No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
[Use of an easily administered instrument to detect the risk of postpartum depression]
Abstract
The detection of postpartum depression (PPD) is an important public health issue because of its negative consequences on both the mother's and the infant's health. Up to now, one of the major difficulties is to find a simple and valid instrument able to detect women at risk to develop PPD already during pregnancy. The present article describes a short, simple questionnaire that was developed in Geneva, the Questionnaire de Dépistage Anténatal du risque de Dépression du Postpartum (DAD-P), previously named le Questionnaire de Genève. The authors propose a preventive strategy and follow-up that can be used by any health professional working with pregnant women.
... AD was repeatedly proven to be a strong predictor of PD (20)(21)(22)(23)(24)(25). AD increases the risk of preeclampsia, edema, premature rupture of membranes, hemorrhage, for pregnant women (26)(27)(28)(29)(30). Excessive weight gain, increased substance use, and severe headaches are other problems of AD for pregnant women (31). For the offspring, AD can not only lead to preterm birth or low birth weight, but also has a persistent adverse effect on their neurological, behavioral, and emotional development (30,32,33). ...
Background: Depression is the most prevalent mental health problem in the pregnant women with significant implications for mother and infant’s health. The content of maternal antenatal representations may be related to their depressive symptoms during the perinatal period. Objectives: This study aimed to compare maternal mental representations between depressed and non-depressed groups of pregnant women. Methods: In a causal-comparative study, participants were selected using an inverse stratified sampling method among pregnant women in the last trimester of pregnancy (depressed mothers = 93, and non-depressed mothers = 97). All participants completed Edinburgh Postnatal Depression Scale (EPDS), Dépistage Anténatal de la Dépression Postnatale (DADP), and semi-structure Interview-R after the consent form. Independent- samples t-test, Two-way ANOVA, and Pearson correlation coefficient were applied to compare maternal mental representations subscales between groups, using SPSS-26. Results: The results showed significantly fewer positive ratings for all subscales of Interview-R, including child, partner, self as mother, and mother as own mother in the depressed group (P < 0.05). In the group of depressed mothers, 57% and 32% of the correlations among the representations of child/self as mother and child/partner were significant, while in the non-depressed group, 28% and 48% of the correlations between child/self as mother and child/ partner were significant (P < 0,05), respectively. The characteristics of self as mother and own mother showed significant differences in the depressed group compared to the non-depressed group (P < 0.05). Conclusions: Depressed pregnant mothers are less likely to differentiate themselves from their children compared to non-depressed pregnant mothers. Besids, depressed pregnant mothers perceive themselves as mothers more positively than their own mothers, while the opposite is true for non-depressed pregnant mothers.
This pilot study explores the effects of a brief individual psychoanalytic therapy on perinatal depressive symptoms. This intervention is based on the Geneva's mother-infant intervention model. A sample of 129 pregnant women was recruited in Geneva (Switzerland) and screened for depressive symptoms with two instruments: the 'Edinburgh postnatal depression scale' (EPDS) and the 'Dépistage anténatal de la dépression postnatale'. A group of 40 women presenting depressive symptoms (treatment group) participated in a four-session intervention called 'Psychotherapy centred on parenthood (PCP)'. It consists in two antenatal and two postnatal sessions and is focussed on changing problematic representations of parenthood. This treatment group was compared to a control group of 88 women without depressive symptoms and following the usual obstetrical care. The main outcome measure was EPDS at 3 and 6 months after delivery. The 'Global assessment functioning scale' was administered at the end of each therapeutic session. The 'Parent-infant relationship global assessment scale' was administered at the two postnatal sessions in order to explore if PCP was also effective in preventing the potential negative effects of depression on mother-infant relationship. Results show that in the treatment group (N = 31), EPDS scores dropped from 12.8 to 4.8; none of these women met the EPDS cut-off score of 12 at 3 and 6 months postpartum. Mother-infant relationship was well adapted for all 31 dyads at the end of the intervention. These results suggest that PCP is a promising intervention for treating perinatal depression and helping mothers engaging in parenting.
CONSTRUCTION AND MULTICENTRIC VALIDATION OF AN ANTEPARTUM SCREENING QUESTIONNAIRE OF POSTPARTUM DEPRESSION
Postpartum depression (PPD) can have deleterious effects on the mother, on infant development and on the mother-child relationship. This depressive state often goes undetected by the mother and by her close relations. In order to prevent the installation of this pathological state, it is important to detect it as soon as possible, during pregnancy, using a simple questionnaire. This paper has two aims : first, to present the construction and validation of a prepartum screening questionnaire of PPD. The construction was carried out using a sample of 570 women consulting during the last trimester of their pregnancy at the Maternity Hospital in Geneva. They were examined a second time three months postpartum to establish the postpartum depressive symptoms using the EPDS (Edinburgh Postnatal Depression Scale of Cox, 1987). Logistic regressions applied to the results led to the construction of a short 6-item scale which was completed by 4 additional questions developped from a tree-based analysis. The " Geneva screening procedure " presents a positive predictive value of 45 %. Its validation was carried out in Yverdon (Switzerland), Paris (France) and Bilbao (Spain) on a total population of 816 women. Different results were obtained for the three cities. A more precise screening procedure was developed which made it possible to obtain a predictive value of 46 % in Paris. The predictive values for Bilbao and Yverdon were not satisfactory (respectively 25 and 27 %). A very important bias in our study was the fact that women having had any psychiatric treatment were excluded. This was particularly notable in Yverdon. On the other hand, our screening procedure presents very good specificities and negative predictive values for the three cities (between 87 and 96 %) which means that if a pregnant women is detected as not at risk, she will have very little probability of developing PPD at three months. The " Geneva screening procedure " offers non-psychiatric care-givers an easy and quick method for detecting pregnant women who are at risk for PPD. This makes it possible to create a dialogue with them about the psychological aspects of maternity, particularly concerning depressive moods. If necessary, preventive measures by a psychiatrist can be instigated before the depressive symptoms appear and thus a postpartum depression can be avoided.