Ashley-Norman Tabitha, Fellmeth Gracia, Brummaier Tobias, Nosten Suphak, Oo May May, Phichitpadungtham Yuwapha, Wai Kerry, Khirikoekkong Napat, Plugge Emma, McGready Rose
School of Medicine, University of Leeds, Leeds, LS2 9JT, UK.
Shoklo Malaria Research Unit, Oxford Tropical Medical Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, 63100, Thailand.
Wellcome Open Res. 2024 Mar 28;7:231. doi: 10.12688/wellcomeopenres.17744.2. eCollection 2022.
Antepartum depression affects around 15% of pregnant women worldwide, and may negatively impact their infants' physical, cognitive and social development, and confer a greater risk of emotional dysregulation in their children. Risk factors for antepartum depression disproportionately affect women from resource-sparse settings. In particular, pregnant refugee and migrant women face many barriers to diagnosis and care of mental health conditions, yet this group is under-represented in the literature. This study explores what refugee and migrant women living along the Thai-Myanmar border perceive as being contributory and protective factors to their antepartum depression, through secondary qualitative analysis of responses to clinical interviews for depression.
Previous research investigating perinatal depression in pregnant refugee and migrant women on the Thai-Myanmar border involved assessing 568 women for depression, using the Structured Clinical Interview for the diagnosis of DSM-IV Disorders (SCID). This study analyses a subsample of 32 women, diagnosed with persistent depression during the antepartum period. Thematic analysis of responses to the SCID and social and demographic surveys was undertaken to investigate factors which contribute towards, or protect against, persistent antepartum depression.
Major themes which women described as contributing towards persistent antepartum depression were financial problems, interpersonal violence, substance misuse among partners, social problems and poor health. Factors women considered as protecting mental wellbeing included social support, accessible healthcare and distractions, highlighting the need for focus on these elements within refugee and migrant settings. Commonly expressed phrases in local Karen and Burmese languages were summarised.
Knowledge of factors affecting mental wellbeing in the study population and how these are phrased, may equip stakeholders to better support women in the study area. This study highlighted the limitations of contextually generic diagnostic tools, and recommends the development of tools better suited to marginalised and non-English speaking groups.
全球约15%的孕妇会出现产前抑郁，这可能会对其婴儿的身体、认知和社会发展产生负面影响，并增加其子女情绪失调的风险。产前抑郁的风险因素对资源匮乏地区的女性影响尤为严重。特别是，怀孕的难民和移民妇女在心理健康状况的诊断和护理方面面临诸多障碍，但这一群体在文献中的代表性不足。本研究通过对抑郁症临床访谈的回答进行二次定性分析，探讨了生活在泰缅边境的难民和移民妇女认为导致其产前抑郁的因素以及保护因素。
先前一项针对泰缅边境怀孕难民和移民妇女围产期抑郁的研究，使用《精神疾病诊断与统计手册》第四版障碍的结构化临床访谈（SCID）对568名妇女进行了抑郁评估。本研究分析了32名在产前被诊断为持续性抑郁的妇女的子样本。对SCID以及社会和人口调查的回答进行了主题分析，以调查导致或预防持续性产前抑郁的因素。
妇女们描述的导致持续性产前抑郁的主要主题包括经济问题、人际暴力、伴侣中的药物滥用、社会问题和健康状况不佳。妇女们认为保护心理健康的因素包括社会支持、可获得的医疗保健和消遣，这突出了在难民和移民环境中关注这些因素的必要性。总结了当地克伦语和缅甸语中常见的表达。
了解影响研究人群心理健康的因素及其表述方式，可能会使利益相关者更好地支持研究区域的妇女。本研究强调了背景通用诊断工具的局限性，并建议开发更适合边缘化和非英语群体的工具。
