Is It Useful to Screen for Anxiety using the GAD-7 in Pregnant Women?

Research Paper Title

Validation of the Generalised Anxiety Disorder Screener (GAD-7) in Spanish Pregnant Women.

Background

Anxiety during pregnancy is one of the most common mental health problems and a significant risk factor for postpartum depression. The Generalised Anxiety Disorder-7 (GAD-7) is one of the most widely used self-report measures of anxiety symptoms available in multiple languages. This study evaluates the psychometric properties and underlying factor structures of the Spanish GAD-7 among pregnant women in Spain.

Methods

Spanish-speaking pregnant women (N = 385) were recruited from an urban obstetrics setting in Northern Spain. Women completed the GAD-7 and the anxiety subscale of the Symptom Checklist (SCL90-R) at three time points, once per trimester. The reliability, concurrent validity, and factor analyses were conducted to evaluate the psychometric properties and factor structure, respectively.

Results

In the first trimester, the GAD-7 demonstrated good internal consistency (a = 0.89). GAD-7 is positively correlated with SCL90-R (anxiety subscale; r=0.75; p < 0.001). The proposed one-factor structure is found using exploratory factor analysis -FACTOR programme – with Unweighted Least Squares procedure and optimal implementation of parallel analysis (GFI = 0.99).

Conclusions

Health providers should screen for anxiety using the GAD-7 during pregnancy among urban Spanish-speaking samples to provide appropriate follow-up care.

Reference

Soto-Balbuena, C. Rodriguez-Munoz, M.F. & Le, H-N. (2021) Validation of the Generalized Anxiety Disorder Screener (GAD-7) in Spanish Pregnant Women. Psicothema. 33(1), pp.164-170. doi: 10.7334/psicothema2020.167.

Education & Training should Aim to improve the Recognition & Treatment of Postpartum OCD

Research Paper Title

Advances in the pharmacological management of obsessive-compulsive disorder in the postpartum period.

Background

Obsessive-compulsive disorder (OCD) is a psychiatric disorder characterised by obsessions and compulsions.

Obsessions are defined as intrusive, recurrent and distressing thoughts, images or impulses, whereas compulsions are defined as repetitive behaviours or mental acts.

While there is an associated distress, and indeed oftentimes, the individual’s awareness that these behaviours are excessive and unreasonable, the individual continues to be disabled by an inability to cease their compulsions.

The postpartum period may herald the onset of OCD or precipitate an exacerbation of the preexisting OCD symptoms.

Common OCD symptom clusters occur in the postpartum period, with specific challenges associated with motherhood and lactation.

Areas Covered

This brief review aims to review the extent and nature of publications evaluating pharmacological treatment of OCD in the postpartum period.

Expert Opinion

Education and training should aim to improve the recognition and treatment of postpartum OCD.

Due to the limited nature of studies, more research is required to assess the role of selective serotonin reuptake inhibitors in the postpartum period.

Reference

Brakoulias, V., Viswasam, K., Dwyer, A., Raine, K.H. & Starcevic, V. (2020) Advances in the pharmacological management of obsessive-compulsive disorder in the postpartum period. Expert Opinion on Pharmacotherapy. 21(2), pp.163-165. doi: 10.1080/14656566.2019.1700229. Epub 2020 Jan 1.

Postpartum: Linking Poor Body Image & Depressive Symptoms

Research Paper Title

A qualitative insight into the relationship between postpartum depression and body image.

Background

This study qualitatively explored the experience of depression and body image concerns in women diagnosed with depression in the postpartum period.

Women’s bodies undergo substantial changes during the perinatal period which can impact their body image and mood post-birth.

However, it remains unknown how women diagnosed with depression experience their body image in the postpartum period.

Methods

Seventeen women in their first postpartum year completed qualitative telephone interviews: seven women diagnosed with depression and ten without depression.

Thematic content analysis identified the main themes of the women’s narratives:

  • Expectations and adjustments to motherhood;
  • Mood in response to changing postpartum body;
  • The context of feeling bad about my body; and
  • Body letting me down and relationship to mood.

Results

Differences in the relationship between body image and mood for postpartum women with depression compared to women without depression were revealed.

Other themes seemed to be experienced in the same way by women with and without depression.

Conclusions

Poor body image and depressive symptoms appear linked during postpartum.

An improved understanding of this association may assist postpartum women to manage negative body image post-birthand prevent the exacerbation of negative emotional health in this period.

Reference

Hartley, E., Fuller-Tyszkiewicz, M., Skouteris, H. & Hill, B. (2020) A qualitative insight into the relationship between postpartum depression and body image. Journal of Reproductive and Infant Psychology. 1-13. doi: 10.1080/02646838.2019.1710119. [Epub ahead of print].

Do Pregnant & Postpartum Women in OUD Treatment have the Potential to Benefit from Access to PSS throughout their Perinatal Period?

Research Paper Title

Peer support specialists and perinatal opioid use disorder: Someone that’s been there, lived it, seen it.

Background

Perinatal opioid use disorder (OUD) has increased drastically since 2000 and is associated with myriad adverse outcomes.

The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends using peer support services to promote sustained remission from substance use disorders (SUDs).

Integrating peer support specialists into perinatal OUD treatment has the potential to improve maternal and child health.

However, there is limited published research on the experiences of pregnant and parenting women with peer support specialists during SUD treatment.

The purpose of this study was to:

  1. Describe experiences of perinatal women undergoing OUD treatment with peer support specialists; and
  2. Describe recommendations for improving or enhancing peer support services.

Methods

For this qualitative descriptive study, the researchers conducted two focus groups in a private location in a clinic that serves postpartum women with OUD (N = 9) who were parenting a child under the age of 5.

The focus groups were voice recorded, professionally transcribed, and analyzed in MAXQDA using content analysis.

Results

Four themes emerged from the data:

  1. Feeling Supported by Peer Support Specialists;
  2. Qualities of an ‘Ideal’ Peer Support Specialist;
  3. Strategies to Improve Interactions with Peer Support Specialists; and
  4. Importance of Communication Across the Perinatal Period.

Participants reported that PSSs had a strong, positive impact on their recovery.

Postpartum women report overall positive experiences receiving peer support services during their pregnancy and postpartum period.

However, participants offered suggestions to improve their interactions with PSSs, such as clarifying the boundaries between peer supporters and clients.

Conclusions

Pregnant and postpartum women in OUD treatment have the potential to benefit from access to PSS throughout their perinatal period.

Future research is needed to determine the impact of PSS on sustained recovery for perinatal women with OUD.

Reference

Fallin-Bennett, A., Elswick, A. & Ashford, K. (2019) Peer support specialists and perinatal opioid use disorder: Someone that’s been there, lived it, seen it. Addictive Behaviors. 102:106204. doi: 10.1016/j.addbeh.2019.106204. [Epub ahead of print].