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BMC Psychiatry
Published in: BMC Psychiatry 1/2016

Open Access 01-12-2016 | Research article

Enhancing reciprocal partner support to prevent perinatal depression and anxiety: a Delphi consensus study

Authors: Pamela Pilkington, Lisa Milne, Kathryn Cairns, Thomas Whelan

Published in: BMC Psychiatry | Issue 1/2016

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Abstract

Background

Systematic reviews have established that partner support protects against perinatal mood problems. It is therefore a key target for interventions designed to prevent maternal and paternal depression and anxiety. Nonetheless, the extant literature is yet to be translated into specific actions that parents can implement. Prevention efforts aiming to facilitate reciprocal partner support within the couple dyad need to provide specific guidance on how partners can support one another to reduce their vulnerability to perinatal depression and anxiety.

Method

Two panels of experts in perinatal mental health (21 consumer advocates and 39 professionals) participated in a Delphi consensus study to establish how partners can support one another to reduce their risk of developing depression and anxiety during pregnancy and the postpartum period.

Results

A total of 214 recommendations on how partners can support each other were endorsed by at least 80 % of both panels as important or essential in reducing the risk of perinatal depression and anxiety. The recommendations were grouped under the following categories: becoming a parent, supporting each other through pregnancy and childbirth, communication, conflict, division of labor, practical support, emotional support, emotional closeness, sexual satisfaction, using alcohol and drugs, encouraging self-care, developing acceptance, and help-seeking.

Conclusion

This study established consensus between consumers and professionals in order to produce a set of guidelines on how partners can support each other to prevent depression and anxiety during pregnancy and following childbirth. It is hoped that these guidelines will inform the development of perinatal depression and anxiety prevention efforts.
Appendix
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Literature
1.
Dunkel SC. Psychological science on pregnancy: stress processes, biopsychosocial models, and emerging research issues. Annu Rev Psychol. 2011;62:531–58.CrossRef
2.
Burke L. The impact of maternal depression on familial relationships. International Review of Psychiatry. 2003;15(3):243–55.CrossRefPubMed
3.
Murray L, Cooper P. Intergenerational transmission of affective and cognitive processes assiociated with depression: infancy and the preschool years. Goodyear IM, editor. New York: Oxford University Press; 2003.
4.
Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T. Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol. 2005;106:1071–83.CrossRefPubMed
5.
Paulson J, Bazemore S. Prenatal and postpartum depression in fathers and its association with maternal depression: a meta-analysis. J Am Med Assoc. 2010;303:1961–9.CrossRef
6.
Dennis CL. Chung-Lee. Postpartum depression help-seeking barriers and maternal treatment preferences: a qualitative systematic review. Birth. 2006;33(4):323–31.CrossRefPubMed
7.
Forder P, Rich J, Harris S, Reilly N, Chojenta C, Austin M-P, et al. The issue of honesty during perinatal screening for depression and anxiety. Melbourne, Australia: Australasian Marcé Society Conference; 2013.
8.
Oddy B, Rowe H, Fisher J. Consumers’ views on the use of diagnostic labels to describe psychological distress in the postpartum: implications for health care. Australian Journal of Primary Health. 2009;15(1):9–16.CrossRef
9.
Brugha TS, Morrell CJ, Slade P, Walters SJ. Universal prevention of depression in women postnatally: cluster randomized trial evidence in primary care. Psychol Med. 2011;41(4):739–48.PubMedCentralCrossRefPubMed
10.
Dennis CL, Ross L. Women’s perceptions of partner support and conflict in the development of postpartum depressive symptoms. J Adv Nurs. 2006;56(6):588–99.CrossRefPubMed
11.
Highet NJ, Gemmill AW, Milgrom J. Depression in the perinatal period: awareness, attitudes and knowledge in the Australian population. Aust N Z J Psychiatry. 2011;45(3):223–31.CrossRefPubMed
12.
Hopkins J, Campbell S. Development and validation of a scale to assess social support in the postpartum period. Archives of Women’s Mental Health. 2008;11(1):57–65.CrossRefPubMed
13.
Rowe H, Fisher J. Development of a universal psycho-educational intervention to prevent common postpartum mental disorders in primiparous women: a multiple method approach. BMC Public Health. 2010;10:499–554.PubMedCentralCrossRefPubMed
14.
Don BP, Mickelson KD. Paternal postpartum depression: the role of maternal postpartum depression, spousal support, and relationship satisfaction. Couple and Family Psychology: Research and Practice. 2012;1(4):323–34.CrossRef
15.
Shapiro A, Gottman J, Carrere S. The baby and the marriage: identifying factors that buffer against decline in marital satisfaction after the first baby arrives. J Fam Psychol. 2000;14(1):59–70.CrossRefPubMed
16.
Divney AA, Sipsma H, Gordon D, Niccolai L, Magriples U, Kershaw T. Depression during pregnancy among young couples: the effect of personal and partner experiences of stressors and the buffering effects of social relationships. J Pediatr Adolesc Gynecol. 2012;25(3):201–7.PubMedCentralCrossRefPubMed
17.
Salmela-Aro K, Aunola K, Saisto T, Halmesmäki E, Nurmi J. Couples share similar changes in depressive symptoms and marital satisfaction anticipating the birth of a child. J Soc Pers Relat. 2006;23(5):781–803.CrossRef
18.
Matthey S, Barnett B, Ungerer J, Waters B. Paternal and maternal depressed mood during the transition to parenthood. J Affect Disord. 2000;60:75–85.CrossRefPubMed
19.
Giallo R, Cooklin A, Wade C, D’Esposito F, Nicholson J. Fathers’ postnatal mental health and child wellbeing at aged five: the mediating role of parental self-efficacy and parenting behaviour. J Fam Issues. 2011;35(11):1543–62.CrossRef
20.
Goodman JH. Paternal postpartum depression, its relationship to maternal postpartum depression, and implications for family health. J Adv Nurs. 2012;45(1):26–35.CrossRef
21.
Rowe H, Holton S, Fisher J. Postpartum emotional support: a qualitative study of women’s and men’s anticipated needs and preferred sources. Australian Journal of Primary Health. 2013;19(1):46–52.CrossRefPubMed
22.
Widarsson M, Engstrom G, Tyden T, Lundberg P, Hammar LM. ‘Paddling upstream’: Fathers’ involvement during pregnancy as described by expectant fathers and mothers. J Clin Nurs. 2015;24(7–8):1059–68.CrossRefPubMed
23.
Ross LE. Perinatal mental health in lesbian mothers: a review of potential risk and protective factors. Women Health. 2005;41(3):113–28.CrossRefPubMed
24.
Buist AE, Westle D, Hill C. Antenatal prevention of postnatal depression. Archive of Women’s Mental Health. 1999;1:167–73.CrossRef
25.
Letourneau N, Duffett-Leger L, Stewart M, Hegadoren K, Dennis CL, Rinaldi CM, et al. Canadian mothers’ perceived support needs during postpartum depression. J Obstet Gynecol Neonatal Nurs. 2007;36(5):441–9.CrossRefPubMed
26.
Bilszta J, Ericksen J, Buist A, Milgrom J. Women’s experience of postnatal depression: beliefs and attitudes as barriers to care. Aust J Adv Nurs. 2010;27(3):44–54.
27.
Pilkington PD, Whelan TA, Milne LC. A review of partner-inclusive interventions for preventing postnatal depression and anxiety. Clin Psychol. 2015;19(2):63–75.CrossRef
28.
Fisher J, Wynter K, Rowe H. Innovative psycho-educational program to prevent common postpartum mental disorders in primiparous women: a before and after controlled study. BMC Public Health. 2010;10:432–47.PubMedCentralCrossRefPubMed
29.
Forsyth C, Skouteris H, Wertheim EH, Paxton SJ, Milgrom J. Men’s emotional responses to their partner’s pregnancy and their views on support and information received. Aust N Z J Obstet Gynaecol. 2011;51(1):53–6.CrossRefPubMed
30.
McKellar LV, Pincombe JI, Henderson AM. Insights from Australian parents into educational experiences in the early postnatal period. Midwifery. 2006;22(4):356–64.CrossRefPubMed
31.
Sword W, Clark AM, Hegadoren K, Brooks S, Kingston D. The complexity of postpartum mental health and illness: a critical realist study. Nurs Inq. 2012;19(1):51–62.CrossRefPubMed
32.
Smith GC, Kohn SJ, Savage-Stevens SE, Finch JJ, Ingate R, Lim Y-O. The effects of interpersonal and personal agency on perceived control and psychological well-being in adulthood. The Gerontologist. 2000;40(4):458–68.CrossRefPubMed
33.
Cairns KE, Yap MB, Reavley NJ, Jorm AF. Identifying prevention strategies for adolescents to reduce their risk of depression: a Delphi consensus study. J Affect Disord. 2015;183:229–38.CrossRefPubMed
34.
Wee KY, Pier C, Milgrom J, Richardson B, Fisher J, Skouteris H. Fathers’ mental health during the ante- and postnatal periods: knowledge, recommendations and interventions. British Journal of Midwifery. 2013;21(5):342–53.CrossRef
35.
Rosenquist SE. When the bough breaks: rethinking treatment strategies for perinatal depression. Am J Clin Hypn. 2013;55(3):291–323.CrossRefPubMed
36.
Pilkington PD, Milne LC, Cairns KE, Lewis J, Whelan TA. Modifiable partner factors associated with perinatal depression and anxiety: a systematic review and meta-analysis. J Affect Disord. 2015;178:165–80.CrossRefPubMed
37.
Rini C, Schetter CD, Hobel CJ, Glynn LM, Sandman CA. Effective social support: antecedents and consequences of partner support during pregnancy. Pers Relat. 2006;13(2):207–29.CrossRef
38.
Austin M-P. Antenatal screening and early intervention for “perinatal” distress, depression and anxiety: where to from here? Archives of Women’s Mental Health. 2004;7(1):1–6.CrossRefPubMed
39.
Milgrom J, Gemmill AW, Bilszta JL, Hayes B, Barnett B, Brooks J, et al. Antenatal risk factors for postnatal depression: a large prospective study. J Affect Disord. 2008;108(1–2):147–57.CrossRefPubMed
40.
Teixeira C, Figueiredo B, Conde A, Pacheco A, Costa R. Anxiety and depression during pregnancy in women andmen. J Affect Disord. 2009;119(1–3):142–8.CrossRefPubMed
41.
Yelland J. Postpartum anxiety, depression and social health: findings from a population-based survey of Australian women. BMC Public Health. 2010;10(1):771–82.PubMedCentralCrossRefPubMed
42.
Seymour M, Giallo R, Cooklin A, Dunning M. Maternal anxiety, risk factors and parenting in the first post-natal year. Child Care Health Dev. 2015;41(2):314–23.CrossRefPubMed
43.
Jones J, Hunter D. Consensus methods for medical and health services research. Br Med J. 1995;311(7001):376–80.CrossRef
44.
Dalkey N, Helmer O. An experimental application of the Delphi method to the use of experts. Manag Sci. 1963;9(3):458–67.CrossRef
45.
McKenna HP. The Delphi technique: a worthwhile research approach for nursing? J Adv Nurs. 1994;19(6):1221–5.CrossRefPubMed
46.
Jorm AF. Using the Delphi expert consensus method in mental health research. Aust N Z J Psychiatry. 2015;49(10):887–897.CrossRefPubMed
47.
Berk L, Jorm AF, Kelly CM, Dodd S, Berk M. Development of guidelines for caregivers of people with bipolar disorder: a Delphi expert consensus study. Bipolar Disorder. 2011;13(5–6):556–70.CrossRef
48.
Kelly CM, Jorm AF, Kitchener BA. Development of mental health first aid guidelines on how a member of the public can support a person affected by a traumatic event: a Delphi study. BMC Psychiatry. 2010;10:49–54.PubMedCentralCrossRefPubMed
49.
Morgan AJ, Jorm AF. Self-help strategies that are helpful for sub-threshold depression: a Delphi consensus study. J Affect Disord. 2009;115(1–2):196–200.CrossRefPubMed
50.
International QSR. NCapture (Version 1.0.136.0). Doncaster, Australia: QSR International Pty Ltd; 2012.
51.
International QSR. NVivo Qualitative Data Analysis Software. 10th ed. Doncaster, Australia: QSR International Pty Ltd; 2012.
52.
53.
Qualtrics. In: Provo, editor. Qualtrics software. UT: Qualtrics; 2013.
54.
Reavley NJ, Ross A, Killackey EJ, Jorm AF. Development of guidelines to assist organisations to support employees returning to work after an episode of anxiety, depression or a related disorder: a Delphi consensus study with Australian professionals and consumers. BMC Psychiatry. 2012;12(1):135–42.PubMedCentralCrossRefPubMed
55.
Edward KL, Castle D, Mills C, Davis L, Casey J. An integrative review of paternal depression. American Journal of Men’s Health. 2015;9(1):26–34.CrossRefPubMed
56.
Wallby T, Modin B, Hjern A. Child health care utilisation in families with young or single mothers in a Swedish county. Journal of Child Health Care. 2012;17(1):17–29.
57.
Habib C. Paternal perinatal depression: an overview and suggestions towards an intervention model. J Fam Stud. 2012;18(1):4–16.CrossRef
58.
Sanders MR, Kirby JN. Consumer engagement and the development, evaluation, and dissemination of evidence-based parenting programs. Behav Ther. 2012;43(2):236–50.CrossRefPubMed
59.
Fischer JA, Kelly CM, Kitchener BA, Jorm AF. Development of guidelines for adults on how to communicate with adolescents about mental health problems and other sensitive topics: a Delphi study. SAGE Open. 2013;3:4.CrossRef
60.
Hasson F, Keeney S, McKenna H. Research guidelines for the Delphi survey technique. J Adv Nurs. 2000;32(4):1008–15.PubMed
61.
Haga SM. Identifying risk factors for postpartum depressive symptoms: the importance of social support, self-efficacy, and emotion regulation. Oslo, Norway: University of Oslo; 2012.
62.
Boyce PM. Risk factors for postnatal depression: a review and risk factors in Australian populations. Archive of Women’s Mental Health. 2003;6 Suppl 2:s43–50.CrossRef
63.
Lee AM, Lam SK, Lau SMSM, Chong CSY, Chui HW, Fong DYT. Prevalence, course, and risk factors for antenatal anxiety and depression. Obstet Gynecol. 2007;110(5):1102–12.CrossRefPubMed
64.
Wee KY, Skouteris H, Pier C, Richardson B, Milgrom J. Correlates of ante- and postnatal depression in fathers: a systematic review. J Affect Disord. 2011;130(3):358–77.CrossRefPubMed
65.
Australian Bureau of Statistics. Family Characteristics, Australia, 2009–10. Canberra, Australia: Australian Bureau of Statistics; 2011.
66.
67.
Kelders SM, Pots WT, Oskam MJ, Bohlmeijer ET, van Gemert-Pijnen JE. Development of a web-based intervention for the indicated prevention of depression. BMC Medical Informatics and Decision Making. 2013;13(26):1–11.
68.
Cooklin AR, Giallo R, Strazdins L, Martin A, Leach LS, Nicholson JM. What matters for working fathers? Job characteristics, work-family conflict and enrichment, and fathers’ postpartum mental health in an Australian cohort. Social Science & Medicine. 2015.
69.
Feinberg ME, Kan ML. Establishing family foundations: intervention effects on coparenting, parent/infant well-being, and parent–child relations. J Fam Psychol. 2008;22(2):253–63.PubMedCentralCrossRefPubMed
Metadata
Title
Enhancing reciprocal partner support to prevent perinatal depression and anxiety: a Delphi consensus study
Authors
Pamela Pilkington
Lisa Milne
Kathryn Cairns
Thomas Whelan
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2016
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-016-0721-0

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