Pearl La Marca-Ghaemmaghami

Hair cortisol concentration (HCC) indicates chronic stress exposure, which is a risk factor in the pathogenesis of burnout and depression. However, findings on HCC are inconsistent. Similarly, intervention studies show mixed effects on HCC. The present study aimed to shed light on these inconsistencies, by additionally considering also hair cortisone. Twenty-five patients with a burnout-related depressive disorder receiving a multimodal inpatient treatment for clinical burnout and 17 matched healthy controls participated in this study. All participants provided 1 cm long hair samples at the beginning and end of the treatment. HCC and hair cortisone levels (HCNC) were determined. Meteorological data and duration of sick leave were considered as potential covariates. Burnout and depression were assessed with self-ratings, the latter also with examiner ratings. There were no significant group differences in glucocorticoid levels. Treatment led to a decrease in both depression severity and hair glucocorticoid concentration in inpatients, while lower HCNC in particular predicted a greater reduction in depression severity. Moreover, meteorological data and the duration of sick leave were also found to have an effect on hair glucocorticoid concentrations. These results suggest that multimodal inpatient treatment of clinical burnout considerably reduced stress on both a psychological and biological level. In parallel, hair glucocorticoids appear to be sensitive biomarkers for the evaluation of treatment success and prediction. Examining both HCC and HCNC in intervention studies may provide clearer results than the usual examination of HCC alone.

Objectives Pregnant women are likely to experience high levels of stress during the COVID-19 pandemic. However, the factors that might influence the extent of experienced emotional distress are poorly understood. Therefore, we aimed to investigate potential correlates of prenatal emotional distress during the COVID-19 pandemic. Methods In total, N = 1437 pregnant women from Germany and Switzerland participated in an online study during the first wave of the COVID-19 pandemic (May–August 2020). The survey assessed prenatal distress, pandemic-related pregnancy stress, general anxiety, fear of childbirth, and several socio-demographic, pregnancy- and COVID-19-related factors. Linear multivariate regression models were the main analytical strategy. Results The results highlight that several factors such as full-time employment, nulliparity, high-risk pregnancy, emotional problems, cancelled prenatal appointments, and stating that COVID-19 affected the choice of birth mode were significantly associated with elevated prenatal distress, anxiety, pandemic-related pregnancy stress, and fear of childbirth. Conversely, access to an outdoor space was a protective factor for pandemic-related pregnancy stress and prenatal distress. Conclusions for Practice Overall, the study highlights significant correlates influencing the levels of emotional distress pregnant women experienced during the COVID-19 pandemic. These findings may contribute to the improvement of maternal prenatal medical and psychological care during a public health crisis of international concern, such as the COVID-19 pandemic.

Einleitung Der Verlust eines Kindes stellt für betroffene Eltern eine der schwersten Belastungen im Leben dar. Ereignet sich ein solch tragischer Verlust in der Perinatalzeit, sehen sich Eltern im Trauerprozess mit zusätzlich schmerzhaften Herausforderungen konfrontiert. Bei der klinischen und ausserklinischen Arbeit wird beobachtet, dass sich Eltern während des Spitalaufenthaltes und der weiterführenden Betreuung durch die ambulante Hebamme unterstützt, aber danach alleingelassen fühlen. Ziel des vorliegenden Angebots ist es daher, Eltern eine nachhaltigere Unterstützungsmöglichkeit zur Verfügung zu stellen. Methode Auf der Grundlage einer Literaturrecherche wurde ein Gruppenangebot konzipiert. Dabei wurde ein interprofessioneller Ansatz verfolgt, bei welchem erfahrene Hebammen mit Weiterbildung in Trauerarbeit und eine Psychotherapeutin mit Spezialisierung in perinatalem Verlust sowie ehemals betroffene Eltern abwechselnd maximal acht betroffene Eltern an sechs Abenden über einen Zeitraum von drei Monaten empfangen. Das Konzept beinhaltet zur Sicherung eines gemeinsamen Bezugsrahmens, dass das Angebot von den Fachpersonen regelmässig reflektiert wird. Am Schluss werden die Eltern eingeladen, mündliche und anonym-schriftliche Rückmeldungen abzugeben. Für die Auswertung der Erfahrungen der Kursleitenden und für die Rückmeldungen der Eltern wurde ein qualitativer Ansatz gewählt. Ergebnisse Seit September 2020 wurde das Angebot zweimal durchgeführt. Insgesamt hatten 15 Mütter und Väter ihr Interesse bekundet, wovon schliesslich drei Mütter und zwei Väter am ersten und ebenso viele Mütter und Väter am zweiten Angebot teilnahmen. Die Fachpersonen beobachteten, dass die Eltern ihre Gefühle ausdrückten und so die Erfahrung machten, dass es den anderen Betroffenen oft ähnlich erging. Die Rückmeldungen der Eltern bestätigten das und zeugten von einem grundsätzlichen Gefühl des Aufgehoben-Seins und der Dankbarkeit für das Angebot. Als besonders hilfreich wurde das interprofessionelle Setting beschrieben. Herausforderungen tauchten auf, wenn Teilnehmerinnen während des laufenden Angebots erneut schwanger wurden. Dies führte in einem Falle bei nicht-schwangeren Teilnehmenden zu Isolationsgefühlen und Rückzug. Die Erfahrung der Kursleitenden zeigte, dass ein hoher Bedarf an Reflexion und Flexibilität notwendig ist, um feinfühlig auf die Bedürfnisse der Teilnehmenden einzugehen und eine konstruktive Gruppendynamik zu fördern. Diskussion Die ersten Ergebnisse zum Angebot sind vielversprechend. Das interprofessionelle Setting ermöglicht eine Teamleistung, welches in ein erweitertes Verständnis für die Teilnehmenden und die Gruppendynamik resultiert. Die regelmässigen Reflexionsrunden und Evaluationen erlauben eine stete Anpassung an die elterlichen Bedürfnisse. Die Relevanz professioneller Begleitung nach perinatalem Verlust ist unbestritten. Die hierfür notwendigen personellen und finanziellen Ressourcen sollten geschaffen werden. Publication Date: 26 November 2021 (online) © 2021. Thieme. All rights reserved. Georg Thieme Verlag Rüdigerstraße 14, 70469 Stuttgart, Germany

Background: The COVID-19 pandemic is a global issue which affects the entire population’s mental health. This study evaluates how restrictions to curtail this pandemic change parenting self-efficacy, depressive symptoms, couple satisfaction and health-related quality of life in parents after delivery of a newborn. Methods: In this prospective single center evaluation of parental self-efficacy and quality of life, four validated questionnaires were used to repeatedly assess parenting self-efficacy (Tool to measure Parental Self-Efficacy, TOPSE), depressive symptoms (Edinburgh Postnatal Depression Scale, EPDS), couple satisfaction (Couple Satisfaction Index, CSI) and health-related quality of life (short form 12, SF12). Fifty-three parents of 50 infants answered a total number of 63 questionnaires during the lockdown period to limit the spread of COVID-19. These questionnaires were matched with 63 questionnaires of 58 other parents that had answered them before or after strong pandemic related measures. Results: Parents experienced lower parenting self-efficacy during the strict pandemic measures as compared to before and after (p = 0.04). In terms of age, socioeconomic, marital status and duration of hospitalization we detected no significant difference between both groups. On univariate linear regression, TOPSE scores were associated with gestational age (p = 0.044, parameter estimate: 1.67, 95% CI: 0.048 to 3.301), birth weight (p = 0.035, parameter estimate: 0.008, 95% CI: 0.001 to 0.015), number of newborns’ siblings (p = 0.0554, parameter estimate: 7.49, 95% CI: −0.174 to 15.145) and distance of home from hospital (p = 0.043, parameter estimate: −0.38, 95% CI: −0.745 to −0.011). Interestingly, there was a positive correlation between quality of life and TOPSE scores, suggesting that those who experience a higher self-efficacy also have a higher quality of life. Conclusions: When implementing a lock-down period psychological effects such as lower experience of parental self-efficacy have to be considered.

Premature birth is stressful for infants and parents and can adversely affect the parent–infant dyad. This mixed-methods pilot study evaluates whether creative music therapy (CMT) can alleviate anxiety, stress, and depressive symptoms in parents and support the bonding process with their infant. Sixteen parent couples were included. Ten couples were randomly allocated to the music therapy group (MTG) and six to the control group (CG). All couples completed psychological questionnaires measuring anxiety and depressive symptoms as well as an implicit measure of parent–infant attachment at two weeks postpartum (T1), at approximate neonatal intensive care unit (NICU) hospitalization halftime (T2), and two weeks after the infant had been discharged (T3). At T1 and T2, the parents additionally completed a questionnaire assessing the degree of stress they experienced at the NICU. Qualitative data were collected through a semi-structured, problem-centered interview with MTG parents at T3. The results of the quantitative analyses revealed reductions in anxiety levels from T1 to T2 (p = 0.002) as well as decreases in depressive symptoms from T2 to T3 (p = 0.022). No such changes were apparent in the CG. In fact, parental stress increased from T1 to T2 (p = 0.016). Significant increases in attachment across time were also observed within the MTG, but not in the CG. The qualitative inquiry confirmed that CMT can support the parent–infant relationship. Being in musical interaction evoked feelings of joy and relaxation in the parents and encouraged them to interact more profoundly with their infant. The results call for a more extensive powered follow-up study to further investigate CMT’s potential for parental well-being and parent–infant bonding.