1,720,980 research outputs found
Depressione materna nel periodo prenatale e postnatale dello sviluppo del bambino:prevalenza, rischio e condizioni socioeconomiche familiari
Get PDFLa depressione perinatale (PND) è una delle complicanze più frequenti
nelle donne in gravidanza e dopo il parto, può causare gravi effetti negativi a breve e lungo termine sia
sulla salute mentale della madre sia sullo sviluppo del feto/bambino e gravare sui costi di trattamento affrontati dai sistemi sanitari. La prevalenza della PND è elevata in tutto il mondo e interessa circa
il 17% nelle donne (Underwood et al., 2017; Hahn-Holbrook et al., 2017; Okagbue et al., 2019). Tuttavia, essa sembra essere sotto diagnosticata (O’Hara, McCabe, 2013). Infatti, studi internazionali (Hahn-Holbrook et
al., 2017) rivelano la mancanza di una stima accurata della prevalenza della depressione postpartum (PPD), che varia notevolmente a seconda della nazione: le disparità delle situazioni socioeconomiche spiegano gran parte
di questa variazione. Diversi studi hanno indagato la relazione tra, da una parte, fattori di rischio sociodemografici ed economici e, dall’altra parte, depressione prenatale (AND; Biaggi et al., 2016) e depressione postpartum (PPD; Hahn-Holbrook et al., 2017). I risultati hanno mostrato che la maggior parte di questi fattori di rischio è correlata a differenze nella prevalenza di AND e/o PPD. Tuttavia, sia la prevalenza che la distribuzione di questi fattori di rischio può variare nel tempo, soprattutto durante periodi di estremo cambiamento socioeconomico (Dijkstra-Kersten et al., nazionali 2015; Ruiz-Pérez et al., 2017).Gli obiettivi di questo lavoro sono i seguenti: valutare la prevalenza della depressione perinatale sia nel periodo prenatale che postnatale (ulteriormente suddiviso in trimestri) in un ampio campione di donne che frequentano centri sanitari in Italia, e analizzare la sua associazione con fattori socioeconomici
Valutare la prevalenza di sintomatologie ansiose e depressive in comorbidità durante la gravidanza per prevenire effetti negativi sullo sviluppo neuromentale del bambino
Get PDFAnsia e depressione sono i disturbi affettivi perinatali più comuni (Molgora et al., 2018; Tambelli et al., 2019; Vismara et al., 2020), con la presenza di sintomi da lievi a gravi. Alcune meta-analisi indicano che in Europa e nelle nazioni ad alto reddito la prevalenza di ansia antepartum clinicamente significativa è di circa il 19% (Dennis et al., 2017) e quella della depressione antepartum è del 18% (Yin et al., 2020). Depressione e ansia spesso possono presentarsi in comorbidità: in letteratura viene segnalato che circa due terzi degli adulti con ansia soffrono anche di depressione (Lamers et al., 2011). Studi condotti sulle famiglie con gemelli evidenziano che la comorbidità può essere spiegata anche da rischi genetici condivisi (Middeldorp et al., 2005) .Alcune ricerche internazionali segnalano che l’ansia e la depressione si presentano spesso in comorbidità anche durante il periodo antepartum (Verreault et al., 2014) e hanno in comune la maggior parte dei fattori di
rischio psicosociali rilevati nella depressione o nell’ansia. I fattori più rilevanti associati al rischio di depressione o ansia sono: assenza del partner o mancanza di supporto sociale, storia di abusi o violenze domestiche, storia
personale di malattia mentale, eventi di vita avversi ed elevato stress percepito, stile cognitivo negativo, basse autostima e autoefficacia, e relazione problematica/non soddisfacente con il partner (Biaggi et al., 2016). Sebbene sia stato suggerito che circa una donna incinta su dieci ha sintomi di ansia in comorbidità con sintomi depressivi da lievi a gravi (Falah-Hassani et al., 2017), tale comorbidità rimane un’area di ricerca poco studiata e
spesso una condizione clinica poco riconosciuta (Fedock, Alvarez, 2018; Goodman, Tyer-Viola, 2010).
Durante la gravidanza, la valutazione dell’ansia e della depressione in comorbidità (CAD) e dei fattori associati è fondamentale per lo sviluppo di strategie di valutazione del rischio efficaci, nonché di programmi di prevenzione e intervento effettivi. Questo è importante per due ragioni principali: in primo luogo, l’ansia e la depressione antepartum hanno effetti avversi diversi e cumulativi sugli esiti sia materni che fetali (O’Donnell et
al., 2014; Grigoriadis et al., 2018; Ierardi et al., 2018; Spry et al., 2020; Wallwiener et al., 2019): studi evidenziano che la CAD antepartum non trattata aumenta il rischio di esiti negativi quali nascita prematura (Field et al., 2010), basso peso e asfissia alla nascita (Accortt et al., 2015), malattia coronarica (Shahhosseini et al., 2015), inizio ritardato dell’allattamento al seno, scarso sviluppo cognitivo infantile (Ibanez et al., 2015), e problemi
di salute mentale nella tarda infanzia (Capron et al., 2015). La seconda ragione, strettamente connessa alla prima, è che gli individui con CAD hanno sintomi più gravi, episodi di malattia più lunghi, maggiori difficoltà
in ambito psicosociale, e risposta più scarsa al trattamento farmacologico rispetto agli individui con uno solo di questi disturbi (Pollack, 2005). L’obiettivo di questo studio è di determinare la prevalenza dei sintomi
di CAD in un ampio campione di donne italiane nel terzo trimestre di gravidanza e di analizzare l’associazione tra CAD e caratteristiche sociodemografiche, ostetriche e di salute mentale
La nascita pretermine del bambino: ansia, depressione materna e scarso supporto sociale
Get PDFLe avversità psicologiche materne sperimentate durante la gravidanza sembrano essere associate a una tendenza verso esiti non ottimali della nascita, come un periodo di gestazione più breve (Grote et al., 2010). La
nascita pretermine (prima delle 37 settimane di gestazione) è la principale causa di morbilità e mortalità neonatale (WHO, 2012) ed è associata a effetti negativi sulla salute mentale delle madri (de Paula Eduardo et al.,
2019) e sulle relazioni madre-figlio (Stefana, Lavelli, 2017), pertanto la nascita pretermine ha un impatto emotivo significativo sulle famiglie, nonché implicazioni economiche per i servizi del settore pubblico. Nonostante la ricerca internazionale su questo argomento sia in crescita, l’evidenza degli effetti specifici della salute mentale prenatale delle donne sugli esiti della nascita rimane a volte poco chiara e conflittuale (Staneva et al., 2015). Tra gli obiettivi del nostro studio abbiamo esaminato l’impatto del disagio psicosociale delle donne in gravidanza (in particolare, ansia, sintomi depressivi, e livello di supporto sociale percepito) sulla nascita pretermine
Cena Loredana, Mirabella, F., Palumbo, G., Gigantesco, A., Trainini, A., & Stefana, A. (2021). Prevalence of maternal antenatal and postnatal depression and their association with sociodemographic and socioeconomic factors: A multicentre study in Italy. Journal of Affective Disorders, 279, 217-221. doi: 10.1016/j.jad.2020.09.136
No full textBackground: Perinatal depression is a widespread and burdensome mental disorder. The objectives of this study were to assess the prevalence of both antenatal and postnatal depression in a large sample of women in Italy and to analyse their association with sociodemographic and socioeconomic factors.
Methods: Cross-sectional data from eleven healthcare centres located throughout Italy (2017-2018) were analysed (n = 1471). Depressive disorder was assessed with the Edinburgh Postnatal Depression Scale (EPDS), and sociodemographic and socioeconomic factors were also measured. Prevalences by perinatal period and by sociodemographic and socioeconomic factors were estimated, and their associations were evaluated using logistic regression models. All analyses were stratified by perinatal period: antenatal (i.e., from conception to delivery) vs. postnatal (i.e., the nine months after delivery).
Results: With a cut-off score set at 12 points, the prevalence of perinatal depression was 6.4% during pregnancy and 19.9% in the postnatal period, and the odds ratio for postpartum vs. antepartum depression was 3.65 (2.56-5.39). High economic status was associated with an approximate fivefold reduction in odds of depression in the antenatal period (ORa: 0.23, 95%CI: 0.10-0.54) and about a sixfold reduction in the postnatal period (ORa: 0.15, 95%CI: 0.05-0.45).
Limitations: The data were cross-sectional. The EPDS has a sensitivity of 55.6%.
Conclusion: The prevalence of perinatal depression in Italy is strongly associated with socioeconomic disadvantages. Early procedures to evaluate socioeconomic status and the provision of economical support for mothers might reduce the prevalence of perinatal depression and its direct and indirect costs
Prevalence of Maternal Postnatal Anxiety and Its Association With Demographic and Socioeconomic Factors: A Multicentre Study in Italy
Get PDFAnxiety is a common perinatal disorder that can cause severe adverse consequences.
This study (a) assesses the prevalence of maternal postnatal anxious symptomatology,
and (b) analyses its association with demographic and socioeconomic variables as well as
obstetric and other psychosocial variables. The assessment included 307 mothers aged
≥18 years with a biological baby aged ≤52 weeks and from seven Italian healthcare
centres, evaluated using a Psychosocial and Clinical Assessment Form (also covering
demographic and socioeconomic factors), and the state scale of the State-Trait Anxiety
Inventory. We found an overall prevalence of self-reported postnatal anxious symptoms
of 34.2%. More specifically, the prevalence was 34.5% at 1–24 weeks postpartum,
and 30.8% at >24 weeks postpartum. No associations between postnatal anxious
symptoms and demographic or socioeconomic variables were observed. As regards the
other variables, the findings indicated antenatal depression or anxiety, parity, and current
psychological support from the partner as having the strongest relationships
Poor social support is associated with preterm birth rather than maternal prenatal anxiety and depression: a retrospective case-control study
Get PDFMaternal psychological adversities experienced during pregnancy appear to be associated with a trend towards suboptimal birth outcomes, including a shorter gestation period . Preterm birth (i.e. birth before 37 completed weeks of gestation) is the leading cause of neonatal morbidity and mortality, and is associated with adverse effects on mothers’ mental health as well as mother-child relationships . This indicates that preterm birth has a significant emotional impact on families, as well as economic implications for public-sector services. However, despite growing research on this topic, evidence of the specific effects of women’s prenatal mental health on birth outcomes remains unclear and conflicting at times.
Therefore, we aimed to examine the impact of pregnant women’s psychosocial distress (specifically, anxiety, depressive symptoms, and level of perceived social support) on preterm birth.
The sample for this retrospective case-control study included participants from a longitudinal investigation (2017–2018) of maternal perinatal mental health.
Participant recruitment was carried out in perinatal health care centres, facilities associated with the Observatory of Perinatal Clinical Psychology, Department of Clinical and Experimental Sciences, University of Brescia, Italy.
This study was conducted in collaboration with the Italian National Institute of Health (Istituto Superiore di Sanità).
The inclusion criteria were being pregnant or having a biological child aged ≤6 months, and being able to speak and read Italian. Exclusion criteria were being under 18 years of age, having current psychotic symptoms, or having issues with substance misuse.
All participants provided written informed consent prior to entering the study. Before signing the consent form, a healthcare professional involved in the study provided each potential participant with detailed information about the study’s aims and methods, as well as the observational nature of the study. The participant information sheets and consent form made explicit the voluntary nature of their involvement and the right to wthdraw from the study at any time. Ethical approval for the study was obtained from the ethics committee of the Healthcare Centre of Bologna Hospital (Register Number: 0077805, June 27, 2017)
The Psychosocial and Clinical Assessment (PCA) form was used to collect information about participants’ sociodemographic characteristics as well as obstetric, clinical, and treatment-related factors. An unstructured clinical interview was used to collect information on both past and current emotional and psychiatric conditions. Both, the PCA and the clinical interview, were administered in person by female clinical psychologists trained in perinatal mental health assessment.
To compare categorical data, a X2 test or the exact Fisher’s test, whenever appropriate (n <5 in any cell), were used. All tests were two-tailed with statistical significance set at p = 0.05. All data were coded and analysed using the Statistical Package for the Social Sciences (SPSS, version 26 for Windows Chicago, Illinois 69606, USA).
Two hundred and sixty-four Italian women (mean age: 34.2 years, SD: 4.8) were included in the analysis. The total sample comprised 43 mothers who had delivered preterm infants, born before 37 gestational weeks (i.e. cases), and 221 mothers who had had full-term deliveries (i.e. controls). The mean gestational age at delivery in the cases and controls was 34.4 ± 2.9 and 39.6 ± 1.1 weeks, respectively. The two groups did not differ in any sociodemographic characteristics (i.e. age, marital status, educational level, employment status, and socioeconomic status), excluding confounding for the main confounding variables, obstetric aspects (i.e. first pregnancy, history of abortions, and assisted reproductive technology), and mental health features (i.e. mild to severe anxiety or depressive symptoms during pregnancy and number of participants taking medication for anxiety or depression). Furthermore, the two groups did not differ in levels of perceived support from partners (it must be noted that more than 80% of full-term mothers and 90% of preterm mothers reported receiving enough or more than enough emotional as well as practical support from their partner). However, compared to the controls, the cases were significantly more likely to perceive less or no practical (X2 = 7.1, p = 0.029) and emotional (X2 = 6.2, p = 0.045) support from friends and relatives during pregnancy.
This study contributed to the relatively scarce literature investigating the association between preterm birth and prenatal maternal mental health and social support characteristics. Our findings align with prior studies that indicated that poor social support enhanced expectant mothers’ stress levels [7], which is a significant predictive factor for preterm birth [8]. Furthermore, recent evidence suggests that support from friends attenuates pregnant women’s psychological stress across the transition to parenthood .
Healthcare professionals engaged in providing care to pregnant women, such as medical general practitioners, gynaecologists, and mental health specialists need to assess the quantity and quality of future mothers’ social support (which is a factor that can affect stress levels in pregnant women), even if the pregnant woman does not have anxiety or depressive symptoms. This is necessary in order to help expectant mothers and to prevent possible adverse effects on the foetus and the neonate. In this sense, our findings can provide useful information to Italian health policy planners to consider developing cost-effective programs for the prevention of premature birth, focused on enhancing the levels of social support for pregnant women. In addition, this study may represent the first step to a more in-depth analysis investigating the perception of support from friends and relatives for mothers of preterm children.
However, findings from the current study must be interpreted in light of three main limitations: i) a limited sample size, ii) lack of assessment of the level of prenatal psychological stress as a variable, and iii) lack of a structured diagnostic interview to diagnose anxiety and depressive symptoms according to DSM-5 criteria. However, it should be noted that the third limitation was attenuated by the fact that all participants were assessed by licensed clinical psychologists trained in perinatal mental health assessment.
Poor social support appears to be a greater risk factor than maternal prenatal anxiety and depressive symptoms, for preterm birth. Thus, it is important for mental health specialists to consider the health and well-being of pregnant women and their future children beyond mental health symptomatology and diagnosis
Early parent-child intervention with Dialogic Book-Sharing: effects on child communicative and socio-emotional development and on parenting. Study protocol for a multicentre randomised controlled trial in Italy. Trials. 2024 Jun 19;25(1):395.
Get PDFAbstract:
Background: Research in the neurosciences has highlighted the importance of intersubjective relationships in promoting neuromental development of the child. Children's learning in early childhood occurs mainly in a dyadic context of an interaction with their parents: from this perspective, good dialogic parent-child communication is required to be promoted also through good educational practices. Dialogic Book-Sharing (DBS), a dialogic form of parent-child communication through the use of wordless picture books, provides a privileged “intersubjective” space and is highly effective in promoting communication, language, attention, behavioural development, and the parent-child relationship. DBS programme, successfully previously trialled in South Africa and the UK, will be applied for the first time In Italy for research purposes in Italian health, educational and maternal-child centres.
Methods: A multicentre randomised controlled trial is being conducted to evaluate DBS parenting intervention for children aged between 14 and 20 months. Parent-child dyads are randomly allocated to a book-sharing intervention group or to a wait-list control group. In the intervention, parents are trained in supportive book-sharing with their children by local staff of the Centres. DBS intervention is carried out in small groups over a period of 4 weeks. Data are collected at baseline, post intervention and at 6 months post intervention with a questionnaire and video recording of parent-child interaction.
Discussion: DBS programme in early childhood could enhance the educational resources offered by Italian health, educational and maternal-child centres, in support of child’s development and parenting. DBS represents a strategic opportunity for bringing about positive effects, also in terms of prevention of socio-emotional and cognitive difficulties. As such it represents a promising response to the new social, health and educational needs of the post-COVID-19 pandemic era caused by the social isolation measures. Furthermore, the application of the DBS methodology is a way to promote the use of books, and thereby counteract the excessive use of technological devices already present in early childhood.
Trial registration: The trial is registered on the International Standard Randomised Controlled Trial Number database, registration number ISRCTN11755019 Registered on 2 November 2023. This is version 1 of the protocol for the trial
Estimating the impact of the COVID-19 pandemic on maternal and perinatal health care services in Italy: results of a self-administered survey
Get PDFThe coronavirus disease 2019 (COVID-19) pandemic is strongly changing the way most people live their lives, and disrupting specialist healthcare systems. Such public health disruptions have resulted in significant collateral damage with particular implications for vulnerable populations, including the perinatal population.
This Study aims to estimate the impact of the COVID-19 pandemic on Italian maternal and perinatal health care services. A questionnaire was designed to evaluate the COVID-19 impact on Italian maternal and perinatal healthcare facilities and their activities and provision of services from March to May 2020. The survey was completed by hospital-based and community-based Italian maternal and perinatal healthcare facilities. Most of these were located in Lombardy or Veneto (the most affected Italian regions). 70% of all facilities reported that the first wave of the COVID-19 pandemic negatively influenced the functioning of one or more aspects of the perinatal service; only 28.4% of facilities all over the country continued to provide outpatient routine visits and examinations as usual; 23.4% of facilities became understaffed during the index period due to various reasons such as ward transfer and sick leave. This is the first Italian study, and among very few international studies that describe the effects of the COVID-19 pandemic on antenatal and postnatal healthcare facilities and their provision of activities and services. Our findings confirm that healthcare systems even in high-income countries were not entirely prepared to handle such a global health emergency; indeed, specialized maternal and perinatal healthcare services have been disrupted by this global health emergency
Prevalence and types of video gaming and gambling activities among adolescent public school students: findings from a cross-sectional study in Italy
Get PDFAbstract
Adolescence is characterized by emotional instability and risk-taking behaviours that can lead to, among other things,
an increased risk of developing pathological video-gaming and gambling habits. The aim of this Study is to assess the
prevalence and type of video gaming and gambling habits in adolescent students attending Italian upper-secondary
schools. The cross-sectional study was conducted via an online survey using validated questionnaires. The primary
outcome measures were the prevalence of past-year video gaming and gambling activities. The sample consisted of
502 adolescent students from frst- and second-grade secondary schools. A total of 40.8% of participants were video
gamers, 4.8% were gamblers, 17.8% were both video gamers and gamblers, and the remaining 36.6% were not players. Among participants who reported video gaming activity (n=294), 68.0% were classifed as nonproblem gamers,
24.5% as at-risk gamers, and 7.5% as disordered video gamers. Among the participants who reported gambling activity (n=113), 85.8% were not problematic gamblers, 8.9% were at-risk gamblers, and 5.3% were pathological gamblers. Only 0.2% of all subjects met the criteria for both pathological gambling and pathological video game use. The
fndings indicate that video gaming and gambling are common leisure times among adolescent students. However,
a small but signifcant minority of these adolescents met the criteria for either severe problem gaming or gambling or
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A Brief Depression Screening Tool for Perinatal Clinical Practice: The Performance of the PHQ-2 Compared with the PHQ-9
Get PDFIntroduction There is ongoing interest in using brief screening instruments to identify perinatal depression in clinical practice. One ultra-brief screening instrument for depression is the Patient Health Questionnaire-2 (PHQ-2), but thus far its accuracy in perinatal clinical practice has been barely researched. In the present study, we aimed to assess the screening accuracy of the PHQ-2 against the Patient Health Questionnaire-9 (PHQ-9) in a large sample of perinatal women. Method A total of 1155 consecutive women attending 11 health care centers throughout Italy completed the PHQ-9 (which includes the PHQ-2) during pregnancy (27-40 weeks) or postpartum (1-13 weeks). Sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio positive, likelihood ratio negative, and overall accuracy were calculated using cut points 3 or greater and 2 or greater. Results During pregnancy, PHQ-2 greater than or equal to 3 revealed low sensitivity (38.4%-44.7%) but high specificity (97.8%-99.3%). In postpartum, it revealed moderate sensitivity (56.9%-70.6%), high specificity (95.8%-99.8%), and fair overall accuracy in pregnancy (70%). The alternative threshold greater than or equal to 2 revealed very high sensitivity (pregnancy: 92.1%-95.2%; postpartum: 87.1%-95.2%), moderate specificity (pregnancy: 78.1%-83.2%; postpartum: 68.8%-81.1%) and good overall accuracy, both during pregnancy (87%) and postpartum (84%). Discussion The PHQ-2 provided acceptable accuracy for screening for depression compared with the PHQ-9. In perinatal screening practice, a threshold of 2 or greater should be preferred as this ensures high sensitivity, missing only approximately 6% to 8% of cases, and a false-positive rate (percentage of women classified as affected with depressive symptoms when they are not) of 19% to 25%
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