Recommendations for mental health professionals in the NICU

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Abstract

This article describes recommended activities of social workers, psychologists and psychiatric staff within the neonatal intensive care unit (NICU). NICU mental health professionals (NMHPs) should interact with all NICU parents in providing emotional support, screening, education, psychotherapy and teleservices for families. NMHPs should also offer educational and emotional support for the NICU health-care staff. NMHPs should function at all levels of layered care delivered to NICU parents. Methods of screening for emotional distress are described, as well as evidence for the benefits of peer-to-peer support and psychotherapy delivered in the NICU. In the ideal NICU, care for the emotional and educational needs of NICU parents are outcomes equal in importance to the health and development of their babies. Whenever possible, NMHPs should be involved with parents from the antepartum period through after discharge.

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Most cited references 42

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Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale.

J Cox, J. Holden, R Sagovsky (1987)

The development of a 10-item self-report scale (EPDS) to screen for Postnatal Depression in the community is described. After extensive pilot interviews a validation study was carried out on 84 mothers using the Research Diagnostic Criteria for depressive illness obtained from Goldberg's Standardised Psychiatric Interview. The EPDS was found to have satisfactory sensitivity and specificity, and was also sensitive to change in the severity of depression over time. The scale can be completed in about 5 minutes and has a simple method of scoring. The use of the EPDS in the secondary prevention of Postnatal Depression is discussed.

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Resilience to loss and potential trauma.

George Bonanno, Maren Westphal, Anthony Mancini (2011)

Initial research on loss and potentially traumatic events (PTEs) has been dominated by either a psychopathological approach emphasizing individual dysfunction or an event approach emphasizing average differences between exposed and nonexposed groups. We consider the limitations of these approaches and review more recent research that has focused on the heterogeneity of outcomes following aversive events. Using both traditional analytic tools and sophisticated latent trajectory modeling, this research has identified a set of prototypical outcome patterns. Typically, the most common outcome following PTEs is a stable trajectory of healthy functioning or resilience. We review research showing that resilience is not the result of a few dominant factors, but rather that there are multiple independent predictors of resilient outcomes. Finally, we critically evaluate the question of whether resilience-building interventions can actually make people more resilient, and we close with suggestions for future research on resilience. © 2011 by Annual Reviews. All rights reserved

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The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and meta-analysis.

Sophie Grigoriadis, Emily VonderPorten, Lana Mamisashvili … (2013)

Depression often remains undertreated during pregnancy and there is growing evidence that untoward perinatal outcomes can result. Our systematic review and meta-analysis was conducted to determine whether maternal depression during pregnancy is associated with adverse perinatal and infant outcomes. MEDLINE, EMBASE, CINAHL, and PsycINFO were searched from their start dates to June 2010. Keywords utilized included depressive/mood disorder, postpartum/postnatal, pregnancy/pregnancy trimesters, prenatal or antenatal, infant/neonatal outcomes, premature delivery, gestational age, birth weight, NICU, preeclampsia, breastfeeding, and Apgar. English language studies reporting on perinatal or child outcomes associated with maternal depression were included, 3,074 abstracts were reviewed, 735 articles retrieved, and 30 studies included. Two independent reviewers extracted data and assessed article quality. All studies were included in the primary analyses, and between-group differences for subanalyses are also reported. Thirty studies were eligible for inclusion. Premature delivery and decrease in breastfeeding initiation were significantly associated with maternal depression (odds ratio [OR] = 1.37; 95% CI, 1.04 to 1.81; P = .024; and OR = 0.68; 95% CI, 0.61 to 0.76; P < .0001, respectively). While birth weight (mean difference = -19.53 g; 95% CI, -64.27 to 25.20; P = .392), low birth weight (OR = 1.21; 95% CI, 0.91 to 1.60; P = .195), neonatal intensive care unit admissions (OR = 1.43; 95% CI, 0.83 to 2.47; P = .195), and preeclampsia (OR = 1.35; 95% CI, 0.95 to 1.92; P = .089) did not show significant associations in the main analyses, some subanalyses were significant. Gestational age (mean difference = -0.19 weeks; 95% CI, -0.53 to 0.14; P = .262) and Apgar scores at 1 (mean difference = -0.05; 95% CI, -0.28 to 0.17; P = .638) and 5 minutes (mean difference = 0.01; 95% CI, -0.08 to 0.11; P = .782) did not demonstrate any significant associations with depression. For premature delivery, a convenience sample study design was associated with higher ORs (OR = 2.43; 95% CI, 1.47 to 4.01; P = .001). Maternal depression during pregnancy is associated with increased odds for premature delivery and decreased breastfeeding initiation; however, the effects are modest. More research of higher methodological quality is needed. © Copyright 2013 Physicians Postgraduate Press, Inc.

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Author and article information

Journal

Journal ID (nlm-ta): J Perinatol

Journal ID (iso-abbrev): J Perinatol

Title: Journal of Perinatology

Publisher: Nature Publishing Group

ISSN (Print): 0743-8346

ISSN (Electronic): 1476-5543

Publication date (Print): December 2015

Publication date (Electronic): 24 November 2015

Volume: 35

Issue: Suppl 1

Pages: S14-S18

Affiliations

[1 ]Department of Psychology, University of Wisconsin-Milwaukee , Milwaukee, WI, USA

[2 ]Department of Pediatrics, Division of Neonatology, New York Presbyterian Morgan Stanley Children's Hospital, Columbia University , New York, NY, USA

[3 ]Department of Social Work, University of Alabama at Birmingham , Birmingham, AL, USA

[4 ]Department of Neonatology, West Penn Hospital , Pittsburgh, PA, USA

[5 ]Department of Psychology, Drexel University , Philadelphia, PA, USA

[6 ]Department of Obstetrics and Gynecology, Drexel University College of Medicine , Philadelphia, PA, USA

[7 ]Department of Pediatrics, University of Kansas Medical Center , Kansas City, KS, USA

[8 ]Cheryl Milford Consulting , Huntington Beach, CA, USA

[9 ]Wisconsin Association for Perinatal Care/Perinatal Foundation , Madison, WI, USA

[10 ]Division of Neonatology, Children's Hospital of Philadelphia , Philadelphia, PA, USA

[11 ]Department of Pediatrics and Neonatology, Health and Science University , Portland, OR, USA

[12 ]College of Nursing, and Department of Psychological and Brain Science, University of Iowa , Iowa City, IA, USA

[13 ]Division of Maternal Fetal Medicine, University of North Carolina , Chapel Hill, NC, USA

Author notes

[* ]9836 Leeward Avenue, Key Largo, FL 33037, USA. E-mail: hynan@ 123456uwm.edu

Article

Publisher Item ID: jp2015144

DOI: 10.1038/jp.2015.144

PMC ID: 4660044

PubMed ID: 26597800

SO-VID: 9b79c3fb-40a8-4b14-92ea-0d2a30a0e768

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License. The images or other third party material in this article are included in the article's Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/

Recommendations for mental health professionals in the NICU

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Chinese Journal of School Health

Most cited references 42

Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale.

Resilience to loss and potential trauma.

The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and meta-analysis.

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