Predictors and incidence of post-partum depression: a longitudinal cohort study.

AIM: This study was designed to identify the incidence and the related factors contributing to post-partum depression (PPD) in women in Iran for the first time. MATERIAL AND METHODS: A total of 2279 eligible pregnant women from 32-42 weeks of pregnancy to 12 weeks post-partum (2009) who attended primary health centers in Mazandaran province were screened for depression using the Iranian version of the Edinburgh Postnatal Depression Scale. Pregnant women free from depression were assessed using validated questionnaires, including the Premenstrual Syndrome Questionnaire, Social Support Appraisal Scale, Network Orientation Scale, General Health Questionnaire, Marital Inventory, Life Events Rating Scale and Parental Expectation Survey. Logistic regression analysis was used to determine the risk factors of PPD. RESULTS: Of 1801 women who screened negative for depression at 32-42 weeks' gestation, cumulative incidence proportions were 6.7%, 4.3% and 4.5% during 0-2, >2-8 and >8-12 weeks post-partum, respectively. The factors predictive of PPD were: history of depression during the first two trimesters of pregnancy (odds ratio [OR] = 2.55, 95% confidence interval [CI] = 1.59-4.1); psychiatric disorder during pregnancy (OR = 1.08, 95%CI = 1.06-1.11); gestational diabetes (OR = 2.93, 95%CI = 1.46-5.88); recurrent urinary infection (OR = 2.25, 95%CI = 1.44-3.52); unwanted pregnancy (OR = 2.5, 95%CI = 1.69-3.7) and low household income (OR = 3.57, 95%CI = 1.49-8.5). The risk was decreased with increasing age (OR = 0.88, 95%CI = 0.84-0.92) and those with high self-efficacy for mothering (OR = 0.7, 95%CI = 0.62-0.78). CONCLUSION: A high rate of new cases of PPD was identified in Iranian women. A combination of psychological, sociological, obstetric and sociodemographic factors can render mothers vulnerable to post-partum depression.

Bio-psycho-socio-demographic and Obstetric Predictors of Postpartum Depression in Pregnancy: A prospective Cohort Study.

OBJECTIVE: There are various attempts to confirm variables that could predict postpartum depression in advance. This study determined antenatal risk factors for postpartum depression in women at risk of developing this disorder. METHODS: A prospective cohort study was conducted with 2279 eligible women who attended at Mazandaran province' primary health centers from 32-42 weeks of pregnancy to eighth postpartum weeks. The women were screened for symptoms of depression using the Iranian version of Edinburgh Postnatal Depression Scale. An Edinburgh Postnatal Depression Scale score of > 12 indicated possible postpartum depression. Univariate and multiple logistic regression models were used for data analysis. RESULTS: A total of 2083women during 32-42 weeks of gestation participated in this study and were followed up to 8-week postpartum. Four hundred and three (19.4%) mothers yielded scores above the threshold of 12. Depression and general health state in pregnancy based on Edinburgh Postnatal Depression Scale (OR = 1.35, CI = 1.3-1.4) and General Health Questionnaire-28 (OR = 1.03, CI = 1.01-1.04), respectively were significant independent antenatal risk factors of depression symptoms at 8-week postpartum. Mothers who lived in nuclear families (OR = 1.38, CI = 1.04-1.84), whose husbands had lower educational status (OR = 0.95, CI = 0.91-0.99), and with delayed prenatal care (OR = 1.01, CI = 1.001-1.03) were more susceptible to postpartum depression. CONCLUSION: A comprehensive antenatal assessment focused on psychiatric problems, environmental and obstetric factors would benefit pregnant women in the prevention of postpartum depression.

The Socio-Demographic and Clinical Factors Associated with Quality of Life among Patients with Haematological Cancer in a Large Government Hospital in Malaysia.

BACKGROUND: The paper examined the quality of life of haematological cancer patients according to their socio-demographic profiles and clinical diagnoses. METHODS: This cross-sectional study was conducted at the tertiary referral centre of Ampang Hospital, Kuala Lumpur, involving 105 patients. The European Organisation for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) questionnaire was used to measure their quality of life. RESULTS: The study involved patients diagnosed with all types of haematological cancer, including non-Hodgkin lymphoma (NHL), acute myelogenous leukaemia (AML), acute lymphoblastic leukaemia (ALL), Hodgkin lymphoma (HL), and multiple myeloma (MM), with a response rate of 83.3%. The patients with ALL, HL, without NHL, and without MM were younger than other patients. There were significant differences in quality of life scores in different socio-demographic groups and types of cancer diagnosis. The global quality of life of the female patients was much better than that of the male patients. Patients who were 40 years old or younger had a better global quality of life and physical functioning, as well as fewer symptoms of constipation, nausea, and vomiting. Employed patients were in less pain but showed greater impairments of cognitive function than did unemployed patients. Patients who earned a monthly wage of RM1000 or less had reduced physical function, more symptoms of pain, and more financial difficulties compared with patients who earned more. Patients with AML tended to have better physical functioning than did patients with MM, whose physical functioning was impaired. Comparatively, more symptoms of dyspnoea were found in ALL and HL patients than in other types of lymphoma. Compared with other patients, those with ALL had a greater loss of appetite, and other lymphoma patients had fewer symptoms of pain. Patients with NHL had impaired role functioning and more constipation compared with other patients. The results were all statistically significant (P < 0.05). CONCLUSION: The quality of life of haematological cancer patients is affected by socio-demographic factors and clinical diagnoses. Efforts should be made to improve the overall quality of life of these patients.

A Case Control Study on Risk Factors Associated with Drug Addiction amongst Malaysian Males

Objectives: Drug addiction poses a significant threat to the health, social and economic fabric of families, communities and nations. The aim of this study was to determine factors associated with drug addiction amongst Malaysian males. Methods: A population-based case control study was carried out in Johor state. Cases were defined as confirmed male drug dependents aged 15 and above. Controls were defined as those aged 15 and above who had never used illegal drugs in their lifetime. A total of 1016 cases were selected at random from a list obtained from the state anti-drug agency and 1106 controls were sampled from a population-based sampling frame. After obtaining verbal consent, they were interviewed by trained graduates. Multiple logistic regression analysis was performed using StataV8.2. The final model was adjusted for smoking, age, alcohol consumption, importance of religion, ethnicity, education level and self-esteem. Results: The final model had good fit (p>0.05) and good discrimination (AUC=0.94). Compared with those aged 15-19 years, the highest risk was amongst the 20-29 years age group (adjusted OR(aOR) 7.2; 95%CI=3.8,13.7) followed by the 30-39 year age group (aOR 5.4; 95%CI=2.9, 10.2) and 40-49 year age groups (aOR 5.0;95%CI=2.6,9.8). Being an ever-smoker was highly associated with drug addiction (aOR 98.7; 95%CI=28.7, 339.5). Compared with the Chinese, Malays (aOR 7.4;95%CI=4.9,11.2) and Indians (aOR 3.8;95%CI=2.1,7.0) had a higher risk of drug addiction. Drug addiction was associated with disagreeing "that religion is important as guidance in their life" (aOR 16.2;95%CI=8.3,31.9), and a histor of alcohol consumption (aOR 7.6; 95%CI=5.6,10.4). Conclusion: In conclusion the important risk factors associated with drug addiction is smoking, ethnicity, age, education level, alcohol consumption and not giving importance to religion as guidance in their life.However an increased self-esteem (aOR 0.6;95%CI=0.4,0.5) is protective against drug addiction.