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1.
J Womens Health (Larchmt) ; 2022 Apr 07.
Article in English | MEDLINE | ID: covidwho-1778870

ABSTRACT

Objective: Studies examining the impact of natural disasters noted that in the setting of stable rates of depression, postpartum depression (PPD) increased in vulnerable subgroups. COVID-19 may similarly impact maternal health. This study aimed to characterize the effect of COVID-19 on the incidence of PPD and to identify vulnerable subgroups. Methods: Retrospective chart review of maternal-newborn dyads was conducted over two epochs: pre-COVID-19 (January 1-June 1, 2019) and during-COVID-19 (January 1-June 1, 2020). PPD was defined as an Edinburgh Postnatal Depression Scale score of ≧ 10 at any postnatal appointment. Prevalence of depression and anxiety was recorded. Data were analyzed using chi-square, Mann-Whitney, and t-tests. Results: Among 1061 dyads (557 in the 2019 epoch, 504 in the 2020 epoch), the epochs had similar clinical and demographic characteristics. Incidence proportion of PPD was similar (16.9% to 18.1%, p = 0.67). In subgroup analyses, this outcome was also similar among primiparous mothers (17.4% to 22.2%, p = 0.22) and publicly insured mothers (23.9% to 25.9%, p = 0.78). The 2020 epoch exhibited higher prevalence of current depression (9.9% to 14.3%, p = 0.03) and anxiety (10.1% to 18.7%, p < 0.001). However, incidence proportion of PPD decreased among women with current mental health diagnoses (41.5% to 31.3%, p = 0.19). Conclusions: A stable PPD incidence despite increased prevalence of current mood disorders highlights the complexity of the biopsychosocial milieu contributing to PPD. Further study of psychiatric care access and treatment is an important next step in understanding relationships between current mood disorders and PPD during the pandemic.

2.
J Huntingtons Dis ; 10(2): 313-322, 2021.
Article in English | MEDLINE | ID: covidwho-1195998

ABSTRACT

BACKGROUND: Safer-at-home orders during the COVID-19 pandemic altered the structure of clinical care for Huntington's disease (HD) patients. This shift provided an opportunity to identify limitations in the current healthcare infrastructure and how these may impact the health and well-being of persons with HD. OBJECTIVE: The study objectives were to assess the feasibility of remote healthcare delivery in HD patients, to identify socioeconomic factors which may explain differences in feasibility and to evaluate the impact of safer-at-home orders on HD patient stress levels. METHODS: This observational study of a clinical HD population during the 'safer-at-home' orders asked patients or caregivers about their current access to healthcare resources and patient stress levels. A chart review allowed for an assessment of socioeconomic status and characterization of HD severity. RESULTS: Two-hundred and twelve HD patients were contacted with 156 completing the survey. During safer-at-home orders, the majority of HD patients were able to obtain medications and see a physician; however, 25% of patients would not commit to regular telehealth visits, and less than 50% utilized an online healthcare platform. We found that 37% of participants were divorced/single, 39% had less than a high school diploma, and nearly 20% were uninsured or on low-income health insurance. Patient stress levels correlated with disease burden. CONCLUSION: A significant portion of HD participants were not willing to participate in telehealth services. Potential explanations for these limitations may include socioeconomic barriers and caregiving structure. These observations illustrate areas for clinical care improvement to address healthcare disparities in the HD community.


Subject(s)
COVID-19 , Huntington Disease , Telemedicine , Adult , Cost of Illness , Female , Healthcare Disparities , Humans , Huntington Disease/epidemiology , Huntington Disease/therapy , Male , Middle Aged , Patient Acceptance of Health Care , SARS-CoV-2 , Socioeconomic Factors , Surveys and Questionnaires
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