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Cross-National Differences in Psychosocial Factors of Perinatal Depression: A Systematic Review of India and Japan.

ABSTRACT: Perinatal depression is prevalent worldwide. However, there are few available studies that discuss the different cultural factors affecting perinatal depression within Asian countries. This study aims to compare the literature regarding related factors relating to perinatal depression in India and Japan, and to synthesize the evidence common to both countries in addition to the country-specific evidence. We conducted a systematic review using several databases (CINAHL, MEDLINE, Pubmed, Ovid, SCOPUS, IndMED, and ICHUSI). Keywords were "antenatal depression" or "postpartum depression", and "India" or "Japan". Both Japanese and English language papers were reviewed. The identified evidence was compared between the two countries, as well as with non-Asian countries based on previous reports. In total, 15 articles on India and 35 on Japan were reviewed. Although several factors were shared between the two countries as well as with other non-Asian countries (vulnerable personality, being abused, age, marital conflict, and lower socio-demographic status), some differing factors were identified between India and Japan and non-Asian countries; India: poor socioeconomic status, living only with the husband, pregnancy not welcomed by the husband, a female baby, and poor relationship with in-laws; Japan: infertility treatment, conflict with work-life balance, poor relationships with biological mother or in-laws, and concerns about social relations with the other mother's friends. To conclude, involving the family and community may be important for implementing both global standardized and culture-specific interventions. In India, treatment involving the in-laws may be effective because large family structure is a significant predictor of perinatal depression. In Japan, a family/community approach involving not only the mother's family of origin but also the working environment is essential.

SUBMITTER: Takegata M

PROVIDER: S-EPMC5746725 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature

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Cross-National Differences in Psychosocial Factors of Perinatal Depression: A Systematic Review of India and Japan.

Takegata Mizuki M Ohashi Yukiko Y Lazarus Anisha A Kitamura Toshinori T

Healthcare (Basel, Switzerland) 20171204 4

Perinatal depression is prevalent worldwide. However, there are few available studies that discuss the different cultural factors affecting perinatal depression within Asian countries. This study aims to compare the literature regarding related factors relating to perinatal depression in India and Japan, and to synthesize the evidence common to both countries in addition to the country-specific evidence. We conducted a systematic review using several databases (CINAHL, MEDLINE, Pubmed, Ovid, SCO ...[more]

PMID: 29207561

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Project description:Background:Perinatal depression is associated with negative effects on child behavioural, cognitive and emotional development, birth outcomes, and physical growth. In India, increased priority accorded to mental health programs mean it is now possible to reduce the population-level burden of perinatal depression. In this secondary analysis of two studies, we aimed to describe the epidemiological features of depression among community- and facility-based samples of perinatal women from rural central India, and to describe the help-seeking behaviours from those women who screened positive for depression. Methods:The Community Study was a multi-round population-based cross-sectional survey (n?=?6087). The Facility Study was a multi-round facility-based cross-sectional survey (n?=?1577). Both studies were conducted in Sehore District, Madhya Pradesh between 2013 and 2017. Field workers conducted structured interviews with perinatal women. The questionnaire had sections relating to sociodemographic characteristics, depression screening using the Patient's Health Questionnaire (PHQ9), treatment seeking for depression-related symptoms, and disability. Using data pooled from both studies, we tested each characteristic for association with the total screening score and with screening positive for depression. Results:We identified 224 perinatal women from the Community Study and 130 perinatal women from the Facility Study, of whom 8.8% and 18.5% screened positive for depression, respectively. For the continuous PHQ9 score, there was evidence of a "U" shaped association with age, and positive associations with pregnancy, disability score, suicidality and being a health facility attendee. For the binary PHQ9 score, there was evidence of positive associations with pregnancy, disability score, suicidality and being a health facility attendee. Conclusions:This study highlights where the largest population-level variations in perinatal depression symptoms are present in this Indian sample, for which mental health service provision should be made a priority. Epidemiological evidence generated by this study, as well as new evidence on peer-delivered interventions for perinatal depression, must be utilized by policy-makers to prioritize mental health services for mothers along with maternal and child health services.

Project description:AimsFew studies have investigated risk factors for psychotic major depression (PMD). We aimed to investigate the biological and psychosocial risk factors associated with PMD compared with other psychotic disorders.MethodsBased on the aetiology and ethnicity in schizophrenia and other psychoses (ÆSOP) study, we used a case-control study to identify and recruit, at baseline and 10-year follow-up, all first episode cases of psychosis, presenting for the first time to specialist mental health services in defined catchment areas in the UK. Population-based controls were recruited from the same areas. Data were collected on: sociodemographics; social isolation; childhood adversity; life events; minor physical anomalies; and neurological soft signs.ResultsLiving alone (aOR = 2.26, CI = 1.21-4.23), basic level qualification (aOR = 2.89, CI = 1.08-7.74), being unemployed (aOR = 2.12, CI = 1.13-3.96), having contact with friends less than monthly (aOR = 4.24, CI = 1.62-11.14), having no close confidants (aOR = 4.71, CI = 2.08-10.68), having experienced childhood adversity (aOR = 2.57, CI = 1.02-6.44), family history of mental illness (aOR = 10.68, CI = 5.06-22.52), family history of psychosis (aOR = 12.85, CI = 5.24-31.51), and having more neurological soft signs (aOR = 1.15, CI = 1.07-1.24) were all associated with a follow-up diagnosis of PMD and schizophrenia. Few variables associated with PMD were also associated with a diagnosis of bipolar disorder. Minor physical anomalies were associated with a follow-up diagnosis of schizophrenia and bipolar disorder, but not PMD.ConclusionsRisk factors associated with PMD appear to overlap with those for schizophrenia, but less so for bipolar disorder. Future work on the differential aetiology of PMD, from other psychoses is needed to find the 'specifier' between PMD and other psychoses. Future research on aetiology in PMD, and perhaps other psychoses, should account for diagnostic change.

Project description:BACKGROUND:Perinatal depression and anxiety are increasingly recognized as important public health issues in low and middle-income countries such as Rwanda and may have negative consequences for both mothers and their infants. Maternal mental health may be particularly challenged in Rwanda because of the prevalence of risk factors such as poverty, low education levels, negative life events and marital problems. However, there are limited data about perinatal depression and anxiety symptoms in Rwanda. This study thus aimed to explore the prevalence of symptoms of perinatal depression and anxiety in Rwanda, and factors associated with them. METHODS:A sample of 165 women in the perinatal period (second and third trimester of pregnancy, up to 1 year postnatal) were interviewed individually over 1 month in October 2013. Women were interviewed at 5 of 14 health centres in the Eastern Province or the affiliated district hospital. Participants answered socio-demographic questions and scales measuring symptoms of perinatal depression (EPDS: Edinburgh Postnatal Depression Scale) and anxiety (SAS: Zung Self-rating Anxiety Scale). RESULTS:Among women in the antenatal period (N?=?85), 37.6% had symptoms indicating possible depression (EPDS ?10) and 28.2% had symptoms associated with clinical levels of anxiety (SAS?>?45). Among women within the postnatal period (N?=?77), 63.6% had symptoms of possible depression, whereas 48,1% had symptoms of probable anxiety. Logistic regression showed that symptoms of postnatal depression were higher for respondents who had four or more living children relative to those having their first child (Odds Ratio: 0.07, C.I. = 0.01-0.42), and for those with a poor relationship with their partner (Odds Ratio: .09, C.I. =0.03-0.25). Any lifetime exposure to stressful events was the only predictor of symptoms of postnatal anxiety (Odds Ratio?=?0.20, C.I. = 0.09-0.44). CONCLUSIONS:Symptoms of postnatal depression and anxiety were prevalent in this Rwandan sample and most strongly predicted by interpersonal and social factors, suggesting that social interventions may be a successful strategy to protect against maternal mental health problems in the Rwandan context.

Project description:BackgroundPerinatal mental health issues affect approximately 10% of women in high-income countries and 30% in low- or middle-income countries. This review aims to determine the prevalence of perinatal depression among mothers and fathers in Pakistan and identify associated risk factors.MethodsWe conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We included quantitative studies on the prevalence or incidence of maternal and paternal perinatal depression, including antenatal or postnatal depression in Pakistan, with or without associated risk factors. We performed an electronic search, dual-title/abstract and full-text screening, and data extraction. Analysis was conducted on Revman and JBI SUMARI software. The quality of the included studies was assessed with the NHLBI tool. This review updated a previously published review that included 43 studies, with the last search date of 31st May 2019, now extended to literature published up to June 30, 2023.ResultsConsistent with the previous review, our analysis of 61 studies indicated a pooled prevalence of 37% (95% confidence interval (CI): 30.6-43.6) for maternal antenatal depression. Postnatal depression at different time points, revealed rates of 34.2% (95% CI: 22.7-46.7), 40.9% (95% CI: 0-97.4), and 43.1% (95% CI: 24.4-62.9) at 3, 6 and 12 months, respectively. Paternal postnatal depression was observed at 40.5% (95% CI: 14.9-69) based on two studies. Risk factors for maternal perinatal depression include multiparity, contraceptive failure, inadequate antenatal care, pregnancy-induced hypertension, previous psychiatric illness, passive smoking, drug abuse, low socio-economic status, marital problems, family hardships, recent bereavement, housing difficulties, food insecurity, husband's illiteracy, his unemployment, and being blamed for child disability.ConclusionThe findings reveal a high prevalence of perinatal depression among mothers with very limited evidence of fathers residing in Pakistan, emphasising the need for prospective studies addressing mental health challenges.RegistrationThis review is registered on PROSPERO (CRD42023442581).

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Cross-National Differences in Psychosocial Factors of Perinatal Depression: A Systematic Review of India and Japan.

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Cross-National Differences in Psychosocial Factors of Perinatal Depression: A Systematic Review of India and Japan.

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