Due to the limitations of the current evidence base, such as the low statistical power of the included studies, it is not possible to draw any clear conclusions about the effectiveness of antidepressants for the prevention of postnatal depression. It is striking that no new eligible trials have been completed in the period of over a decade since the last published version of this review. Larger trials are needed which include comparisons of antidepressant drugs with other prophylactic treatments (e.g. psychological interventions), and examine adverse effects for the fetus or infant. Future reviews in this area may benefit from broadening their focus to examine the effectiveness of antidepressants for the prevention of perinatal (i.e. antenatal or postnatal) depression, which could include studies comparing antidepressant discontinuation with continuation for the prevention of relapse of depression during pregnancy and the postnatal period.

Purpose of review Children and adolescents with mental health difficulties, and people associated with them, can experience stigma as a result of these difficulties. This article aims to provide an update on the literature pertaining to mental health-related stigma in children and adolescents. Recent findings Recent studies have investigated public stigma, self-stigma and affiliate stigma related to child and adolescent mental health difficulties. Research has typically employed a cross-sectional design. Significant variation was identified in both study methodology and study findings. Qualitative studies offer a unique perspective of stigma from the point of view of the stigmatized individual. Significantly, quantitative analysis has found different variables to be associated with stigma in different geographical locations, even when similar measures are used. Summary Stigma can have a significant detrimental impact on the quality of life for those affected. Careful attention should therefore be paid to stigma in the assessment and treatment of children and adolescents with mental health difficulties. Furthermore, its impact on their caregivers should not be overlooked. Further research is needed to understand the role of social and cultural factors in the development and impact of stigma, and may aid production of antistigma interventions.

ObjectiveTo explore women's views on the acceptability of being asked about mental health problems at antenatal booking. DesignQualitative study. SettingBrief semi-structured qualitative interviews were conducted with women in a private setting at a hospital, or at women's homes. Interview discussions centered around three key questions: "What was it like for you answering the questions about your mood?", "Were there any questions you found upsetting, distressing or confronting?" and "Did the midwife give you some feedback about your answers?" MeasurementsInterviews were audio-recorded, transcribed verbatim, and analysed using thematic and framework approaches. ParticipantsAn ethnically diverse sample [32% white British/Irish, 68% non-white, non-British] of 52 women living in the study area. Findings ACCEPTED MANUSCRIPTMost women found mental health enquiry acceptable. A smaller proportion reported difficulties and many of these women had a past or current mental health problem and/or a history of abuse. These women reported difficulty due to the emotional responses triggered by the questions and the way disclosures were handled. In general, women wanted to be asked clear questions about mental health problems, to have sufficient time to discuss issues, and to receive responses from midwives which were normalising and well-informed about mental health. ConclusionsThis study highlights that women want midwives to ask clearly-framed questions about mental health problems [addressing past and current mental health concerns], and valued responses from midwives that were normalising, well-informed and allowed for discussion. Implications for PracticeTraining should be provided to midwives on how to appropriately respond to women's distress during mental health enquiry, and on referral to support services.