Previous History Of Depression Research Articles

Prevalence of anxiety and depression and their associated risk factors throughout pregnancy and postpartum: a prospective cross-sectional descriptive multicentred study

ObjectiveTo assess the prevalence of anxiety and depression and their associated risk factors throughout the pregnancy and postpartum process using a new screening for the early detection of mental health problems.DesignA prospective cross-sectional descriptive multicentred study. Participants were consecutively enrolled at ≥ 12 weeks’ gestation and followed at three different time points: at 12–14 weeks of pregnancy, at 29–30 weeks of pregnancy, and 4–6 weeks postpartum. All women completed a mental screening at week 12–14 of pregnancy consisting of two questions from the Generalised Anxiety Disorder Scale (GAD-2) and the two Whooley questions. If this screening was positive, the woman completed the Edinburgh Postnatal Depression Scale (EPDS).SettingSeven primary care centres coordinated by a Gynaecology and Obstetrics Department in the city of Terrassa (Barcelona) in northern Spain.ParticipantsPregnant women (N = 335, age 18–45 years), in their first trimester of pregnancy, and receiving prenatal care in the public health system between July 2018 and July 2020.FindingsThe most relevant factors associated with positive screening for antenatal depression or anxiety during pregnancy, that appear after the first trimester of pregnancy, are systematically repeated throughout the pregnancy, and are maintained in the postpartum period were: a history of previous depression, previous anxiety, abuse, and marital problems. In weeks 12–14 early risk factors for positive depression and anxiety screening and positive EPDS were: age, smoking, educational level, employment status, previous psychological/psychiatric history and treatment, suicide in the family environment, voluntary termination of pregnancy and current planned pregnancy, living with a partner and partner’s income. In weeks 29–30 risk factors were: being a skilled worker, a history of previous depression or anxiety, and marital problems. In weeks 4–6 postpartum, risk factors were: age, a history of previous depression or anxiety or psychological/psychiatric treatment, type of treatment, having been mistreated, and marital problems.ConclusionsEarly screening for anxiety and depression in pregnancy may enable the creation of more effective healthcare pathways, by acting long before mental health problems in pregnant women worsen or by preventing their onset. Assessment of anxiety and depression symptoms before and after childbirth and emotional support needs to be incorporated into routine practice.

Prenatal affective cognitive training to reduce the risk of postpartum depression (PACT): study protocol for a randomized controlled trial

BackgroundPostpartum depression (PPD) affects 30–50% of women with a history of previous depression or bipolar disorder and 8% of women with no history of depression. Negative cognitive biases in the perception of infant cues and difficulties with emotion regulation are replicated risk factors. Current interventions focus on detecting and treating rather than preventing PPD. The aim of this randomized controlled intervention trial is therefore to investigate the potential prophylactic effects of prenatal affective cognitive training for pregnant women at heightened risk of PPD.MethodsThe study will enrol a total of 292 pregnant women: 146 at high risk and 146 at low risk of PPD. Participants undergo comprehensive assessments of affective cognitive processing, clinical depressive symptoms, and complete questionnaires at baseline. Based on the responses, pregnant women will be categorized as either at high or low risk of PPD. High-risk participants will be randomized to either prenatal affective cognitive training (PACT) or care as usual (CAU) immediately after the baseline testing. The PACT intervention is based on emerging evidence for efficacy of affective cognitive training approaches in depression, including cognitive bias modification, attention bias modification, mindfulness-inspired emotion regulation exercises, and working memory training. Participants randomised to PACT will complete five individual computerised and virtual reality-based training sessions over 5 weeks. The primary outcome is the difference between intervention arms in the incidence of PPD, assessed with an interview 6 months after birth. We will also assess the severity of depressive symptoms, rated weekly online during the first 6 weeks postpartum.DiscussionThe results will have implications for future early prophylactic interventions for pregnant women at heightened risk of PPD. If the PACT intervention reduces the incidence of PPD, it can become a feasible, non-invasive prophylactic strategy during pregnancy, with positive mental health implications for these women and their children.Trial registrationClinicalTrials.gov NCT06046456 registered 21-09-2023, updated 08-07-2024.

Prevalence of depression and its associated factors among medical students of a rural medical college in Karnataka

Introduction: Depression among medical students is an overlooked public health issue in India. Addressing this problem is crucial to prevent its negative impact on educational performance and career development through early detection and appropriate interventions. This study aimed to assess the prevalence of depression and its associated factors among medical students. Materials and methods: 305 medical students selected randomly were assessed for depression using the Beck Depression Inventory. The relationships between depression and various factors, including academic year, social influences such as addictive habits, family issues, a history of depression, and living away from home were assessed. Results: 137 (44.91%) students were found to have some degree of depression according to Becks Inventory Scale. Majority (81.02%) of them were found to have mild to moderate depression while the prevalence of severe and very severe depression was 6.10% and 2.25% respectively. The difference between the grade of depression and year of studying was found to be statistically significant. Factors such as being coerced into the MBBS program instead of choosing it, academic performance during the course, and a history of previous depression had a significant impact on the likelihood of developing depression. Conclusion: Depression is notably common among medical students in this region. Our results highlight the need for widespread screening and psychiatric counseling for this vulnerable group. Keywords: medical students; depression; Becks depression; inventory scale

Antenatal depression and its predictors among HIV positive women in Sub-Saharan Africa; a systematic review and meta-analysis.

Antenatal depression in Human Immunodeficiency Virus (HIV) positive pregnant women can have significant adverse effects on both the mother and newborns, yet it is often overlooked in pregnancy care in Sub-Saharan Africa (SSA). Despite this, there is limited data on the combined prevalence of antenatal depression and its predictors among HIV-positive women in the region. To assess the pooled prevalence of antenatal depression and its associated factors among HIV-positive women in SSA. All primary cross-sectional studies published before 1st January/2024, were included. We conducted searches in relevant databases; PubMed, HINARI, Web of Science, PsycINFO, Psychiatry Online, ScienceDirect, and Google Scholar. The Joanna Briggs Institute checklist was used to critically appraise the selected studies. To assess heterogeneity among the studies, we utilized the I2 test. Publication bias was evaluated using a funnel plot and Egger's test. The forest plot was used to present the combined proportion of antenatal depression and odds ratio, along with a 95% confidence interval. The pooled prevalence of antenatal depression among HIV-positive women in Sub-Saharan Africa was found to be 30.6% (95% CI, 19.8%-41.3%). Factors significantly associated with antenatal depression among HIV-positive women in SSA included being unmarried (AOR: 3.09, 95% CI: 1.57 - 6.07), having a previous history of depression (AOR: 2.97, 95% CI: 1.79 - 4.91), experiencing intimate partner violence (IPV) (AOR: 2.11, 95% CI: 1.44 - 3.09), and experiencing stigma (AOR: 1.36, 95% CI: 1.05 - 1.76). High prevalence of antenatal depression among HIV-positive women in SSA underscores the need for prioritizing identification and management. Interventions addressing factors like IPV and stigma, along with training for healthcare providers in recognizing symptoms and providing support, are recommended. https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024508236.

Perinatal posttraumatic stress disorder as a predictor of mother-child bonding quality 8 months after childbirth: a longitudinal study

BackgroundNegative childbirth experiences can be related to the onset of perinatal post-traumatic stress symptomatology (P-PTSS), which significantly impacts the mother and the infant. As a response in the face of the discomfort caused by P-PTSS, maladaptive emotion regulation strategies such as brooding can emerge, contributing to the consolidation of post-partum depressive symptoms. Ultimately, both types of symptomatology, P-PTSS and post-partum depression, can act as risk factors for developing mother-child bonding difficulties. Still, this full set of temporal paths has to date remained untested. The present longitudinal study aimed to analyze the risk factors associated with the appearance of P-PTSS after post-partum and to test a path model considering the role of P-PTSS as an indirect predictor of bonding difficulties at eight months of postpartum.MethodsAn initial sample of pregnant women in the third trimester of gestation (N = 594) participated in a longitudinal study comprising two follow-ups at two and eight months of postpartum. The mothers completed online evaluations that included socio-demographic data and measures of psychological variables. A two-step linear regression model was performed to assess the predictive role of the variables proposed as risk factors for P-PTSS, and a path model was formulated to test the pathways of influence of P-PTSS on bonding difficulties.ResultsA history of psychopathology of the mother, the presence of depression during pregnancy, the presence of medical complications in the mother, and the occurrence of traumatic birth experiences all acted as significant predictors of P-PTSS, explaining 29.5% of its variance. Furthermore, the path model tested further confirmed an indirect effect of P-PTSS, triggered by a negative childbirth experience, on subsequent bonding difficulties eight months after labor through its association with higher levels of brooding and, ultimately, postpartum depression levels. A further path showed that bonding difficulties at two months postpartum can persist at eight months postpartum due to the onset of brooding and postpartum depression symptoms.ConclusionWe identified a set of robust predictors of P-PTSS: the mother’s previous history of depression, perinatal depression during pregnancy, the presence of medical complications in the mother and the occurrence of traumatic birth experiences, which has important implications for prevention. This is particularly relevant, as P-PTSS, when triggered by a negative childbirth experience, further indirectly predicted the development of mother-child bonding difficulties through the mediation of higher use of brooding and symptoms of postpartum depression. These findings can serve as a basis for developing new longitudinal studies to further advance the understanding of perinatal mechanisms of mental health.

Harnessing Consumer Wearable Digital Biomarkers for Individualized Recognition of Postpartum Depression Using the All of Us Research Program Data Set: Cross-Sectional Study.

Postpartum depression (PPD) poses a significant maternal health challenge. The current approach to detecting PPD relies on in-person postpartum visits, which contributes to underdiagnosis. Furthermore, recognizing PPD symptoms can be challenging. Therefore, we explored the potential of using digital biomarkers from consumer wearables for PPD recognition. The main goal of this study was to showcase the viability of using machine learning (ML) and digital biomarkers related to heart rate, physical activity, and energy expenditure derived from consumer-grade wearables for the recognition of PPD. Using the All of Us Research Program Registered Tier v6 data set, we performed computational phenotyping of women with and without PPD following childbirth. Intraindividual ML models were developed using digital biomarkers from Fitbit to discern between prepregnancy, pregnancy, postpartum without depression, and postpartum with depression (ie, PPD diagnosis) periods. Models were built using generalized linear models, random forest, support vector machine, and k-nearest neighbor algorithms and evaluated using the κ statistic and multiclass area under the receiver operating characteristic curve (mAUC) to determine the algorithm with the best performance. The specificity of our individualized ML approach was confirmed in a cohort of women who gave birth and did not experience PPD. Moreover, we assessed the impact of a previous history of depression on model performance. We determined the variable importance for predicting the PPD period using Shapley additive explanations and confirmed the results using a permutation approach. Finally, we compared our individualized ML methodology against a traditional cohort-based ML model for PPD recognition and compared model performance using sensitivity, specificity, precision, recall, and F1-score. Patient cohorts of women with valid Fitbit data who gave birth included <20 with PPD and 39 without PPD. Our results demonstrated that intraindividual models using digital biomarkers discerned among prepregnancy, pregnancy, postpartum without depression, and postpartum with depression (ie, PPD diagnosis) periods, with random forest (mAUC=0.85; κ=0.80) models outperforming generalized linear models (mAUC=0.82; κ=0.74), support vector machine (mAUC=0.75; κ=0.72), and k-nearest neighbor (mAUC=0.74; κ=0.62). Model performance decreased in women without PPD, illustrating the method's specificity. Previous depression history did not impact the efficacy of the model for PPD recognition. Moreover, we found that the most predictive biomarker of PPD was calories burned during the basal metabolic rate. Finally, individualized models surpassed the performance of a conventional cohort-based model for PPD detection. This research establishes consumer wearables as a promising tool for PPD identification and highlights personalized ML approaches, which could transform early disease detection strategies.

Depression during pregnancy and associated factors among women in Ethiopia: a systematic review and meta-analysis

BackgroundPregnancy is one of the most remarkable experiences in a woman’s life. Prenatal depression, characterized by stress and worry associated with pregnancy, can reach severe levels. On a global scale, mental and addictive disorders affect more than one billion people, causing 19% of years lived with disability. It is estimated that 25–35% of pregnant women experience depressive symptoms, with 20% meeting the diagnostic criteria for major depression.MethodsA systematic review and meta-analysis were conducted to examine depression during pregnancy in Ethiopia. The search was conducted from March 1–31, 2023. Data extraction used Microsoft Excel, and analysis was performed using STATA version 17. The New Castle-Ottawa Scale quality assessment tool was employed to evaluate the methodological quality of included studies. The Cochrane Q test and I2 statistics were used to assess heterogeneity. A weighted inverse variance random-effects model estimated the pooled level of antenatal depression (APD). Publication bias was detected using a funnel plot and Begg’s and Egger’s tests.ResultsOut of 350 studies searched, 18 were included in the analysis. The overall pooled prevalence of depression in Ethiopia was 27.85% (95% CI: 23.75–31.96). Harari region reported the highest prevalence (37.44%), while Amhara region had the lowest (23.10%). Factors significantly associated with depression included unplanned pregnancies, low social support, low income, previous history of depression, intimate partner violence, and history of abortion.ConclusionThis systematic review and meta-analysis demonstrate that approximately one-quarter of pregnant women in Ethiopia experience depression during pregnancy. Unplanned pregnancy, low social support, low income, previous history of depression, history of abortion, and intimate partner violence are determinants of depression. To address this high prevalence, the Ethiopian government and stakeholders should develop policies that incorporate counseling during pregnancy follow-ups. Improving the quality of life for pregnant women is crucial for the well-being of families, communities, and the nation as a whole.

Difficulties in Pregnancy Adjustment as Predictors of Perinatal Depression: Indirect Effects through the Role of Brooding Rumination and Maternal-Fetal Bonding.

The aim of this research was to study the ways in which problems of adaptation to pregnancy influence the development of symptoms of perinatal depression via the presence of brooding and low maternal-fetal bonding, in addition to other risk factors previously established in the literature. Representative sample of pregnant women in the third trimester of gestation (N = 594) completed an online survey that included sociodemographic data and measures of perinatal depression, adjustment to pregnancy, bonding, and brooding. Other risk factors were also assessed as covariates, such as previous history of depression, generalized anxiety, perceived social support, and experience of stressful life events. Descriptive and correlational analyses were performed on the scores obtained by the subjects with the different instruments. A path model was formulated to establish the pathways through which adjustment influences perinatal depression symptomatology. On the one hand, the presence of brooding (worst adjustment to pregnancy → high brooding → perinatal depression symptomatology), and on the other hand, the quality of maternal-fetal bonding (worst adjustment to pregnancy → poor quality fetal-maternal bonding → perinatal depression symptomatology) would act as a mediator. The factors proposed by the literature were predictive of perinatal depressive symptomatology and the quality of adjustment to pregnancy. Problems adjusting to changes during pregnancy and experiencing it unsatisfactorily may predict individual differences in perinatal depressive symptoms. Significantly, this relationship was mediated by two key factors, the presence of brooding and low quality of the maternal-fetal bond. Our results provide evidence in favor of the existence of multiple paths through which difficulties in adapting to pregnancy can favor the occurrence of higher levels of perinatal depressive symptoms and identify new avenues for developing research in this area and preventive interventions empirically informed.

RISK FACTORS ASSOCIATED WITH POSTPARTUM DEPRESSION

Postpartum Depression (PPD) begins to be reported in the 17th and 18th centuries. In the gravidic-puerperal period some events occur such as physiological, psychological and psychosocial changes. The main risk factors for the onset of PPD include: extreme anxiety; stressful events; previous history of depression; lack of family support; unwanted or planned pregnancy; relationship with partner; low socioeconomic status; dependence on alcohol, tobacco, or other drugs; and history of domestic violence. The diagnosis is made by health professionals and through the use of two symptom tracking instruments which are the Edinburgh Postpartum Depression Scale (EPDS) and the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM 5). This work aimed to identify and know the risk factors associated with Postpartum Depression, as well as discuss prevention and methods for early diagnosis. This is an integrative literature review study. Articles indexed in the databases Virtual Health Library (VHL), Scientific Electronic Library Online (Scielo) and Pubmed were used, using the descriptors (DESC) Postpartum Depression or Puerperium, Postpartum Depression or Risk Factors and Postpartum Depression or Nursing Care. From the searches in the cited databases, 81,226 articles were found, which were submitted to the inclusion and exclusion criteria established in this work. After applying the filters, inclusion and exclusion criteria, duplicity, reading the full abstracts, 15 articles were chosen to answer the research question. This study aimed to identify the risk factors associated with PPD. The articles of this review point out that its development occurs through some determinants that arise during pregnancy and postpartum. The risk factors cited by the researches that favor the emergence of PPD include: stressful events during pregnancy, previous history of depression, age, level of education, number of children, marital status, family income. For this, it is important that the health team is in constant training in order to promote health and prevention. With this, it will be possible to observe the decrease in maternal morbidity and mortality rates, infanticides, minimizing complications for puerperae, less damage to the development of babies, as well as maintaining the integrity of the effective mother-child bond, without interfering in the relationship with partners and family members.

The Underlying Factors for Postpartum Depression Severity in Iran: A Single-Center Study.

Postpartum depression (PPD) is a common mental disorder among women and it can cause negative consequences for them, children, and families; however, accurate statistics and underlying factors on PPD and its severity are not available in Iran. In this cross-sectional study, 200 women referred to an academic hospital for normal vaginal delivery, which had a full-term and single pregnancy and had passed between 6 weeks and 6 months of delivery, were selected by convenience sampling methods. The Edinburgh Depression Inventory and the checklist for demographic information of mothers were completed. The prevalence of postpartum depression was 11.0% and 68.2% of mothers had a mild type. 31.8% had a history of depression. There was a significant relationship between the severity of postpartum depression in women with a previous history of depression (P = 0.012). Between postpartum depression and maternal age (P = 0.115), body mass index at delivery (P = 0.571), number of pregnancies (P = 0.693), number of deliveries (P = 0.446), number of abortions (P = 0.424), willing or unwilling pregnancy (P = 0.451), neonatal sex (P = 0.533), history of neonatal hospitalization (P = 0.725), previous history disease (P = 0.725) was no statistical association. The prevalence of PPD was approximately 11%, and there was a significant association between postpartum depression severity and a history of depression Physicians and policymakers should consider early screening for PPD, especially among women with previous depression.

The Impact of Post-Stroke Depressive Symptoms on Cognitive Performance in Women and in Men: A 4 Month Prospective Study.

Background: Depressive symptoms have been associated with cognitive impairment after stroke, and women may be specifically affected. Objective: The aim of this study was to investigate gender-specific characteristics in the relationship between changes in depression severity and changes in cognitive performance after stroke. Methods: We prospectively evaluated 73 patients without a previous history of depression in the first and fourth months after a first ischemic stroke. The severity of depressive symptoms was assessed using the 31-item version of the Hamilton Rating Scale for Depression, and executive function, attention, working memory, and verbal fluency were assessed using a neuropsychological battery. Results: We included 46 (63.0%) men and 27 (36.9%) women, with mean ages of 55.2 (SD ± 15.1) and 46.8 (SD ± 14.7) years, respectively. We found significant improvement in the digit span forward and Stroop dots from month 1 to month 4 post stroke for both men and women. Women, but not men, presented a correlation between changes in phonemic verbal fluency and changes in the 31-item version of the Hamilton Rating Scale for Depression scores. Improvement in depression was correlated with improvement in verbal fluency, and worsening in depression was correlated with worsening in verbal fluency. Conclusions: Our results suggest that women might be more vulnerable to the relationship between depressive symptoms and cognitive performance, and improvement of depression may be necessary for women's improvement in phonemic verbal fluency from the first to the fourth month after a stroke. We did not adjust the results for multiple comparisons. Thus, our findings might be considered preliminary, and confirmatory studies, also focusing on specific characteristics of women that could explain these differences, are warranted.

Stress levels among healthcare workers and adult population during the third wave of COVID-19 pandemic in a metropolitan city

Introduction: The impact of coronavirus disease 2019 (COVID-19) on public health has been widespread with clinically diverse manifestations ranging from asymptomatic presentation to critical illness. COVID-19 might influence different aspects of the stress process on the general population and healthcare workers (HCWs).&#x0D; Objectives: To examine the relationship of demographic variables with depression, anxiety, and stress and to compare stress levels in HCWs and the general population.&#x0D; Method: A cross-sectional study was conducted. A sample of 1,063 participants was collected based on two groups. The first group comprised of HCWs who were directly looking after COVID-19 confirmed or suspected patients and working in any primary, secondary, or tertiary care hospitals. The second group comprised of participants working in public-dealing departments or businesses. Depression Anxiety Stress Scale-42 (DASS-42) was administered to assess depression, anxiety, and stress.&#x0D; Result: Young people, females, and people having less work experience and without civil defense or disaster management training were more depressed, anxious, and stressed. Participants who had no access to scientific journals were more stressed. Average time spent on social media on COVID-19-related information, history of psychological illnesses, and use of sedatives after the COVID-19 pandemic positively predicted anxiety, depression, and stress. There was no significant difference in the scores of depression, anxiety, and stress for HCWs and the general population. &#x0D; Conclusion: The anxiety levels were comparable among HCWs and adults, with vulnerable groups being female gender, young adults, and those who had a previous history of depression or substance abuse. Special consideration must be given to mental health, and protocols must be designed to provide psychological and emotional support to susceptible individuals.

Psychiatric morbidity among pregnant and non pregnant women in Ibadan, Nigeria

A comparative cross-sectional study was conducted among 991 pregnant and 674 non-pregnant women of reproductive age attending healthcare facilities in Ibadan, Nigeria using the General Health Questionnaire-12 (GHQ), and WHO self-reporting questionnaire (SRQ). Logistic regression analysis was conducted to identify predictors of psychiatric morbidity at p < 0.05. A significantly higher proportion of pregnant women experienced psychological distress on the GHQ (51.8%) and psychiatric morbidity on SRQ (33.3%) compared with 28.6% and 18.2% of non-pregnant women, respectively. Predictors of psychiatric morbidity among pregnant women were the type of facility, poor satisfaction and communication with partners, the experience of violence in the home, previous abortions, and previous history of depression. Psychiatric morbidity among non-pregnant women was predicted by younger age, previous history of depression, poor satisfaction and communication with partners. There is a need for early identification of psychiatric morbidity among women of reproductive age, to ensure early interventions and prevent long-term disability. Impact statement What is already known on this subject? Psychiatric morbidity has immense effects on a woman’s quality of life, social functioning, obstetric outcome, and economic productivity. What do the results of this study add? Psychiatric morbidity among women of reproductive age is high. Pregnant women when compared to non-pregnant women had significantly higher rates of psychiatric morbidity. This high prevalence of psychiatric morbidity in both groups was predicted by poor satisfaction and communication with partners, and a previous history of depression. What are the implications of these findings for clinical practice and/or further research? Simple screening for women of reproductive age attending healthcare facilities may help with the early identification of psychiatric morbidity leading to prompt interventions, and preventing long-term disability.

Depression and anxiety in systemic lupus erythematosus: A case-control study on prevalence and associated factors in a single-center cohort.

To evaluate the prevalence of self-perceived depression and anxiety in patients with systemic lupus erythematosus (SLE) and to explore associated factors. Cross-sectional study of unselected patients with SLE (ACR-97 criteria) and controls with chronic inflammatory rheumatic diseases. Both completed the Hospital Anxiety and Depression Scale (HADS). Demographic and clinical characteristics, comorbidity, and treatments were collected, and a multivariate analysis was performed to explore factors associated with depression and anxiety in SLE. The study population comprised 172 patients and 215 controls. Women accounted for 93% of the patients with SLE. Fibromyalgia was recorded in 12.8% and a history of depression in 17%. According to HADS, 37.2% fulfilled the diagnostic criteria for depression and 58.7% those for anxiety; prevalence was similar in the controls (32.6% and 55.1%, respectively). Up to a third of patients with self-perceived depression were not receiving antidepressants. There was no concordance between a previous history of depression and current depression. In the multivariate model, current depression was associated with single marital status (OR 2.69; 95% CI: 1.17-6.42; p = .022), fibromyalgia (7.69; 2.35-30.72; p = .001), smoking (3.12; 1.24-8.07; p = .016), severity of SLE (0.76; 0.6-0.94; p = .016), and organ damage (1.27; 1.01-1.61; p = .042). Current anxiety was only associated with fibromyalgia (3.97; 1.21-17.98; p = .036). Depression and anxiety are most likely underdiagnosed in SLE. Prevalence appears to be similar to that of other chronic inflammatory rheumatic diseases. Anxiety is associated with fibromyalgia, while depression is also associated with single marital status, smoking, organ damage, and severity of SLE.

FACTOR ASSOCIATED WITH STRESS, ANXIETY, AND DEPRESSION AMONG MEDICAL STUDENTS IN TABUK CITY, 2022

Introduction: Stress, anxiety, and depression can be associated with severe harmful consequences to the physical, mental and social well-being of the affected populations. This study was conducted to determine the prevalence of stress, anxiety, and depression among medical students at Tabuk University and to identify the associated risk factors. Methods: Cross-sectional study, self-administered questionnaire distributed among medical students at Tabuk University. Results:The completequestionnaires were received from 241 participants giving a response rate of 62.7%.Prevalence of depression among medical students was 28.6%, anxiety 46.05%, and stress 13.2%. prevalence of depression among basic years was 38%, anxiety 53%, and stress 7.7% while the prevalence is less in clinical years at 27%, 44%, and 5.6% for depression, anxiety and stress respectively. The prevalence of depression was higher among female medical students at 41.1% while the prevalence in males was 21.9%. anxiety is also higher in females 56.6% and 38.1% and males. Stress was 9.5% in female and 2.5% in male medical students. In our study, the factors that affected stress, anxiety, and depression among medical students. Gender, previous history of depression or anxiety, family history of suicidal attempts, and mental illness were determinant factors for stress, depression, and anxiety. Also, stress was significantly affected by academic performance. Students with good, very good, and excellent academic performance tended to have no stress. Conclusions: Our findings in this study suggest that anxiety and depression are prevalent among Tabuk University medical students.The prevalence more in female and basic years medical students. Other risk factors include previous history of mental illnesses, a family history of suicidal attempts, and academic performance.

Risk Factors of Postpartum Depression.

Postpartum depression (PPD) is a widespread mental health problem and one of the prime causes of maternal suffering and ill health. On a global level, the prevalence of the disorder is about 10 to 15%. Symptoms generally appear within the first four to six weeks, which is the high-risk period. However, it may develop up to one year post-delivery. PPD presents with symptoms of classical depression, including mood fluctuations, bouts of crying, lack of interest in the child, and even thoughts of suicide. PPD not only has adverse effects on the mother's health but also hampers the growth and development of the child. It hampers the formation of a healthy mother-child bond, which in turn may impact feeding practices. The social environment of the infant during the first few months is primarily provided by the mother, and PPD may thus impact the child's development. It also increases the child's susceptibility to malnutrition. Research on postpartum depression has garnered momentum within the last few years. However, the masses are still largely unaware of the disorder and its implications. There is also an inadequacy of awareness of the risk factors of PPD. The cross-cultural differences in manifestations and appropriate preventive measures have not been extensively studied. Some risk factors for PPD are similar to those for classic depression; however, obstetrical and pediatric factors are also involved. This literature review aims to assess the currently known risk factors for PPD, their strength of association, and probable mechanisms to help identify the high-risk group and enable the implementation of preventive measures or facilitate early diagnosis. The factors identified spanned sociodemographic, biological, psychological, and obstetric domains. These included socioeconomic standing, marital relationship, history of psychiatric illness, social support, gestational diabetes, vitamin D deficiency, immigration status, delivery method, violence and abuse, birth experience, and biological and epigenetic markers. The risk factors for postpartum depression are numerous and may have strong to weak associations with the development of PPD. A previous history of depression or psychiatric illness, depressive symptoms during pregnancy, gestational diabetes, and a lack of spousal and social support were the most powerful risk factors. Other significant factors include complications during pregnancy, low socioeconomic status, and stressful life events. Studies on maternal age and chronic illness as risk factors were inconclusive. The roles of genetic and epigenetic markers, cultural factors, and vitamin D insufficiency require further investigation.

Effect of Trauma Mechanism of Injury on Post-Traumatic Stress Disorder and Depression Screening

INTRODUCTION: Few data exist guiding surgeons on the management of trauma-induced mental health issues. We hypothesize that the mechanism of injury (MoI) affects posttraumatic stress disorder (PTSD) and depression in trauma patients. METHODS: This is a retrospective cohort study of adult Level I trauma center patients from March 2018 to June 2021 completing a 3-month follow-up screening for PTSD with PCL-5 and depression with PHQ-9 scoring. Demographics and hospitalization details were culled from electronic medical records. MoI was categorized as blunt: low energy, blunt: high energy, and penetrating type by CDC Field Triage Guidelines. Baseline characteristics were compared. Scores were dichotomized before generating logistic and ordinal regression models. RESULTS: A total of 1,148 trauma patients underwent follow-up screening for PTSD and depression. MoI included 67.6% blunt: high energy, 23.2% blunt: low energy, and 9.2% penetrating trauma. Penetrating patients were more likely to screen PTSD positive (odds ratio [OR] 1.72, 95% CI 0.98 to 2.93) and blunt: low energy patients were less likely (OR 0.49, 95% CI 0.28 to 0.84). MoI did not significantly influence depression screening. Patients with previous depression history were more likely to screen positive for PTSD (OR 2.80, 95% CI 1.70 to 4.61) and experience higher depression scores (OR 2.36, 95% CI 1.61 to 3.47; Figure).Figure.: ISS, injury severity score; PTSD, posttraumatic stress disorder.CONCLUSION: Mechanism of injury influences psychiatric sequelae in trauma patients. Compared wth blunt mechanisms, penetrating trauma patients were more likely to screen positive for PTSD. Blunt: low energy provided a protective effect. Routine PTSD screening, especially after penetrating trauma, may identify patients requiring further investigation and intervention.

Prevalence of depression and associated factors among pregnant women attending antenatal care in public health institutions of Awabale Woreda, East Gojjam Zone, Northwestern Ethiopia: A cross-sectional study.

Antenatal depression is a serious health problem and has negative consequences for the mother, fetus, and the entire family. However, it is a neglected component of care especially bay health care providers for women in pregnancy. The purpose of this study was to assess the prevalence of depression and associated factors among pregnant women attending antenatal clinics in public health institutions, in the Awabale Woreda. An institutional-based cross-sectional study was conducted in 2018 and a stratified sampling technique was used to select the study health institutions. All seven public health institutions in Awabale District were included to select 393 mothers and the sample size was proportionally allocated based on the number of target mothers. We used EpiData version 3.1software for data entry and SPSS version 20 software for cleaning and analysis. A Bivariable logistic regression analysis was used to identify the association between each outcome variable and the factor. Again, a multivariable logistic regression analysis was employed to identify factors associated with each outcome variable, and variables with a p-value less than 0.05 were taken as significant variables. Edinburgh Postnatal Depression Scale was used to declare the presence of antenatal depression with a cut point score of 13 and above. This study showed that 63(17.8%) pregnant mothers had antenatal depressive symptoms. Women who were employed 85% reduced to develop antenatal depression than housewives [AOR = 0.15(0.001-0.25)]. Pregnant women who attended high school and above educational level were 18 times more likely to develop antenatal depression than women who had no formal education [AOR18.15 (2.73-120.76)]. Women who had poor husband feeling on the current pregnancy were 4.94 more likely to develop antenatal depression than women who had good partner feeling on the current pregnancy [AOR = 4.94(95%CI: 1.78-13.72)]. Women who had a history of depression were 8.2 times to develop antenatal depression than women who had no history of depression [AOR = 8.22 (95%CI: 2.87-23.57)]. This study revealed that approximately one-fifth of pregnant women developed antenatal depression. Women's occupational status, educational status, previous history of depression, and poor husband feeling on the current pregnancy were the significant factors of antenatal depression.

Frequency and Determinants of Postpartum Depression among Mothers Living in Karachi

Objective: To determine the frequency of Postpartum Depression (PPD) among mothers living in Karachi and to find out the determinants of predispose mothers to Postpartum Depression. Study Design and Setting: The study was cross sectional analytical and was carried by online survey of mothers living in Karachi Methodology: Total duration was six months from 1st January, 2020 to 31st July, 2020. The calculated sample size of study was 369. The study was approved by the Ethical Review Committee of Bahria University Health Sciences Campus, Karachi. Random sampling technique was used to recruit subjects. 294 participants were part of the research. Mothers with previous history of depression and those who had given birth to healthy babies were included in the study. Mothers who have had miscarriage or pre-mature babies were excluded. Questionnaires in both English and Urdu languages were used for the research. PPD was assessed by the help of Edinburgh Post Natal Depression Scale (EPDS). The score of greater than 12 was considered to be indicative of PPD. Results: A total of 294 mothers were enrolled in the study, 187 mothers had an EPDS score &gt;12 giving prevalence of PPD as 63.6%. This study showed that mothers with PPD were more likely not to breastfeed their child (p=0.01), had lack of family support (p=0.00) and had previous history of depression as well (p=0.00). Conclusion: The present study concluded that frequency of postpartum depression was 63.6%. Lack of breastfeeding, previous history of depression and lack of family support were among the determinants that predispose mothers to postpartum depression.

Levels of depressive symptoms in cardiac patients attending cardiac rehabilitation with a history of depression: pre Covid-19 and Covid-19 period comparison

BackgroundThe large-scale changes in cardiac rehabilitation (CR) programme delivery in response to COVID-19 has led to diminished provision. The influence of these service changes on the depression symptoms of patients in CR programmes is unknown. Our study investigated the extent of depressive symptoms prior to and during the COVID-19 periods in patients with a previous history of depression at the start of CR.MethodsUse of Registry routine practice data, National Audit of Cardiac Rehabilitation (NACR), from COVID-19 period Feb 2020 and Jan 2021, as well as pre COVID-19 period Feb 2019 and Jan 2020, was extracted. Depressive symptoms were defined according to Hospital Anxiety and Depression Score ≥ 8. Chi-square tests and independent samples t-tests were used to investigate baseline characteristics. Additionally, a binary logistic regression to examine the factors associated with high levels of depressive symptoms.ResultsIn total 3661 patients with a history of depression were included in the analysis. Patients attending CR during COVID-19 were found to be 11% more likely to have high levels of acute depressive symptoms compared to patients attending CR prior to COVID-19. Physical inactivity, increased anxiety, a higher total number of comorbidities, increased weight, and living in the most deprived areas were statistically significant factors associated with high levels of acute depressive symptoms at the start of CR following multivariate adjustments.ConclusionOur research suggests that following a cardiac event patients with prior history of depression have high levels of acute depressive symptoms at CR baseline assessment. This finding exists in both the pre Covid-19 and Covid-19 periods in patients with a history of depression.