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      Effect of biological, psychological, and social factors on maternal depressive symptoms in late pregnancy: a cross-sectional study

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          Abstract

          Introduction

          Depression commonly occurs during pregnancy and has become a major public health concern. Depression not only affects the individual but also causes adverse consequences for families and children. However, little is known regarding the depression status and its influencing factors in women during late pregnancy in China. This study aimed to assess the prevalence of maternal depressive symptoms in late pregnancy during the coronavirus disease 2019 (COVID-19) pandemic and further explore the effect of biological, psychological, and social factors on depressive symptoms.

          Methods

          An institution-based cross-sectional survey was conducted among eligible women in the late pregnancy stage and underwent prenatal examination at Lianyungang Maternal and Child Health Hospital in Jiangsu Province, Eastern China from December 2022 to February 2023. Data regarding depressive symptoms and biological, psychological, and social factors of the pregnant women were collected via a structured questionnaire. Chi-square test, Fisher's exact tests, and binary logistics regression were used to analyze the data.

          Results

          In total, 535 women in the late pregnancy stage were included in this study, 75 (14.0%) of whom exhibited depressive symptoms. A binary logistic regression analysis revealed that pregnant women who were multiparous ( OR: 2.420, 95% CI: 1.188–4.932) and had moderate or severe insomnia symptoms ( OR: 4.641, 95% CI: 1.787–12.057), anxiety ( OR: 8.879, 95% CI: 4.387–17.971), high fear of COVID-19 ( OR: 2.555, 95% CI: 1.255–5.199), moderate or severe family dysfunction ( OR: 2.256, 95% CI: 1.141–4.461), and poor social support ( OR: 2.580, 95% CI: 1.050–6.337) tended to show depressive symptoms. Conversely, pregnant women who received regular prenatal care ( OR: 0.481, 95% CI: 0.243–0.951) and had good drinking water quality at home ( OR: 0.493, 95% CI: 0.247–0.984) were more likely to avoid developing depressive symptoms.

          Conclusion

          This study found that the prevalence of maternal depressive symptoms during late pregnancy was high and had multiple influencing factors. Thus, screening for depressive symptoms in women in the late pregnancy stage and providing special intervention programs are necessary, especially for those with risk factors.

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          Most cited references52

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          The Fear of COVID-19 Scale: Development and Initial Validation

          Background The emergence of the COVID-19 and its consequences has led to fears, worries, and anxiety among individuals worldwide. The present study developed the Fear of COVID-19 Scale (FCV-19S) to complement the clinical efforts in preventing the spread and treating of COVID-19 cases. Methods The sample comprised 717 Iranian participants. The items of the FCV-19S were constructed based on extensive review of existing scales on fears, expert evaluations, and participant interviews. Several psychometric tests were conducted to ascertain its reliability and validity properties. Results After panel review and corrected item-total correlation testing, seven items with acceptable corrected item-total correlation (0.47 to 0.56) were retained and further confirmed by significant and strong factor loadings (0.66 to 0.74). Also, other properties evaluated using both classical test theory and Rasch model were satisfactory on the seven-item scale. More specifically, reliability values such as internal consistency (α = .82) and test–retest reliability (ICC = .72) were acceptable. Concurrent validity was supported by the Hospital Anxiety and Depression Scale (with depression, r = 0.425 and anxiety, r = 0.511) and the Perceived Vulnerability to Disease Scale (with perceived infectability, r = 0.483 and germ aversion, r = 0.459). Conclusion The Fear of COVID-19 Scale, a seven-item scale, has robust psychometric properties. It is reliable and valid in assessing fear of COVID-19 among the general population and will also be useful in allaying COVID-19 fears among individuals.
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            The Insomnia Severity Index: psychometric indicators to detect insomnia cases and evaluate treatment response.

            Although insomnia is a prevalent complaint with significant morbidity, it often remains unrecognized and untreated. Brief and valid instruments are needed both for screening and outcome assessment. This study examined psychometric indices of the Insomnia Severity Index (ISI) to detect cases of insomnia in a population-based sample and to evaluate treatment response in a clinical sample. Participants were 959 individuals selected from the community for an epidemiological study of insomnia (Community sample) and 183 individuals evaluated for insomnia treatment and 62 controls without insomnia (Clinical sample). They completed the ISI and several measures of sleep quality, fatigue, psychological symptoms, and quality of life; those in the Clinical sample also completed sleep diaries, polysomnography, and interviews to validate their insomnia/good sleep status and assess treatment response. In addition to standard psychometric indices of reliability and validity, item response theory analyses were computed to examine ISI item response patterns. Receiver operating curves were used to derive optimal cutoff scores for case identification and to quantify the minimally important changes in relation to global improvement ratings obtained by an independent assessor. ISI internal consistency was excellent for both samples (Cronbach α of 0.90 and 0.91). Item response analyses revealed adequate discriminatory capacity for 5 of the 7 items. Convergent validity was supported by significant correlations between total ISI score and measures of fatigue, quality of life, anxiety, and depression. A cutoff score of 10 was optimal (86.1% sensitivity and 87.7% specificity) for detecting insomnia cases in the community sample. In the clinical sample, a change score of -8.4 points (95% CI: -7.1, -9.4) was associated with moderate improvement as rated by an independent assessor after treatment. These findings provide further evidence that the ISI is a reliable and valid instrument to detect cases of insomnia in the population and is sensitive to treatment response in clinical patients.
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              The need for a new medical model: a challenge for biomedicine

              G. Engel (1977)
              The dominant model of disease today is biomedical, and it leaves no room within tis framework for the social, psychological, and behavioral dimensions of illness. A biopsychosocial model is proposed that provides a blueprint for research, a framework for teaching, and a design for action in the real world of health care.
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                Author and article information

                Contributors
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                06 June 2023
                2023
                : 14
                : 1181132
                Affiliations
                Department of Obstetrics, Lianyungang Maternal and Child Health Hospital, Lianyungang , Jiangsu, China
                Author notes

                Edited by: Ashwani Kumar Mishra, All India Institute of Medical Sciences, India

                Reviewed by: Humaira Maheen, The University of Melbourne, Australia; Ben Nephew, Worcester Polytechnic Institute, United States

                *Correspondence: Qian Meng lygmq6326@ 123456163.com
                Article
                10.3389/fpsyt.2023.1181132
                10281506
                37346902
                4d41987b-01b1-48f9-a4ab-14fd4aa96417
                Copyright © 2023 Chen, Liu, Min, Tong, Liu, Meng and Zhang.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 07 March 2023
                : 23 May 2023
                Page count
                Figures: 1, Tables: 4, Equations: 0, References: 52, Pages: 10, Words: 8020
                Categories
                Psychiatry
                Original Research
                Custom metadata
                Public Mental Health

                Clinical Psychology & Psychiatry
                depressive symptoms,pregnancy,biological factors,psychological factors,social factors

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