Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Maternal depression HEART Reading Pack

990 views

Published on

This presentation looks at what maternal depression is and why we should treat it. Prevention of intergenerational impact is important here. Integrating treatment into health systems is discussed.

Published in: Healthcare
  • Did u try to use external powers for studying? Like ⇒ www.HelpWriting.net ⇐ ? They helped me a lot once.
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • Vitiligo Miracle Video - Heal Vitiligo In 7 Days =>> https://j.mp/3kTNHDZ
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • Hello! I do no use writing service very often, only when I really have problems. But this one, I like best of all. The team of writers operates very quickly. It's called ⇒ www.WritePaper.info ⇐ Hope this helps!
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • Strange "water hack" burns 2lbs overnight. Do this hack to drop 2lb of fat in 8 hours (video tutorial) ❤❤❤ https://url.cn/5yLnA6L
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • Be the first to like this

Maternal depression HEART Reading Pack

  1. 1. Maternal Mental Health: Overview of the HEART Reading Pack Prof Crick Lund Department of Psychiatry and Mental Health University of Cape Town Email: crick.lund@uct.ac.za
  2. 2. What is depression?1 Core requirements: • Depressed mood (feels sad, empty or hopeless) • Loss of interest and enjoyment/pleasure • Reduced energy leading to increased fatigue and diminished activity. Plus 3 or more of the following: significant weight gain/loss; insomnia/hypersomnia; psychomotor agitation/retardation; feeling excessively worthless/guilty; diminished ability to think/concentrate; recurrent thoughts of death/suicide Note: • Symptoms must cause clinically significant distress or impairment in social, occupational or other important areas of functioning • Symptoms must persist for at least a 2 week period (major depressive episode) 1. DSM-5, American Psychiatric Association, 2013; ICD-10, WHO, 2010
  3. 3. What is maternal depression? • Depression experienced by a mother during pregnancy or the postnatal period (first 12 months of her baby’s life) • The experience of maternal depression may vary substantially across cultures, and is expressed in various idioms of distress, e.g.: – kufungisisa “thinking too much” in Zimbabwe – ukudakumba “being sad or unhappy” and ucingakakhulu “thinking too much” in South Africa – yandimukuba “being struck by pressure” in Uganda
  4. 4. Why should we treat maternal depression? The burden of Common perinatal mental disorders (depression and anxiety) is high: – High income countries: 13% (antenatal); 10% (postnatal) – Low and middle-income countries: 16% (antenatal) ; 20% (postnatal) Fisher et al 2012 Photo: Alexia Beckerling
  5. 5. Why should we treat maternal depression? Prevention: intergenerational impact Antenatal distress Postnatal distress • Chronic mental illness • Drugs / alcohol • Suicide/Infanticide Child Infancy • Emotional problems • Cognitive problems • Poor growth • Diarrhoeal disease • Malnutrition Childhood / Adolescence • Mental health problems • Impaired mother-child relationships Mother Poor bonding Dysfunction may influence the next generation Trans-placental
  6. 6. Risk Factors
  7. 7. Why should we integrate? The good news • Unique opportunities for health system contact with mothers – Antenatal Care – Postnatal Care • Evidence for effective treatment – Low resource settings (India, Pakistan, Chile) – WHO Thinking Healthy Manual – The Perinatal Mental Health Project model (South Africa) • Efficient investment for child outcomes (Heckman’s model)
  8. 8. Investment hypothesis Investing in Early Human Development: Timing and Economic Efficiency Orla Doyle, Colm P. Harmon, James J. Heckman,and Richard E. Tremblay Econ Hum Biol. 2009 March; 7(1): 1–6.
  9. 9. Steps to integrating mental health care into routine maternal health care • Select a suitable locally relevant screening or detection tool. • Adapt and translate the screening tool if necessary. • Conduct a needs assessment. • Based on the identified need, design a stepped care approach, appropriate to local setting: – Step 1: Routine or selected antenatal and postnatal screening – Step 2: Screen positives referred for evidence- based counseling – Step 3: Referral of mothers who are not responsive to counseling for assessment by medical doctor for potential anti-depressant medication. Photo: PMHP
  10. 10. Cautionary notes • Consider options for screening tools carefully. • 5-day training using the WHO Thinking Healthy manual • Ongoing supervision of counselors is essential! • Select counselors carefully based on: – Personal capacity for empathy – Motivation – Skills

×