Relationship between postpartum mood disorder and birth experience: a prospective observational study.

BACKGROUND: This study aims to investigate the relationship between the birth experience and the risk of developing postpartum depression or post-traumatic stress disorder. METHODS: In this prospective, longitudinal, observational study, women were assessed at different time points for depression and post-traumatic stress disorder. The risk of depression or post-traumatic stress disorder based on patient characteristics and specific birth events was assessed within three months postpartum. RESULTS: We enrolled 600 women; 426 were eligible for postpartum assessment. At six weeks and three months postpartum, 15.9% and 12.7% screened positive for depression respectively. Positive post-traumatic stress disorder screenings at six weeks and three months postpartum were 6.2% and 5.1% respectively. Twenty-seven women (8.3%) with a negative screening at six weeks converted to a positive depression or post-traumatic stress disorder screening at three months. A pre-existing history of anxiety or depression was associated with an increased risk of developing depression (aOR 2.12, 95% CI 1.30 to 3.47) and post-traumatic stress (aOR 3.15, 95% CI 1.42 to 7.02) within three months postpartum. The risk of developing post-traumatic stress disorder within three months postpartum was also increased among patients experiencing their first delivery (aOR 2.55, 95% CI 1.10 to 5.88) or operative management of postpartum hemorrhage (aOR 4.44, 95% CI 1.16 to 17.02). CONCLUSION: Depression and post-traumatic stress symptoms either persisted or had new onset at three months postpartum. Mental health screening and postpartum follow-up after six weeks should be considered in high-risk patients who have a history of psychopathology, nulliparity, or undergo operative management of postpartum hemorrhage.

Temporal constraints in processing of nonverbal rhythmic patterns.

This study investigates the effect of a mental content of presented stimuli, normal aging and individual differences in cognitive abilities on temporal limits of an integration mechanism. Younger and older subject grouped together the beats generated by a metronome. Subjects were asked to listen to the beats of a metronome and to accentuate mentally every second, third, fourth...etc. beat, to create a subjective rhythm. This rhythm exists, in fact, only in subjects' mind and not objectively. Subjects reported verbally how many clicks they were able to integrate into a perceptual unit. On this basis, the time interval during which subjects were able to integrate temporally separated stimuli was calculated (number of beats reported as being integrated x time distance between beats) for different metronome frequencies. The results show, firstly, that the length of integration periods significantly depends on the frequency of presented metronome beats. When the frequency of metronome beats is high, the time interval during which the subjects integrate beats into a single perceptual unit is shorter. Secondly, older adults integrate information during a longer time interval than younger ones. Thirdly, the length of an integration period is related to a subjects' level of cognitive ability. These results suggest that the length of an integration period is not a constant, stable feature, but varies across the life span depending on the mental content of the information presented and individual factors.

[References for evaluation scales in quality assurance in rehabilitation--1. II. Measuring functional independence in rehabilitation with the Functional Independence Index]. / Hinweise auf Bewertungsinstrumente zur Qualitätssicherung in der Rehabilitation--Blatt 1. II. Messung der funktionalen Selbständigkeit in der Rehabilitation mit dem Funktionalen Selbständigkeitsindex (FIM).

Presented is an instrument assessing functional independence in rehabilitation. This instrument, the Functional Independence Measure (FIM), was developed in the USA and translated into German. Considerable experience and research has accumulated concerning its application, formal properties and function in interdisciplinary rehabilitation. Application and evaluation of the FIM is demonstrated in a case study. The FIM is shown to be a reliable and highly informative instrument measuring disability according to ICIDH criteria in clinical practice. It reflects reliably the amount of help and assistance required by the individual patient.