Introduction Postpartum depression (PPD) is the commonest postpartum psychiatric condition, with prevalence rates around 20%1. PPD is associated with a range of adverse outcomes for both the mother and infant2. Therefore, identifying modifiable risk factors for perinatal depression is an important public health issue3. Objectives To explore the role of dysfunctional attitudes towards motherhood in postpartum depressive symptoms and disorder. Methods 247 women were evaluated in the third (12.08±4.25 weeks) and sixth months (31.52± 7.16 weeks) postpartum with the Attitudes Towards Motherhood Scale4, the Postpartum Depression Screening Scale5 and the Diagnostic Interview for Psychological Distress-Postpartum6. Correlation analysis was performed followed by linear/logistic regression analysis when the coefficients proved significant (p<.05), using SPSS. Results Dysfunctional beliefs towards motherhood concerning judgement by others and maternal responsibility positively correlated with depressive symptoms at the third (.528; .406) and the sixth months (.506; .492) postpartum. Those dysfunctional beliefs were predictors of depressive symptoms at the third (ß=.440; ß=.151) and sixth months (ß=.322; ß.241) explaining 29.4% and 30.2% of its variance, respectively. Having dysfunctional beliefs at the third month significantly increase the likelihood of being diagnosed with Major Depression (DSM5) both in the third (Wald=9.992, OR=1.169; Wald=16.729, OR=1.231) and sixth months (Wald=5.638, OR=1.203; Wald=7.638, OR=1.301) (all p<.01). Conclusions Cognitive distortions should be included in the assessment of risk factors for PPD. Early identification of women presenting motherhood-specific cognitive biases may be crucial for implementing preventive interventions favoring a more positive and healthier motherhood experience. Disclosure No significant relationships.

Introduction The Perinatal period is a time of vulnerability for developing psychiatric disorders of higher prevalence in the female gender - depression and anxiety 1 . Numerous authors have proposed that maternal psychological factors could influence pregnancy course and the well-being of mother and newborn 2 . Objectives To explore the relationship between perinatal psychological disorder and physiological parameters evaluated at birth, such as the Apgar Index (AI; 1, 5 and 10 minutes), head circumference, weight, length and age. Methods 533 women answered, in the second trimester of pregnancy (16.98±4.83 weeks of gestation), several questions about psychosocial variables, the Perinatal Depression Screening Scale 3 and the Perinatal Anxiety Screening Scale 4 . Of these, 208 (39.0%) women were interviewed with the Diagnostic Interview for Psychological Distress 5 . Newborn physiological parameters were obtained from electronic health records. Results AI was significantly (p<.01) and moderately (r≈.25) correlated with maternal anxious symptomatology, and with the experience of a stressful event in the last year (only AI 1 minute). Newborns of women with clinically relevant anxious symptomatology (>cutoff point, 14.6%) had significantly lower AI (p<.05), which was also observed in newborns of women who considered having had a stressful event (only AI 1 minute). Women’s newborns with maternal anxiety disorders during pregnancy (5.3%), had significantly lower values in AI, head circumference, weight and age of birth. Regression analyses showed that anxiety in pregnancy (symptoms and/or diagnoses) is a predictor of newborn physiological parameters, explaining significant percentages(r≈22%; p<.05) of its variability. Conclusions Early detection of psychological disorders in pregnancy, namely anxiety, is determinant to prevent adverse neonatal outcomes. Disclosure No significant relationships.

Introduction The postpartum depression screening scale (PDSS; Beck & Gable, 2002) is a widely used measure to assess women's depressive symptoms after their children's birth. Pereira et al. adapted, validated and developed a short-version of PDSS for Portuguese women (PDSS-21). Objective To examine the factor structure of the PDSS–21, using confirmatory factor analysis (CFA) in a sample of Portuguese women in the postpartum period. Methods The sample was composed of 208 women (mean age = 32.72; SD = 4.49) who completed the PDSS–21 approximately at the 6th week postpartum. CFA was used to test the model suggested by prior exploratory factor analyses of PDSS–21. AMOS software was used. Results After two items were deleted and some errors were correlated, CFA indicated a good fit for the second-order factor ( χ 2 /df = 1.793; CFI = 0.957; GFI = 0.889, rmsea = 0.062; P [rmsea ≤ 0.05] < 0.056). The 19–item PDSS showed excellent internal consistency (α = 0.92) and the four dimensions presented Cronbach's alphas ranging between good (α = 0.83) and excellent (α = 0.93). Conclusions These findings suggest that the 19–item PDSS obtained through CFA is a reliable and valid measure to assess depressive symptoms among women in the postpartum period. Disclosure of interest The authors have not supplied their declaration of competing interest.

IntroductionThe Depression, Anxiety and Stress Scales are widely used in clinical and non-clinical populations, both in research and clinical settings. The need for briefer but valid and reliable instruments has motivated the reduction of the original 42-item scale to a short 21-version. On Portuguese samples, Pais-Ribeiro et al. (2004) found that the original 3-factor solution (stress, anxiety and depression) explained 50.35% of the variance and in an exploratory analysis; Xavier et al. (2015) presented a two factor solution and a modified three-factor solution with a sample of pregnant women, both with adequate factors’ reliability (< 0.70) and explaining above 50% of the variance.AimsBased on the previous results of factor analysis with Portuguese samples, the present study aimed to perform confirmatory factor analyses (using Mplus software) to evaluate which dimensional structure best fitted the data.MethodsThe sample comprised 234 students (78.2% female), between 18–26 years old (M = 20.55; SD = 1.66). Eighty-five percent of the participants were on their first three years of college education. Participants filled the Portuguese version of the DASS-21.ResultsOur results showed that the original 3-factor structure had the best model fit [χ2(186) = 475.465, P < 0.05; RMSEA = 0.082, 90% CI = 0.073–0.091; CFI = 0.918; TLI = 0.908; SRMR = 0.05]. Good reliability was found for all subscales (0.92 for stress, 0.87 for anxiety and 0.91 for depression subscale).ConclusionsThe DASS-21 is a reliable instrument that, with student populations, seems to have better performance when used with a 3-factor structure. Further research is needed to confirm this structure in Portuguese clinical samples.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Introduction Pereira et al. (2013) adapted to the antenatal period and validated a shorter version of the original 35-items Postpartum Depression Screening Scale (PDSS [1]), composed of 24 items, selected from the exploratory factor analysis matrix. In their study, the researchers considered this version a useful alternative to evaluate depressive symptoms in pregnancy, taking into account its reliability, concurrent validity and satisfactory combinations of sensitivity and specificity to screen for antenatal depression. Aim To confirm the four dimensions’ structure of the PDSS-24 using confirmatory factor analysis. Methods 616 women (mean age: 32.29 ± 4.466) in the second trimester of pregnancy (mean weeks of gestation = 17.13 ± 4.929), with uncomplicated pregnancies, completed the PDSS-24 while waiting for their routine prenatal consultation at local health medical centers. Results The 4-dimensional model of PDSS-24 presented good fit (χ 2 [242] = 893,275; RMSEA = 0.067, CFI = 0.934, TLI = 0.94, PGFI = 0.717; P <.001). The PDSS-24 Cronbach's alpha was α=0.90; all factors presented good/excellent reliability: Derealization and failure (a = 0.87); Concentration difficulties and anxiety (a = 0.81), Suicidal ideation (a = 0.94), and sleeping difficulties (a = 0.89). Conclusion This further validation study emphasizes that PDSS-24 in an adequate measure of antenatal depressive symptoms. To better distinguish it from the version to use in the postpartum (PDSS-21 [2]), from now on, we will denominate it perinatal depression screening scale-24. Disclosure of interest The authors have not supplied their declaration of competing interest.

IntroductionThe Depressive Anxiety and Stress Scale (DASS-21; Antony et al., 1998) had been widely used to measure psychological distress among clinical and non-clinical populations, including in Portugal (Pais-Ribeiro et al., 2004). Although DASS-21 has been considered useful to evaluate psychological distress in the perinatal period, studies reporting on its psychometrics are scarce (Brunton et al., 2015).ObjectiveTo investigate the psychometric properties of the DASS-21 in a Portuguese sample of pregnant women.MethodsFour hundred and twenty-seven pregnant women (mean age: 32.56 ± 4.785 years) in their second trimester of pregnancy (17.34 ± 4.790 weeks of gestation) completed the Portuguese versions of DASS-21 and of Postpartum Depression Screening Scale (PDSS-24; Pereira et al., 2013).ResultsThe DASS-21 Cronbach's alpha was “very good” (a = 0.92). Following the Kaiser and the Cattel Scree Plot criteria, two factorial structures were explored. Three factors structure (explained variance/EV = 57.18%): F1-stress (included 8 items; α = 0.89); F2-Anxiety (7 items; α = 0.79); F3-Depression (6 items; α = 0.82). In the two factors structure (EV = 50.96), the Stress and Anxiety items load in the same factor (F1: 15 items; α = 0.91) and the F2 is composed of the Depression items (F2: 6 items; α = 0.82). Pearson correlations between DASS-21 total and dimensional scores and the PDSS-24 scores were all significant, positive and moderate to high (@.50).ConclusionsThe Portuguese version of DASS-21 has good reliability, construct and concurrent validity when used with pregnant women. Its factorial structure significantly overlaps with the original, with only one item loading in another factor. DASS-21 could be very useful in diverse settings in the perinatal period.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionThe impact of mindfulness in improving insomnia symptoms is documented in different samples (e.g. anxiety disorders; insomnia samples) and mindfulness based programs for pregnancy refer the association between mindfulness development and the reduction of insomnia symptoms/improvement of sleep.ObjectiveTo explore differences in the Facets Mindfulness Questionnaire-10 (FMQ-10; Azevedo et at. 2015), between sleep groups, in Portuguese pregnant women.MethodsFour hundred and nineteen pregnant women (mean age: 32.51 ± 4.759; weeks of gestation: 17.32 ± 4.803) answered the Facets Mindfulness Questionnaire-10 and the Insomnia Assessment Scale (IAS, Marques et al., 2015). Three sleep groups were created considering all the IAS items: good sleepers (no insomnia symptoms; no associated daily impairment); insomnia symptoms groups (one/more insomnia symptoms; no associated daily impairment; exclusion of other conditions/disorders explaining the symptoms); insomniacs (one/more insomnia symptoms; one/more daily associated impairment; exclusion of other conditions/disorders explaining the symptoms).ResultsThere were significant differences in the total FMQ-10 score, the F1/Nonjudging of inner experience and the F2/acting with awareness, between sleep groups [respectively, F (2.402) = 6,933; P = 0.001; F (2.406) = 10.243; P = 0.001; F (2.406) = 37.431; P = 0.002]. Tukey tests indicated that the mean total FMQ-10 and F1/Nonjudging of inner experience scores of good sleepers and insomnia symptoms group were significantly higher than of the insomniacs. The mean value of F2/acting with awareness in the good sleepers was significantly higher than of the insomniacs.ConclusionsIt seems important to develop mindfulness to improve sleep in pregnancy or reduce the impact of insomnia symptoms (common at pregnancy).Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionMindfulness refers to the capacity of being present and aware, without feeling the need to react or judge that experience (Kabat Zinn, 1990). This ability is associated with mental health and stress reduction (Baer, 2014; Teasdale et al., 2014). Five Facet Mindfulness Questionnaire (FFMQ) is widely used to measure mindfulness and its relation to psychopathology (Gregorio and Gouveia, 2011).ObjectiveTo analyze the psychometric properties of the Portuguese 15 items FFMQ (Baer; Gregório et al., authors’ manuscript) in a Portuguese sample of pregnant women.MethodsA total of 427 pregnant women (Mean age: 32.56 ± 4.785 years) in their second trimester of pregnancy (17.34 ± 4.790 weeks of gestation) completed the Portuguese version of FFMQ-15.ResultsThe FFMQ-15 Cronbach's alpha was unsatisfactory (α = 0.62) and five items presented low (< 0.20) correlations and had the effect of increasing Cronbach alpha if removed. Without these items, α increased to a satisfactory level (0.72) and all the ten items contributed to internal consistency. The factorial analysis of these ten items resulted in a three factors solution, which explained variance (EV) was of 53.9%. Based on items content, the meaningful three factors were denominated as follows: F1 Nonjudging of experience (EV 27.69%; α = 0.77), F2 Acting with awareness (18.00%; α = 0.77) and F3 Observing and describing (8.21%; α = 0.73).ConclusionsAlthough the FFMQ-15 has shown good psychometric properties in other samples, in this sample of pregnant women a 10-items FMQ (Facets of Mindfulness Questionnaire) version performed better, presenting good reliability and validity in evaluating three mindfulness facets.Disclosure of interestThe authors have not supplied their declaration of competing interest.