Mood and anxiety and their related disorders (AD) account for a significant proportion of mental health conditions, with close to thirty percent of the population (28.8 %) suffering from an AD at some time in their life, and over fifteen percent of the population (16.2 %) suffering from a mood disorder. Half of all depressed patients also report symptoms meeting criteria for one or more AD. Depression is the leading cause of disease-related disability among women, and women are also 1.6–1.7 times more likely to suffer from depression and/or AD during their lifetime than are men. The perinatal period is of particular importance as maternal mood and anxiety difficulties are associated with adverse pregnancy outcomes, compromised parenting, impaired affect and behaviour regulation, and insecure attachment in offspring.
Anxiety during pregnancy is associated with adverse pregnancy outcomes such as miscarriage, preeclampsia, preterm delivery, and low birth weight. Further, children of highly anxious mothers have twice the risk for ADHD. Prenatal anxiety has been identified as a strong predictor of postpartum depression, even after controlling for prenatal depression levels.
In published reports of the prevalence and/or incidence of AD in pregnancy and/or the postpartum in which samples are either representative or unselected, and assessments are based on gold standard assessment methods (i.e., diagnostic interviewing), the prenatal prevalence of AD ranges from 13 to 21 %, with the postpartum prevalence ranging from 11 to 17 %. Postpartum incidence ranged from 2.2 to 8.8 %. None of these studies have included the full spectrum of the AD. A key objective of this research is to estimate the prevalence/incidence of the full spectrum of postpartum AD. If maternal AD are as common as they appear to be, then these disorders have serious negative consequences for a significant proportion of infants/children.
Depression and anxiety in pregnancy represent two of the strongest risk factors for postpartum depression. Similarly, postpartum depression is associated with significant emotional and marital distress as well as compromised physical and social functioning. Although a number of large-scale, high quality studies have assessed the prevalence of pre and postnatal depression (i.e., an episode of major depression), using gold standard assessment methods (i.e., diagnostic interviewing), to our knowledge, these estimates are based exclusively on episodic criteria or symptom severity; they are not based on the full diagnostic criteria for major depressive disorder. Consequently, it is likely that bipolar conditions contribute to the prevalence of postpartum depression. This possibility, to our knowledge, remains uninvestigated, and represents one of the objectives of the current research.
Screening for depression among postpartum women is routine in many places. The Edinburgh Postnatal Depression Scale (EPDS) is the most commonly used self-report instrument for the assessment of postpartum depression. Although the EPDS does contain items specific to anxiety, it is unknown whether the EPDS may be sufficient to detect the majority of women suffering from an AD. As a part of this study we have gathered data to determine if the current EPDS screening for depression is sufficient to detect AD also, or if there is a need for additional screening for anxiety.
Obstetrical complications, by definition, imply a threat to the health and well-being of the mother, her developing infant, or both. Over 20 % of all pregnancies involve obstetrical risks and account for up to 8000 births per year in British Columbia (BC), Canada alone. While pregnancy can be a source of stress and anxiety for women who are experiencing normal, low-risk pregnancy, it is likely much more stressful and anxiety producing for women experiencing a pregnancy fraught with difficulties. It is therefore likely that the prevalence of stress and AD among women experiencing a medically high-risk pregnancy may be even higher. Understanding the extent of stress and anxiety among high-risk obstetrical patients would provide extremely important information regarding the mental health needs of this group of vulnerable women. Despite the serious nature of medically high-risk pregnancies, which contribute to excess maternal and perinatal morbidity and mortality and corner a disproportionate among of health services expenditures, to date there have been no systematic studies of the prevalence of perinatal stress and anxiety among these women. This research aims to address this gap.
อารมณ์ และความวิตกกังวล และโรคที่เกี่ยวข้องของพวกเขา (AD) บัญชีในสัดส่วนที่สำคัญของโรคจิต มีร้อยละสามสิบของประชากร (28.8%) ทุกข์ทรมานจากการโฆษณาในบางเวลาในชีวิตของพวกเขา และกว่าห้าเปอร์เซ็นต์ของประชากร (16.2%) ทุกข์ทรมานจากความผิดปกติของอารมณ์ นอกจากนี้ครึ่งหนึ่งของผู้ป่วยซึมเศร้าทั้งหมดยังรายงานประชุมเกณฑ์สำหรับโฆษณาอย่าง น้อยหนึ่งอาการ ภาวะซึมเศร้าเป็นสาเหตุของการพิการที่เกี่ยวข้องกับโรคสตรี และผู้หญิงยัง 1.6 – 1.7 ครั้งมักประสบภาวะซึมเศร้าและ/หรือโฆษณาในช่วงชีวิตของพวกเขากว่าคน ระยะปริกำเนิดมีความสำคัญเฉพาะเป็นแม่อารมณ์และความวิตกกังวลปัญหาเกี่ยวข้องกับผลร้ายตั้งครรภ์ โจมตีนี่ ความบกพร่องทางด้านผล และควบคุมพฤติกรรม และสิ่งที่แนบที่ไม่ปลอดภัยในลูกหลานความวิตกกังวลระหว่างตั้งครรภ์เป็นเกี่ยวข้องกับผลร้ายตั้งครรภ์ เช่นแท้งบุตร preeclampsia ส่ง preterm น้ำหนักต่ำเกิด เพิ่มเติม เด็กของมารดาสูงกระตือรือร้นมีสองความเสี่ยงสำหรับภาระผูกพัน ความวิตกกังวลก่อนคลอดมีการระบุเป็นจำนวนประตูแข็งแรงโรคซึมเศร้าหลังคลอด แม้หลังจากควบคุมระดับภาวะซึมเศร้าก่อนคลอดในรายงานเผยแพร่ชุกและ/หรืออุบัติการณ์ของโฆษณาในการตั้งครรภ์หรือหลังคลอดซึ่งมีตัวอย่างให้พนักงาน หรือไม่ และประเมินผลตามวิธีการประเมินมาตรฐาน (เช่น วินิจฉัยสัมภาษณ์ข้อมูลส่วนตัว), ชุกก่อนคลอดของโฆษณาช่วง 13 21% มีตั้งแต่ 11 ถึง 17% ส่วนหลังคลอด เกิดหลังคลอดที่อยู่ในช่วงจาก 2.2 8.8% ไม่มีการศึกษาเหล่านี้ได้รวมความถี่ทั้งหมดของโฆษณา วัตถุประสงค์หลักของงานวิจัยนี้จะประเมินชุก/อุบัติการณ์ของความถี่ทั้งหมดของ AD หลังคลอด ถ้าแม่โฆษณาทั่วไป ตามที่ปรากฏเป็น แล้วโรคเหล่านี้มีผลลบอย่างจริงจังในสัดส่วนที่สำคัญของทารก/เด็กDepression and anxiety in pregnancy represent two of the strongest risk factors for postpartum depression. Similarly, postpartum depression is associated with significant emotional and marital distress as well as compromised physical and social functioning. Although a number of large-scale, high quality studies have assessed the prevalence of pre and postnatal depression (i.e., an episode of major depression), using gold standard assessment methods (i.e., diagnostic interviewing), to our knowledge, these estimates are based exclusively on episodic criteria or symptom severity; they are not based on the full diagnostic criteria for major depressive disorder. Consequently, it is likely that bipolar conditions contribute to the prevalence of postpartum depression. This possibility, to our knowledge, remains uninvestigated, and represents one of the objectives of the current research.Screening for depression among postpartum women is routine in many places. The Edinburgh Postnatal Depression Scale (EPDS) is the most commonly used self-report instrument for the assessment of postpartum depression. Although the EPDS does contain items specific to anxiety, it is unknown whether the EPDS may be sufficient to detect the majority of women suffering from an AD. As a part of this study we have gathered data to determine if the current EPDS screening for depression is sufficient to detect AD also, or if there is a need for additional screening for anxiety.Obstetrical complications, by definition, imply a threat to the health and well-being of the mother, her developing infant, or both. Over 20 % of all pregnancies involve obstetrical risks and account for up to 8000 births per year in British Columbia (BC), Canada alone. While pregnancy can be a source of stress and anxiety for women who are experiencing normal, low-risk pregnancy, it is likely much more stressful and anxiety producing for women experiencing a pregnancy fraught with difficulties. It is therefore likely that the prevalence of stress and AD among women experiencing a medically high-risk pregnancy may be even higher. Understanding the extent of stress and anxiety among high-risk obstetrical patients would provide extremely important information regarding the mental health needs of this group of vulnerable women. Despite the serious nature of medically high-risk pregnancies, which contribute to excess maternal and perinatal morbidity and mortality and corner a disproportionate among of health services expenditures, to date there have been no systematic studies of the prevalence of perinatal stress and anxiety among these women. This research aims to address this gap.
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