Meta-Analysis Shows Effective Psychological Treatment for Perinatal Depression

Depression during pregnancy and after the birth of a child is highly prevalent and an important public health problem. Psychological interventions are the first-line treatment and, although a considerable number of randomized trials have been conducted, no recent comprehensive meta-analysis has evaluated treatment effects.

We used an existing database of randomized controlled trials of psychotherapies for adult depression and included studies aimed at perinatal depression. Random effects models were used in all analyses. We examined the effects of the interventions in the short and long term, and also examined secondary outcomes.

Forty-three studies with 49 comparisons and 6270 participants between an intervention and control group were included. The overall effect size was g = 0.67 [95% confidence interval (CI) 0.45~0.89; numbers needed-to-be-treated = 4.39] with high heterogeneity (I2 = 80%; 95% CI 75~85). This effect size remained largely unchanged and significant in a series of sensitivity analyses, although some publication bias was found. The effects remained significant at 6–12 months follow-up. Significant effects were also found for social support, anxiety, functional limitations, parental stress and marital stress, although the number of studies for each outcome was low. All results should be considered with caution because of the high levels of heterogeneity in most analyses.

Psychological interventions are probably effective in the treatment of perinatal depression, with effects that last at least up to 6–12 months and probably also have effects on social support, anxiety, functional impairment, parental stress, and marital stress.

Sex and gender role differences on stress, depression, and anxiety symptoms in response to the COVID-19 pandemic over time

IntroductionStress, depression, and anxiety symptoms have been reported during the pandemic, with important inter-individual differences. Past cross-sectional studies have found that sex and gender roles may contribute to the modulation of one’s vulnerability to develop such symptoms. This longitudinal study aimed to examine the interaction of sex and psychological gender roles on stress, depression, and anxiety symptoms in adults during the COVID-19 pandemic.MethodsFollowing the confinement measures in March 2020 in Montreal, stress, depression, and anxiety symptoms were assessed every 3 months (from June 2020 to March 2021) with the Depression, Anxiety and Stress Scale among 103 females and 50 males. Femininity and masculinity scores were assessed with the Bem Sex Role Inventory before the pandemic and were added as predictors along with time, sex, and the interactions between these variables using linear mixed models.ResultsWe observed similar levels of depressive symptoms between males and females, but higher levels of stress and anxious symptoms in females. No effects of sex and gender roles on depressive symptoms were found. For stress and anxiety, an interaction between time, femininity, and sex was found. At the beginning of the pandemic, females with high femininity had more stress symptoms than males with high femininity, whereas females with low femininity had more anxiety symptoms 1 year after the confinement measures compared to males with low femininity.DiscussionThese findings suggest that sex differences and psychological gender roles contribute to heterogeneous patterns of stress and anxiety symptoms over time in response to the COVID-19 pandemic.

The functional connectome in obsessive-compulsive disorder: resting-state mega-analysis and machine learning classification for the ENIGMA-OCD consortium

Click here for the article published by Molecular Psychiatry. Molecular Psychiatry, Published online: 02 May 2023; doi:10.1038/s41380-023-02077-0 The functional connectome in obsessive-compulsive disorder: resting-state mega-analysis and machine learning classification for the ENIGMA-OCD consortium Continue reading … Disclaimer: The content of this article has not been checked or verified. Proceed at your own risk. Back to …

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Multiple psychotherapeutic approaches and perspectives on eco-anxiety

In highly diverse psychotherapy practices, psychotherapists with their individual schemas and personalities treat patients who are just as individual, each with his/her own partially dysfunctional schema, personality, worldview, and life situation. Intuition gained through experience is often applied, and a wide range of perspectives, techniques, and treatment options appropriate to the specific situation and psychotherapist-patient relationship are required for successful treatment of eco-anxiety manifestations. Several examples will be used to present the approaches of different psychotherapeutic approaches to eco-anxiety such as analytical psychology, logotherapy and existential analysis, psychodrama, and Morita-therapy. The treatment-possibilities-expanding psychotherapy science is presented, which helps psychotherapists to look beyond their original learned approach and learn about new perspectives and treatment methods in a methodologically sound way, which they already do intuitively.

Tracking perceived stress, anxiety, and depression in daily life: a double-downward spiral process

IntroductionPrevious studies using retrospective questionnaires have suggested a complex relationship between perceived stress and related negative emotions and emphasized their importance in mental health. However, how daily perceived stress, anxiety, and depression interact dynamically in a natural context remains largely unexplored.MethodsThis study conducted a longitudinal survey that applied experience sampling methodology to data from 141 Chinese college students (58% women, mean age = 20.1 ± 1.63 years).ResultsThe hierarchical linear models confirmed that daily perceived stress and negative emotions (i.e., perceived depression and anxiety) could reciprocally reinforce one another with the characteristic dynamics of a cognitive–emotional downward spiral. Additionally, anxiety and depression could further circularly aggravate each other imminently. These two intertwined downward-spiral processes constitute a double-downward-spiral model.DiscussionThe findings contribute to a better understanding of the interactive mechanisms underlying perceived stress and its related negative emotions in everyday life and highlight the significance of early emotion regulation and stress relief in healthy people.

Postpartum people’s experiences of and responses to the COVID-19 pandemic during the first year of the pandemic: A descriptive qualitative study

Women’s Health, Volume 19, Issue , January-December 2023. Background:Most evidence on the impact of pandemic on perinatal population’s experiences has reported such effects in a portion of the pandemic.Objectives:The aim of this study was to understand the postpartum people’s experiences of and responses to the coronavirus disease 2019 pandemic during the first year and to identify their health care needs.Design:This is a descriptive qualitative study.Methods:This study was conducted in British Columbia, Canada, between March 2020 and April 2021. Participants (N = 268) were at 4 months postpartum and were recruited as part of the Pregnancy Specific Anxiety Tool study through prenatal care clinics and classes, community laboratory services and social media. Qualitative data were obtained using six online open-ended questions and were analysed using thematic analysis.Results:Findings were grouped under five central themes: protecting baby (with three categories including hypervigilance, constant decision-making to find balance and developmental issues); psychological adjustments (with three categories including coping, anxiety and grief); experience of isolation and lack/loss of support (with two categories including isolation and loss of expected support); unexpected interruptions and life events (with four categories including interrupted maternity leave, unexpected changes/life events, positive impacts and interruption in health care services); and perceived postpartum care needs (with five categories including in-person visits, allowing support persons, providing information/education/support groups, mental health and social support and pro-active check-ins).Conclusion:Several impacts of the pandemic persisted throughout the first year, particularly isolation and lack of support. These findings can inform responsive health care services to address the emerging needs of postpartum people throughout the pandemic.

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