groups of our cohort, we use the T-test and non-parametric tests for continue variables. For discrete variables, we used the Chi2 test of Pearson. The clinical population of the day unit is comparable to the mother-baby units in terms of psychosocial fragility but the psychopathological profile of the parents entering the day unit shows more anxiety disorder and less post-partum psychosis. The babies' development quotient is in the average range at T1 and is maintained at T2. In the day unit, the number of symptoms as well as the relational withdrawal of the babies is reduced between T1 and T2. The quality of parent-child relationship is improved between T1 and T2. The children of the group of pejorative evolution had a lower developmental quotient at the T1 and an overrepresentation of traumatic life events. These results indicate that parent-baby day unit lead to positive outcomes in clinical situations with anxio-depressive parents, relational withdrawal of the babies, functional problems of the babies but not when a significant impact on the development of the baby already exists. The results of this study can guide therapeutic approaches for the benefit of care in parent-baby day units, and improve the development of the child and of the dyadic relationships.

Perceived social support, newborn temperament and socioeconomic status in postpartum depression: report from southwest Serbia

Aim of the studyThe aim of this study is to asses the relationship between postpartum depression and perceived social support, newborn temperament, and selected sociodemographic variables.Subject or material and methodsThe sample consisted of 145 mothers, with an average age of 27, mostly married. The following instruments were used in the research: Questionnaire on sociodemographic characteristics, Neonatal temperament scale, Edinburgh scale of postpartum depression - EPDS and Scale of perceived social support.ResultsThe results showed that reduced social support from partners, friends, and family, difficult newborn temperament, and low socioeconomic status correlated with postpartum depression.DiscussionThe practical implications of the research are reflected in the understanding of social support as a significant predictor of depression in the postpartum period and the implementation of the social component in the system of support and assistance to pregnant women and mothers.ConclusionsRecognizing the factors that cause mood disorders after childbirth is an important part of the diagnosis and prevention of postpartum depression. Postpartum depression is a non-psychotic postpartum mood disorder that can last up to 12 months postpartum. The etiological disorder is still not differentiated because it is differentiated through a bio-psycho-social basis.

WHAT WOMEN ARE AFRAID OF IN CHILDBIRTH: THE ASSOCIATION BETWEEN FEAR OF CHILDBIRTH, DEPRESSION, AND ANXIETY DISORDER

For many families, the birth of a child is a strong emotional experience. Not only the birth itself but also the expecting period, and sometimes even planning. Despite the fact that most births in modern culture are safe, pregnant women have a fear of childbirth or anxiety before it. Data show that approximately % of pregnant women suffer from a high level of fear of childbirth (Wij ma et.al, ). Depression and anxiety disorder can be the cause of fear in the upcoming birth but it happens that the fear of childbirth is present without depression and anxiety disorder (https://pubmed. ncbi.nlm.nih.gov/ /). The purpose of the study is to investigate the relationship between fear of childbirth, perinatal depression and anxiety disorder. A sample of pregnant women who agreed to participate in the study underwent an anonymous survey in which the level of fear was assessed on the FOC scale, the symptoms of perinatal depression were evaluated with the Edinburgh Scale, and the level of anxiety was measured by GAD-. In addition, an in-depth interview was conducted with each pregnant woman.

Unplanned Pregnancy and Depressive Symptoms during the COVID-19 Pandemic.

This is a cross-sectional study conducted with pregnant women who underwent prenatal care at basic health units in São Luís City, Maranhão State, Brazil. The authors used a semistructured questionnaire to assess the socioeconomic, demographic, and clinical characteristics of pregnant women as well as the Edinburgh Scale to investigate depressive symptoms. In order to assess the association between the explanatory variable and the outcome variable, Poisson logistic regression was performed with statistical significance at p < 0.05. A total of 205 women were interviewed, most aged between 18 and 29 years (66.83%). Of this total, 74.63% had not planned their pregnancy and 26.67% had depressive symptoms. The variables unplanned pregnancy (PR = 1.41; CI = 0.99−2.00; p = 0.05) and not undergoing psychological counseling (PR = 1.42; CI = 0.51−0.83; p ≤ 0.01) correlated with depressive symptoms during pregnancy. It is thus possible to link the variables unplanned pregnancy (p > 0.05) and not undergoing psychological counseling (p = 0.001) to depression. Therefore, it is important to monitor the mental health of pregnant women, especially in situations of vulnerability.

Women's empowerment, maternal depression, and stress: Evidence from rural Burkina Faso

ObjectiveThough there is a wide array of evidence that women's empowerment is associated with more positive health and nutritional outcomes for women and children, evidence around the relationship with mental health or subjective well-being remains relatively limited. The objective of this paper is to explore this relationship in longitudinal data from rural Burkina Faso. MethodsWe analyze the association between empowerment measured using the project-level Women's Empowerment in Agriculture Index (pro-WEAI), and two additional outcomes of interest: stress (measured using the SRQ-20) and maternal depression (measured using the Edinburgh scale for post-partum depression). The analysis employs both cross-sectional specifications and panel specifications conditional on individual fixed effects. ResultsWe find evidence of substantial negative correlations between the empowerment score and maternal stress and depression measured using both continuous and binary variables. This relationship seems to be particularly driven by self-efficacy and respect among household members, where higher scores have negative associations with depression and stress that are both large in magnitude and precisely estimated. ConclusionEnhanced mental health may be another channel for a positive effect of empowerment on women's welfare.

The effect of emotion regulation training on psychological well-being and school burnout of nursing students

Purpose: Understanding the importance of psychological well-being and school burnout in nursing students, as young human resources with high job sensitivity, the present study aimed to study the effect of emotion regulation training on nursing students' psychological well-being and school burnout. Design/methodology/approach: This experimental-interventional study was conducted at Kurdistan University of Medical Sciences (n = 381). Ninety nursing students were selected by stratified random sampling according to inclusion criteria. The participants were placed in two case groups (n = 45) and control (n = 45). Emotion regulation training was designed and implemented for the case group. Data collection tools included self-design demographic questionnaires, school burnout of Brusso scale, and psychological well-being of Warwick Edinburgh scale. The validity and reliability of the tools were evaluated and confirmed. The data were collected before and one month after the intervention for both groups. Finally, they were analyzed using SPSS-v24 software. Findings: The mean (±SD) of psychological well-being scores of the participants in the intervention group before and after the implementation of emotion regulation training were 47.91 (5.70) and 55.35 (4.99), respectively.

Effects of Oxidative Stress in Acute Poisoning in Central India

Background: Tissue inflammation, low food intake of micronutrients due to sleepiness, free radical burst from activated macrophages, and excessive medication cause oxidative stress in acute poisoning. If not neutralised by antioxidants, these free radicals may contribute to tissue inflammation. The word oxidative stress refers to a scenario in which free radical generation and antioxidant defence are out of balance. In humans, oxidative stress is caused by a reduction in bodily antioxidants when free radical generation exceeds endogenous antioxidant levels, resulting in significant cell damage/death.&#x0D; Free radicals may destroy all major macromolecules, including lipids, proteins, and nucleic acids, but lipids are the most vulnerable.&#x0D; Aim: To evaluate antioxidant status in acute amitriptyline poisoning (AP) cases undergoing routine standard treatment (RST) after supplementation with Vitamin C and alpha lipoic acid either alone or in combination, and compare it with that of normal healthy volunteers.&#x0D; Material and Method: A total of 150 people were enrolled in the study, and they were split into five groups. They came from the IMCU and the Toxicology Ward. The consent of the patients' attendants was sought. The patients were chosen at random. To classify the level or grade of coma in poisoned individuals, the Edinburgh scale was utilized. At the time of admission and discharge, the levels of plasma cholinesterase, SOD, catalase, Glut-peroxidase, Glutathione transferase, MDA, Total-Antioxidant, LDH, and CK were measured.&#x0D; Results: This study offers quantifiable recommendations for vitamin C and alpha lipoic acid intake to aid in rapid recovery and glutathione antioxidant status. On supplementation with vitamin C and alpha lipoic acid, we detected a significant decrease in catalase activity in all groups of acute Amitriptyline poisoning cases. For Gr. V (acute Amitriptyline poisoning cases), we found reduced glutathione activity on admission and higher values on discharge. In light of the preceding discussion, it is worth noting that the higher LDH and CPK in groups that may be attributable to pulmonary infarction rather than cardiac or skeletal muscle involvement could be due to pulmonary infarction.&#x0D; Conclusion: Supplementation with vitamin C and alpha lipoic acid improved antioxidant levels during therapy. We propose that the antioxidant level of acute amitriptyline poisoning cases be examined for more successful recovery, and that diets poor in antioxidants may cause recovery to be sluggish. Oral supplementation, in our opinion, will be more successful for chronic Amitriptyline poisoning patients for a longer period of time, while IV form of vitamin C and alpha lipoic acid will be more effective for acute Amitriptyline poisoning instances.&#x0D; Keywords: Amitriptyline, MDA, Total-Antioxidant, LDH, CK, SOD, AP, RST.

Individual Differences in Cognitive Constructs: A Comparison Between American and Chinese Culture Groups.

Previous studies on human cognition show that people with different cultural backgrounds may differ in various ways. However, there are other unexplored possibilities for cultural differences including degree of handedness thought to reflect hemispheric coordination, reliance on verbal versus visual representation in problem solving, and working memory capacity both spatial and operational. We assessed each of these using the Edinburgh scale, a validated scale of style of processing, and two automatic working memory span tasks. Participants were either native Chinese students (who spoke Mandarin) or American students. Data showed that culture impacted the set of measures but gender did not and these factors did not interact. Chinese and American students showed the largest difference in their operational working memory. We also examined the pattern of correlations among the measures across the two groups and found differences due to cultural group as well.

Do depressive symptoms among pregnant women assisted in Primary Health Care services increase the risk of prematurity and low birth weight?

Objective:to investigate associations between depressive symptoms during pregnancy, low birth weight, and prematurity among women with low-risk pregnancies assisted in public Primary Health Care services.Method:prospective cohort with 193 pregnant women, using the Edinburgh Postnatal Depression Scale, telephone interviews, and medical records available in the health services. Associations of interest were obtained using the Cox regression model.Results:the participants were aged 24.9 years old (median) and had 11 years of schooling (median); 82.4% lived with their partners, and gestational age at the birth was 39 weeks (median). Twenty-five percent of the participants scored ≥13 on the Edinburgh scale. Depressive symptoms did not appear associated with low birth weight (RR=2.06; CI95%=0.56-7.61) or prematurity (RR=0.86; CI95%=0.24-3.09) in the adjusted analysis. However, premature labor increased the risk of low birth weight (RR=4.81; CI95%=1.01-23.0) and prematurity (RR=7.70; CI95%=2.50-23.7). Additionally, each week added to gestational age decreased the risk of low birth weight (RR=0.76; CI95%=0.61-0.95).Conclusion:the presence of depressive symptoms among women with low-risk pregnancies was not associated with low birth weight or prematurity.

Клинико-биомеханические результаты многоуровневых ортопедических вмешательств при crouch gait

The aim of this study was to evaluate the results of multilevel interventions in patients with spastic diplegia and crouch gait. Materials and methods The study cohort consisted of 39 patients (10 females, 29 males). The average age of the patients was 16.3 ± 4.29 years (range, 7 to 26 years). In 19 cases, the GMFCS level was III, in 16 cases it corresponded to level II and in 4 cases to level I. The gait study data were analyzed in two groups of patients. In group 1, patients did not have any previous orthopedic interventions, and the crouch gait pattern was considered to have developed naturally (15 patients). In group 2, patients underwent previous operations on the tendon-muscular apparatus (in other medical institutions) such as fibromyotomy (16 patients) or open lengthening of the Achilles tendon (8 patients). The crouch gait pattern in group 2 was considered iatrogenic. Gait analysis using the Edinburgh Scale and 3D analysis was performed before surgery, and at one to 2 years after the interventions. Results Upon comparing the pre- and postoperative indicators of the Edinburgh scale, there was an improvement in the indicators of movements in the ankle joint both in the supporting and in the non-supporting phases of the stride cycle for both groups: a decrease in the maximum dorsal flexion of the foot under load, an improvement in the maximum extension in the knee joint during the support phase, practically complete elimination of the pathological orientation of the foot relative to the motion vector, as well as improvement of the position in the knee joint immediately before the initial contact with the supporting surface. Computer gait analysis showed that multilevel surgical interventions improved the parameters of the knee flexion angle at the time of initial contact, increased the amplitude of knee joint extension in the support phase of the stride, normalized the orientation of the foot relative to the motion vector, reduced or completely corrected the pathological values of the dorsal flexion of the foot in the support phase of the stride and reduced the energetic intensity of movements. There was no significant increase in the indicators reflecting the strength characteristics of the plantar flexors, which reflects a pronounced suppression of the function of these muscles in the development of crouch gait. GPS changed from 17.1 ± 3.01 to 13.4 ± 3.19 for natural crouch gait and from 15.9 ± 6.16 to 14.8 ± 4.6 for iatrogenic one. Conclusion The crouch gait pattern is not homogeneous, both in terms of natural and iatrogenic development, and in terms of orthopedic disorders. The iatrogenic pattern develops with excessive surgical weakening of the plantar flexors of the foot, even if there is no pathological rotation of the lower limb segments in younger patients and with lower GMFCS levels. The planning of multilevel surgical treatment is based on 3D gait analysis and should be aimed at eliminating orthopedic components of the pathology that determine the crouch gait pattern. Surgical treatment enables to improve the kinetics and kinematics in the knee joint and the kinematic indicators of the ankle joint and, in general, increase the gait profile indicator.

Personal and Family Resources Related to Depressive and Anxiety Symptoms in Women during Puerperium.

Introduction: This study investigated the relationship between personal and family resources (i.e., social support, family functioning, self-efficacy in care, sense of coherence and perceived burden of care) and depressive and anxiety symptoms in women during the puerperium, adjusting for stressors. Methods: This is a quantitative research design, carried out through a descriptive, cross-sectional correlation study. This study includes 212 women over the age of 19 who gave birth from March to September 2019 in Maternal and Child Hospital of Jaén (Spain). Women were selected during the immediate postpartum period. The variables analysed were postpartum depressive symptoms (Edinburgh scale), anxiety symptoms (STAI state anxiety questionnaire), perceived social support (Duke-UNC-11), family functioning (family APGAR), self-efficacy in care (Lawton), sense of coherence (SOC-13), perceived burden (Caregiver Strain Index) and stressful life events (Holmes and Rahe). The main analysis consisted of a multiple linear regression. Results: The regression model of depressive symptoms found a positive association with perceived burden (β = 0.230, p = 0.015) and negative associations with self-efficacy in care (β = −0.348, p < 0.001), social support (β = −0.161, p < 0.001) and sense of coherence (β = −0.081, p = 0.001). The regression model of anxiety symptoms obtained a positive association with perceived burden (β = 1.052, p < 0.001) and negative associations with self-efficacy in care (β = −0.329, p = 0.041), social support (β = −0.234, p = 0.001) and sense of coherence (β = −0.262, p < 0.001). Discussion: Firstly, depressive and anxiety symptoms in the puerperium period may be more prevalent than in other periods of a woman’s life. Secondly, perceived social support, self-efficacy in caring for the newborn and sense of coherence may be protective factors for depressive and anxiety symptoms in the puerperium period. Finally, perceived burden in caring for the newborn may be a risk factor for these symptoms.

Depresión posparto en mujeres puérperas del Hospital General Materno Infantil San Pablo: La información cruda anonimizada se compartirá a solicitud por el autor corresponsal. . Los autores declaran que no hubo financiamiento para la realización de este trabajo. .La información cruda anonimizada se compartirá a solicitud por el autor corresponsal.

Objectives: To determine the prevalence of postpartum depression in women attended at the San Pablo Maternal and Child General Hospital between June and August 2018, describe the sociodemographic characteristics of patients and identify diseaserelated factors. Materials and methods: Observational, descriptive crosssectional prospective study performed on 140 women who had a newlyborn between June and August 2018 at the San Pablo Maternal and Child General Hospital, public hospital from Asuncion, Paraguay, dependency of the Public Health and Social Welfare Secretary. The diagnosis of postpartum depression was made by applying the Edinburgh postpartum depression scale. It measures age, ethnicity, previous illnesses, prenatal complications, pregnancy planning, toxicological habits, living with the newborns father or with a family member, relationship with newborns father, personal and family history of depression, support family, parity, origin, area, birth route, marital status, schooling, number of pregnancies, history of parental separation in childhood and newborns hospitalization. Descriptive statistics and univariate analysis were performed in order to determine diseaserelated factors. Results: Among the 140 women studied, 47 women had an Edinburgh scale score greater than or equal to 10, therefore, a prevalence of 34% of postpartum depression was found among respondents. Among women with positive score, 15% (7) reported suicidal ideation in the previous week. The univariate analysis showed that the personal history of previous depression (p <0.05; OR: 3.17), newborns hospitalization (p <0.05; OR: 2.34), domestic violence (p <0.05; 0R: 6.15), prior and postpartum stress due to various circumstances (p <0.05; OR: 3.01) and live outside the city (p <0.05; OR: 5.37) are significantly related to the development of postpartum depression. Conclusion: the prevalence of depressive traits was high in the study population, pregnant women with a history of prior depression have a high risk of developing the disease and will need additional evaluations and the establishment of preventive treatment. In adittion, there are diseaserelated factors identified in the development of postpartum depression such as newborns hospitalization, being a victim of domestic violence, prior and postpartum stress, and living outside the city.

Comments on psychological impact of COVID-19 lockdown: An online survey from India.

Comments on psychological impact of COVID-19 lockdown: An online survey from India.

Sensitivity and Specificity of the Edinburgh Postnatal Depression Scale (EPDS) among Iranian Mothers: A Psychometric Study

Background: There are few psychometric studies addressing sensitivity and specificity of the Persian version of the Edinburgh Postnatal Depression Scale (EPDS). Therefore, there is a need for future studies to identify the best cut-off point for EPDS score. The present study is aimed at assessing the validity of the EPDS among Iranian mothers. Materials and Methods: The study is a secondary analysis on a descriptive correlational design to evaluate the sensitivity and the specificity of the Persian version of EPDS. The study was conducted in Mashhad, Iran, among 200 postpartum women attending routine post-natal care at six health service centers selected through stratified sampling method, and mothers completed the EPDS tool. Statistical analyses were performed using SPSS software version 16.0. The sensitivity and specificity of the EPDS were assessed against the DSM-IV criteria for depression with Receiver operating characteristic (ROC) curves using MedCalc statistical software (version 13.0). Results: 30% of mothers were depressed based on the Edinburgh scale. The best cut-off point to discriminate mothers with depression (a combination major and minor depression) from normal women in postpartum period was >10 with sensitivity 87.95% and specificity 93.86%. The highest area under the receiver operating characteristic curve (ROC= 0.959). For women with major depression, the best cut-off point was 16 with sensitivity 94.12% and specificity 94.54% (ROC= 0.98). Conclusion: In conclusion, the finding of this psychometric study showed the Persian version of EPDS can be used as a valid tool at a cut-off score of >10 to screen mothers with a combination major and minor depression and at cut-off score of >16 for screening those with major depression in postpartum period in health care center.

Perinatal depressive symptoms: Prevalence and associated psychosocial factors

Perinatal depression is a major depression episode that starts during pregnancy and the postpartum period; and is an important cause of health risks in women and infants. A cross-sectional observational study was conducted with information from the records of 112 pregnant women or in the immediate postpartum period who were surveyed to determine the possible association between perinatal depressive symptoms and psychosocial factors occurring in the last year. The prevalence of clinically significant perinatal depressive symptoms using the Edinburgh scale was of 22.36%. The logistic regression model found association between clinically significant perinatal depressive symptoms (score on the Edinburgh scale≥12 and the following psychosocial factors: end of the couple's relationship (OR=6.26; 95% CI, 1.91–20.49), severe economic problems (OR=6.61; 95% CI, 1.86–23.45), and the death of a family member (OR=3.79; 95% CI, 1.12–12.74). In this study, one in four women had broken up with their partner and had severe economic problems during pregnancy, also one of ten had suffered the death of a loved one in the past year. These psychosocial factors were strongly associated with the presence of depressive symptoms with clinical importance. These finding offer the opportunity to consider psychosocial factors as a source of maternal stress that could be easily identified in the prenatal controls that pregnant women receive to identify women at risk of experiencing depressive symptoms in the perinatal period, which will enable appropriate treatment to be given to those who need it.

7-LB: Dichloroacetate Improves Cognitive Function during Hypoglycemia in T1DM Patients

Magnetic Resonance Spectroscopy (MRS) studies have suggested that exposure to recurrent hypoglycemia (RH) reduces brain cortical Pyruvate Dehydrogenase (PDH) flux in animal models. Examination of rat cortical RNA for inhibitory PDH kinase (PDK) isoform expression patterns identified a two-fold upregulation of PDK4 (p&amp;gt;0.01) after three episodes of hypoglycemia. To date no study has examined the functional role of PDH complex inhibition in the cognitive deficits associated with hypo in patients with T1DM. In a randomized controlled cross-over trial of 11 intensively treated T1DM subjects we examined whether PDK inhibition by dichloroacetate (DCA; 12.5mg/kg), which maintains PDH in its active state might restore cognitive function, counterregulatory hormonal responses and symptoms during clamped hypoglycemia (target 50mg/dL). Cognitive testing included measures of visual matching ability and short term visual and auditory memory as well as the ability to manage conflicting information while ignoring task-irrelevant information. Symptom ratings during hypoglycemia were measured using a modified Edinburgh scale. We found that DCA ingestion is associated with increased performance related to visual memory (DCA: 89% correct vs. Placebo: 69% correct, p=0.049), as well as a faster response time during the multitasking test (549ms DCA vs. 603ms placebo; p=0.028). On the Edinburgh scale, patients reported lower ratings of warmness during hypoglycemia with DCA vs. Placebo (2.5 vs. 3.6; p=0.075). Furthermore, we did not observe an effect of DCA on CRR hormonal responses. These results suggest that inhibition of PDH flux by enhanced PDK activity significantly contributes to cognitive impairment under hypoglycemia and may contribute to subjective symptoms and possibly hypoglycemia awareness. We therefore conclude that strategies focusing on reactivation of oxidative glucose metabolism in the brain may play an important role in mitigating the negative impact of hypoglycemia on cognitive function. Disclosure D. Groskreutz: None. D. Trico: None. N. Tai: None. R. Belfort-DeAguiar: Research Support; Self; Silver Palate Kitchens, Inc. J. Leventhal: None. W. Lam: None. M. Knight: None. J. Gannon: None. R.I. Herzog: Consultant; Spouse/Partner; Boehringer Ingelheim Pharmaceuticals, Inc. Funding JDRF

The Relationship between Gestational Weight Gain and Postpartum Depression in Normal and Overweight Pregnant Women.

Objective To investigate the relationship between weight gain in pregnancy and postpartum depression (PPD) in normal and overweight pregnant women. Methods The participants of this prospective cohort study were 223 healthy pregnant women with the first trimester body mass index (BMI) between 18.5 and 30 and the gestational age of 10-14 weeks and depressed women were excluded with Beck questionnaire in the first trimester. The evaluation included weight gain at the end of the second and third trimesters and the screening of PPD in 6-8 weeks after delivery by Edinburgh scale. Results 49 participants were excluded from the study and data from 174 people were analyzed. 32.2% of mothers were scored above 12 in the Edinburgh scale. The only variable associated with depression was the third trimester weight gain (OR 1.17, 95%CI 1.04-1.32). Conclusion In addition to considering other risk factors for postpartum depression, health care providers should consider the higher probability of PPD in prepregnancy normal and overweight women who have excessive weight gain especially in the third trimester of pregnancy.

Síntomas depresivos perinatales: prevalencia y factores psicosociales asociados

Perinatal depression is a major depression episode that starts during pregnancy and the postpartum period; and is an important cause of health risks in women and infants. A cross-sectional observational study was conducted with information from the records of 112 pregnant women or in the immediate postpartum period who were surveyed to determine the possible association between perinatal depressive symptoms and psychosocial factors occurring in the last year. The prevalence of clinically significant perinatal depressive symptoms using the Edinburgh scale was of 22.36%. The logistic regression model found association between clinically significant perinatal depressive symptoms (score on the Edinburgh scale ≥ 12 and the following psychosocial factors: end of the couple's relationship (OR=6.26; 95% CI, 1.91-20.49), severe economic problems (OR=6.61; 95% CI, 1.86-23.45), and the death of a family member (OR=3.79; 95% CI, 1.12-12.74). In this study one in four women had broken up with their partner and had severe economic problems during pregnancy, also one of ten had suffered the death of a loved one in the past year. These psychosocial factors were strongly associated with the presence of depressive symptoms with clinical importance. These finding offer the opportunity to consider psychosocial factors as a source of maternal stress that could be easily identified in the prenatal controls that pregnant women receive to identify women at risk of experiencing depressive symptoms in the perinatal period, which will enable appropriate treatment to be given to those who need it.

Relação entre Depressão Pós-Parto e Apoio Social: Revisão Sistemática da Literatura

In order to conduct a systematic review of the scientific literature on the relationship between postpartum (PPD) depression and social support, it was carried out a survey of online articles that have established this relationship. The search for papers published from January 2000 to August 2011 was performed in the databases APA PsycNET, EBSCOhost, Pepsic, PubMed, and Scielo. It was selected studies written in Portuguese or English, that had used quantitative method, the Edinburgh Scale of Post-partum Depression Scale (EPDS), applied between delivery and 12 months from childbirth to evaluate PPD, and social support measures. It was identified 24 articles, conducted in 11 countries. It was examined, besides the association with social support measures, the number and age of participants, EPDS scores, and other factors associated with the occurrence of PPD. Although using different instruments to assess social support, 23 studies (96% of sample size) have found that the higher the social support perceived by mothers, the lower the prevalence of PPD. The results of this work show, particularly for health professionals and health services, the importance of early detection of depression signs, and of the adoption of preventive measures in the care for women during and after pregnancy.