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      Perinatal depression screening and prevention: Descriptive findings from a multicentric program in the South of Italy

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          Abstract

          Introduction

          Perinatal depression (PD) is a cluster of clinical depressive symptoms occurring globally during pregnancy or after childbirth, with a prevalence of 11.9%. Risk factors for PD among pregnant women may include personality traits of neuroticism, low personal resilience, higher anxiety, avoidance in close relationships, as well as dysfunctional coping strategies.

          Methods

          We report on descriptive findings of a screening/prevention program aimed to detect depressive symptoms and associated risk factors in a large sample of women ( N = 1,664) accessing the gynecological departments of the Regione Puglia (South of Italy) from July to November 2020. Pregnant women were assessed in their third trimester of pregnancy (T0), after childbirth (T1), and those at risk for PD within 1 year from delivery (T2–T4); The Edinburgh Postnatal Depression Scale (EPDS) has been employed for the screening of PD over time as well as other standardized measures for neuroticism, resilience, coping strategies, and quality of life.

          Results

          Of 1,664, n = 1,541 were tested at T1, and 131 scored ≥ 12 at EPDS (14.6 ± 2.95), showing a higher risk for PD. They were followed over time at 1, 6, and 12 months after childbirth (T2–T4), and 15 of them scored ≥ 12 (EPDS) at T4. Women with a higher risk of PD also reported higher levels of neuroticism, lower levels of personal resilience, more anxiety and avoidance in close relationships, higher employment of dysfunctional coping strategies (e.g., denial, self-blame, etc.), and lower quality of life (0.0008 < all p < 0.0001).

          Conclusion

          This study confirmed the benefit of screening programs for the early detection of PD among pregnant women. We may suggest a set of risk factors to be considered in the clinical assessment of PD risk as well as the promotion of similar programs to improve depressive outcomes and pathways to care for PD on the basis of a more accurate assessment and referral.

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          Most cited references75

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          Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC).

          Resilience may be viewed as a measure of stress coping ability and, as such, could be an important target of treatment in anxiety, depression, and stress reactions. We describe a new rating scale to assess resilience. The Connor-Davidson Resilience scale (CD-RISC) comprises of 25 items, each rated on a 5-point scale (0-4), with higher scores reflecting greater resilience. The scale was administered to subjects in the following groups: community sample, primary care outpatients, general psychiatric outpatients, clinical trial of generalized anxiety disorder, and two clinical trials of PTSD. The reliability, validity, and factor analytic structure of the scale were evaluated, and reference scores for study samples were calculated. Sensitivity to treatment effects was examined in subjects from the PTSD clinical trials. The scale demonstrated good psychometric properties and factor analysis yielded five factors. A repeated measures ANOVA showed that an increase in CD-RISC score was associated with greater improvement during treatment. Improvement in CD-RISC score was noted in proportion to overall clinical global improvement, with greatest increase noted in subjects with the highest global improvement and deterioration in CD-RISC score in those with minimal or no global improvement. The CD-RISC has sound psychometric properties and distinguishes between those with greater and lesser resilience. The scale demonstrates that resilience is modifiable and can improve with treatment, with greater improvement corresponding to higher levels of global improvement. Copyright 2003 Wiley-Liss, Inc.
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            Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale.

            The development of a 10-item self-report scale (EPDS) to screen for Postnatal Depression in the community is described. After extensive pilot interviews a validation study was carried out on 84 mothers using the Research Diagnostic Criteria for depressive illness obtained from Goldberg's Standardised Psychiatric Interview. The EPDS was found to have satisfactory sensitivity and specificity, and was also sensitive to change in the severity of depression over time. The scale can be completed in about 5 minutes and has a simple method of scoring. The use of the EPDS in the secondary prevention of Postnatal Depression is discussed.
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              You want to measure coping but your protocol's too long: consider the brief COPE.

              Studies of coping in applied settings often confront the need to minimize time demands on participants. The problem of participant response burden is exacerbated further by the fact that these studies typically are designed to test multiple hypotheses with the same sample, a strategy that entails the use of many time-consuming measures. Such research would benefit from a brief measure of coping assessing several responses known to be relevant to effective and ineffective coping. This article presents such a brief form of a previously published measure called the COPE inventory (Carver, Scheier, & Weintraub, 1989), which has proven to be useful in health-related research. The Brief COPE omits two scales of the full COPE, reduces others to two items per scale, and adds one scale. Psychometric properties of the Brief COPE are reported, derived from a sample of adults participating in a study of the process of recovery after Hurricane Andrew.
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                Author and article information

                Contributors
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                05 August 2022
                2022
                : 13
                : 962948
                Affiliations
                [1] 1Department of Clinical and Experimental Medicine, University of Foggia , Foggia, Italy
                [2] 2Department of Medical and Surgical Sciences, University of Foggia , Foggia, Italy
                [3] 3Unit of Gynecology, Di Venere Hospital , Bari, Italy
                [4] 4Unit of Gynecology, Vito Fazzi Hospital , Lecce, Italy
                [5] 5Unit of Psychology, Vito Fazzi Hospital , Lecce, Italy
                [6] 6Dipartimento Promozione Salute , Regione Puglia, Bari, Italy
                [7] 7Dipartimento Promozione Della Salute e del Benessere Animale , Regione Puglia, Bari, Italy
                Author notes

                Edited by: Gaia Sampogna, University of Campania “L. Vanvitelli,” Italy

                Reviewed by: Egor Chumakov, Saint Petersburg State University, Russia; Giulia Menculini, University of Perugia, Italy

                *Correspondence: Antonio Ventriglio, a.ventriglio@ 123456libero.it

                ORCID: Annamaria Petito, orcid.org/0000-0001-7788-3591; Luigi Nappi, orcid.org/0000-0001-7184-0822; Antonio Ventriglio, orcid.org/0000-0002-3934-7007

                These authors share first authorship

                This article was submitted to Public Mental Health, a section of the journal Frontiers in Psychiatry

                Article
                10.3389/fpsyt.2022.962948
                9389401
                35990082
                1acd1e62-8201-4104-a8e6-0f419787ffad
                Copyright © 2022 Bellomo, Severo, Petito, Nappi, Iuso, Altamura, Marconcini, Giannaccari, Maruotti, Palma, Vicino, Perrone, Tufariello, Sannicandro, Milano, Arcidiacono, Di Salvatore, Caroli, Di Pinto and Ventriglio.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 07 June 2022
                : 07 July 2022
                Page count
                Figures: 1, Tables: 8, Equations: 0, References: 75, Pages: 14, Words: 9895
                Categories
                Psychiatry
                Original Research

                Clinical Psychology & Psychiatry
                perinatal depression,pregnancy,epds,screening,prevention
                Clinical Psychology & Psychiatry
                perinatal depression, pregnancy, epds, screening, prevention

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