Tag: Postpartum Depression

  • Housing affordability for new mothers may help stave off postpartum depression

    Housing affordability for new mothers may help stave off postpartum depression

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    Becoming a parent comes with lots of bills. For new mothers, being able to afford the rent may help stave off postpartum depression.

    “Housing unaffordability has serious implications for mental health,” said Katherine Marcal, an assistant professor at the Rutgers School of Social Work and author of a study published in the journal Psychiatry Research. “For mothers who rent their homes, the ability to make monthly payments appears to have a correlation to well-being.”

    Housing hardship – missing rent or mortgage payments, moving in with others, being evicted or experiencing homelessness – has been associated with increased risk for depression. Yet little is understood about unique manifestations of housing hardship among postpartum mothers in renter households, said Marcal.

    To address this gap, Marcal used data from the Future of Families and Child Wellbeing Study, a multiyear study of nearly 5,000 children born in the United States between 1998 and 2000. As part of the research, mothers were interviewed in hospitals shortly after giving birth, and five times over the next 15 years.

    Marcal drew on data for 2,329 mothers who reported being renters at year one of the survey. Participants were asked a series of questions related to housing hardship. For instance, had they ever missed a rent or utility payment, moved in with friends or family or spent at least one night homeless during the postpartum year?

    Using latent class analysis, a modeling approach that allows clustering of data and statistical inference, Marcal used Future of Families and Child Wellbeing Study responses to investigate manifestations of housing hardship.

    Four groups emerged from the data: a “stable” group with very little housing hardship; “rent-assisted” mothers with government housing assistance; “cost-burdened” mothers who skip periodic rent and utility payments but manage to avoid most severe housing outcomes; and a “housing insecure” group or mothers who experience elevated rates of displacement.

    Finally, these clustered data were analyzed with responses from year three of the Future of Families and Child Wellbeing Study, when participants were asked if they had experienced major depressive and anxiety disorders.

    What emerged was a clear connection between housing hardship and depression. Mothers in the housing insecure group were far more likely to be depressed than those in the stable group. For anxiety risk, the best determinant was whether rent was paid each month. In total, the prevalence of maternal depression was 21 percent, while the prevalence of anxiety was 5 percent.

    Marcal also identified a racial component to the findings: Black renters were less likely than whites to be cost-burdened.

    The reason is counterintuitive, Marcal said.

    Black families are more likely to receive rental assistance, but Blacks are also more likely to be evicted faster than whites.”


    Katherine Marcal, Assistant Professor, Rutgers School of Social Work 

    In other words, Black tenants don’t remain cost-burdened for long. “They’re either making their rent payments or they’re getting evicted or moving out,” Marcal said.

    Taken together, the findings highlight the importance of government housing support for low-income families.

    “Rental assistance is very effective in keeping people housed and in reducing risk for depression and anxiety,” Marcal said. “But what this research shows is that we need to do a much better job at promoting equity in assistance programs.”

    Source:

    Journal reference:

    Marçal, K. (2024). Housing hardship and maternal mental health among renter households with young children. Psychiatry Research. doi.org/10.1016/j.psychres.2023.115677.

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  • Cognitive behavioral therapy helps prevent postpartum mental health challenges in low-resource settings

    Cognitive behavioral therapy helps prevent postpartum mental health challenges in low-resource settings

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    Results from a large clinical trial funded by the National Institutes of Health show that an intervention for anxiety provided to pregnant women living in Pakistan significantly reduced the likelihood of the women developing moderate-to-severe anxiety, depression, or both six weeks after birth. The unique intervention was administered by non-specialized providers who had the equivalent of a bachelor’s degree in psychology-;but no clinical experience. The results suggest this intervention could be an effective way to prevent the development of postpartum mental health challenges in women living in low-resource settings.

    In low resource settings, it can be challenging for women to access mental health care due to a global shortage of trained mental health specialists. This study shows that non-specialists could help to fill this gap, providing care to more women during this critical period.”


    Joshua A. Gordon, M.D., Ph.D., Director of the National Institute of Mental Health, part of NIH

    Led by Pamela J. Surkan, Ph.D., Sc.D., of Johns Hopkins Bloomberg School of Public Health, Baltimore, the study was conducted in the Punjab Province of Pakistan between April 2019 and January 2022. Pregnant women with symptoms of at least mild anxiety were randomly assigned to receive either routine pregnancy care or a cognitive behavioral therapy (CBT)-based intervention called Happy Mother-Healthy Baby. The researchers assessed the participants (380 women in the CBT group and 375 women in the routine care group) for anxiety and depression six weeks after the birth of their child.

    The researchers found that 9% of women in the intervention group developed moderate-to-severe anxiety compared with 27% of women in the routine care group. Additionally, 12% percent of women in the intervention group developed depression compared with 41% of women in the routine care group.

    “Postpartum depression not only harms mothers, it is also associated with poorer physical growth and delayed cognitive development in their children,” said Dr. Surkan. “The link between maternal and child health highlights the critical importance of developing effective ways to address postpartum anxiety and depression.”

    The Happy Mother-Healthy Baby intervention was created using input from pregnant women in a hospital in Rawalpindi, Pakistan. Pregnant women took part in six intervention sessions where they learned to identify anxious thoughts and behaviors, such as thoughts about possible miscarriage, and to practice replacing them with helpful thoughts and behaviors. The first five sessions were conducted in early to mid-pregnancy, and the sixth session occurred in the third trimester.

    Prior research suggests that up to 30% of women in the Global South, which includes South America, Africa, and most of southern Asia, report experiencing anxiety during pregnancy. Anxiety during pregnancy predicts the development of anxiety and depression after birth, making the prenatal period a prime target for intervention. However, it can be challenging for women living in low-resource settings to access trained clinical care. The findings from this study demonstrate that an intervention such as Happy Mother-Healthy Baby could be an effective way to help prevent the development of postpartum depression and anxiety in settings where specialist clinical care may be hard to access.

    “In the future, we can build on these findings through implementation research. Having identified an intervention that works, the next step is to figure out the best ways to deliver effective treatment to the people who need it, bridging the gap between science and practice,” said Dr. Surkan.

    Source:

    Journal reference:

    Surkan, P. J., et al. (2024). Anxiety-focused cognitive behavioral therapy delivered by non-specialists to prevent postnatal depression: a randomized, phase 3 trial. Nature Medicine. doi.org/10.1038/s41591-024-02809-x.

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