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Antepartum depressive symptoms (ADS) are highly prevalent and may affect the mother and child. Cognitive–behavioural therapy and interpersonal therapy are effective psychological interventions for depression. However, low adherence and high attrition rates in studies of prevention and treatment of antepartum depression suggest that these approaches might not be entirely suitable for women with mild/moderate ADS. Considering the protective association between resilience and ADS, women with ADS might benefit more from interventions focusing on promotion of mental well-being and resilience.
Aims
We aimed to provide an overview of studies evaluating the effectiveness of antepartum resilience-enhancing interventions targeting the improvement of ante- and postpartum depressive symptoms. We also investigated whether these interventions improve resilience and resilience factors in the peripartum period.
Method
We conducted a systematic review, using PRISMA guidelines. Studies were eligible for inclusion when they utilised a randomised controlled trial or quasi-experimental design, studied pregnant women with ADS, and implemented psychological interventions that (a) aimed to reduce maternal ADS and/or prevent peripartum major depression, and (b) addressed one or more psychological resilience factors.
Results
Five of the six included cognitive–behavioural therapy interventions and all four mindfulness-based interventions were effective in reducing peripartum depressive symptoms and/or the incidence of depression. However, the methodological quality of most of the included studies was low to moderate. Only three studies assessed change in resilience factors.
Conclusions
Resilience-enhancing interventions might be beneficial for mental well-being of pregnant women with ADS, although more rigorously designed intervention studies are needed.
Sheltered housing is associated with quality-of-life improvements for individuals with serious mental illness (SMI). However, there are equivocal findings around safety outcomes related to this type of living condition.
Aims
We aimed to investigate raw differences in prevalence and incidence of crime victimisation in sheltered housing compared with living alone or with family; and to identify groups at high risk for victimisation, using demographic and clinical factors. We do so by reporting estimated victimisation incidents for each risk group.
Method
A large, community-based, cross-sectional survey of 956 people with SMI completed the Dutch Crime and Victimisation Survey. Data was collected on victimisation prevalence and number of incidents in the past year.
Results
Victimisation prevalence was highest among residents in sheltered housing (50.8%) compared with persons living alone (43%) or with family (37.8%). We found that sheltered housing was associated with increased raw victimisation incidence (incidence rate ratio: 2.80, 95% CI 2.36–3.34 compared with living with family; 1.87, 95% CI 1.59–2.20 compared with living alone). Incidence was especially high for some high-risk groups, including men, people with comorbid post-traumatic stress disorder and those with high levels of education. However, women reported less victimisation in sheltered housing than living alone or with family, if they also reported drug or alcohol use.
Conclusions
The high prevalence and incidence of victimisation among residents in sheltered housing highlights the need for more awareness and surveillance of victimisation in this population group, to better facilitate a recovery-enabling environment for residents with SMI.
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