Depressive Symptoms In Women Research Articles

Personal construct therapy vs. cognitive behavioural therapy in the treatment of depression in women with fibromyalgia: a multicentre randomized controlled trial with a 6-month follow-up

IntroductionDepressive symptoms are common in patients with Fibromyalgia (FM), a chronic and disabling pain syndrome. Psychological interventions are mostly focused in negative thinking and behavioural activation. However, several studies suggest that personal identity is also affected by FM.ObjectivesWe aimed to examine the effects of Personal Construct Therapy (PCT), an idiographic approach that emphasizes identity features and interpersonal construal, on depressive symptoms in women with FM.MethodsIn the context of a multicentre parallel randomized trial (Trial Registry: NCT02711020), 106 women with FM and presenting depressive symptoms were randomized either to either Cognitive Behavioural Therapy (CBT; n = 55), taken as a gold standard comparison, or PCT (n = 51). In total, 69 patients completed the treatment and the six-month follow-up assessment (CBT = 32 and PCT = 37). Both treatments were applied on case formulation premises.ResultsLinear mixed-effects models were performed to compare depressive symptoms between treatment conditions. Anxiety and pain measures were treated as secondary outcomes. Participants in both conditions significantly reduced their levels of depression and anxiety as well as the impact of FM but no significant between treatment differences were found. Analysis of clinically significant change for depressive symptoms and pain was also similar between both conditions.ConclusionsPCT resulted equally effective in the treatment of depressive symptoms in women with FM when compared with CBT, both offered in a modular format. Thus, PCT with tis focus on identity issues can be considered as an alternative treatment for these patients.DisclosureNo significant relationships.

Depressive symptoms in the peripartum: incidence and associated characteristics

IntroductionThe peripartum is a period at high risk for the onset of depressive symptoms. The prevalence of peripartum depression (PD) ranges from 6 to 20% and is burdened with high adverse birth outcomes, poor mother-infant bonding, and a high risk for suicidal ideation and attempts. However, PD is underrecognized and consequently undertreated.ObjectivesWe aimed at screening depressive symptoms in women during pregnancy and postpartum, and evaluating the socio-demographic and clinical characteristics associated with depressive symptoms.Methods199 women, 55 during pregnancy and 144 in the postpartum period, consecutively admitted to the Perinatal Mental Health Service of Ancona (Italy) were administered a socio-demographic and clinical questionnaire together with the Edinburgh Postnatal Depression Scale (EPDS). Women scoring ≥ 12 at the EPDS were considered screening positive.ResultsTwenty women (10%) were screening-positive. These women were more often foreigners (R2=0,032; β=0,178; p=0,012), single (R2=0,026; β=0,163; p=0,022), with a positive psychiatric family history (R2=0,114; β=-0,337; p=0,001) and more frequently affected by physical comorbidities unrelated to pregnancy (R2=0,03; β=0-0,174; p=0,014). These women also had more gestational comorbidities such as gestational hypertension (R2=0,02; β=-0,154; p=0,030), shortening of uterus neck (R2=0,05; β=-0,234; p=0,001), and miscarriage threats/placental abruption (R2=0,004; β=-0,067; p=0,001).ConclusionsOur study highlighted the association between depressive symptoms and potentially dangerous gestational comorbidities. Our results further stress the need to screen all women in the peripartum for the presence of depression, in order to identify those at-risk and eventually put in place strategies to prevent further complications to mothers and children.DisclosureNo significant relationships.

Educational Attainment Inequalities in Depressive Symptoms in More Than 100 000 Individuals in Europe

IntroductionIncreasing educational attainment (EA) could decrease the occurrence of depression. We investigated the relationship between EA and depressive symptoms in older individuals across four European regions.Objectives1) examine association between EA and depressive symptoms 2) determine, if there is an upper limit to this association 3) explore regional and demographic differences within this relationship across EuropeMethodsWe studied 108 315 Europeans (54 % women, median age 63 years old) in Europe assessing EA and depressive symptoms. Logistic regression estimated the association between EA and depressive symptoms, adjusting for sociodemographic and health-related factors; testing for sex/age/region and education interactions.ResultsHigher EA was associated with lower odds of depressive symptoms, independent of sociodemographic and health-related factors. A threshold of the lowest odds of depressive symptoms was detected at the first stage of tertiary education (OR 0.60; 95% CI 0.55-0.65; p<0.001; relative to no education). Central and Eastern Europe showed the strongest association (OR for high vs. low education 0.37; 95% CI 0.33-0.40; p<0.001) and Scandinavia the weakest (OR for high vs. low education 0.69; 95% CI 0.60-0.80; p<0.001). The association was strongest amongst younger individuals. There was a sex and education interaction only within Central and Eastern Europe.ConclusionsLevel of EA is reflected in later-life depressive symptoms, suggesting that supporting individuals in achieving EA, and considering those with lower EA at increased risk for depression, could lead to decreased burden of depression across the life-course. Further educational support in Central and Eastern Europe may decrease the higher burden of depressive symptoms in women.DisclosureNo significant relationships.

The relationship between subclinical depressive symptoms and metabolic parameters in women: a subanalysis of the Bialystok PLUS study.

Clinically overt depression is associated with an increased risk for insulin resistance. Data regarding the impact of subclinical depressive symptoms on the risk of diabetes are limited. The study aimed to assess the relationship of subclinical depressive symptoms with body fat distribution and diabetes risk in women. The analysis included 250 women, 68 with subclinical depressive symptoms and 182 controls. A clinical examination, oral glucose tolerance test, and lipid and liver enzyme level assessments were performed. Body composition was estimated by dual‑energy X‑ray absorptiometry. The participants completed the Beck Depression Inventory (BDI) questionnaire. The women with subclinical depressive symptoms had higher visceral adipose tissue (VAT) mass than the control group. The groups did not differ in the body mass index, waist circumference, total fat, fat‑free, android, and gynoid fat mass. Homeostatic Model Assessment for Insulin Resistance (HOMA‑IR) and alanine aminotransferase (ALT) activity were higher in the women with subclinical depressive symptoms than in the control group. In the women with subclinical depressive symptoms, we observed a positive correlation between the severity of somatic‑vegetative symptoms reported in the BDI and VAT mass, HOMA‑IR, and gamma glutamyltransferase (GGT) activity. Dysglycemia occurred more frequently in the women with subclinical depressive symptoms. In a subgroup analysis of postmenopausal women, the individuals with subclinical depressive symptoms had higher HOMA‑IR, GGT, ALT, and triglyceride / high‑density lipoprotein cholesterol ratios than the control group. Subclinical depressive symptoms in women might predispose to dysglycemia.

How does stigma influence depressive symptoms among women who underwent termination of pregnancy for foetal anomaly: A path analysis.

The purpose of this study was to explore the effect and paths of stigma on depressive symptoms in women who underwent termination of pregnancy for foetal anomaly (TOPFA). Stigma may cause distress and depressive symptoms for women with TOPFA. However, few studies have examined the relationship between stigma and depression in women with TOPFA. This study followed the STROBE checklist. A cross-sectional survey was conducted among 469 women with TOPFA. The path analysis used hierarchical multiple regression and structural equation model to examine the mediating role of social support and psychological flexibility on the relationship between stigma and depressive symptoms. Hierarchical multiple regression analysis revealed the mediation effect of psychological flexibility between stigma and depressive symptoms. By contrast, social support did not present such effect. The structural equation model confirmed that stigma, directly and indirectly, affected depressive symptoms. Many women with TOPFA have severe depressive symptoms and that stigma is an important influencing factor. Psychological flexibility plays an essential role in mitigating the effects of stigma on depressive symptoms. Healthcare professionals should focus on measuring and intervening on stigma and psychological flexibility for alleviating the depressive symptoms of women with TOPFA. No Patient or Public Contribution.

Bedtime procrastination in the relationship between self-control and depressive symptoms in medical students: From the perspective of sex differences

BackgroundDepressive symptoms typically exhibit sex differences among medical students and are associated with bedtime procrastination (BP) and self-control. However, it remains unclear whether sex differences exist in the relationship between these variables. MethodsA cross-sectional observational study was conducted among 402 medical students from a public university in China. Students’ depressive symptoms, BP, and trait self-control were assessed using the Chinese version of the Beck Depression Inventory (BDI)-II, the Bedtime Procrastination Scale, and the Self-control Scale, respectively. Applying a BDI cutoff value of 14, 364 valid participants were divided into non-depressed (<14) and depressed (≥14) groups. ResultsBinary logistic regression revealed that BP was an independent predictor of the prevalence of depressive symptoms in women only. Hierarchical regression showed that high BP levels were independently positively correlated to more depressive symptoms only in non-depressed women. In contrast, low self-control levels were independently negatively correlated to more depressive symptoms in non-depressed and depressed female students. Furthermore, structural equation modeling reflected the mediating role of BP between self-control and depressive symptoms in the non-depressed female group only. ConclusionsSex differences exist in the effect of BP on depressive symptoms as well as the relationship between self-control and depressive symptoms among Chinese medical students. As a moderator, sex regulates the mediating effect of BP on the relationship between self-control and depressive symptoms in the non-depressed group. These findings provide a sex-specific perspective for targeted prevention and intervention of depressive symptoms among high-risk medical students, especially during the non-depressed period.

Maternal depressive symptom trajectories from preconception through postpartum: Associations with offspring developmental outcomes in early childhood

BackgroundTwo theoretical frameworks, the cumulative stress and match-mismatch model, propose that patterns of maternal depressive symptoms over early periods of offspring development predict outcomes in opposing ways. Studies have yet to test these theories across the preconception, prenatal, and early postnatal period. Study 1 identified trajectories of maternal depressive symptoms from preconception to postpartum. Study 2 examined associations of these trajectories with offspring developmental outcomes in early childhood. MethodsIn Study 1, women (n = 362) enrolled in a longitudinal study were assessed prior to conception and through a subsequent pregnancy and postpartum. In Study 2, a subsample of 125 mother-child pairs completed home visits in early childhood. Mothers reported on child temperament at age 4. Children completed assessments of executive function at age 5. ResultsFour trajectories of maternal depressive symptoms were identified: low-stable, increasing, decreasing, persistent. In controlled analyses, children of women with decreasing symptoms were lower in maternal ratings of effortful control at age four (β = −0.24, p = .003). Children of women with increasing symptoms scored lower on an inhibitory control task at age five (β = −0.35, p = .001). ConclusionsChanges in maternal depressive symptoms, but not stable symptoms, were associated with lower maternal ratings of effortful control and poorer performance on an inhibitory control task. Results are consistent with the match-mismatch model. Assessment of preconception depressive symptoms in women and changes in symptoms may be beneficial for early intervention for women and children.

Sleep disturbance, neuro-immune markers, and depressive symptoms in older age: Conditional process analysis from the English Longitudinal Study of Aging (ELSA)

This study aimed to investigate the long-term association between subjective sleep disturbance and depressive symptoms in older adults, and ascertain whether this association is partially mediated by neuro-immune markers, while testing the moderation of sex using conditional process analyses, i.e., combinations of mediation and moderation analyses. We analysed data of 2124 participants aged 50 and above from the English Longitudinal Study of Ageing (ELSA) across three waves of data collection. Sleep disturbance was assessed in 2008/9, serum levels of high sensitivity C-reactive protein (hs-CRP), insulin like growth factor-1 (IGF-1), white blood cell (WBC) count in 2012/2013, and self-reported depressive symptoms in 2016/2017. After accounting for health-related and psychosocial confounders, results showed that sleep disturbance significantly predicted depressive symptoms at follow-up in the whole sample and hs-CRP in women, but not in men. Hs-CRP also predicted depressive symptoms only in women. Moreover, hs-CRP significantly mediated the association between sleep disturbance and depressive symptoms in women, but not in men. The association between sleep disturbance and IFG-1was marginal, and the latter did not mediate the association between sleep and depressive symptoms neither in women nor in men. Results on WBC count were all non-significant. In conclusion, sleep disturbance resulted significantly associated with depressive symptoms in a long-term follow-up. Moreover, ELSA data provide preliminary evidence that increased inflammation may mediate this association in women. Future longitudinal studies may advance the knowledge in the field considering the mediating role of proinflammatory cytokines such as interleukin-6.

Women's relative earnings and depressive symptoms in dual-earner households in South Korea: Traditional gender role attitudes as moderators.

This study investigated the association between relative earnings and depressive symptoms among 578 married women from dual-earning households. We also examined the moderating role of both spouses' traditional gender role attitudes. Women's relative earnings in their households did not directly predict their depressive symptoms. However, there was a significant three-way interaction effect of women's relative earnings and both spouses' traditional gender role attitudes on women's depressive symptoms. Particularly, women with considerably stronger-than-average traditional gender role attitudes reported more depressive symptoms when their relative earnings were greater and when their husbands showed strong traditional gender role attitudes. However, women holding even slightly weaker-than-average traditional gender role attitudes reported significantly fewer depressive symptoms as their relative earnings increased, even when their husbands showed strong traditional gender role attitudes. These results indicate that traditional wives with high relative earnings may feel threatened by the discrepancy between their values (traditional gender role attitudes) and behaviors (high relative earnings), especially when their husbands hold strong traditional gender role attitudes.

Transcranial Electrical Stimulation for Relief of Peripartum Mental Health Disorders in Women Undergoing Cesarean Section With Combined Spinal-Epidural Anesthesia: A Pilot Randomized Clinical Trial.

ObjectiveThis study aimed to explore transcranial electrical stimulation (tES) to relieve peripartum anxiety and depressive symptoms in women undergoing cesarean section with combined spinal–epidural anesthesia.MethodsThis double-blind, randomized, sham-controlled trial was conducted in the Affiliated Hospital of Xuzhou Medical University from March 2021 and May 2021. One hundred and forty-eight full-term parturients giving birth by elective cesarean section were selected, and 126 were included in the intent-to-treat analysis. Parturients were provided standardized anesthesia and randomized to the active-tES (a-tES) group and sham-tES group. Parturients and outcome assessors were blinded to treatment allocation. The primary outcome was the changes in peripartum mental health disorders, including anxiety, assessed by the Pregnancy-Related Anxiety Questionnaire-Revised 2 (PRAQ-R2). Secondary outcomes included peripartum depressive symptoms, assessed by the Edinburgh Postnatal Depression Scale (EPDS), maternal satisfaction, fatigue level, sleep quality index, and pain score during and after operation. Data were collected before entering the operating room (T0), between post-anesthesia and pre-surgery (T1), before leaving the operating room (T2), and at 24 h post-surgery (T3).ResultsOne hundred and twenty-six eligible parturients were enrolled in the two groups: a-tES group (N = 62) and sham-tES group (N = 64). Treatment with tES resulted in significantly lower scores of anxiety compared with sham-tES (T2: P < 0.001; T3: P = 0.001). Moreover, the a-tES groups showed a significant reduction in depression scores (T2: P = 0.003; T3: P = 0.032).ConclusionIn this randomized pilot study, tES treatment is efficacious in alleviating peripartum anxiety and depressive symptoms in women undergoing cesarean section and has been demonstrated to be a novel strategy for improving peripartum mental health disorders.Clinical Trial Registration[www.chictr.org.cn], identifier [ChiCTR2000040963].

Trajectories and Depressive Symptoms During the Perinatal Period: A Longitudinal Population-Based Study in China.

Most women in the perinatal period face sleep issues, which can affect their mental health. Only a few studies have focused on sleep trajectories and depressive symptoms of women during the perinatal period in China. This study aims to explore the development trajectory of sleep quality by classifying pregnant women according to the changes in their sleep quality during pregnancy and postpartum and investigate the correlation between different sleep quality trajectory groups and depressive symptoms. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality, and the Edinburgh Postnatal Depression Scale (EPDS) was used to assess the symptoms of depression. Participants (n = 412) completed the assessment of sleep quality, depressive symptoms, and some sociodemographic and obstetric data at 36 weeks of gestation, 1 week after delivery, and 6 weeks after delivery. The group-based trajectory model (GBTM) was used to complete the trajectory classification, and logistic regression was used to analyze the predictive factors of postpartum depressive symptoms. Four different sleep quality trajectories were determined: “stable-good,” “worsening,” “improving,” and “stable-poor” groups. The results demonstrate that poor sleep trajectories, social support and parenting experience during the perinatal period are related to postpartum depression. Screening for prenatal sleep problems is crucial for identifying the onset of perinatal depressive symptoms.

Association Between Unequal Division of Caregiving Work and South Korean Married Women's Depressive Symptoms.

Background:A disproportionate amount of family caregiving can negatively impact married women's mental health. This study aims to examine the relationship between depressive symptoms in South Korean women and the satisfaction with their husband's participation in family caregiving.MethodsRaw data from 1,515 of the participants in the 2014, 2016, and 2018 Korean Longitudinal Survey of Women and Families were analyzed. Satisfaction with husbands' participation in family caregiving was classified as satisfied, less satisfied, and not satisfied. The survey used the Center for Epidemiologic Studies Depression Scale to measure depressive symptoms. The association was examined using a generalized estimating equations model.ResultsResults indicated 22.2% of the participating women reported depressive symptoms. Women who reported dissatisfaction with their husband's participation in caregiving were 2.54 times more likely to report depressive symptoms than the women who were satisfied. Subgroup analysis indicated that women with higher levels of education, were more likely to have depressive symptoms when they were not satisfied with their husbands' participation in caregiving.ConclusionMarried women who reported being dissatisfied with their husbands' participation in caregiving were more likely to report depressive symptoms. These results suggest the need to create environments with fair distribution of caregiving duties to minimize depressive symptoms in women.

Role of self-efficacy for pain management and pain catastrophizing in the relationship between pain severity and depressive symptoms in women with breast cancer and pain

Purpose This study evaluated the relationship between pain and depressive symptoms through pain self-efficacy and pain catastrophizing in breast cancer patients with pain. Design Secondary analysis of a randomized trial investigating a cognitive-behavioral pain management protocol. Sample Females (N = 327) with stage I–III breast cancer and report of at least moderate pain. Methods Pain severity, pain self-efficacy, pain catastrophizing, and depressive symptoms were measured. The proposed model was assessed using structural equation modeling. Results Higher pain severity was significantly related to lower pain self-efficacy and higher pain catastrophizing. Lower pain self-efficacy and higher pain catastrophizing were significantly related to more depressive symptoms. Higher pain severity was significantly associated with more depressive symptoms through lower pain self-efficacy and higher pain catastrophizing. The association between pain severity and depressive symptoms was not significant when specified as a direct effect. Conclusion Pain severity related to depressive symptoms in breast cancer patients via pain self-efficacy and pain catastrophizing. Implications for psychosocial providers Measurement of pain self-efficacy and pain catastrophizing should be incorporated into comprehensive pain assessments for women with breast cancer, as these variables may be relevant therapeutic targets. Psychosocial symptom management interventions should include strategies that increase pain self-efficacy and decrease pain catastrophizing because these pain-related cognitive variables appear to drive the relationship between pain severity and depressive symptoms.

Vitamin D Supplementation for the Treatment of Depressive Symptoms in Women with Type 2 Diabetes: A Randomized Clinical Trial.

Aim To determine the efficacy and safety of vitamin D3 supplementation in reducing depressive symptoms in women with type 2 diabetes (T2D), depression, and low vitamin D. Methods In this double-blind randomized active comparator-controlled trial, women with significant depressive symptoms as assessed by the Center for Epidemiologic Studies Depression (CES-D) scale received weekly oral vitamin D3 supplementation (50,000 IU) or an active comparator (5,000 IU) for 6 months. Assessments of vitamin D, 25-hydroxyvitamin D [25 (OH) D], and depression were measured at baseline, 3 months, and 6 months. Results A total of 129 women were randomized, from which 119 completed the study (57 in lower dose and 62 in higher dose). Participants had an average 25 (OH) D and HbA1c of 20.8 ng/mL and 7.8%, respectively, at baseline. They were diverse (48% Black) and had a mean age of 50 and T2D for about 8 years. Upon completion of vitamin D3 supplementation, serum 25 (OH) D levels increased with 50,000 IU (+34 ng/mL) and 5,000 IU (+10 ng/mL). There was no difference in CES-D scores by treatment dose. Overall, depressive symptoms significantly improved over time with an average CES-D decline of 12.98 points (95% CI: −15.04 to −10.93; p < 0.001). Among women with moderate baseline depressive symptoms, those receiving the lower dose had nominally lower depression scores at follow-up than those in the higher dose cohort. Among women with severe baseline depressive symptoms, the improvement in follow-up depression scores was the same regardless of dose. Conclusions There was no difference in the dosing effect of vitamin D3 supplementation for the treatment of depressive symptoms in women with T2D who present with significant symptoms and low vitamin D. Regardless of the dose, participants' mood improved over time. Further study of vitamin D to target depressive symptoms in comorbid populations is needed.

Marital experiences and depressive symptoms among older adults in rural South Africa

This paper advances the understanding of how marital transitions may influence mental health by investigating these associations among a population of rural, Black South Africans aged 40+ that was directly impacted by apartheid. Using two waves of data from 4,176 men and women in Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI), we investigated associations between marital experiences and depressive symptoms, by gender, and explored whether economic resources is a moderator of these associations. We found that experiencing a marital dissolution was associated with more depressive symptoms than remaining married for both men and women. We also found that men, but not women, report greater depressive symptoms if they remained separated/divorced, remained widowed, or remained never married between waves. We found no evidence that a decline in wealth moderated the impact of marital dissolution on depressive symptoms for women or men. These findings suggest that the documented benefits of marriage for mental health, and differences by gender in those benefits, may extend to older, rural South Africans, despite the unique experiences of this population.

Postpartum Depressive Symptoms and Experiences During COVID-19.

Purpose:To identify postpartum depression risk and describe experiences of women in the first 6 weeks after giving birth during the COVID-19 pandemic.Study Design and Methods:Using a convergent mixed-methods approach, we recruited a convenience sample of women living in the United States who gave birth March 1, 2020 or later from social media Web sites. Participants completed the Postpartum Depression Screening Scale-Short Form and provided written answers to open-ended questions regarding their experiences at home with their new infant.Results:Our 262 participants were on average 32.6 years of age, the majority were White (82%), married or partnered (91.9%), and college educated (87.4%). Mean postpartum depression score was 17.7 (SD = 5.9) with 75% scoring ≥14, indicating significant postpartum depressive symptoms. Qualitative content analysis revealed five themes: Isolation and seclusion continue; Fear, anxiety, and stress filled the days; Grieving the loss of normal: It's just so sad; Complicated by postpartum depression: A dark time; and There is a silver lining. Quantitative and qualitative findings provided a holistic view of women's depressive symptoms and experiences at home with their infants during the COVID-19 pandemic.Clinical Implications:Although policies that reduce risk of COVID-19 exposure and infection for patients and the health care team must continue to be implemented, the adverse effects of depressive symptoms on maternal–infant wellbeing within the context of increased isolation due to the pandemic need to be kept at the forefront. Nurses need to be aware of the consequences of women sheltering in place and social distancing on maternal–infant outcomes, particularly on depression and likelihood of breastfeeding.

Associations of combining paid work and family care with gender-specific differences in depressive symptoms among older workers and the role of work characteristics.

ObjectivesThis study aims to provide insight into (i) how the combination of paid work and family care is longitudinally associated with gender-related differences in depressive symptoms and (ii) the role of work characteristics in this association.MethodsData were derived from STREAM, a Dutch prospective cohort study of older workers aged 45–64 years. Respondents were included if they were employed in at least one measurement between 2015 and 2017 (N=12 447). Mixed-models were applied to disentangle between-person (BP) and within-person (WP) effects of family caregiving on depressive symptoms. Analyses were stratified by gender. Work characteristics (social support, autonomy, emotional and mental workload) were separately added to the multivariable models.ResultsFor older employees, family caregiving was positively associated with depressive symptoms between and within persons for both women [BP B=0.80, 95% confidence interval (CI) 0.52–1.08; WP B=0.32, 95% CI 0.08–0.56] and men (BP B=0.75, 95% CI 0.45–1.05; WP B=0.25, 95% CI 0.01–0.48). Social support at work reduced the adverse effect of family care on depressive symptoms for women (BP) and men (BP and WP). Emotional workload partly explained the effect of family care for both women and men (BP).ConclusionsThe longitudinal association between family care and mental health was similar for male and female employees. Resources at work (ie, social support) could protect caregiving employees against depressive symptoms. More research is needed regarding the relative impact of the care context compared to the work context of working family caregivers.

Can the Healthy Start Risk Screen Predict Perinatal Depressive Symptoms among High-Risk Women?

Objectives: Early detection of depression in at-risk populations is critical for ensuring better maternal and child health outcomes. This study assessed whether Healthy Start Prenatal Risk Screening (HSPRS) could predict depressive symptoms in women enrolled in a Healthy Start (HS) program in under-resourced, high-risk communities of Hillsborough County. Methods: Data from HS participants were included for those who were evaluated using the HSPRS and the Edinburgh Postnatal Depression Scale (EPDS). A correlation analysis determined if the HSPRS score was associated with a positive EPDS screen, and HSPRS questions related to the participants psychosocial environment were assessed individually to determine their predictive potential. The crude odds ratio (OR) and adjusted OR (controlling for sociodemographic covariates) were calculated for each question of interest. Results: A total of 736 women were included, with 122 (16.5%) scoring 14 or greater on the EPDS, indicating probable depression risk. There were significant differences between women at risk for depression compared to those not at risk regarding maternal age (p-value = 0.03) and marital status (p-value = 0.01). There were no significant differences in education, ethnicity, or race. The total HSPRS score had a weak yet significant correlation with the EPDS score (r = 0.14, p-value = 0.0001), and seven individual HSPRS questions were significantly associated with risk for perinatal depression. Conclusions for Practice: By focusing on responses to key HSPRS questions rather than the overall score, women may receive access to much needed services more quickly, thereby reducing the risk for poorer maternal and developmental outcomes. Significance: A young maternal age and single marital status have been identified as risk factors for perinatal depression. Additionally, women from racial/ethnic minority groups or low-income populations are more likely to experience depression. Thus, in communities where women exhibit many pre-identified risk factors for perinatal depression, the ability to quickly identify those at the highest risk is imperative. This work indicates that among medically and socially high-risk mothers enrolled in a HS program, the overall HSPRS score was not as predictive of perinatal depression as individual responses to key questions. Attention to these responses could result in women receiving much needed services quicker.

Perceived Social Support Partially Mediates the Impact of Temperament and Character on Postpartum Depression.

IntroductionTemperament and character of pregnant women, especially harm avoidance (HA) and self-directedness (SD) have been identified as risk factors for postpartum depression, in addition to poor social support. However, the relationship between these personality traits and social support for depressive symptoms after delivery has not been examined.MethodsData were extracted from a prospective cohort survey on pregnant women conducted in Nagoya, Japan that included the Temperament and Character Inventory (TCI), the Social Support Questionnaire (J-SSQ), and the Edinburgh Postnatal Depression Scale (EPDS) at approximately week 25 and 1 month postpartum. A mediation analysis using structural equation modeling (SEM) was used to test if social support in pregnancy is a mediator between personality traits and postpartum depressive symptoms.ResultsThousand five hundred and fifty-nine women were included in the analysis. Both harm avoidance and SD were significantly associated with depressive symptoms (total effect: β [SE], 0.298 [0.041], P < 0.001 for harm avoidance; total effect: β [SE], −0.265 [0.067], P < 0.001 for SD). Mediation analysis showed that the effect of harm avoidance on depressive symptoms was partially mediated by low social support (direct effect: β [SE], 0.193 [0.004], P < 0.001; indirect effect: β [SE], 0.082 [0.034], P = 0.015). Self-directedness on depressive symptoms was not found to be mediated by low social support.ConclusionResults indicate that poor social support worsens depressive symptoms in women with high HA during pregnancy. Limitations include a possible selection bias due to the limited target facilities; most variables being evaluated based on self-report questionnaires, and different number of samples available for analysis between harm avoidance and SD.

Sexual Violence as a Key Predictor of Depressive Symptoms in Women: Korean Longitudinal Survey of Women and Families.

The purpose of this study was to identify the influence of violence on depressive symptoms in women. We analyzed panel data from the Korean Longitudinal Survey of Women and Families (n = 6,632). Exposure to sexual violence was a significant predictor of the onset of depressive symptoms. After adjusting for all covariates, other predictors included the perception of a poor or very poor health status than normal and participants in their 40s and 50s versus participants younger than 40 years. Assessing exposure to sexual violence might be beneficial for evaluating depressive symptoms in women who are newly diagnosed with depression.