Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-09T16:19:27.920Z Has data issue: false hasContentIssue false
  • English
  • Français

Prevalence and factors associated with depression and depression-related healthcare access in mothers of 9-month-old infants in the Republic of Ireland

Published online by Cambridge University Press:  15 February 2017

S. M. Cruise ,
R. Layte ,
M. Stevenson  and
D. O'Reilly
S. M. Cruise*
Affiliation:
Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland UKCRC Centre of Excellence for Public Health (NI), Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
R. Layte
Affiliation:
Department of Sociology, Trinity College Dublin, Dublin, Ireland Economic and Social Research Institute, Dublin, Ireland
M. Stevenson
Affiliation:
Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland UKCRC Centre of Excellence for Public Health (NI), Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
D. O'Reilly
Affiliation:
Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland UKCRC Centre of Excellence for Public Health (NI), Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
*
*Address for correspondence: Dr S. Cruise, Centre for Public Health, Institute of Clinical Sciences Block B, Queen's University Belfast, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BJ, Northern Ireland, UK. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Aims.

Untreated maternal depression during the postpartum period can have a profound impact on the short- and long-term psychological and physical well-being of children. There is, therefore, an imperative for increased understanding of the determinants of depression and depression-related healthcare access during this period.

Methods.

Respondents were 11 089 mothers of 9-month-old infants recruited to the Growing Up in Ireland study. Of this sample, 10 827 had complete data on all relevant variables. Respondents provided sociodemographic, socioeconomic and household information, and completed the Center for Epidemiologic Studies Depression Scale (CESD).

Results.

11.1% of mothers scored above the CESD threshold for depression. 10.0% of depressed mothers and 25.4% of depressed fathers had depressed partners. Among depressed mothers, 73.1% had not attended a healthcare professional for a mental health problem since the birth of the cohort infant. In the adjusted model, the likelihood of depression was highest in mothers who: had lower educational levels (odds ratio (OR) 1.26; 95% confidence intervals (CIs) 1.08, 1.46); were unemployed (OR 1.27; 95% CIs 1.10, 1.47); reported previous mental health problems (OR 6.55; 95% CIs 5.68, 7.56); reported that the cohort child was the result of an unintended pregnancy (OR 1.43; 95% CIs 1.22, 1.68), was preterm (OR 1.35; 95% CIs 1.07, 1.70), or had health/developmental problems (OR 1.20; 95% CIs 1.04, 1.39); had no partner in the household (OR 1.33; 95% CIs 1.04, 1.70) or were living with a depressed partner (OR 2.66; 95% CIs 1.97, 3.60); reported no family living nearby (OR 1.33; 95% CIs 1.16, 1.54); were in the lowest income group (OR 1.60; 95% CIs 1.21, 2.12). The primary determinant of not seeking treatment for depression was being of non-white ethnicity (OR 2.21; 95% CIs 1.18, 4.13).

Conclusions.

Results highlight the prevalence of maternal depression in the later postpartum period, particularly for lower socioeconomic groups, those with previous mental health problems, and those with limited social support. The large proportion of unmet need in depressed mothers, particularly among ethnic minority groups, emphasises the need for a greater awareness of postpartum mental health problems and increased efforts by healthcare professionals to ensure that mothers can access the required services.

Keywords

Cross-sectional studydepressionepidemiologymood disorders postpartumhealthcare accesswomen
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 27 , Issue 5 , October 2018 , pp. 468 - 478
Copyright
Copyright © Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ahmed, A, Stewart, DE, Teng, L, Wahoush, O, Gagnon, AJ (2008). Experiences of immigrant new mothers with symptoms of depression. Archives of Women's Mental Health 11, 295–303.Google Scholar
Almeida, DM, Kessler, RC (1998). Everyday stressors and gender differences in daily distress. Journal of Personality and Social Psychology 75, 670–680.Google Scholar
Beck, CT (2001). Predictors of postpartum depression: an update. Nursing Research 50, 275–285.Google Scholar
Beck, CT, Gable, RK, Sakala, C, Declercq, ER (2011). Postpartum depressive symptomatology: results from a two-stage US national survey. Journal of Midwifery and Women's Health 56, 427–435.Google Scholar
Brugha, TS, Sharp, HM, Cooper, S-A, Weisender, C, Britto, D, Shinkwin, R, Sherrif, T, Kirwan, PH (1998). The Leicester 500 Project. Social support and the development of postnatal depressive symptoms, a prospective cohort survey. Psychological Medicine 28, 63–79.Google Scholar
Carpenter, M, Nagell, K, Tomasello, M, Butterworth, G, Moore, C (1998). Social cognition, joint attention, and communicative competence from 9 to 15 months of age. Monographs of the Society for Research in Child Development 63, 1–174.Google Scholar
Chung, EK, McCollum, KF, Elo, IT, Lee, HJ, Culhane, JF (2004). Maternal depressive symptoms and infant health practices among low-income women. Pediatrics 113, e523–e529.Google Scholar
Dennis, CL, Chung-Lee, L (2006). Postpartum depression help-seeking barriers and maternal treatment preferences: a qualitative systematic review. Birth 33, 323–331.Google Scholar
Evans, J, Heron, J, Francomb, H, Oke, S, Golding, J, on behalf of the Avon Longitudinal Study of Parents and Children Study Team (2001). Cohort study of depressed mood during pregnancy and after childbirth. British Medical Journal 323, 257–260.Google Scholar
Falah-Hassani, K, Shiri, R, Vigod, S, Dennis, C-L (2015). Prevalence of postpartum depression among immigrant women: a systematic review and meta-analysis. Journal of Psychiatric Research 70, 67–82.Google Scholar
Fearon, RP, Bakermans-Kranenburg, MJ, Van IJzendoorn, MH, Lapsley, A, Roisman, GI (2010). The significance of insecure attachment and disorganization in the development of children's externalizing behavior: a meta-analytic study. Child Development 81, 435–456.Google Scholar
Flynn, HA, Davis, M, Marcus, SM, Cunningham, R, Blow, FC (2004). Rates of maternal depression in pediatric emergency department and relationship to child service utilization. General Hospital Psychiatry 26, 316–322.Google Scholar
Gavin, NI, Gaynes, BN, Lohr, KN, Meltzer-Brody, S, Gartlehner, G, Swinson, T (2005). Perinatal depression: a systematic review of prevalence and incidence. Obstetrics and Gynecology 106, 1071–1083.Google Scholar
Gaynes, BN, Gavin, N, Meltzer-Brody, S, Lohr, KN, Swinson, T, Gartlehner, G, Brody, S, Miller, WC (2005). Perinatal depression: prevalence, screening accuracy, and screening outcomes. Summary, Evidence Report/Technology Assessment 119, 1–8.Google Scholar
Gjerdingen, D, Crow, S, McGovern, P, Miner, M, Center, B (2011). Changes in depressive symptoms over 0–9 months postpartum. Journal of Women's Health 20, 381–386.Google Scholar
Hammen, C (2002). Context of stress in families of children with depressed parents. In Children of Depressed Parents: Mechanisms of Risk and Implications for Treatment (ed. Goodman, SH and Gotlib, IH), pp. 175–199. American Psychological Association: Washington, DC, US.Google Scholar
Harris, M, Jones, D, Grant, J (1983). The nonverbal context of mothers’ speech to infants. First Language 4, 21–30.Google Scholar
Harris, M, Barlow-Brown, F, Chasin, J (1995 a). The emergence of referential understanding: pointing and the comprehension of object names. First Language 15, 19–34.Google Scholar
Harris, M, Yeeles, C, Chasin, J, Oakley, Y (1995 b). Symmetries and asymmetries in early lexical comprehension and production. Journal of Child Language 22, 1–18.Google Scholar
Higgins, A, Tuohy, T, Murphy, R, Begley, C (2016). Mothers with mental health problems: contrasting experiences of support within maternity services in the Republic of Ireland. Midwifery 36, 28–34.Google Scholar
Horwitz, SM, Briggs-Gowan, MJ, Storfer-Isser, A, Carter, AS (2009). Persistence of maternal depressive symptoms throughout the early years of childhood. Journal of Women's Health 18, 637–645.Google Scholar
Huang, ZJ, Wong, FY, Ronzio, CR, Yu, SM (2007). Depressive symptomatology and mental health help-seeking patterns of U.S.- and foreign-born mothers. Maternal and Child Health Journal 11, 257–267.Google Scholar
Joutsenniemi, K, Moustgaard, H, Martikainen, P (2013). Parental use of antidepressant medication and family type in the risk for incident psychiatric morbidity in offspring. Journal of Epidemiology and Community Health 67, 703–705.Google Scholar
Kessler, RC (2006). The epidemiology of depression among women. In Women and Depression: a Handbook for the Social, Behavioral, and Biomedical Sciences (ed. Keyes, CLM and Goodman, SH), pp. 22–40. Cambridge Univ. Press: New York.Google Scholar
Layte, R, Nolan, A (2015). Eligibility for free GP care and the utilisation of GP services by children in Ireland. International Journal of Health Economics and Management 15, 3–27.Google Scholar
Lieb, R, Isensee, B, Höfler, M, Pfister, H, Wittchen, H-U (2002). Parental major depression and the risk of depression and other mental disorders in offspring: a prospective-longitudinal community study. Archives of General Psychiatry 59, 365–374.Google Scholar
Lovejoy, MC, Graczyk, PA, O'Hare, E, Neuman, G (2000). Maternal depression and parenting behavior: a meta-analytic review. Clinical Psychology Review 20, 561–592.Google Scholar
Lyons-Ruth, K, Alpern, L, Repacholi, B (1993). Disorganized infant attachment classification and maternal psychosocial problems as predictors of hostile-aggressive behaviour in the preschool classroom. Child Development 64, 572–585.Google Scholar
Martins, C, Gaffan, E (2000). Effects of early maternal depression on patterns of infant-mother attachment: a meta-analytic investigation. Journal of Child Psychology and Psychiatry 41, 737–746.Google Scholar
Matthay, S (2010). Are we overpathologising motherhood? Journal of Affective Disorders 120, 263–266.Google Scholar
Melchior, LA, Huba, GJ, Brown, VB, Reback, CJ (1993). A short depression index for women. Educational and Psychological Measurement 53, 1117–1125.Google Scholar
Moss, E, Cyr, C, Dubois-Comtois, K (2004). Attachment at early school age and developmental risk: examining family contexts and behavior problems of controlling-caregiving, controlling-punitive, and behaviorally disorganized children. Developmental Psychology 40, 519–532.Google Scholar
National Institute for Health and Clinical Excellence (NICE) (2014). Antenatal and Postnatal Mental Health: Clinical Management and Service Guidance. National Institute for Health and Clinical Excellence: London.Google Scholar
Nomura, Y, Warner, V, Wickramaratne, P (2001). Parents concordant for major depressive disorder and the effect of psychopathology in offspring. Psychological Medicine 31, 1211–1222.Google Scholar
O'Hara, MW, Swain, AM (1996). Rates and risk of postpartum depression – a meta-analysis. International Review of Psychiatry 8, 37–54.Google Scholar
O'Reilly, D, O'Dowd, T, Galway, KJ, Murphy, AW, O'Neill, C, Shryane, E, Steele, K, Bury, G, Gilliland, A, Kelly, A (2007). Consultation charges in Ireland deter a large proportion of patients from seeing the GP: results of a cross-sectional survey. European Journal of General Practice 13, 231–236.Google Scholar
Paulson, JF, Bazemore, SD (2010). Prenatal and postpartum depression in fathers and its association with maternal depression. JAMA 303, 1961–1969.Google Scholar
Renken, B, Egeland, B, Marvinney, D, Mangelsdorf, S, Sroufe, LA (1989). Early childhood antecedents of aggression and passive-withdrawal in early elementary school. Journal of Personality 57, 257–281.Google Scholar
Templeton, L, Velleman, R, Persaud, A, Milner, P (2003). The experiences of postnatal depression in women from black and minority ethnic communities in Wiltshire, UK. Ethnicity and Health 8, 207–221.Google Scholar
Teng, L, Robertson Blackmore, E, Stewart, DE (2007). Healthcare worker's perceptions of barriers to care by immigrant women with postpartum depression: an exploratory qualitative study. Archive of Women's Mental Health 10, 93–101.Google Scholar
Thornton, M, Williams, J, McCrory, C, Murray, A, Quail, A (2013). Growing Up in Ireland National Longitudinal Study of Children: Design, Instrumentation and Procedures for the Infant Cohort at Wave One (9 Months), Technical Report Number 2. Department of Children and Youth Affairs: Dublin, Ireland. http://www.growingup.ie/fileadmin/user_upload/documents/Technical_Reports/9_month_instrumentation_report_final_18.12.13.pdf (last accessed 30th September 2016).Google Scholar
Trevarthen, C, Hubley, P (1978). Secondary intersubjectivity: confidence, confiding and acts of meaning in the first year. In Action, Gesture, and Symbol: the Emergence of Language (ed. Lock, A), pp. 183–230. Academic Press: Oxford, England.Google Scholar
Turner, KM, Sharp, D, Folkes, L, Chew-Graham, C (2008). Women's views and experiences of antidepressants as a treatment for postnatal depression: a qualitative study. Family Practice 25, 450–455.Google Scholar
Van IJzendoorn, MH, Goldberg, S, Kroonenberg, PM, Frenkel, OJ (1992). The relative effects of maternal and child problems on the quality of attachment: a meta-analysis of attachment in clinical samples. Child Development 63, 840–858.Google Scholar
Zink, T, Levin, L, Wollan, P, Putnam, F (2006). Mother's comfort with screening questions about sensitive issues, including domestic violence. American Board of Family Medicine 19, 358–367.Google Scholar
Supplementary material: File

Cruise supplementary material

Cruise supplementary material 1

Download Cruise supplementary material(File)
File 13.7 KB
Supplementary material: File

Cruise supplementary material

Cruise supplementary material 2

Download Cruise supplementary material(File)
File 16.2 KB