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      Validation of the Iranian version of the Postpartum Specific Anxiety Scale 12-item research short-form for use during global crises (PSAS-IR-RSF-C)

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          Abstract

          Background

          Due to its high pervasiveness and adversarial consequences, postpartum anxiety has been one of the most worrying public health concerns in the last decade. According to previous research, the occurrence of mental disorders among women in the postpartum period upsurges significantly in the course of universal disasters. The Postpartum Specific Anxiety Scale – Research Short Form – for use in global Crises [PSAS-IR-RSF-C] has not been used in Iran for postpartum women during a health system shock. Consequently, this study was conducted to determine the validity and reliability of the Persian version (PSAS-IR-RSF-C) during the COVID-19 pandemic.

          Methods

          This cross-sectional study was performed with 180 women who were between six weeks and six months after delivery, by random sampling method from December 2021 to June 2022. The validity of the PSAS-RSF-C in terms of face, content, was analyzed, and the construct validity was assessed using exploratory and confirmatory factor analyses. Internal consistency and test–retest reliability of the questionnaire were measured using (Cronbach’s alpha, McDonald’s ω) and intraclass correlation coefficient (ICC), respectively.

          Results

          The content validity index and content validity ratio of the Persian version of the PSAS-IR-RSF-C were 0.96 and 0.98, respectively. A three-factor structure was extracted during the exploratory factor analysis process, and model validity was confirmed by the values of fit indices. Cronbach's alpha coefficient, McDonald’s ω and intra-cluster correlation coefficient (95% confidence interval) were 0.74, 0.92 (0.78 to 0.93) and 0.97 (0.93 to 0.98), respectively.

          Conclusions

          For the specific assessment of postpartum anxiety among Iranian women during crises, the Persian version of the PSAS-IR-RSF-C is a valid and reliable tool.

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          Most cited references36

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          A brief measure for assessing generalized anxiety disorder: the GAD-7.

          Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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            The psychological impact of quarantine and how to reduce it: rapid review of the evidence

            Summary The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.
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              Perinatal depressive and anxiety symptoms of pregnant women along with COVID-19 outbreak in China

              Background On January 20, 2020, a new coronavirus epidemic with “human-to-human” transmission was officially announced by the Chinese government, which caused significant public panic in China. Pregnant women may be particularly vulnerable and in special need for preventative mental health strategies. Thus far, no reports exist to investigate the mental health response of pregnant women to the COVID-19 outbreak. Objective The aim of the present study is to examine the impact of COVID-19 outbreak on the prevalence of depressive and anxiety symptoms and the corresponding risk factors among pregnant women across China. Study Design A multi-center cross-sectional study was initiated in early December 2019 to identify mental health concerns in pregnancy using the Edinburgh Postnatal Depression Scale (EPDS). This study provided a unique opportunity to compare the mental status of pregnant women before and after the announcement of the COVID-19 epidemic. A total of 4124 pregnant women during their third trimester from 25 hospitals in 10 provinces across China were examined in this cross-sectional study from January 1 to February 9, 2020. Of these women, 1285 were assessed after January 20, 2020 when the coronavirus epidemic was publically announced and 2839 were assessed before this pivotal time point. The internationally recommended EPDS was used to assess maternal depression and anxiety symptoms. Prevalence rates and risk factors were compared between the pre and post study groups. Results Pregnant women assessed after the declaration of COVID-19 epidemic had significantly higher rates of depressive symptoms (26.0% vs 29.6%, P=0.02) than women assess pre-epidemic announcement. These women were also more likely to endorse thoughts of self-harm (P=0.005). The depressive rates were positively associated with the number of newly-confirmed COVID-19 cases (P=0.003), suspected infections (P=0.004), and death cases per day (P=0.001). Pregnant women who were underweight pre-pregnancy, primiparous, < 35 years old, employed full-time, middle income, and had appropriate living space were at increased risk to develop depressive and anxiety symptoms during the outbreak. Conclusion Major life-threatening public health events such as the COVID-19 outbreak may increase the risk for mental illness among pregnant women including thoughts of self-harm. Strategies targeting maternal stress and isolation such as effective risk communication and the provision of psychological first aid may be particularly useful to prevent negative outcomes for women and their fetuses.
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                Author and article information

                Contributors
                sepidehmashayekh@yahoo.com
                m.asghari862@gmail.com
                maryammontazeri5053@yahoo.com
                V.Fallon@liverpool.ac.uk
                Sergio.Silverio@kcl.ac.uk
                mirghafourvand@gmail.com
                Journal
                BMC Psychiatry
                BMC Psychiatry
                BMC Psychiatry
                BioMed Central (London )
                1471-244X
                14 July 2023
                14 July 2023
                2023
                : 23
                : 511
                Affiliations
                [1 ]GRID grid.412888.f, ISNI 0000 0001 2174 8913, Students Research Committee, Midwifery Department, Faculty of Nursing and Midwifery, , Tabriz University of Medical Sciences, ; Tabriz, Iran
                [2 ]Cabrini Research, Cabrini Health, Melbourne, VIC 3144 Australia
                [3 ]GRID grid.1002.3, ISNI 0000 0004 1936 7857, School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, , Monash University, ; Melbourne, VIC 3004 Australia
                [4 ]GRID grid.412888.f, ISNI 0000 0001 2174 8913, Road Traffic Injury Research Center, , Tabriz University of Medical Sciences, ; Tabriz, Iran
                [5 ]GRID grid.10025.36, ISNI 0000 0004 1936 8470, Department of Psychology, Institute of Population Health, , University of Liverpool, ; Liverpool, UK
                [6 ]GRID grid.13097.3c, ISNI 0000 0001 2322 6764, Department of Women and Children’s Health, School of Life Course and Population Sciences, , King’s College London, ; London, UK
                [7 ]GRID grid.412888.f, ISNI 0000 0001 2174 8913, Social Determinants of Health Research Center, , Tabriz University of Medical Sciences, ; Tabriz, Iran
                [8 ]GRID grid.411230.5, ISNI 0000 0000 9296 6873, Menopause Andropause Research Center, , Ahvaz Jundishapur University of Medical Sciences, ; Ahvaz, Iran
                Article
                4998
                10.1186/s12888-023-04998-0
                10347867
                36593442
                c8a664ec-94b1-4f29-ab3c-9ebfdd7076c2
                © The Author(s) 2023

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 20 November 2022
                : 4 July 2023
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100004366, Tabriz University of Medical Sciences;
                Categories
                Research
                Custom metadata
                © BioMed Central Ltd., part of Springer Nature 2023

                Clinical Psychology & Psychiatry
                global crises,postpartum anxiety,short-form,psas-ir-rsf-c,maternal mental health,psychometrics,iranian women

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