Background: Epidemics or pandemics, such as the current Coronavirus Disease 2019 (COVID-19) crisis, pose unique challenges to healthcare professionals (HCPs). Caring for patients during an epidemic/pandemic may impact negatively on the mental health of HCPs. There is a lack of evidence-based advice on what would be effective in mitigating this impact. Objectives: This rapid review synthesizes the evidence on the psychological impact of pandemics/epidemics on the mental health of HCPs, what factors predict this impact, and the evidence of prevention/intervention strategies to reduce this impact.Method: According to rapid review guidelines, systematic searches were carried out inEmbase.com, PubMed, APA PsycINFO-Ovid SP, and Web of Science (core collection). Searches were restricted to the years 2003 or later to ensure inclusion of the most recent epidemic/pandemics, such as Severe Acute Respiratory Syndrome (SARS). Papers written in French or English, published in peer-reviewed journals, and of quantitative design using validated measures of mental health outcomes were included. Of 1308 papers found, 50 were included. The full protocol for this rapid review was registered with Prospero (reg.no.CRD42020175985).Results: Results show that exposed HCPs working with patients during an epidemic/pandemic are at heightened risk of mental health problems in the short and longer term, particularly: psychological distress, insomnia, alcohol/drug misuse, and symptoms of posttraumatic stress disorder (PTSD), depression, anxiety, burnout, anger, and higher perceived stress. These mental health problems are predicted by organizational, social, personal, and psychological factors and may interfere with the quality of patient care. Few evidence-based early interventions exist so far.Discussion: HCPs need to be provided with psychosocial support to protect their mental wellbeing if they are to continue to provide high quality patient care. Several recommendations relevant during and after an epidemic/pandemic, such as COVID-19, and in preparation for a future outbreak, are proposed.

The City Birth Trauma Scale (City BiTS) assesses posttraumatic stress disorder symptoms following childbirth (PTSD-FC). Recent studies investigating the latent factor structure of PTSD-FC in women reported mixed results. No validated French questionnaire exists to measure PTSD-FC symptoms. Therefore, this study first aimed to validate the French version of the City BiTS (City BiTS-F). Second, it aimed to establish the latent factor structure of PTSD-FC. French-speaking women with infants aged 1 to 12 months old (n = 541) completed an online cross-sectional survey. Questionnaires included the City BiTS-F, the PTSD Checklist, the Edinburgh Postnatal Depression Scale, and the anxiety subscale of the Hospital Anxiety and Depression Scale. Additionally, sociodemographic and medical data were collected. The two-factor model with birth-related symptoms (BRS) and general symptoms (GS) fit the data well, whereas the four-factor model was not confirmed. The bifactor model with a general factor and the BRS and GS gave the best fit to the data, suggesting that use of the total score in addition to the BRS and GS subscales scores is justified. High reliability (α = .88 to .90) and good convergent and divergent validity were obtained. Discriminant validity was calculated with weeks of gestation, gravidity, history of traumatic childbirth and event, and mode of delivery. The City BiTS-F is a reliable and valid measure of PTSD-FC symptoms in French-speaking women. Both total score and BRS or GS subscale scores can be calculated. This psychometric tool is of importance for clinical and research purposes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Preventive evidence-based interventions for childbirth-related posttraumatic stress disorder (CB-PTSD) are lacking. Yet, 18.5% of women develop CB-PTSD symptoms following an unplanned caesarean section (UCS). This two-arm, multicentre, double-blind superiority trial tested the efficacy of an early single-session intervention including a visuospatial task on the prevention of maternal CB-PTSD symptoms. The intervention was delivered by trained maternity clinicians. Shortly after UCS, women were included if they gave birth to a live baby, provided consent, and perceived their childbirth as traumatic. Participants were randomly assigned to the intervention or attention-placebo group (allocation ratio 1:1). Assessments were done at birth, six weeks, and six months postpartum. Group differences in maternal CB-PTSD symptoms at six weeks (primary outcomes) and six months postpartum (secondary outcomes) were assessed with the self-report PTSD Checklist for DSM-5 (PCL-5) and by blinded research assessors with the Clinician-administered PTSD scale for DSM-5 (CAPS-5). Analysis was by intention-to-treat. The trial was prospectively registered (ClinicalTrials.gov, NCT03576586). Of the 2068 women assessed for eligibility, 166 were eligible and 146 were randomly assigned to the intervention (n = 74) or attention-placebo control group (n = 72). For the PCL-5, at six weeks, a marginally significant intervention effect was found on the total PCL-5 PTSD symptom count (β = −0.43, S.E. = 0.23, z = −1.88, p < 0.06), and on the intrusions (β = −0.73, S.E. = 0.38, z = −1.94, p < 0.0525) and arousal (β = −0.55, S.E. = 0.29, z = −1.92, p < 0.0552) clusters. At six months, a significant intervention effect on the total PCL-5 PTSD symptom count (β = −0.65, S.E. = 0.32, z = −2.04, p = 0.041, 95%CI[−1.27, −0.03]), on alterations in cognition and mood (β = −0.85, S.E. = 0.27, z = −3.15, p = 0.0016) and arousal (β = −0.56, S.E. = 0.26, z = −2.19, p < 0.0289, 95%CI[−1.07, −0.06]) clusters appeared. No group differences on the CAPS-5 emerged. Results provide evidence that this brief, single-session intervention carried out by trained clinicians can prevent the development of CB-PTSD symptoms up to six months postpartum.

Introduction Emergency caesarean section (ECS) qualifies as a psychological trauma, which may result in postnatal post-traumatic stress disorder (PTSD). Maternal PTSD may not only have a significant negative impact on mother–infant interactions, but also on long-term infant development. The partner’s mental health may also affect infant development. Evidence-based early interventions to prevent the development of postpartum PTSD in mothers are lacking. Immediately after a traumatic event, memory formation is vulnerable to interference. There is accumulating evidence that a brief behavioural intervention including a visuospatial task may result in a reduction in intrusive memories of the trauma. Methods and analysis This study protocol describes a double-blind multicentre randomised controlled phase III trial testing an early brief maternal intervention including the computer game ‘Tetris’ on intrusive memories of the ECS trauma (≤1 week) and PTSD symptoms (6 weeks, primary outcome) of 144 women following an ECS. The intervention group will carry out a brief behavioural procedure including playing Tetris. The attention-placebo control group will complete a brief written activity log. Both simple cognitive tasks will be completed within the first 6 hours following traumatic childbirth. The intervention is delivered by midwives/nurses in the maternity unit. The primary outcome will be differences in the presence and severity of maternal PTSD symptoms between the intervention and the attention-placebo control group at 6 weeks post partum. Secondary outcomes will be physiological stress and psychological vulnerability, mother–infant interaction and infant developmental outcomes. Other outcomes will be psychological vulnerability and physiological regulation of the partner and their bonding with the infant, as well as the number of intrusive memories of the event. Ethics and dissemination Ethical approval was granted by the Human Research Ethics Committee of the Canton de Vaud (study number 2017–02142). Dissemination of results will occur via national and international conferences, in peer-reviewed journals, public conferences and social media. Trial registration number NCT 03576586.

The distinct influence of different, but comorbid, maternal mental health (MMH) difficulties (postpartum depression, anxiety, childbirth-related posttraumatic stress disorder) on infant sleep is unknown, although associations between MMH and infant sleep were reported. This cross-sectional survey aimed: (1) to examine associations between MMH symptoms and infant sleep; (2) to extract data-driven maternal MMH symptom profiles from MMH symptoms; and (3) to investigate the distinct influence of these MMH symptom profiles on infant sleep when including mediators and moderators. Mothers of 3–12-month-old infants (n = 410) completed standardized questionnaires on infant sleep, maternal perception of infant negative emotionality, and MMH symptoms. Data was analyzed using: (1) simple linear regressions; (2) factor analysis; and (3) structural equation modelling. MMH symptoms were all negatively associated with nocturnal sleep duration and only postpartum depression and anxiety symptoms were associated with night waking. Three MMH symptom profiles were extracted: depressive, anxious, and birth trauma profiles. Maternal perception of infant negative emotionality mediated the associations between the depressive or anxious profiles and infant sleep but only for particular infant ages or maternal education levels. The birth trauma profile was not associated with infant sleep. The relationships between MMH and infant sleep may involve distinct mechanisms contingent on maternal symptomatology.

There is no evidence on the latent structure of symptoms of childbirth-related posttraumatic stress disorder (CB-PTSD) in fathers and to date, no validated French instrument exists to measure CB-PTSD in partners, although the City Birth Trauma Scale (partner version) (City BiTS (P)) was developed to measure such CB-PTSD symptoms. This study aimed to validate the French version of the City BiTS-P (City BiTS-F (P)) in partners attending childbirth and to examine its factor structure, reliability, and validity. French-speaking fathers of 1-to-12-month-olds participated in this online cross-sectional survey (n = 280). They completed the City BiTS-F (P), the PTSD Checklist, the Edinburgh Postnatal Depression Scale, and the anxiety subscale of the Hospital Anxiety and Depression Scale, as well as sociodemographic and medical items. The four-factor model did not fit well the data, contrary to the two-factor model with birth-related symptoms (BRS) and general symptoms (GS). However, the bifactor model with a general factor and the BRS and GS provided the best fit to the data. High reliability (α = .88-.89), and good convergent and divergent validity were found. Fathers with a history of traumatic childbirth reported higher total and subscale scores. Our findings provide evidence for the use of the City BiTS-F (P) as a reliable and validated tool to assess CB-PTSD symptoms in French-speaking partners. The use of the total score in addition to the BRS and GS subscale scores is warranted. (PsycInfo Database Record (c) 2023 APA, all rights reserved).