Unmet needs in mental healthcare for women with clinically significant symptoms of perinatal depression and/or anxiety during the COVID-19 pandemic

IF 5.3 2区医学 Q1 PSYCHIATRY

Acta Psychiatrica Scandinavica Pub Date : 2024-02-11 DOI:10.1111/acps.13664

Raquel Costa, Ana Mesquita, Emma Motrico, Sara Domínguez-Salas, Pelin Dikmen-Yildiz, Sandra Saldivia, Eleni Vousoura, Ana Osorio, Claire A. Wilson, Rena Bina, Drorit Levy, Andri Christoforou, Maria Fernanda González, Camelia Hancheva, Ethel Felice, Tiago Miguel Pinto

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引用次数: 0

Abstract

Objective/Background

Unmet needs in perinatal mental healthcare are an important public health issue particularly in the context of a stressful life event such as the COVID-19 pandemic but data on the extent of this problem are needed.

Aim

The aim of this study is to determine the (1) proportion of women with clinically significant symptoms of perinatal depression, anxiety or comorbid symptoms of depression and anxiety, receiving mental healthcare overall and by country and (2) factors associated with receiving mental healthcare.

Method

Women in the perinatal period (pregnancy or up to 6 months postpartum) participating in the Riseup-PPD-COVID-19 cross-sectional study, reported on sociodemographic, social support health-related factors, and COVID-19 related factors, and on symptoms of depression (Edinburgh Postnatal Depression Scale [EPDS]) and anxiety (Generalised Anxiety Disorder [GAD-7]) using self-report questionnaires. Clinically significant symptoms were defined as EPDS ≥ 13 for depression and GAD-7 ≥ 10 for anxiety. Mental healthcare was defined as self-reported current mental health treatment.

Results

Of the 11 809 participants from 12 countries included in the analysis, 4 379 (37.1%) reported clinically significant symptoms of depression (n = 1 228; 10.4%; EPDS ≥ 13 and GAD-7 ⟨ 10), anxiety (n = 848; 7.2%; GAD-7 ≥ 10 and EPDS ⟨ 13) or comorbid symptoms of depression and anxiety (n = 2 303; 19.5%; EPDS ≥ 13 and GAD-7 ≥ 10). Most women with clinically significant symptoms of depression, anxiety, or comorbid symptoms of depression and anxiety were not receiving mental healthcare (89.0%). Variation in the proportion of women with clinically significant symptoms of depression and/or anxiety reporting mental healthcare was high (4.7% in Turkey to 21.6% in Brazil). Women in the postpartum (vs. pregnancy) were less likely (OR 0.72; 95% CI 0.59-0.88), whereas women with previous mental health problems (vs. no previous mental health problems) (OR 5.56; 95% CI 4.41-7.01), were more likely to receive mental healthcare.

Conclusion

There are high unmet needs in mental healthcare for women with clinically significant symptoms of perinatal depression and/or anxiety across countries during the COVID-19 pandemic. Studies beyond the COVID-19 pandemic and covering the whole range of mental health problems in the perinatal period are warranted to understand the gaps in perinatal mental healthcare.

Abstract Image

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在 COVID-19 大流行期间，围产期抑郁症和/或焦虑症临床症状明显的妇女的心理保健需求未得到满足。

目标/背景：围产期心理保健需求未得到满足是一个重要的公共卫生问题，尤其是在 COVID-19 大流行这样一个紧张的生活事件背景下，但我们需要有关这一问题严重程度的数据。目的：本研究旨在确定：(1) 有临床意义的围产期抑郁症状、焦虑症状或抑郁和焦虑合并症状的妇女接受心理保健的总体比例和国家比例；(2) 与接受心理保健相关的因素：参与 Riseup-PPD-COVID-19 横向研究的围产期妇女（怀孕或产后 6 个月内）通过自我报告问卷，报告了社会人口学、社会支持健康相关因素和 COVID-19 相关因素，以及抑郁症状（爱丁堡产后抑郁量表 [EPDS]）和焦虑症状（广泛性焦虑症 [GAD-7]）。有临床意义的症状是指抑郁症 EPDS ≥ 13，焦虑症 GAD-7 ≥ 10。心理保健定义为自我报告的当前心理保健治疗：在纳入分析的来自 12 个国家的 11 809 名参与者中，有 4 379 人（37.1%）报告了有临床意义的抑郁症状（n = 1 228；10.4%；EPDS ≥ 13 和 GAD-7 ⟨10）、焦虑症状（n = 848；7.2%；GAD-7 ≥ 10 和 EPDS ⟨13）或抑郁和焦虑的合并症状（n = 2 303；19.5%；EPDS ≥ 13 和 GAD-7 ≥ 10）。大多数有临床意义的抑郁、焦虑症状或抑郁和焦虑合并症状的妇女都没有接受心理保健（89.0%）。临床上有明显抑郁和/或焦虑症状的妇女报告接受心理保健的比例差异很大（土耳其为 4.7%，巴西为 21.6%）。产后妇女（与怀孕妇女相比）接受心理保健的可能性较低（OR 0.72；95% CI 0.59-0.88），而以前有心理健康问题的妇女（与以前没有心理健康问题的妇女相比）接受心理保健的可能性较高（OR 5.56；95% CI 4.41-7.01）：结论：在 COVID-19 大流行期间，各国有临床症状的围产期抑郁和/或焦虑妇女的心理保健需求尚未得到满足。为了了解围产期心理保健方面的差距，有必要开展 COVID-19 大流行之外的研究，并涵盖围产期的所有心理健康问题。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Psychiatrica Scandinavica 医学-精神病学

CiteScore

11.20

自引率

3.00%

发文量

135

审稿时长

6-12 weeks

期刊介绍： Acta Psychiatrica Scandinavica acts as an international forum for the dissemination of information advancing the science and practice of psychiatry. In particular we focus on communicating frontline research to clinical psychiatrists and psychiatric researchers. Acta Psychiatrica Scandinavica has traditionally been and remains a journal focusing predominantly on clinical psychiatry, but translational psychiatry is a topic of growing importance to our readers. Therefore, the journal welcomes submission of manuscripts based on both clinical- and more translational (e.g. preclinical and epidemiological) research. When preparing manuscripts based on translational studies for submission to Acta Psychiatrica Scandinavica, the authors should place emphasis on the clinical significance of the research question and the findings. Manuscripts based solely on preclinical research (e.g. animal models) are normally not considered for publication in the Journal.