At the end of 2019, a new form of pneumonia disease known as the corona virus disease 2019 (COVID-19) rapidly spread throughout most provinces of China, and the total global number of COVID-19 cases has surpassed 500 000 by Mar. 27, 2020 (WHO, 2020). On Jan. 30, 2020, the World Health Organization (WHO) declared COVID-19 a global health emergency (WHO, 2020). COVID-19 causes most damage to the respiratory system, leading to pneumonia or breathing difficulties. The confirmed case fatality risk (cCFR) was estimated to be 5% to 8% (Jung et al., 2020). Besides physical pain, COVID-19 also induces psychological distress, with depression, anxiety, and stress affecting the general population, quarantined population, medical staff, and patients at different levels (Kang et al., 2020; Xiang et al., 2020). Previous research on patients in isolation wards highlighted the risk of depressed mood, fear, loneliness, frustration, excessive worries, and insomnia (Abad et al., 2010).
Adult ; Anxiety ; therapy ; Betacoronavirus ; China ; Coronavirus Infections ; psychology ; therapy ; Depression ; therapy ; Dialectical Behavior Therapy ; Female ; Humans ; Pandemics ; Pneumonia, Viral ; psychology ; therapy ; Postpartum Period ; Pregnancy ; Pregnant Women ; psychology

OBJECTIVE: To investigate the association of genetic polymorphisms of norepinephrine metabolizing enzymes with postpartum depression and analyze the risk factors for postpartum depression in women following cesarean section. METHODS: A total of 591 Chinese woman of Han Nationality undergoing caesarean section were enrolled in this study. The diagnosis of postpartum depression was established for an Edinburgh Postnatal Depression Scale (EPDS) score ≥9. For all the women without antepartum depression, the genotypes of catechol-O-methyltransferase (COMT; at 5 sites including rs2020917 and rs737865) and monoamine oxidase A (rs6323) were determined using Sequenom Mass Array single nucleotide polymorphism (SNP) analysis. We analyzed the contribution of the genetic factors (SNPs, linkage disequilibrium and haplotype) to postpartum depression and performed logistic regression analysis to identify all the potential risk factors for postpartum depression and define the interactions between the genetic and environmental factors. RESULTS: The incidence of postpartum depression was 18.1% in this cohort. Univariate analysis suggested that COMT polymorphism at rs2020917 (TT genotype) and rs737865 (GG genotype) were significantly correlated with the occurrence of postpartum depression ( < 0.05). Logistic regression analysis showed that COMT polymorphism at rs2020917 (TT genotype) and rs737865 (GG genotype), severe stress during pregnancy, and domestic violence were the risk factors for postpartum depression ( < 0.05); no obvious interaction was found between the genetic polymorphisms and the environmental factors in the occurrence of postpartum depression. CONCLUSIONS The rs2020917TT and rs737865GG genotypes of COMT, stress in pregnancy, and domestic violence are the risk factors for postpartum depression.
Catechol O-Methyltransferase ; genetics ; Cesarean Section ; adverse effects ; Depression, Postpartum ; diagnosis ; enzymology ; genetics ; Domestic Violence ; psychology ; Female ; Gene-Environment Interaction ; Genotype ; Haplotypes ; Humans ; Linkage Disequilibrium ; Monoamine Oxidase ; genetics ; Norepinephrine ; metabolism ; Polymorphism, Single Nucleotide ; Postoperative Complications ; diagnosis ; enzymology ; genetics ; Pregnancy ; Pregnancy Complications ; etiology ; psychology ; Risk Factors ; Stress, Psychological

To explore the correlation between kynurenine (KYN) metabolites and postpartum depression (PPD), and to provide new possible explanation for the pathogenesis of postpartum depression (PPD).
 Methods: A total of 726 Chinese women, who received cesarean section, were enrolled in this study. PPD was diagnosed with an Edinburgh Postnatal Depression Scale (EPDS) score ≥13. Twenty-four women with PPD and 48 matched women without PPD were randomly selected. The perinatal serum concentrations of KYN, quinolinic acid (QUIN) and kynurenic acid (KYNA) were measured. Subsequently, the puerperants were compared for the differences in the serum concentrations of KYN, QUIN and KYNA at the end of term, day 1 and day 3 after cesarean section, respectively.
 Results: The incidence of PPD was 7.99%. Of clinical characteristics, pressure during pregnancy was significantly different between subjects with or without PPD (P<0.01). Patients with PPD showed significantly increased serum KYN concentration (P<0.05) at the end of term, increased serum QUIN concentration (P<0.05) and decreased KYNA concentration (P<0.05) on the third day after cesarean section as compared with the control women. Furthermore, the KYNA/QUIN ratio was significantly higher in patients with PPD as compared to the control women on the third day after cesarean section (P<0.01).
 Conclusion: The contribution of alterations in plasma levels of KYN, QUIN and KYNA is closely related with the incidence of PPD, and correction of KYNA/QUIN ratio could be a new strategy for the prevention and treatment of postpartum depressive symptoms.
Biomarkers ; blood ; Cesarean Section ; psychology ; China ; epidemiology ; Depression, Postpartum ; blood ; epidemiology ; Female ; Humans ; Incidence ; Kynurenic Acid ; blood ; Kynurenine ; blood ; Pregnancy ; Quinolinic Acid ; blood

INTRODUCTIONThis study aimed to examine how improving infant sleep impacted the emotional well-being of mothers.

METHODSThe participants were 80 mothers of infants aged 6-12 months; they attended a primary care medical clinic in Adelaide, Australia, for assistance with infant sleep problems. Behavioural intervention consisted of a 45-minute consultation, where verbal and written information describing sleep physiology and strategies to improve infant sleep was provided. Mothers were followed up 2-6 weeks later. Mothers rated their confidence (C), pleasure (P) and frustration (F) on a scale from 0 to 10, and completed the Depression Anxiety Stress Scale 21 at each consultation. The number of night-time awakenings and time taken to see an improvement in infant sleep were also reported.

RESULTSThere was a significant increase in the C and P scores, and a significant decrease in the F scores (all p < 0.001). The mean total CPF score increased significantly from 14 to 25 (maximum score = 30). There was also a significant decrease in depression, anxiety and stress in the mothers (all p < 0.001). The mean number of maximum night awakenings also decreased significantly, from 4.9 to 0.5 (p < 0.001). The mean time taken to see improved infant sleep, as reported by the mothers, was 2.8 nights.

CONCLUSIONA single consultation using a behavioural strategy to improve infant sleep was effective in improving infant sleep and in increasing maternal emotional well-being. In particular, the scores for 'pleasure in being a mother' increased dramatically.

Adult ; Australia ; Depression, Postpartum ; etiology ; prevention & control ; psychology ; Female ; Humans ; Infant ; Infant Care ; methods ; Middle Aged ; Mother-Child Relations ; Mothers ; psychology ; Psychiatric Status Rating Scales ; Sleep Wake Disorders ; complications ; prevention & control

To estimate the national prevalence of paternal postpartum depression in China and evaluate its association with maternal postpartum depression.
 Methods: Systematic literature searches were conducted in databases including PubMed, Web of Science, Embase, Medline, China National Knowledge Infrastructure (CNKI), Wangfang Database, Chinese science & technology journal database (VIP) and SinoMed database. The articles reported the prevalence of paternal postpartum depression in China were collected from inception to October 1, 2015. Random effect models were used to calculate pooled estimates and 95% confidence intervals. Subgroup analysis were undertaken by period of measurement, case identification, study location and study quality.
 Results: Fourteen studies with a total sample size of 3 819 partners were included in this study. The pooled estimate of paternal postpartum depression was 13.6% (95% CI 8.7%-21.3%). The Pearson correlation coefficien between maternal PPD and paternal PPD was 0.295 (95% CI 0.218-0.367). The subgroup analysis showed that the estimates of paternal PPD in 0-5+6 weeks postpartum, 6-8 weeks postpartum and 8+1-24 weeks postpartum were 28.7%, 11.4% and 5.5%, respectively; when the rating scale was used as case identification method, the estimate of paternal PPD was 16.8%, and it was 4.1% when interview was used. The estimate of paternal PPD in inner areas was 22.2%, in coastal areas was 13.3% and in Hongkong/Taiwan was 7.8%. In studies with lower quality, the estimate of paternal PPD was 23.0%, and it was 9.1% in studies with higher quality.
 Conclusion: The national prevalence of paternal postpartum depression in China was at a high level, particularly during the postpartum 0-5+6 weeks. Paternal postpartum depression also showed a moderate positive correlation with maternal postpartum depression.
Asian Continental Ancestry Group ; China ; epidemiology ; Depression, Postpartum ; epidemiology ; Fathers ; psychology ; Female ; Humans ; Male ; Mothers ; psychology ; Postpartum Period ; Prevalence

PURPOSE: This study was done to develop a prediction model for postpartum depression by verifying the mediation effect of antepartum depression. A hypothesized model was developed based on literature reviews and predictors of postpartum depression by Beck. METHODS: Data were collected from 186 pregnant women who had a gestation period of more than 32 weeks and were patients at a maternity hospital, two obstetrics and gynecology specialized hospitals, or the outpatient clinic of K medical center. Data were analysed with descriptive statistics, correlation and exploratory factor analysis using the SPSS/WIN 18.0 and AMOS 18.0 programs. RESULTS: The final modified model had good fit indices. Parenting stress, antepartum depression and postpartum family support had statistically significant effects on postpartum depression, and defined 74.7% of total explained variance of postpartum depression. Antepartum depression had significant mediation effects on postpartum depression from stress in pregnancy and self-esteem. CONCLUSION: The results of this study suggest that it is important to develop nursing interventions including strategies to reduce parenting stress and improve postpartum family support in order to prevent postpartum depression. Especially, it is necessary to detect and treat antepartum depression early to prevent postpartum depression as antepartum depression can affect postpartum depression by mediating antepartum factors.
Adult ; Depression/*psychology ; Depression, Postpartum/etiology/*psychology ; Female ; Gestational Age ; Humans ; *Models, Theoretical ; Parenting/psychology ; Postpartum Period ; Pregnancy ; Pregnant Women/*psychology ; Self Efficacy ; Social Support ; Stress, Psychological ; Surveys and Questionnaires

PURPOSE: To identify the effects of foot reflexology massage on fatigue, stress and depression of postpartum women. METHODS: A nonequivalent control group pre-post design was used. A total of 70 women in a postpartum care center were recruited and were assigned to the experimental group (35) or control group (35). Foot reflexology massage was provided to the experimental group once a day for three days. Data were collected before and after the intervention program which was carried out from December, 2013 to February, 2014. Data were analyzed using Chi-square test, Fisher's exact test, and t-test. RESULTS: The level of fatigue in the experimental group was significantly lower than the control group (t= - 2.74, p =.008). The level of cortisol in the urine of women in the experimental group was significantly lower than the control group (t= - 2.19, p =.032). The level of depression in the experimental group was significantly lower than the control group (t= - 3.00, p =.004). CONCLUSION: The results show that the foot reflexology massage is an effective nursing intervention to relieve fatigue, stress, and depression for postpartum women.
Adult ; Depression, Postpartum/*prevention & control ; *Fatigue ; Female ; Foot ; Humans ; Hydrocortisone/blood ; Infant, Newborn ; Male ; *Massage ; Postpartum Period/*psychology ; *Stress, Psychological ; Surveys and Questionnaires

PURPOSE: Prenatal depression is a significant predictor for postpartum depression. However, there is a lack of research on risk factors for Korean women related to prenatal depression and the relationship between prenatal depression during the three trimesters and postpartum depression. Therefore, aims of this study were (1) to identify the prevalence of depression during all three trimesters and the postpartum period, (2) to evaluate the relationship between prenatal depression in each trimester and postpartum depression, and (3) to identify the relationship and differences in prenatal depression based on sociodemographic factors in Korean women. METHODS: One hundred and fifty three Korean women were recruited from three maternity clinics in Korea. Prenatal and postpartum depressions were evaluated in the first, second (24-26 weeks), third (32-34 weeks) trimester and 4 weeks postpartum with the Edinburgh Postnatal Depression Scalee-Korean. RESULTS: The prevalence of depression in the prenatal and postpartum period ranged from 40.5% to 61.4%. Depression in the second and the third trimester was significantly correlated with depression in the postpartum period. Unemployment and household income were risk factors for prenatal depression in the first and second trimesters. CONCLUSIONS: To assist women suffering from postpartum depression and prevent its effects, women should be screened for prenatal depression during all three trimesters. For Korean women with high risk factors for prenatal depression, we suggest that the Korean government establish healthcare policies related to depression screening as routine prenatal care and mental health referral systems.
Adult ; Depression/*epidemiology ; Depression, Postpartum/*epidemiology ; Female ; Humans ; Longitudinal Studies ; Postpartum Period/*psychology ; Pregnancy ; Pregnancy Trimesters/*psychology ; Prenatal Care ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors ; Socioeconomic Factors ; Young Adult

The postpartum depression outcome and the effect of psychological intervention were studied in order to reduce the occurrence and development of the postpartum depression. A survey of 4000 women within 4-6 weeks postpartum in 80 communities in Shenzhen, China was performed using random cluster sampling method. By employing Edinburgh Postnatal Depression Scale (EPDS) as a screening tool, the positive women (defined as EPDS ≥10) were randomly divided into intervention group and control group at a ratio of 1:2. The women in the intervention group were treated by means of mailing postpartum depression prevention and treatment knowledge manual, face-to-face counseling, and telephone psychological counseling interventions aiming at individual risk factors, while those in the control group were treated with conventional methods. EPDS scores were assessed in these two groups again at 6th month postpartum. Totally, 3907 valid questionnaires were obtained. All the 771 positive women were divided into two groups: 257 in the intervention group, and 514 in the control group. At 6th month postpartum, the EPDS scores in the intervention group were decreased significantly, from baseline stage (12.84±3.02) to end stage (3.05±2.93), while EPDS scores in the control group were reduced from 12.44±2.78 to 6.94±4.02. There were significant differences in the EPDS scores at end stage between the two groups (t=13.059, P<0.001). Psychological intervention can reduce postpartum depression, with better maternal compliance. It is feasible and necessary to establish postpartum depression screening and psychological intervention model in community-hospital and include the postpartum depression screening, intervention, and follow-up into the conventional healthcare.
Adolescent ; Adult ; Depression, Postpartum ; diagnosis ; psychology ; therapy ; Female ; Follow-Up Studies ; Humans ; Interview, Psychological ; Mass Screening ; Psychotherapy ; methods ; Risk Factors ; Surveys and Questionnaires ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the prevalence and risk factors of postpartum depression (PPD) in Tianhe district of Guangzhou.

METHODSA total of 1428 postpartum women in 3 hospitals in Tianhe District of Guangzhou were screened with Edinburg Postnatal Depression Scale (EPDS), Social Support Rating Scale (SSRS) and a self-designed questionnaire of PPD-related factors during the period from May to September, 2013.

RESULTSThe prevalence of PPD was 20.03% in these women. Unconditional logistic regression analysis showed a significant correlation of PPD with education, delivery mode, only daughter, relationship between mother-in-law and daughter-in-law, newborn gender satisfaction and housing condition (P<0.05). Multivariate logistic regression analysis identified education, delivery mode, only daughter, relationship between mother-in-law and daughter-in-law, and newborn gender satisfaction as the risk factors for PPD, and housing condition was negatively correlated with the incidence of PPD with an OR value of 0.900. Compared with healthy postpartum women, the patients with PPD exhibited significantly reduced total score of social support rating scale, score of objective support, score of subjective support, and social utilization degree.

CONCLUSIONThe prevalence of PPD is high in Tianhe District of Guangzhou, and health education and psychosocial intervention should be offered to prevent PPD.

Adult ; China ; epidemiology ; Depression, Postpartum ; epidemiology ; Female ; Humans ; Incidence ; Postpartum Period ; psychology ; Prevalence ; Risk Factors ; Young Adult