Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Government College University, Faisalabad, Faisalabad, Pakistan.
Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Government College University, Faisalabad, Faisalabad, Pakistan.
PeerJ. 2024 Jul 18;12:e17711. doi: 10.7717/peerj.17711. eCollection 2024.
Postpartum depression (PPD) is prevalent among women after childbirth, but accessing mental healthcare for PPD is challenging. This study aimed to assess the treatment gap and barriers to mental healthcare access for women with PPD symptoms living in Punjab, Pakistan.
A multicenter cross-sectional study was conducted in five populous cities of Punjab from January to June 2023 by administering the questionnaire to the women using stratified random sampling. A total of 3,220 women in first 6 months postpartum were screened using the Edinburgh Postnatal Depression Scale. Of them, 1,503 women scored thirteen or above, indicating potential depressive disorder. Interviews were conducted to explore help-seeking behavior and barriers to accessing mental healthcare. Descriptive statistics along with nonparametric tests (, Kruskal-Wallis, Mann-Whitney U) were used and group differences were examined. Scatter plot matrices with fitted lines were used to explore associations between variables. Classification and regression tree methods were used to classify the importance and contribution of different variables for the intensity of PPD.
Only 2% of women ( = 33) with high PPD symptoms sought mental healthcare, and merely 5% of women ( = 75) had been in contact with a health service since the onset of their symptoms. 92.80% of women with PPD symptoms did not seek any medical attention. The majority of women, 1,215 (81%), perceived the need for mental health treatment; however, 91.23% of them did not seek treatment from healthcare services. Women who recently gave birth to a female child had higher mean depression scores compared to those who gave birth to a male child. Age, education, and birth location of newborn were significantly associated ( < 0.005) with mean barrier scores, mean social support scores, mean depression scores and treatment gap. The results of classification and regression decision tree model showed that instrumental barrier scores are the most important in predicting mean PPD scores.
Women with PPD symptoms encountered considerable treatment gap and barriers to access mental health care. Integration of mental health services into obstetric care as well as PPD screening in public and private hospitals of Punjab, Pakistan is critically needed to overcome the treatment gap and barriers.
产后抑郁症（PPD）在分娩后的女性中很常见，但获得 PPD 的精神保健服务具有挑战性。本研究旨在评估在巴基斯坦旁遮普省生活的有 PPD 症状的女性的治疗差距和获得精神保健服务的障碍。
本研究于 2023 年 1 月至 6 月在旁遮普省的五个人口较多的城市进行了一项多中心横断面研究，通过分层随机抽样向女性发放问卷。共有 3220 名产后 6 个月内的女性使用爱丁堡产后抑郁量表进行了筛查。其中，1503 名女性得分为 13 分或以上，表明存在潜在的抑郁障碍。对这些女性进行了访谈，以探索寻求帮助的行为和获得精神保健服务的障碍。使用描述性统计和非参数检验（，Kruskal-Wallis，Mann-Whitney U），并检查组间差异。使用散点图矩阵和拟合线来探索变量之间的关联。使用分类和回归树方法来对不同变量对 PPD 严重程度的重要性和贡献进行分类。
仅有 2%（n=33）的高 PPD 症状女性寻求了精神保健服务，仅有 5%（n=75）的女性自症状出现以来曾与卫生服务机构接触过。92.80%的 PPD 症状女性未寻求任何医疗关注。大多数女性，1215 名（81%）认为需要进行心理健康治疗；然而，其中 91.23%的女性没有向医疗保健服务机构寻求治疗。最近生下女婴的女性的抑郁评分平均值高于生下男婴的女性。年龄、教育程度和新生儿出生地点与平均障碍评分、平均社会支持评分、平均抑郁评分和治疗差距显著相关（p<0.005）。分类和回归决策树模型的结果表明，工具性障碍评分在预测 PPD 评分均值方面最为重要。
有 PPD 症状的女性面临着相当大的治疗差距和获得精神保健服务的障碍。需要将精神保健服务纳入旁遮普省的产科护理中，并在该省的公立和私立医院中进行 PPD 筛查，以克服治疗差距和障碍。
