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      Maternal Psychological Distress & Mental Health Service Use During the COVID-19 Pandemic

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          Research Highlights

          • Maternal depression and anxiety prevalence rates appear elevated during COVID-19

          • Risk factors for depression and anxiety were evaluated based on child age ranges

          • Prior psychopathology, poor marital quality, and financial strain affected risk

          • Mothers primarily obtained mental health information through online resources

          Abstract

          Background

          Mental health problems are increasingly recognized as a significant and concerning secondary effect of the COVID-19 pandemic. Research on previous epidemics/pandemics suggest that families, particularly mothers, may be at increased risk, but this population has yet to be examined. The current study (1) described prevalence rates of maternal depressive and anxiety symptoms from an online convenience sample during the COVID-19 pandemic, (2) identified risk and protective factors for elevated symptoms, and (3) described current mental health service use and barriers.

          Methods

          Participants ( N = 641) were mothers of children age 0-8 years, including expectant mothers. Mothers completed an online survey assessing mental health, sociodemographic information, and COVID-19-related variables.

          Results

          Clinically-relevant depression was indicated in 33.16%, 42.55%, and 43.37% of mothers of children age 0-18 months, 18 months to 4 years, and 5 to 8 years, respectively. Prevalence of anxiety was 36.27%, 32.62%, and 29.59% for mothers across age groups, respectively. Binary logistic regressions indicated significant associations between risk factors and depression/anxiety across child age groups.

          Limitations

          Cross-sectional data was used to describe maternal mental health problems during COVID-19 limiting the ability to make inferences about the long-term impact of maternal depression and anxiety on family well-being.

          Conclusions

          Maternal depression and anxiety appear to be elevated in the context of COVID-19 compared to previously reported population norms. Identified risk factors for depression and anxiety across different child age ranges can inform targeted early intervention strategies to prevent long-term impacts of the COVID-19 pandemic on family well-being and child development.

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          Most cited references27

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          Mental Health and the Covid-19 Pandemic

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            Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries.

            Maternal depression, a non-psychotic depressive episode of mild to major severity, is one of the major contributors of pregnancy-related morbidity and mortality. Maternal depression (antepartum or post partum) has been linked to negative health-related behaviours and adverse outcomes, including psychological and developmental disturbances in infants, children, and adolescents. Despite its enormous burden, maternal depression in low-income and middle-income countries remains under-recognised and undertreated. In this Series paper, we systematically review studies that focus on the epidemiology of perinatal depression (ie, during antepartum and post-partum periods) among women residing in low-income and middle-income countries. We also summarise evidence for the association of perinatal depression with infant and childhood outcomes. This review is intended to summarise findings from the existing literature, identify important knowledge gaps, and set the research agenda for creating new generalisable knowledge pertinent to increasing our understanding of the prevalence, determinants, and infant and childhood health outcomes associated with perinatal depression. This review is also intended to set the stage for subsequent work aimed at reinforcing and accelerating investments toward providing services to manage maternal depression in low-income and middle-income countries.
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              Parenting in a time of COVID-19

              Coronavirus disease 2019 (COVID-19) is changing family life. The United Nations Educational, Scientific and Cultural Organization estimates 1·38 billion children are out of school or child care, without access to group activities, team sports, or playgrounds. Parents and caregivers are attempting to work remotely or unable to work, while caring for children, with no clarity on how long the situation will last. For many people, just keeping children busy and safe at home is a daunting prospect. For those living in low-income and crowded households, these challenges are exacerbated. This has serious implications. Evidence shows that violence and vulnerability increase for children during periods of school closures associated with health emergencies. 1 Rates of reported child abuse rise during school closures. Parents and children are living with increased stress, media hype, and fear, all challenging our capacity for tolerance and long-term thinking. For many, the economic impact of the crisis increases parenting stress, abuse, and violence against children. But times of hardship can also allow for creative opportunity: to build stronger relationships with our children and adolescents. WHO, UNICEF, the Global Partnership to End Violence Against Children, the United States Agency for International Development USAID, the US Centers for Disease Control and Prevention (CDC), Parenting for Lifelong Health, and the UK Research and Innovation Global Challenges Research Fund Accelerating Achievement for Africa's Adolescents Hub are collaborating to provide openaccess online parenting resources during COVID-19. These resources focus on concrete tips to build positive relationships, divert and manage bad behaviour, and manage parenting stress. They are shared through social media, and they are accessible on non-smartphones through the Internet of Good Things. A team of international volunteers are producing translations in 55 languages. Importantly, these parenting resources are based on robust evidence from randomised controlled trials in low-income and middle-income countries.2, 3, 4 COVID-19 is not the first virus to threaten humanity, and it will not be the last. We need to utilise effective strategies to strengthen families to respond, care, and protect a future for the world's children. 5 For WHO's information on parenting in the time of COVID-19 see https://www.who.int/emergencies/diseases/novelcoronavirus-2019/advice-forpublic/healthy-parenting For UNICEF's tips for parenting during the COVID-19 outbreak see https://www.unicef.org/coronavirus/covid-19-parentingtips For Parenting for Lifelong Health's COVID-19 resources see https://www.covid19parenting.com/ For CDC's guidance for schools see https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/guidance-for-schools.html This online publication has been corrected. The corrected version first appeared at thelancet.com on April 9, 2020
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                Author and article information

                Contributors
                Journal
                J Affect Disord
                J Affect Disord
                Journal of Affective Disorders
                Published by Elsevier B.V.
                0165-0327
                1573-2517
                20 July 2020
                20 July 2020
                Affiliations
                [1 ]Department of Psychology, University of Calgary, Calgary, AB, Canada
                [2 ]Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Canada
                [3 ]Department of Psychology, University of Manitoba, Winnipeg, Canada
                [4 ]Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
                [5 ]Children's Hospital Research Institute of Manitoba, Winnipeg, Canada
                [6 ]George and Fay Yee Centre for Healthcare Innovation, Winnipeg, Canada
                [7 ]Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
                [8 ]Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Canada
                Author notes
                [* ]Address correspondence and reprint requests: Emily Cameron, Department of Psychology, University of Calgary, 2500 University Drive, NW, Calgary, AB, T2N 1N4. camerone@ 123456ucalgary.ca
                Article
                S0165-0327(20)32526-X
                10.1016/j.jad.2020.07.081
                7370903
                32736186
                fb1de4be-3ca8-4209-8e24-39b56397aa5b
                © 2020 Published by Elsevier B.V.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 14 May 2020
                : 6 July 2020
                : 8 July 2020
                Categories
                Article

                Clinical Psychology & Psychiatry
                depression,anxiety,maternal,mental health services,covid-19
                Clinical Psychology & Psychiatry
                depression, anxiety, maternal, mental health services, covid-19

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