Biomedical subjects

Anne Buist

Publications and source records attributed to Anne Buist.

11 recordsLinked to original sources

PubMed2006

National program for depression associated with childbirth: the Australian experience.

Routine screening was introduced as a joint research/public-health initiative across 43 health services in Australia, funded by beyondblue, the National Australian Depression Initiative. This program included assessing risk factors and prevalence of depression in perinatal women. Other objectives included increasing awareness of the condition, training of relevant staff, and assessing the feasibility of a screening program. Women were screened antenatally and postnatally with a demographic questionnaire and the Edinburgh Postnatal Depression Scale. A subgroup of women and health professionals was surveyed. Over 40,000 women participated directly in the program. Data and issues for specific groups are presented. There was a high level of acceptability to women and health professionals involved. Screening is acceptable and feasible as part of the mental-health management of perinatal women. It needs to be supplemented with information for women and education and support for staff.

Adult↗

PubMed2006

Acceptability of routine screening for perinatal depression.

BACKGROUND: To assess the acceptability of routine screening for perinatal depression. METHOD: Postnatal women (n=860) and health professionals (n=916) were surveyed after 3 years of routine perinatal (antenatal and postnatal) use of the Edinburgh Postnatal Depression Scale (EPDS). RESULTS: Over 90% of women had the screening explained to them and found the EPDS easy to complete; 85% had no difficulties completing it. Discomfort with screening was significantly related to having a higher EPDS score. A majority of health professionals using the EPDS was comfortable and found it useful. LIMITATIONS: The sample involved only maternity services supporting depression screening. In addition, the response rate from GPs was low. CONCLUSIONS: Routine screening with the EPDS is acceptable to most women and health professionals. Sensitive explanation, along with staff training and support, is essential in implementing depression screening.

Adult↗

PubMed2006

Perinatal depression--assessment and management.

BACKGROUND: Depression and anxiety often begin in pregnancy, particularly third trimester, therefore 'perinatal' rather than postnatal depression might be a better term to describe this disorder. OBJECTIVE: This article outlines an approach to assessment and management of perinatal depression. DISCUSSION: Psychological difficulties are common after childbirth and have potentially serious consequences. Treatment needs to consider the complex interplay of biology and psychology, and both mother and infant need consideration. Early, assertive identification and sensitive management, mindful of risks and benefits to both mother and infant, is the best current approach to improving outcomes.

Antidepressive Agents↗

PubMed2005

Postnatal depression: a Korean perspective.

OBJECTIVE: To provide insight into the cultural influences on postnatal depression (PND) in women from Korean backgrounds. CONCLUSIONS: Lack of support has been seen to be a key risk factor in postnatal depression. In Korean society, little research has been done on this disorder, but it is likely that traditional support might have a protective role. Erosion of this with westernization of Korea, or isolation in Korean immigrants to Australia, is likely to be significant for new mothers from this cultural background.

Asian People↗

PubMed2005

Recognition and management of perinatal depression in general practice--a survey of GPs and postnatal women.

OBJECTIVE: To identify ways to improve detection and access to treatment. METHODS: A survey of general practitioners and postnatal women across Australia addressing knowledge of, and attitudes to, postnatal depression using case vignettes. RESULTS: General practitioners were significantly more likely to recognise depression than postnatal women, who were likely to seek help for more general or baby related issues. Both GPs and women favoured help from partners and counselling, but GPs significantly favoured antidepressants and women, natural therapies. DISCUSSION: Women have a low likelihood of presenting for depression, suggesting a role for screening by GPs. Women preferred psychological and social management than drugs for depression perinatally.

Adult↗

PubMed2004

Improving the postnatal outcomes of new mothers.

BACKGROUND: Postnatal depression persists worldwide as a troubling issue for many new mothers and their families. The practice of early discharge within 72 hours after birth from maternity hospitals in Australia requires community-based care of new mothers, typically provided by community midwives initially, and then by maternal and child health nurses (MCHN). This latter workforce encounters the onset of distress/depression in vulnerable women and is expected to manage their care, but their training does not equip sufficiently them to do this. AIMS: The aim of the study was to evaluate the effectiveness of brief training for MCHN in early detection and effective management of mildly distressed new mothers. METHODS: A controlled comparative longitudinal study was carried out with a group of first-time mothers recruited through antenatal clinics at four major hospitals in a large Australian city. Forty MCHN were allocated to the intervention group. Those in the intervention group received training in the identification and management of distressed mothers. Intervention group nurses also had access to a liaison psychiatric network for consultation and referrals. Other nurses were allocated to the control group, which provided standard management services to new mothers in their catchment areas. Mothers' outcomes in psychological and psychosocial functioning were assessed; comparing those cared for by the nurses who had received the intervention with those cared for by standard practices. Mothers' satisfaction with the maternal and child health nurse services was also assessed. RESULTS: Levels of distress peaked in early pregnancy in both groups and reduced over the study period. Rates and group levels of psychological distress and psychosocial functioning did not differ over time between mothers receiving care from the enhanced trained nurses and those receiving standard care. Differential group findings were apparent in attrition, with the more distressed mothers withdrawing from the control group and the less distressed withdrawing from the intervention group. Satisfaction with maternal and child health nurse services was high in both groups. Limitations of the study included events occurring while the study was in progress, such as staffing upheaval and unrest following the introduction of compulsory competitive tendering requirements, heavy workloads and the concurrent introduction of computerized case records that required the rapid familiarization with computer usage. CONCLUSIONS: Findings indicate that the extra training of MCHN did not substantially assist in the detection and management of postnatal distress in these new mothers. Unexpected ecological conditions of workforce disruption and extra workloads may have mitigated against the success of the programme. Limitations of the study are examined and the implications for future research are discussed.

Adolescent↗

PubMed2003

Promoting positive parenthood: emotional health in pregnancy.

Depression is a common problem in the general population and is projected to be one of the major health issues facing the world in 2020 (WHO). Serious consequences exist for the sufferer, and the family. Given that women are twice as likely to suffer from depression, and are at particular risk in the child bearing years, children from infancy may be affected, with long term ramifications. Postnatal depression (PND) occurs in 14% of women, and there may be a similar number affected antenatally. The perinatal period thus is a crucial time to identify depression, and offers an excellent opportunity to screen women due to their increased contact with health services. In order to do so, services need to reevaluate their priorities, and assess barriers to screening. These barriers include attitudes to mental illness, anxiety about how to deal with mental illness in health professionals who are not trained in this area, and--most importantly--resource implications. It is argued that without attempting to address this, identify and remedy the deficiencies, change will not occur. This paper looks to examine the prevalence of depression in the perinatal period, the associated concerns and the difficulties of identification at this time through a review of key relevant papers in this area, and proposes a framework to approach the problem.

Australia↗

PubMed2003

Motherhood and schizophrenic illnesses: a review of the literature.

OBJECTIVE: To provide an overview of the current knowledge on the impact of motherhood on women with schizophrenia and schizoaffective disorder. METHOD: The published literature was selectively reviewed and assessed, based on a complete MEDLINE and PsychLIT (1971 to current) search, including English and non-English journals and books. RESULTS: Research to date into motherhood and schizophrenic illnesses has been limited by a number of methodological constraints, limiting the ability to draw conclusions and the prevention of relapses and mother-infant difficulties. These constraints have included: a paucity of prospective studies with initial, antenatal recruitment; variable definitions of the length of the puerperium; significant changes in psychiatric classification; the heterogeneity of postpartum psychotic disorders, with the majority being mood or schizoaffective disorder rather than schizophrenia; selection biases inherent in studying mother-baby unit inpatients; difficulties in life events research in general, such as its retrospective nature and confounding, illness factors; and the specificity versus non-specificity of childbirth as a unique or discrete life event. CONCLUSIONS: Further study is required to explore: the impact of child care, parenting and having a partner on the course of women with schizophrenic and schizoaffective disorders during the first postpartum year; whether women with postpartum relapses of these mental illnesses are likely to have slower recoveries than those women with the same diagnoses but without young children; and protective factors against postpartum relapse.

Depression, Postpartum↗

PubMed2002

Olanzapine excretion in human breast milk: estimation of infant exposure.

Newer antipsychotic drugs offer significant clinical advantages for the treatment of psychosis. In particular for the treatment of postpartum disorders newer agents may be suited due to their favourable side-effect profiles. Of concern is the passage of the drugs into breast milk and what potential risks this poses for an infant who is breastfed. The excretion of olanzapine into the breast milk of five lactating women with postpartum psychosis was examined in this study. Nine pairs of plasma and breast-milk samples were collected and the concentration of olanzapine determined by high-performance liquid chromatography. Single-point milk-to-plasma ratios were calculated and ranged from 0.2 to 0.84 with a mean of 0.46. The median relative infant dose was 1.6% (range 0-2.5%) of the weight-adjusted maternal dose. During the study period, there were no apparent ill effects on the infant as a consequence of exposure to these doses of olanzapine. As with other antipsychotic drugs this study demonstrates that olanzapine passes into breast milk. The long-term effects of exposure in infants exposed to olanzapine requires further investigation.

Adult↗

PubMed2000

Sertraline in paired blood plasma and breast-milk samples from nursing mothers.

Paired blood and breast-milk samples were collected from 10 nursing mothers receiving sertraline. Samples were collected at steady state when the patients had been taking stable doses of 50-150 mg/day over several weeks. Sertraline concentrations in both fluids were determined using a specific, validated HPLC method. Plasma and milk concentrations showed a wide inter-individual variability for the same dose. Mean plasma concentrations were linearly related to dose, but this was not the case for breast-milk concentrations. An overall milk to plasma ratio of 1.76+/-1.72 was recorded. The average dose to the infants ranged from 1.1 to 31.1 &mgr;g/kg, which is less than 2 per cent of the maternal dose per day. Further studies are necessary to determine if these doses are detrimental to the development of the infant. Copyright 2000 John Wiley & Sons, Ltd.

Journal Article↗

PubMedDate not supplied

Men's adjustment to fatherhood: implications for obstetric health care.

OBJECTIVE: To assess factors affecting first-time fathers' transition to parenthood. DESIGN: A longitudinal repeated measures study in which participants were interviewed in mid-pregnancy and completed assessments in late pregnancy, in early postpartum, and at 4 months postpartum. SELLING AND PARTICIPANTS: Two hundred twenty-five first-time fathers were recruited from a major obstetric hospital in Melbourne, Victoria, from 1995 to 1998, via their partners. MAIN OUTCOME MEASURES: Men were seen separately from their spouses, and questionnaires assessing parity history, social support, marital satisfaction, anger, anxiety, and gender role stress were completed at each time. Prenatal and postnatal distress were measured by the Edinburgh Postnatal Depression Scale. RESULTS: Men's peak period of distress was at the first assessment in pregnancy, where there was an overrepresentation of younger men, who were employed part-time and in shorter relationships. For most of the men, their anxieties decreased steadily postpartum. Lower relationship satisfaction was associated with distress, as was gender role stress, both antenatally and postpartum. Distress was also seen to affect men's attachment to their infants. CONCLUSIONS: Although most men deal effectively with the transition to fatherhood, a small group of distressed men may have continued problems in their role as a parent and partner. If more attention can be paid to their anxieties antenatally, it might benefit the men, their partners, and their infants.

Adaptation, Psychological↗