Background Mental illness is associated with increased risk of violence towards others, but the e... more Background Mental illness is associated with increased risk of violence towards others, but the extent to which psychiatric disorders are associated with increased risk of violence to partners is unclear. We aimed to establish risk of intimate partner violence (IPV) among men and women with diagnosed psychiatric disorders, and to examine mental illness and mental health service …
Background Although the effectiveness of screening tools for detecting depression in pregnancy ha... more Background Although the effectiveness of screening tools for detecting depression in pregnancy has been investigated, there is limited evidence on the cost-effectiveness. This is vital in providing full information to decision makers. This study aimed to explore the cost-effectiveness of different screening tools to identify depression in early pregnancy compared to no screening. Methods A decision tree was developed to model the identification and treatment pathways of depression from the first antenatal appointment to 3-months postpartum using the Whooley questions, the Edinburgh Postnatal Depression Scale (EPDS) and the Whooley questions followed by the EPDS, compared to no screening. The economic evaluation took an NHS and Personal Social Services perspective. Model parameters were taken from a combination of sources including a cross-sectional survey investigating the diagnostic accuracy of screening tools, and other published literature. Cost-effectiveness was assessed in term...
A summary of key features from a systematic review protocol registered in PROSPERO International ... more A summary of key features from a systematic review protocol registered in PROSPERO International prospective register of systematic reviews.
Highlights • Prevalence of lifetime trauma experience in a community birth cohort is 32%.• Mother... more Highlights • Prevalence of lifetime trauma experience in a community birth cohort is 32%.• Mothers with experience of lifetime trauma have higher depressive symptoms.• Antenatal depressive symptoms are a risk factor for self-reported impaired bonding.
Perinatal mental health has become a significant focus of interest in recent years, with investme... more Perinatal mental health has become a significant focus of interest in recent years, with investment in new specialist mental health services in some high‐income countries, and inpatient psychiatric mother and baby units in diverse settings. In this paper, we summarize and critically examine the epidemiology and impact of perinatal mental disorders, including emerging evidence of an increase of their prevalence in young pregnant women. Perinatal mental disorders are among the commonest morbidities of pregnancy, and make an important contribution to maternal mortality, as well as to adverse neonatal, infant and child outcomes. We then review the current evidence base on interventions, including individual level and public health ones, as well as service delivery models. Randomized controlled trials provide evidence on the effectiveness of psychological and psychosocial interventions at the individual level, though it is not yet clear which women with perinatal mental disorders also ne...
The response to the coronavirus outbreak and how the disease and its societal consequences pose r... more The response to the coronavirus outbreak and how the disease and its societal consequences pose risks to already vulnerable groups such those who are socioeconomically disadvantaged and ethnic minority groups. Researchers and community groups analysed how the COVID-19 crisis has exacerbated persisting vulnerabilities, socio-economic and structural disadvantage and discrimination faced by many communities of social disadvantage and ethnic diversity, and discussed future strategies on how best to engage and involve local groups in research to improve outcomes for childbearing women experiencing mental illness and those living in areas of social disadvantage and ethnic diversity. Discussions centred around: access, engagement and quality of care; racism, discrimination and trust; the need for engagement with community stakeholders; and the impact of wider social and economic inequalities. Addressing biomedical factors alone is not sufficient, and integrative and holistic long-term publ...
Background Mental illness is associated with increased risk of violence towards others, but the e... more Background Mental illness is associated with increased risk of violence towards others, but the extent to which psychiatric disorders are associated with increased risk of violence to partners is unclear. We aimed to establish risk of intimate partner violence (IPV) among men and women with diagnosed psychiatric disorders, and to examine mental illness and mental health service …
Background Although the effectiveness of screening tools for detecting depression in pregnancy ha... more Background Although the effectiveness of screening tools for detecting depression in pregnancy has been investigated, there is limited evidence on the cost-effectiveness. This is vital in providing full information to decision makers. This study aimed to explore the cost-effectiveness of different screening tools to identify depression in early pregnancy compared to no screening. Methods A decision tree was developed to model the identification and treatment pathways of depression from the first antenatal appointment to 3-months postpartum using the Whooley questions, the Edinburgh Postnatal Depression Scale (EPDS) and the Whooley questions followed by the EPDS, compared to no screening. The economic evaluation took an NHS and Personal Social Services perspective. Model parameters were taken from a combination of sources including a cross-sectional survey investigating the diagnostic accuracy of screening tools, and other published literature. Cost-effectiveness was assessed in term...
A summary of key features from a systematic review protocol registered in PROSPERO International ... more A summary of key features from a systematic review protocol registered in PROSPERO International prospective register of systematic reviews.
Highlights • Prevalence of lifetime trauma experience in a community birth cohort is 32%.• Mother... more Highlights • Prevalence of lifetime trauma experience in a community birth cohort is 32%.• Mothers with experience of lifetime trauma have higher depressive symptoms.• Antenatal depressive symptoms are a risk factor for self-reported impaired bonding.
Perinatal mental health has become a significant focus of interest in recent years, with investme... more Perinatal mental health has become a significant focus of interest in recent years, with investment in new specialist mental health services in some high‐income countries, and inpatient psychiatric mother and baby units in diverse settings. In this paper, we summarize and critically examine the epidemiology and impact of perinatal mental disorders, including emerging evidence of an increase of their prevalence in young pregnant women. Perinatal mental disorders are among the commonest morbidities of pregnancy, and make an important contribution to maternal mortality, as well as to adverse neonatal, infant and child outcomes. We then review the current evidence base on interventions, including individual level and public health ones, as well as service delivery models. Randomized controlled trials provide evidence on the effectiveness of psychological and psychosocial interventions at the individual level, though it is not yet clear which women with perinatal mental disorders also ne...
The response to the coronavirus outbreak and how the disease and its societal consequences pose r... more The response to the coronavirus outbreak and how the disease and its societal consequences pose risks to already vulnerable groups such those who are socioeconomically disadvantaged and ethnic minority groups. Researchers and community groups analysed how the COVID-19 crisis has exacerbated persisting vulnerabilities, socio-economic and structural disadvantage and discrimination faced by many communities of social disadvantage and ethnic diversity, and discussed future strategies on how best to engage and involve local groups in research to improve outcomes for childbearing women experiencing mental illness and those living in areas of social disadvantage and ethnic diversity. Discussions centred around: access, engagement and quality of care; racism, discrimination and trust; the need for engagement with community stakeholders; and the impact of wider social and economic inequalities. Addressing biomedical factors alone is not sufficient, and integrative and holistic long-term publ...
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Papers by Louise M Howard