The point prevalence of post-partum perinatal mental health disorders and associated psychosocial characteristics in Malta: a study protocol

Abstract

Background: Perinatal mental health disorders are considered to be a major public health concern. Left untreated, maternal psychopathology can extent to the rest of the family unit, and increase the risk of psychological and psychiatric co-morbidity in the child.  Thus, a better understanding of the overall burden of these disorders is fundamental to inform policy makers and produce practice change. Worldwide, perinatal mental health disorders are known to affect approximately 20% of pregnant and postnatal women.  However, the prevalence of these disorders in Malta, an island in the center of the Mediterranean Sea with approximately 4,000 births annually, remains unknown. The primary objective of this cross-sectional study will be to address this gap in knowledge and define the local prevalence of perinatal psychopathology. Methods: A representative sample of 300 postnatal women from birth up to one year after childbirth, resident in Malta, will be recruited through a stratified random technique. Participation will involve two phases.  In the first stage, selected participants will be asked to self-complete the Edinburgh postnatal depression scale (EPDS), the generalized anxiety disorder-7 item (GAD-7), the Yale Brown obsessive compulsive scale (YBoCS), the Post-Traumatic Stress Disorder Checklist for DSM-V (PCL-5), and the difficulties in emotional regulation scale (DERS) questionnaires.  In the second stage, those women who score equal or above the cut-off values in any of these questionnaires, will be assessed using the diagnostic mini-international neuropsychiatric interview (MINI) to confirm or refute a diagnosis of a mental health disorder. Conclusions: In addition to determining the local prevalence, scores from the self-report instruments will be correlated with MINI diagnostic outcomes to determine the best cut-off value for a provisional diagnosis for each of these tools. Basic demographic details and psychosocial characteristics will be recorded.