Objective: To assess the accuracy of the Edinburgh Postnatal Depression Scale (EPDS) in screening for severe depression and other mental disorders in women at the end of puerperium. Materials and methods: We administered the Czech version of the EPDS to assess depressive symptoms and the Mini International Neuropsychiatric Interview to determine psychiatric diagnoses in 243 women at the end of their puerperium. Then, we determined the frequencies of severe depressive disorder and other psychiatric disorders in our cohort. Furthermore, we assessed the sensitivity, specificity, positive predictive value, negative predictive value, and other diagnostic variables for the presence of severe depression and other psychiatric disorders for different threshold scores on EPDS. We evaluated the detection potential of EPDS for detecting monitored mental disorders by using the receiver operating characteristic curve analysis and determining the area under the curve. Results: Severe depressive disorder was present in 2.5% (95% CI: 1.1–5.3%) of women. Any monitored mental disorder was present in 13.6% (95% CI: 9.8–18.5%). The best sensitivity/specificity ratio for detecting major depressive disorder was found for the EPDS threshold score ≥ 11; sensitivity was 83% (95% CI: 35–99%) and specificity was 79% (95% CI: 74–84%). The EPDS ≥ 11 then achieved a sensitivity of 76% (95% CI: 58–89%) and specificity of 82% (95% CI: 76–87%) for the detection of any mental disorder of interest. Conclusion: Our results showed that the Czech version of EPDS has good internal consistency, and the EPDS score ≥ 11 achieves the best combination of sensitivity and specificity values for detecting major depressive disorder. Screening with EPDS in women at the end of puerperium can detect psychiatric disorders other than severe major depression. Key words: Edinburgh postpartum depression scale – screening – perinatal mental health – puerperium – postpartum depression

ObjectivePostpartum depression (PPD) is a serious condition with debilitating consequences for the mother, offspring, and the whole family. The scope of negative outcomes of PPD highlights the need to specify effective diagnostics and treatment which might differ from major depressive disorder (MDD). In order to improve our clinical care, we need to better understand the underlying neuropathological mechanisms of PPD. Therefore, we conducted a systematic review of published neuroimaging studies assessing functional, structural, and metabolic correlates of PPD.MethodsRelevant papers were identified using a search code for English-written studies in the PubMed, Scopus, and Web of Science databases published by March 2022. Included were studies with structural magnetic resonance imaging, functional magnetic resonance imaging, both resting-state and task-related, magnetic resonance spectroscopy, or positron emission tomography. The findings were analyzed to assess signatures in PPD-diagnosed women compared to healthy controls. The review protocol was registered in PROSPERO (CRD42022313794).ResultsThe total of 3,368 references were initially identified. After the removal of duplicates and non-applicable papers, the search yielded 74 full-text studies assessed for eligibility. Of them, 26 met the inclusion criteria and their findings were analyzed and synthesized. The results showed consistent functional, structural, and metabolic changes in the default mode network and the salient network in women with PPD. During emotion-related tasks, PPD was associated with changes in the corticolimbic system activity, especially the amygdala.DiscussionThis review offers a comprehensive summary of neuroimaging signatures in PPD-diagnosed women. It indicates the brain regions and networks which show functional, structural, and metabolic changes. Our findings offer better understanding of the nature of PPD, which clearly copies some features of MDD, while differs in others.

The former East Germany rarely features in contemporary discussions about distressed migration.1 When it does, this typically occurs in the context of antirefugee violence and the rise of right-wing nationalist movements and political parties such as Pegida and the AfD.2 Biases and violence against distressed migrants, many of whom arrived in Germany from a number of African, Middle Eastern, and Central Asian countries between the early 2010s and the so-called "refugee crisis" of 2015, tend to be higher in former East German federal states. This is in part because of the GDR's fraught relationship with the legacy of pre-1949 German history, specifically with National Socialism and Second Reich colonialism, for which the East German state failed to shoulder full responsibility.3 Yet 1 Distressed migration here serves as an umbrella term for migrants who are more frequently regarded in terms of their specific motivationsas refugees, asylum seekers, or undocumented immigrantsfor seeking a new home in another country. Normative discourse ignores distress as an underlying commonality by distinguishing among different motivations for migration. While insisting on the important legal distinctions between terms such as refugee and asylum seeker, Homi Bhabha recently used the terms "distressed migration/migrant" when talking about the general phenomenological condition of refugees and asylum seekers alike. Bhabha, Homi. "Statelessness and Death: Reflections on the Burdened Life." Delivered at the Cornell School of Criticism and Theory on June 18 2018. https://sct.cornell.edu/videos/2018-videos/. As Nicholas Courtman states in the context of writing about refugees in contemporary German works by Jenny Erpenbeck and Terézia Mora: While there are marked and contested legal distinctions between these terms, they "exist as a muddled amalgamation in the public imaginary."

Scholarship has often ascribed to the third generation of East German writers associated with the Prenzlauer Berg scene (1979–89) a monolithic attitude of dissociation from the ‘really existing socialist state’. The present study reevaluates Prenzlauer Berg literary production in the light of its engagement with the transnational aesthetic and political projects of the avantgardes from before and after the Second World War, which continued to be thematised in the literature and culture of unified Germany after the fall of the Wall. A continuous engagement with the avantgardes can be discerned in two texts by the erstwhile Prenzlauer Berg poet and contemporary novelist Jan Faktor: first, in the serial poem ‘Georgs Sorgen um die Zukunft’ (1982), and second, in the novel Georgs Sorgen um die Vergangenheit (2010). The poem, I argue, criticises the advanced state of ideological decay in the GDR in the 1980s but also generates possibilities for an aesthetic renewal. The post‐‘Wende’ novel narrates the history of state‐sponsored socialism in Czechoslovakia from a transnational standpoint that fosters the formation of an entangled past among countries of the former Eastern bloc. The novel's reflection on the disintegration of architectural projects once meant to organise life for a socialist future, however, commemorates the utopian spirit of the Russian Constructivist avantgarde and its productivist aesthetic. Der dritten Generation ostdeutscher Autoren, die zur Prenzlauer Berg‐Szene (1979–89) gehörten, schreibt die Literaturwissenschaft häufig eine monolithische Entfremdung vom ‘real‐existierenden Sozialismus’ zu. Das Engagement dieser Schriftsteller für die Wiederbelebung von transnationalen ästhetischen und politischen Projekten der Avantgarde aus der Epoche vor und nach dem zweiten Weltkrieg, die auch in der Literatur und Kultur des vereinigten Deutschlands thematisiert wird, gibt jedoch Anlass, die literarische Produktion am Prenzlauer Berg neu zu bewerten. Eine andauernde Beschäftigung mit den Avantgardisten lässt sich, wie ich in der vorliegenden Studie zeige, zum Beispiel in zwei Texten des ehemaligen Prenzlauer Berg‐Dichters und heutigen Romanautoren Jan Faktor ausmachen: Faktors serielles Gedicht Georgs Sorgen um die Zukunft (1982) kritisiert eine fortgeschrittene Phase des Ideologieverfalls der DDR der 1980er Jahre und zeigt zugleich neue Möglichkeiten der ästhetischen Erneuerung auf. Sein in der Nachwendezeit geschriebener Roman Georgs Sorgen um die Vergangenheit (2010) erzählt die Geschichte des Staatssozialismus in der Tschechoslowakei aus einer transnationalen Perspektive, welche die Bildung einer zwischen den früheren Ostblockländern verflochtenen Vergangenheit befördert. Durch die im Roman angestellten Betrachtungen über den Zerfall der architektonischen Projekte, die einst das Leben für die sozialistische Zukunft organisieren sollten, wird dennoch der utopische Geist des russischen Konstruktivismus und seine produktivistische Ästhetik in der Erinnerung bewahrt.