New research suggests two-thirds (67%) of pregnant women in London aged between 16 and 24 years have mental health problems including depression, anxiety disorders, post-traumatic stress disorder and obsessive compulsive disorder, according to new research funded by the National Institute for Health Research (NIHR). Anxiety disorders, in particular social phobia, are especially high.
By comparison, the research suggests roughly one in five (21%) pregnant women in London aged 25 years and over have mental health problems.
Researchers from Institute of Psychiatry, Psychology & Neuroscience at King's College London recruited 575 women through their first antenatal appointment with an inner-city London maternity service. Of this group, 57 women were aged between 16 and 24.
All women were interviewed using a psychiatric gold standard diagnostic interview to determine if they met the criteria for one or more mental health condition. The researchers also recorded information about their socio-demographic background, such as ethnicity, educational level and employment status.
According to the research, published today in BJPsych Open, pregnant women under 25 were also more likely to be non-white, single, living in poverty, homeless or living in emergency accommodation, unemployed, or have an unplanned pregnancy.
The rate of lifetime abuse was high (38.9%), with rates of sexual abuse at 20.6% and partner abuse at 19.5%. The researchers note that this is probably an under-estimate, as abuse is often under-reported. Experience of abuse and living alone were both risk factors for mental health problems in this group.
Lead author Dr Georgia Lockwood Estrin, Senior Research Associate at King's College London, said: "We've shown a shockingly high prevalence of mental disorders in young pregnant women aged 16 to 24 years in London compared with women aged 25 years or older. We found that, in comparison to previous research has focused primarily on postnatal depression, young women experience a broad range of mental disorders during early pregnancy, with anxiety disorders being particularly prevalent."
The researchers particularly highlight that the high risk for mental disorders is not limited to pregnant teenagers, as may have been suggested by previous research, but remains high for women in their early 20s.
The research suggests that more could be done to target perinatal mental health services at women aged under 25. This aligns with the recent NHS Long Term Plan and NHS Five Year Plan* to ensure that by 2023/24 at least 54,000 more women each year can access evidence-based specialist mental health care during the perinatal period.
Prof Louise Howard, senior author on the paper and NIHR Research Professor in maternal mental health at King's College London, said: "We were alarmed to see such high rates of mental illness in pregnant women under 25. The recent National Well-Being Survey and other studies have highlighted that around one in four women under 25 have self-harmed and/or have mental illness, higher than in previous surveys, but our study suggests that pregnant women under 25 are at even higher risk of mental disorders.
"This study needs to be repeated as it is based on relatively small numbers of women in a particular area of London, but our findings highlight the need for maternity services to ensure pregnant women under 25 are comprehensively assessed for mental health problems and domestic or sexual abuse so they can receive appropriate treatment and help."
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*NHS Long Term Plan: https://www.longtermplan.nhs.uk/ and NHS Five Year Forward View: https://www.england.nhs.uk/five-year-forward-view/
Notes to editors
About the National Institute for Health Research
The National Institute for Health Research (NIHR) is the nation's largest funder of health and care research. The NIHR:
- Funds, supports and delivers high quality research that benefits the NHS, public health and social care
- Engages and involves patients, carers and the public in order to improve the reach, quality and impact of research
- Attracts, trains and supports the best researchers to tackle the complex health and care challenges of the future
- Invests in world-class infrastructure and a skilled delivery workforce to translate discoveries into improved treatments and services
- Partners with other public funders, charities and industry to maximise the value of research to patients and the economy
The NIHR was established in 2006 to improve the health and wealth of the nation through research, and is funded by the Department of Health and Social Care. In addition to its national role, the NIHR commissions applied health research to benefit the poorest people in low- and middle-income countries, using Official Development Assistance funding.
This work uses data provided by patients and collected by the NHS as part of their care and support and would not have been possible without access to this data. The NIHR recognises and values the role of patient data, securely accessed and stored, both in underpinning and leading to improvements in research and care. http://www.nihr.ac.uk/patientdata
About King's College London and the Institute of Psychiatry, Psychology & Neuroscience
King's College London is one of the top 10 UK universities in the world (QS World University Rankings, 2018/19) and is among the oldest universities in England. King's has an outstanding reputation for world-class teaching and cutting-edge research. Since our foundation, King's students and staff have dedicated themselves in the service of society. King's will continue to focus on world-leading education, research and service, and will have an increasingly proactive role to play in a more interconnected, complex world. http://www.kcl.ac.uk
The Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's College London is the premier centre for mental health and related neurosciences research in Europe. It produces more highly cited publications in psychiatry and mental health than any other university in the world (Scopus, 2016), with 12 of the most highly cited scientists in this field. World-leading research from the IoPPN has made, and continues to make, an impact on how we understand, prevent and treat mental illness and other conditions that affect the brain. http://www.kcl.ac.uk/ioppn
Journal
BJPsych Open