Early Management of Depression in Adolescent Pregnancy: An Integrative Review

Main Article Content

Sunetr Boobpamala
Puangpaka Kongvattananon
Chomchuen Somprasert


The purpose of this article was to discuss the factors associated with depressive symptoms in adolescent pregnancy and its early management. An integrative review was conducted to search databases such as CINAHL, Scopus, PubMed, and DynaMed for articles from 2008-2018. Thirteen published articles were selected by the PRISMA process. The results showed that the factors related to depressive symptoms in adolescent pregnancy that had the highest significance were the stigma perspective, lack of self-esteem, lack of support from family and spouse, barriers in accessing health services, and personal characteristics such as drug use, alcohol consumption, having history of depression, and experienced abuse. The findings of early management showed five emerging themes: 1) screening in early pregnancy, 2) promoting self-esteem, 3) promoting family and spouse support, 4) providing specific health care service, and 5) cooperation of all stakeholders. Early management is significant to a decrease in the severity of depressive symptoms in adolescent pregnancy, and it requires the collaborative work of all stakeholders in the health care system, such as nurses, physicians, psychologist, and the community, including family and friends.

Article Details

How to Cite
Boobpamala, S., Kongvattananon, P., & Somprasert, C. (2019). Early Management of Depression in Adolescent Pregnancy: An Integrative Review. The Journal of Behavioral Science, 14(1), 97-113. Retrieved from https://so06.tci-thaijo.org/index.php/IJBS/article/view/124622
Research Articles
Author Biographies

Sunetr Boobpamala, Nursing Faculty, Thammasat University

Ph.D. Student at Nursing Faculty, Thammasat University, Thailand

Puangpaka Kongvattananon, Nursing Faculty, Thammasat University

Assistant Professor at Faculty of Nursing, Thammasat University, Thailand

Chomchuen Somprasert, Nursing Faculty, Thammasat University

Assistant Professor at Faculty of Nursing, Thammasat University, Thailand


American College of Obstetricians and Gynecologists (ACOG). (2016). ACOG statement on depression screening. Retrieved June 8, 2018, from https://www.acog.org/About-ACOG/News-Room/Statements/2016/ACOG-Statement-on-Depression-Screening
American Pregnancy Association. (2017). Depression in pregnancy. Retrieved June 7, 2018, from http://americanpregnancy.org/pregnancy-health/depression-during-pregnancy/
Boath, E. H., Henshaw, C. & Bradley, E. (2013). Meeting the challenges of teenage mothers with postpartum depression: overcoming stigma through support. Journal of Reproductive and Infant Psychology, 31(4), 352-369. doi:10.1080/02646838.2013. 800635
Bernard, J. (1982). The Future of Marriage. New Haven, CT: Yale University.
Buzi, R. S., Smith, P. B., Kozinetz, C. A., Peskin, M. F., & Wiemann, C. M. (2015). A Socioecological framework to assessing depression among pregnant teens. Maternal and Child Health Journal, 19(10), 2187–2194. doi: 10.1007/s10995-015-1733-y
Cast, A. D., & Burke, P. J. (2002). A Theory of self-esteem. Social Forces, 80(3), 1041-1068.
Coelho, F. M. C., Pinheiro, R. T., Silva, R. A., Quevedo, L. A., Souza, L., Dias, M.,…Pinheiro, K. A. T. (2013). Major depressive disorder during teenage pregnancy: Socio-demographic, obstetric and psychosocial correlates. Revista Brasileira de Psiquiatria, 35(1), 51–56. doi: 10.1016/j.rbp.2012.03.006
Conway, C. A. (2010). ACOG encourages screening for depression during and after pregnancy. Retrieved June 8, 2018, from https://www.law.uh.edu/healthlaw/perspec tives/2010/(CC)%20ACOG.pdf
Corcoran, J. (2016). Teenage pregnancy and mental health. Societies, 6(3), 21. doi:10.3390/ soc6030021
DeVito, J. (2010). How adolescent mothers feel about becoming a parent. Journal of Perinatal Education, 19(2), 25–34.
Freitas, G. V. S., Cais, C. F. S., Stefanello, S., & Botega, N. J. (2008). Psychosocial conditions and suicidal behavior in pregnant teenagers: a case-control study in Brazil. European Child Adolescent Psychiatry, 17(6), 336-42.
Gecas, V. (1982). The self-concept. Annual review of Sociology, 8, 1–33.
Gecas, V., & Schwalbe, M. L. (1983). Beyond the looking-glass self: social structure
and efficacy-based self-esteem. Social Psychology Quarterly, 46(2), 77–88.
Goossens, G., Kadji, C., & Delvenne, V. (2015). Teenage Pregnancy: a psychopathological risk for mothers and babies? Psychiatria Danubina, 27(1), 499–503.
Gyesaw, N. K., & Ankomah, A. (2013). Experiences of pregnancy and motherhood among teenage mothers in a suburb of Accra, Ghana: a qualitative study. International Journal of Women’s Health, 12(5), 773–780. doi:10.2147/IJWH.S51528
Hodgkinson, S. C., Colantuoni, E., Roberts, D., Berg-Cross, L., & Horolyn, M. E. (2010). Depressive symptoms and birth outcomes among pregnancy teenagers. Journal Pediatric Adolescent Gynecology, 23(1), 16-22. doi:10.1016/j.jpag.2009.04.006
House, J. S. (1987). Social support and social structure. Sociological Forum, 2(1), 135-146.
House, J. S., & Kahn, R. L. (1985). Measures and concepts of social support. NY: Academic.
House, J. S., Umberson, D., & Landis, K. R. (1988). Structures and processes of social support. Annual Review of Sociology, 14(1988), 293-318.
Jesse, D. E., & Swanson, M. S. (2007). Risks and resources associated with antepartum risk for depression among rural southern women. Nursing Research, 56(6), 378–386.
doi: 10.1097/01.NNR.0000299856.98170.19
Jesse, D. E., Kim, H., & Herndon, C. (2014). Social support and self‐esteem as mediators between stress and antepartum depressive symptoms in rural pregnant women. Research in Nursing & Health, 37(3), 241-252. doi:10.1002/nur.21600
Kasak, R., Serisathien, Y., & Bangpichet, A. (2013). Factors predicting depression in adolescent pregnant woman. Journal of Nursing Science, 31(2), 45.
Koleva, H., & Stuart, S. (2014). Risk factors for depressive symptoms in adolescent pregnancy in a late-teen subsample. Archives of Women's Mental Health, 17(2), 155–158.
Kumar, P., & Magon, N. (2012). Hormonal in pregnancy. Nigerian Medical Journal, 53(4), 179-183. doi:10.4103/0300-1652.107549
Kumar, M., Huang, K., Othieno, C., Wamalwa, D., Madeghe, B., Osok, J.,…McKay, M. M. (2017). Adolescent pregnancy and challenges in Kenyan context: Perspectives from multiple community stakeholders. Global Social Welfare, 5(1), 11–27. doi:10.1007/s40609-017-0102-8
Lara, M. A., Berenzon, S., García, F. J., Medina-Mora, M. E., Rey, G. N., Velazquez, J. A. V., & Lopez, M. L. G. (2012). Population study of depressive symptoms and risk factors in pregnant and parenting Mexican adolescents. Revista Panamericana Salud Publica, 31(2), 102-108.
Lijun, S., Son, J., & Lin, N. (2015). The sage handbook of social network analysis. Retrieved June 19, 2018, from https://www.researchgate.net/publication/261710356_Social_ Support?enrichId
Meadows-Oliver, M. & Sadler, L. (2010). Depression among adolescent mothers enrolled in a high school parenting program. Journal Psychosocial Nursing Mental Health Services, 48(12), 34–41. doi: 10.3928/02793695-20100831-04.
Moher, D., Liberati. A., Tetzlaff, J., & Altman, D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Medicine, 6(7), e1000097. doi:10.1371/journal.pmed.1000097
Mulligan, A. (2011). Evidence In-Sight request summary: The relationship between self-esteem and mental health outcomes in children and youth. Retrieved June 23, 2018, from http://www.excellenceforchildandyouth.ca/sites/default/files/resource/EIS_Self _Esteem_MH.pdf
Muzik, M., Rosenblum K., Schuster, M., Kohler, E. S., Alfafara, E., & Miller, N. (2016).
A mental health and parenting intervention for adolescent and young adult mothers and their infants. Journal of Depression & Anxiety, 5(3), 1-6. doi: 10.4172/2167-1044.1000233
Osborne, S., & O’Keane, V. (2009). Management of depression during pregnancy. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1002/pnp.113
Parekh, R. (2017). What is depression? American Psychiatric Association. Retrieved June 6, 2018, from https://www.psychiatry.org/patients-families/depression/what-is-depression.
Phipps, M. G., Raker, C. A., Ware, C. F., & Zlotnick, C. (2013). Randomized controlled trial
to prevent postpartum depression in adolescent mothers. American Journal of Obstetrics & Gynecology, 208(3), 192.e1–192.e6. doi: 10.1016/j.ajog.2012.12.036
Pires, R., Araujo-Pedrosa, A., & Canavarro, M. C. (2014). Examining the links between perceived impact of pregnancy, depressive symptoms, and quality of life during adolescent pregnancy: the buffering role of social Support. Maternal Child Health Journal, 18(4), 789–800. doi:10.1007/s10995-013-1303-0
Records, K. (2011). Prenatal depression. International Journal of Childbirth Education, 26(4), 19-22.
Reid, V., & Meadows-Oliver, M. (2007). Postpartum depression in adolescent mothers: an integrative review of the literature. Journal of Pediatric Health Care, 21(5), 289-298.
Rogers, C. R. (1951). Client Center Therapy. Boston: Houghton Mifflin.
Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, NJ: Princeton University.
Rosenberg, M. (1990). The self-concept: Social product and social force. In M. Rosenberg & R. Turner (eds.), Social psychology: Sociological perspectives (593–624). New Brunswich, NJ: Transaction.
Song, L., Son, J., & Lin, N. (2011). Social support. Retrieved April 11, 2018, from https://www.researchgate.net/publication/261710356_Social_Support
Sowislo, J. F., & Orth, U. (2012). Does low self-esteem predict depression and anxiety?
A meta-analysis of longitudinal studies. Psychological Bulletin, 139(1), 213–240.
doi: 10.1037/a0028931
Tzilos, G. K., Zlotnick, C., Raker, C., Kuo, C. & Phipps, M. G. (2012). Psychosocial factors associated with depression severity in pregnant adolescents. Archives of Women’s Mental Health, 15(5), 397–401. doi: 10.1007/s00737-012-0296-9
Watts, M. C. N. C., Liamputtong, P., & Mcmichael, C. (2015). Early motherhood: A qualitative study exploring the experiences of African Australian teenage mothers in greater Melbourne, Australia. BMC Public Health, 15(873), 1-11. doi: 10.1186/s12889-015-2215-2
Whittemore, R., & Knafl, K. (2005). The integrative review: Updated methodology. Journal of Advanced Nursing, 52(5), 546–553. doi:10.1111/j.1365-2648.2005.03621
World Health Organization. (2016). Mental Health. Retrieved April 11, 2018, from http://www.who.int/mental_health/management/depression/en/
World Health Organization. (2018). Adolescent health. Retrieved April 11, 2018, from http://www.who.int/topics/adolescent_health/en/