Understanding Of Postpartum Depression Research Articles

Bridging Neurobiological Insights and Clinical Biomarkers in Postpartum Depression: A Narrative Review.

Postpartum depression (PPD) affects 174 million women worldwide and is characterized by profound sadness, anxiety, irritability, and debilitating fatigue, which disrupt maternal caregiving and the mother-infant relationship. Limited pharmacological interventions are currently available. Our understanding of the neurobiological pathophysiology of PPD remains incomplete, potentially hindering the development of novel treatment strategies. Recent hypotheses suggest that PPD is driven by a complex interplay of hormonal changes, neurotransmitter imbalances, inflammation, genetic factors, psychosocial stressors, and hypothalamic-pituitary-adrenal (HPA) axis dysregulation. This narrative review examines recent clinical studies on PPD within the past 15 years, emphasizing advancements in neuroimaging findings and blood biomarker detection. Additionally, we summarize recent laboratory work using animal models to mimic PPD, focusing on hormone withdrawal, HPA axis dysfunction, and perinatal stress theories. We also revisit neurobiological results from several brain regions associated with negative emotions, such as the amygdala, prefrontal cortex, hippocampus, and striatum. These insights aim to improve our understanding of PPD's neurobiological mechanisms, guiding future research for better early detection, prevention, and personalized treatment strategies for women affected by PPD and their families.

Postpartum depression among first-time Jordanian mothers: levels and associated factors

ABSTRACT Postpartum depression among first-time mothers is a sensitive issue and few studies were conducted related to this topic in developing countries including Jordan. Thus, this study purposed to assess postpartum depression levels and associated factors among Jordanian first-time mothers. A cross-sectional design was adopted, and 193 postpartum first-time mothers living in Amman governorate were recruited. A questionnaire consisting of two parts was used to record data, sociodemographic and maternal health, and Patient Health Questionnaire (PHQ-9). Findings showed that 34.1% of the women experienced postpartum depression. The employment, gravida, antenatal health problems, breastfeeding problems, newborn health problems, and availability of assistance during the postpartum period significantly correlated with postpartum depression. Thus, the understanding of postpartum depression and related factors would provide important empirical evidence for healthcare professionals and policy-makers when planning to develop strategies and measures to minimize postpartum depression among first-time mothers.

Postpartum depression and postpartum post-traumatic stress disorder: prevalence and associated factors

BackgroundDespite the increased global interest from researchers in postpartum depression (PPD) and postpartum post-traumatic stress disorder (PP-PTSD), studies of PPD in China have shown a wide range of variability. Indeed, the prevalence and risk factors for PP-PTSD have received little attention in China.AimTo determine the prevalence of PPD and PP-PTSD in China, and to examine the relationships between a range of sociodemographic, pregnancy-related, and newborn-related variables, and PPD and PP-PTSD.MethodsA cross-sectional study involving 1136 women who returned to the obstetrics clinic for routine postpartum examination were enrolled. The sociodemographic, pregnancy-related, and newborn-related characteristics were collected. Social support, and PPD and PP-PTSD symptoms were measured by the Perceived Social Support Scale (PSSS), the Edinburgh Postnatal Depression Scale (EPDS), and the Perinatal Post-traumatic Stress Questionnaire (PPQ).ResultsThe prevalence rates of PPD and PP-PTSD symptoms were 23.5 and 6.1%, respectively. A multivariate model showed that the presence of PP-PTSD was the strongest risk factor for PPD symptoms and vice versa. Other risk factors for PPD included low sleep quality, low social support and newborn’s incubator admission. In terms of PP-PTSD symptoms, risk factors included the presence of PPD symptoms, non-Han ethnicity, and low social support, while having one child was a protective factor.ConclusionsThis study addressed some gaps in the literature and provided a better understanding of PPD and PP-PTSD in China, which may contribute to early detection and intervention. Attention should be paid to women who are most susceptible to PPD and/or PP-PTSD, including those with low social support, low sleep quality, newborn’s incubator admission, non-Han ethnicity, and women with siblings.

Questionnaire to Assess Knowledge, Attitude, and Prevention Behaviors of Taiwanese Postpartum Women Regarding Postpartum Depression

Aim: Postpartum depression is a highly prevalent disorder, and it has been recognized as a public health problem. In Chinese culture, after childbirth, women must stay at home for postpartum confinement. However, more than 50% of postpartum women tend to experience depression symptoms 3–4 days after delivery. Although the prevention and causes of postpartum depression have been extensively studied, the assessment tools used are usually based on Western cultures. A Chinese-version assessment scale was necessary. The objective of this study was to develop a culturally sensitive questionnaire for assessing the knowledge, attitude, and prevention behaviors toward postpartum depression of Taiwanese women, and examined the associations among postpartum depression knowledge, attitude, and prevention. Methods: Two-phase study was conducted. First, a postpartum depression scale was developed and its reliability and validity were tested in 50 people. Second, 639 postpartum women from seven hospitals were asked to complete the questionnaire. Results: The questionnaire, which contained four subscales and 16 questions (Cronbach's α = .82–.84), was administered in the postpartum room and required 5–10 min for completion. This questionnaire showed face validity and high acceptance, the factor analysis showed that the questionnaire has acceptable structural reliability. High scores on the postpartum depression knowledge and attitude subscales were associated with higher prevention behavior subscale scores. Conclusion: The finding of this questionnaire is an effective tool for determining postpartum women’s understanding of postpartum depression. Understanding postpartum depression knowledge, attitude and prevention are essential to assess and promote the postnatal care

Postpartum Depression and Access to Mental Healthcare among Migrant South Asian Women in Canada: A Literature Review

Although there has been an increase in research on postpartum depression (PPD) among migrant Asian women, there is particularly limited attention given to migrant South Asian women. This is a significant limitation considering the rapidly changing demographics in Canada. Migrant South Asian women face a plethora of unique challenges, which affects their mental health and further prevents them from receiving adequate and equitable mental healthcare services. For migrant South Asian women, many of these stressors are especially amalgamated in the vulnerable postpartum period, resulting in variances of postpartum mood disorders such as postpartum blues, non-psychotic postpartum depression, and in more severe cases, postpartum psychosis. While cultural values and rituals may be protective in curbing PPD symptoms in some instances, in other cases, however, they exacerbate and perhaps even worsen PPD. The objective of this literature review is to provide a basic understanding of postpartum depression among the migrant South Asian community in Canada. It aims to answer questions pertaining to the types of postpartum mood disorders that women can potentially suffer from, its risk factors, its prevalence among migrant women, as well as the socio-cultural and gender-related barriers to attaining access to mental healthcare services and treatments for PPD in Canada. Around 40 documents were examined, summarized and synthesized for this literature review. These included scholarly journal articles, non-scholarly articles, health-related websites, position papers, and medical journals.

Using clinical decision support as a means of implementing a universal postpartum depression screening program.

A major barrier to the diagnosis of postpartum depression (PPD) includes symptom detection. The lack of awareness and understanding of PPD among new mothers, the variability in clinical presentation, and the various diagnostic strategies can increase this further. The purpose of this study was to test the feasibility of adding clinical decision support (CDS) to the electronic health record (EHR) as a means of implementing a universal standardized PPD screening program within a large, at high risk, population. All women returning to the Mount Sinai Hospital OB/GYN Ambulatory Practice for postpartum care between 2010 and 2013 were presented with the Edinburgh Postnatal Depression Scale (EPDS) in response to a CDS "hard stop" built into the EHR. Of the 2102 women who presented for postpartum care, 2092 women (99.5%) were screened for PPD in response to a CDS hard stop module. Screens were missing on ten records (0.5%) secondary to refusal, language barrier, or lack of clarity in the EHR. Technology is becoming increasingly important in addressing the challenges faced by health care providers. While the identification of PPD has become the recent focus of public health concerns secondary to the significant social burden, numerous barriers to screening still exist within the clinical setting. The utility of adding CDS in the form of a hard stop, requiring clinicians to enter a standardized PPD mood assessment score to the patient EHR, offers a sufficient way to address a primary barrier to PPD symptom identification at the practitioner level.

Recognition of Risk Factors for Postpartum Depression in Refugee and Immigrant Women: Are Current Screening Practices Adequate?

Currently little is known of postpartum depression (PPD) screening and referral for refugee and immigrant women in Northern New England where the foreign born population has been rapidly expanding in the past decade. Research on PPD has focused largely on the general population leaving a large gap in our understanding of PPD in this vulnerable group. A retrospective chart review was conducted from a tertiary medical center with 1,160 births per year. Total sample n=126, 28% scored at risk for PPD. 39% of women at risk had follow up documented as a phone call alone, however 43% of that at risk group did not speak English. Focuses on the suitability of tools that have not been psychometrically tested for this population and may be culturally inappropriate for non western women. Lack of appropriate follow up is challenged and who is best placed to perform screening is considered.

Validity of Postpartum Depression Screening Across Socioeconomic Groups: A Review of the Construct and Common Screening Tools

This integrative literature review evaluates the construct validity and potential for bias of commonly used postpartum depression screening tools in women with low socioeconomic status. Multiple search strategies were applied to identify literature addressing the validity of the Beck Depression Inventory, Center for Epidemiological Studies-Depression Scale, Edinburgh Postnatal Depression Scale, and Postpartum Depression Screening Scale from January 1980 thru January 2010. Twenty articles were identified, eight of which explicitly included women with low-socioeconomic status. Only three of these articles directly evaluated construct validity. The screening tools reviewed lack the comprehensive psycho-metric evaluation needed to support their extensive use across socioeconomically diverse populations that may result in missed opportunities to identify postpartum depression. This issue stems from serious limitations in the understanding of postpartum depression itself. An alternate understanding of and approach to screening for depression across all women in their developmental and environmental context is recommended.

Depression in New Mothers: Causes, Consequences, and Treatment Alternatives

Back to table of contents Previous article Next article Book ReviewFull AccessDepression in New Mothers: Causes, Consequences, and Treatment AlternativesLillian Mezey M.D.Lillian Mezey M.D.Search for more papers by this authorPublished Online:1 Jan 2007https://doi.org/10.1176/ps.2007.58.1.144AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail An update of Dr. Kendall-Tackett's first book, Postpartum Depression (1993), Depression in New Mothers addresses recent advances in the understanding of postpartum depression and its treatment. In the foreword, Jane Honikman states that "denial and ignorance are two of the barriers in recognizing and treating women suffering from perinatal mood disorders." Thus the purpose of the book, as articulated by Kendall-Tackett is, "You have before you an opportunity to make a real difference in the lives of mothers and babies. My goal is to equip you to do just that." Kendall-Tackett, a psychologist and a lactation consultant, divides this new book into several sections, each addressing myths surrounding postpartum depression: a review of the harmful effects of maternal depression, a discussion of causes and risks for development of postpartum depression, and assessment and treatment of the syndrome. The book seems directed toward nonphysician practitioners—such as nurses, social workers, midwives, and lactation consultants—who interact with perinatal women. The information about diagnosis of depression and somatic treatments, including medications, is fairly rudimentary and seems most useful in helping to determine when to refer a woman for more extensive mental health assessment and treatment. Bipolar disorder, psychosis, mood stabilizers or antipsychotics, and genetics are barely discussed, and electroconvulsive therapy is not mentioned at all. Given the severity of these syndromes, especially postpartum psychosis, it would seem prudent to give them more attention. However, two valuable lists address the assessment of suicide risk and the need for hospitalization.Depression in New Mothers focuses throughout on issues of breast feeding and also on trauma and PTSD, sometimes in ways not directly associated with postpartum depression. These two areas are clearly of special interest to the author, and the emphasis causes the book to seem unbalanced. In a similar regard, there seemed to be a bias toward herbal remedies, "alternative" therapies, diet, and supplements in excess of the evidence supporting their efficacy in postpartum depression. An especially interesting topic covered in the book, which may be often overlooked, is the psychological impact of "negative birth experiences." Factors such as losing a sense of control over the labor and delivery process, being traumatized physically by invasive procedures, feeling unsupported, and feeling like a failure can all lead to depression and may even lead to PTSD. All of these, obviously, can then impact parenting.Overall, I found the book to be disorganized to read, sometimes jumping around to different topics, going off on tangents, describing studies in a confusing manner, and listing studies that do not directly apply to the topic at hand. Some of the interventions, such as "community-based care" and "preventive intervention," are not well described, but the book does a good job of describing cognitive-behavioral therapy and interpersonal psychotherapy.Depression in New Mothers meets its goal of raising awareness of perinatal depressive syndromes and discusses relevant social factors, but, from my perspective, the book does not comprehensively cover assessment and treatment strategies. Dr. Mezey is assistant professor of clinical psychiatric medicine at University of Virginia School of Medicine, Charlottesville, and is also affiliated with Valley Community Services Board, Staunton, Virginia. FiguresReferencesCited byDetailsCited byNone Volume 58Issue 1 January, 2007Pages 144-144PSYCHIATRIC SERVICES January 2007 Volume 58 Number 1 Metrics PDF download History Published online 1 January 2007 Published in print 1 January 2007