Miller, Michelle L.; Kroska, Emily B.; Grekin, Rebecca
Background Negative affect (NA) and positive affect (PA) in the early postpartum period have been associated with postpartum depressive symptoms, but the exact relationship is not well understood. This study aimed to determine if NA and PA in the immediate postpartum period predicted postpartum depressive symptoms over and above well-established predictors (previous trauma, history of depression). Methods Participants were prospectively recruited from a Mother-Baby Unit at a large Midwestern academic medical center in the United States from April 2011 to April 2014. Participants (N = 526) completed the Daily Experiences Questionnaire (DEQ), a self-report measure which assessed NA and PA, within three days post-delivery. Participants then reported their depressive symptoms at two weeks (n = 364) and twelve weeks postpartum (n = 271). Results Hierarchical regression analyses indicated that low PA and high NA after birth significantly predicted depressive symptoms early (at 2 weeks) and later (at 12 weeks) in the postpartum period, over and above previous traumatic experiences and history of depression. Limitations The sample was relatively homogenous, and data were from self-report instruments. Conclusions The current study found NA and PA in the days immediately after birth predicted depressive symptoms at multiple time points in the postpartum period. Because the perinatal period places women at a higher risk for depressive symptomatology, prevention and early intervention are critical. Measuring affect in hospitals immediately after birth may provide a more normalized set of items that is predictive of later depression, which will allow physicians to identify those at highest risk for developing depressive symptoms. PMID:27716540
Miller, Michelle L; Kroska, Emily B; Grekin, Rebecca
Negative affect (NA) and positive affect (PA) in the early postpartum period have been associated with postpartum depressive symptoms, but the exact relationship is not well understood. This study aimed to determine if NA and PA in the immediate postpartum period predicted postpartum depressive symptoms over and above well-established predictors (previous trauma, history of depression). Participants were prospectively recruited from a Mother-Baby Unit at a large Midwestern academic medical center in the United States from April 2011 to April 2014. Participants (N=526) completed the Daily Experiences Questionnaire (DEQ), a self-report measure which assessed NA and PA, within three days post-delivery. Participants then reported their depressive symptoms at two weeks (n=364) and twelve weeks postpartum (n=271). Hierarchical regression analyses indicated that low PA and high NA after birth significantly predicted depressive symptoms early (at 2 weeks) and later (at 12 weeks) in the postpartum period, over and above previous traumatic experiences and history of depression. The sample was relatively homogenous, and data were from self-report instruments. The current study found NA and PA in the days immediately after birth predicted depressive symptoms at multiple time points in the postpartum period. Because the perinatal period places women at a higher risk for depressive symptomatology, prevention and early intervention are critical. Measuring affect in hospitals immediately after birth may provide a more normalized set of items that is predictive of later depression, which will allow physicians to identify those at highest risk for developing depressive symptoms. Copyright © 2016 Elsevier B.V. All rights reserved.
Iliadis, S I; Koulouris, P; Gingnell, M; Sylvén, S M; Sundström-Poromaa, I; Ekselius, L; Papadopoulos, F C; Skalkidou, A
Postpartum depression (PPD) is a common childbirth complication, affecting 10-15 % of newly delivered mothers. This study aims to assess the association between personality factors and PPD. All pregnant women during the period September 2009 to September 2010, undergoing a routine ultrasound at Uppsala University Hospital, were invited to participate in the BASIC study, a prospective study designed to investigate maternal well-being. Depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) while the Depression Self-Rating Scale (DSRS) was used as a diagnostic tool for major depression. Personality traits were evaluated using the Swedish Universities Scale of Personality (SSP). One thousand thirty-seven non-depressed pregnant women were included in the study. Non-depressed women reporting high levels of neuroticism in late pregnancy were at high risk of developing postpartum depressive symptoms (PPDSs) at 6 weeks and 6 months after delivery, even after adjustment for confounders (adjusted odds ratio (aOR) = 3.4, 95 % confidence interval (CI) 1.8-6.5 and adjusted odds ratio (aOR) = 3.9, 95 % CI 1.9-7.9). The same was true for a DSRS-based diagnosis of major depression at 6 months postpartum. Somatic trait anxiety and psychic trait anxiety were associated with increased risk for PPDS at 6 weeks (aOR = 2.1, 95 % CI 1.2-3.5 and aOR = 1.9, 95 % CI 1.1-3.1), while high scores of mistrust were associated with a twofold increased risk for PPDS at 6 months postpartum (aOR 1.9, 95 % CI 1.1-3.4). Non-depressed pregnant women with high neuroticism scores have an almost fourfold increased risk to develop depressive symptoms postpartum, and the association remains robust even after controlling for most known confounders. Clinically, this could be of importance for health care professionals working with pregnant and newly delivered women.
... do not need treatment. The symptoms of postpartum depression last longer and are more severe. You may ... treatment right away, often in the hospital. Postpartum depression can begin anytime within the first year after ...
Wu, Yelena P.; Selig, James P.; Roberts, Michael C.; Steele, Ric G.
The vast majority of new mothers experience at least some depressive symptoms. Postpartum maternal depressive symptoms can greatly influence children's outcomes (e.g., emotional, cognitive, language, and social development). However, there have been relatively few longitudinal studies of how maternal depressive symptoms may influence children's…
Chapman, Shawna L. Carroll; Wu, Li-Tzy
National survey data suggest that new mothers have high prevalences of alcohol and illicit drug use. Depression correlates with substance use, and new mothers with postpartum depression (PPD) may be at high risk for substance use. Understanding postpartum substance use and its relationship to PPD can inform future research and intervention. A literature search was conducted resulting in 12 studies published from 1999–2012 examining postpartum alcohol use, drug use, or combined postpartum depression and substance use. Postpartum alcohol (prevalence range 30.1%−49%) and drug use (4.5%–8.5%) were lower than use among not pregnant, not postpartum women (41.5%–57.5%; 7.6%–10.6%, respectively) but higher than use among pregnant women (5.4%–11.6%; 3.7%–4.3%, respectively). Correlates of postpartum problem drinking were being unemployed, unmarried, and a cigarette smoker. Prevalence of drug use was highest among white new mothers, followed by Blacks and Hispanics, but Black new mothers appeared at greater risk of drug use. No identified studies examined correlates of postpartum drug use beyond race/ethnicity. Postpartum depressive symptoms were prevalent among postpartum substance users and those with a substance use history (19.7%–46%). The postpartum period is a critical time. Prevalent substance use and the scarcity of studies warrant research to identify means to reduce maternal substance use. PMID:23879459
Jobst, Andrea; Krause, Daniela; Maiwald, Carina; Härtl, Kristin; Myint, Aye-Mu; Kästner, Ralph; Obermeier, Michael; Padberg, Frank; Brücklmeier, Benedikt; Weidinger, Elif; Kieper, Susann; Schwarz, Markus; Zill, Peter; Müller, Norbert
During the postpartum period, women are at higher risk of developing a mental disorder such as postpartum depression (PPD), a disorder that associates with mother-infant bonding and child development. Oxytocin is considered to play a key role in mother-infant bonding and social interactions and altered oxytocin plasma concentrations were found to be associated with PPD. In the present study, we evaluated oxytocin plasma levels and depressive symptoms during pregnancy and the postpartum period in healthy women. We evaluated 100 women twice during pregnancy (weeks 35 and 38) and three times in the postpartum period (within 2 days and 7 weeks and 6 months after delivery) by measuring oxytocin plasma levels with enzyme-linked immunosorbent assay (ELISA) and assessing depressive symptoms with the Montgomery-Asberg Depression Rating Scale. Oxytocin plasma levels significantly increased from the 35th week of gestation to 6 months postpartum in all women. However, levels decreased from the 38th week of gestation to 2 days after delivery in participants with postpartum depressive symptoms, whereas they continuously increased in the group without postpartum depressive symptoms; the difference between the course of oxytocin levels in the two groups was significant (Δt2-t3: t = 2.14; p = 0.036*). Previous depressive episodes and breastfeeding problems predicted postpartum depressive symptoms. Our results indicate that alterations in the oxytocin system during pregnancy might be specific for women who develop postpartum depressive symptoms. Future studies should investigate whether oxytocin plasma levels might have predictive value in women at high risk for PPD.
Vafai, Yassaman; Steinberg, Julia R; Shenassa, Edmond D
Maternal postpartum depression has been shown to be one of the main predictors of externalizing and internalizing behaviors in toddlers and adolescents. Research suggests that presence of such behaviors can be observed as early as infancy. The current study uses longitudinal data from 247 mothers to examine the relationship between postpartum depressive symptoms at 8 weeks and the infant's externalizing and internalizing behaviors at 12 months. In unadjusted linear regression models, there were associations between postpartum depressive symptoms and infant externalizing behaviors (β=0.082, SE=0.032, p=0.012) and internalizing behaviors (β=0.111, SE=0.037, p=0.003). After controlling for potential confounding factors, including maternal age, race, education, home ownership, smoking status in the postpartum period, marital status, parenting stress, and happiness from becoming a parent, the associations between postpartum depressive symptoms and infant externalizing (β=0.051, SE=0.034, p=0.138) and internalizing behaviors (β=0.077, SE=0.040, p=0.057) were reduced and became non-significant. Furthermore, in these models the total amount of variance explained was 17.2% (pexternalizing behaviors and 10.5% (pexternalizing behaviors was maternal age (β=-0.074, SE=0.030, p=0.014), and of internalizing behaviors was white non-Hispanic ethnicity (β=-1.33, SE=0.378, p=0.0005). A combined effect of the confounding factors seems to explain the finding of no significant independent association between postpartum depressive symptoms and infant externalizing and internalizing behaviors. Copyright © 2015 Elsevier Inc. All rights reserved.
Navarrete, Laura Elena; Lara-Cantú, María Asunción; Navarro, Claudia; Gómez, María Eugenia; Morales, Francisco
To study perinatal anxiety symptoms in a sample of Mexican mothers. A) To evaluate the effect of certain psychosocial factors during pregnancy on anxiety symptoms at two postpartum time intervals; and B) to determine whether this symptomatology is related to symptoms of postnatal depression. In this secondary data analysis, 156 women were interviewed during pregnancy (T1): 149 were interviewed again at 6 weeks postpartum (T2) and 156 at 4-6 months postpartum (T3). Subjects were selected from women seeking prenatal attention at three health centers in Mexico City who presented with depressive symptomatology and/or previous history of depression. Two models were subjected to multivariate regression analysis to determine the influence of psychosocial factors in pregnancy (age, education, partner status, social support [APGAR], stress events, self-esteem [Coopersmith], depressive symptomatology [BDI-II], and anxiety [SCL-90]) on anxiety symptomatology (SCL-90) in T2 and T3. Two additional linear regression analyses were performed to evaluate the influence of prenatal anxiety symptomatology (SCL-90) on postpartum depression symptoms (BDI-II), one for each postnatal period (T2, T3). The variables that predicted postpartum anxiety symptomatology in T2 were anxiety symptoms and lack of social support; in T3 they were anxiety symptoms, lack of a partner, and lack of social support. Prenatal anxiety symptoms predicted postpartum depressive symptomatology at both postpartum intervals (T2, T3). Untreated prenatal anxiety symptomatology is predictive of symptoms of anxiety and depression in the postpartum period, suggesting the need for timely detection and treatment. Women lacking social support or partners are a population particularly vulnerable to anxiety symptoms, and merit interventions that address these issues.
Full Text Available Postpartum parental depression, even of mild intensity and short duration, has negative consequences on child development, including increased externalizing and internalizing symptoms. Studies revealed that the links between parental depression and child development are mediated by parenting difficulties. On the other hand, the mediating role of problematic family-level relationships, such as low coparenting support and high conflict between the parents, has rarely been considered, although coparenting difficulties have been linked with both increased depressive symptoms in parents and increased symptoms in toddlers. In the present study, we proposed testing a comprehensive mediation model linking parental depression, coparenting, and child symptoms. At 3 months postpartum, a convenience sample of 69 parental couples completed the Edinburgh Postnatal Depression Scale. In addition, we assessed levels of coparenting support and conflict during a mother–father–infant play situation, the Lausanne Trilogue Play. At 18 months postpartum, both parents assessed child symptoms with the Symptom Checklist Questionnaire. The results showed that coparenting support mediated the links between parental depressive symptoms and child symptoms, but only for mothers: Maternal depressive symptoms were linked with lower coparenting support, which in turn predicted increased psychofunctional symptoms and behavior problems assessed by mothers. Although coparenting conflict behaviors were not predicted by parents’ depressive symptoms, higher conflict was unexpectedly linked with fewer behavior problems assessed by both parents. The present study allowed us to unveil complex pathways between mild parental mood disturbances, family-level relationships, and child development in the first months of the child’s life.
Caparros-Gonzalez, Rafael A; Romero-Gonzalez, Borja; Strivens-Vilchez, Helen; Gonzalez-Perez, Raquel; Martinez-Augustin, Olga; Peralta-Ramirez, Maria Isabel
Postpartum depression affects a huge number of women and has detrimental consequences. Knowing the factors associated with postpartum depression during pregnancy can help its prevention. Although there is evidence surrounding behavioral or psychological predictors of postpartum depression, there is a lack of evidence of biological forecasters. The aim of this study was to analyze the sociodemographic, obstetric, and psychological variables along with hair cortisol levels during the first, second, and third trimesters of pregnancy that could predict postpartum depression symptoms. A sample of 44 pregnant women was assessed during 3 trimesters of pregnancy and the postpartum period using psychological questionnaires and hair cortisol levels. Participants were divided into 2 groups: a group with postpartum depression symptoms and a group with no postpartum depression symptoms. Results showed significant positive differences between groups in the first trimester regarding the Somatization subscale of the SCL-90-R (p Depression, Anxiety, and GSI subscales (p postpartum depression symptoms. In conclusion, our study provided evidence that psychopathological symptoms, pregnancy-specific stress, and hair cortisol levels can predict postpartum depression symptoms at different time-points during pregnancy. These findings can be applied in future studies and improve maternal care in clinical settings.
Lee, Chien-Ti; Stroo, Marissa; Fuemmeler, Bernard; Malhotra, Rahul; Østbye, Truls
Background Although depressive symptoms are common postpartum, few studies have followed women beyond 12 months postpartum to investigate changes in the number and severity of these symptoms over time, especially in overweight and obese women. Using two complementary analytical methods, this study aims to identify trajectories of depressive symptoms over two years postpartum among overweight or obese mothers, and assess the demographic, socio-economic , and health covariates for these trajectories. Methods Using longitudinal data from two behavioral intervention studies (KAN-DO and AMP; N = 844), we used latent growth modeling to identify the overall trajectory of depressive symptoms and how it was related to key covariates. Next, we used latent class growth analysis to assess the heterogeneity in the depressive symptom trajectories over time, and thereby, identify subgroups of women with distinct trajectories. Findings The overall trajectory of depressive symptoms over two years postpartum was relatively stable in our sample. However, the presence of three distinct latent class trajectories [stable-low (82.5%), decreasing symptoms (7.3%) and increasing symptoms (10.2%)], identified based on trajectory shape and mean depressive symptom score, supported heterogeneity in depressive symptom trajectories over time. Lower maternal education was related to a higher symptom score, and poorer subjective health status at baseline predicted inclusion in the increasing symptoms trajectory. Conclusions In some overweight or obese mothers postpartum depressive symptoms do not resolve quickly. Practitioners should be aware of this phenomenon and continue to screen for depression for longer periods of time postpartum. PMID:25213748
Halbreich, Uriel; Karkun, Sandhya
The prevalence of postpartum depression (PPD) is currently considered to be 10-15%. Most studies were performed with a brief unidimensional instruments (mostly the Edinburgh Postnatal Depression Scale-EPDS) with focus on depression and not on other symptoms and disorders. Most cited studies were conducted in Western economically developed countries. We reviewed the literature on prevalence of postpartum depression and depressive symptoms in a wide range of countries. 143 studies were identified reporting prevalence in 40 countries. It is demonstrated that there is a wide range of reported prevalence of PPD ranging from almost 0% to almost 60%. In some countries like Singapore, Malta, Malaysia, Austria and Denmark there are very few reports of PPD or postpartum depressive symptoms, whereas in other countries (e.g. Brazil, Guyana, Costa Rica, Italy, Chile, South Africa, Taiwan and Korea) reported postpartum depressive symptoms are very prevalent. We believe that the widely cited mean prevalence of PPD-10-15% is not representative of the actual global prevalence and magnitude of the problem, due to the wide range of reports. The variability in reported PPD might be due to cross-cultural variables, reporting style, differences in perception of mental health and its stigma, differences in socio-economic environments (e.g. poverty, levels of social support or its perception, nutrition, stress), and biological vulnerability factors. The elucidation of the underlying processes of this variability as well as the diversity of postpartum normal versus abnormal expressions of symptoms may contribute to better understanding of the diversified ante, peri- and postpartum phenomena.
Gould, Jacqueline F; Best, Karen; Makrides, Maria
Postpartum depression (PPD) is the most prevalent mood disorder associated with childbirth. No single cause of PPD has been identified, however the increased risk of nutritional deficiencies incurred through the high nutritional requirements of pregnancy may play a role in the pathology of depressive symptoms. Three nutritional interventions have drawn particular interest as possible non-invasive and cost-effective prevention and/or treatment strategies for PPD; omega-3 (n-3) long chain polyunsaturated fatty acids (LCPUFA), vitamin D and overall diet. We searched for meta-analyses of randomised controlled trials (RCT's) of nutritional interventions during the perinatal period with PPD as an outcome, and checked for any trials published subsequently to the meta-analyses. Fish oil: Eleven RCT's of prenatal fish oil supplementation RCT's show null and positive effects on PPD symptoms. Vitamin D: no relevant RCT's were identified, however seven observational studies of maternal vitamin D levels with PPD outcomes showed inconsistent associations. Diet: Two Australian RCT's with dietary advice interventions in pregnancy had a positive and null result on PPD. With the exception of fish oil, few RCT's with nutritional interventions during pregnancy assess PPD. Further research is needed to determine whether nutritional intervention strategies during pregnancy can protect against symptoms of PPD. Given the prevalence of PPD and ease of administering PPD measures, we recommend future prenatal nutritional RCT's include PPD as an outcome. Copyright © 2016 Elsevier B.V. All rights reserved.
Abdollahi, Fatemeh; Zarghami, Mehran; Sazlina, Shariff-Ghazali; Lye, Munn-Sann
Prolonged depression during the post-partum period is associated with maternal and infant mortality and morbidity. Less attention has been given to factors that predict the persistence of depression beyond the first 3 months post-partum. From a longitudinal cohort of 2279 women who attended Mazandaran's primary health centres in 2009, 478 women with an Edinburgh Postnatal Depression Scale (EPDS) score of 12 or greater in the third trimester of pregnancy were recruited. Persistently depressed women (depressed at all three occasions: during pregnancy, and at 2 and 12 weeks post-partum) were compared with those without depression to determine demographic, cultural, obstetric and biopsychosocial predictors for persistence of depression. Data were analysed using chi-square test, t-test and logistic regression models. The stability of depression was found in 193 (46.2 %) of 418 depressed cases who were followed up over the study period. Of those mothers who scored more than the threshold of 12 during the third trimester of pregnancy, 277 (66.3%) and 221 (52.9%) had high EPDS at 2 and 12 weeks post-partum. Psychological distress (based upon the General Health Questionnaire), low maternal parental self-efficacy (based upon the Parental Expectation Survey) and perceived social isolation (based upon the Network Orientation Scale) were independent predictors of persistent depression. Fewer depressed mothers in this study were found to recover during the first 3 months after giving birth. Psychosocial factors predicted sustained depression from pregnancy to 3 months post-partum. The findings highlight the significance of support in enhancing maternal mental health. © 2015 Wiley Publishing Asia Pty Ltd.
Giri, Rajendra Kumar; Khatri, Resham Bahadur; Mishra, Shiva Raj; Khanal, Vishnu; Sharma, Vidya Dev; Gartoula, Ritu Prasad
Post-partum depression is a common complication of women after childbirth. The objective of this study was to determine the prevalence of and factors associated with depressive symptoms among post-partum mothers attending a child immunization clinic at a maternity hospital in Kathmandu, Nepal. This cross-sectional study was conducted among 346 post-partum mothers at six to ten weeks after delivery using systematic random sampling. Mothers were interviewed using a semi-structured questionnaire. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for depressive symptoms. Logistic regression analysis was used to calculate the association of post-partum depressive symptoms with socio-demographic and maternal factors. The prevalence of post-partum depressive symptoms among mothers was 30%. Mothers aged 20 to 29 years were less likely to have depressive symptoms (adjusted odds ratio (aOR) = 0.40; 95% CI: 0.21-0.76) compared to older mothers. Similarly, mothers with a history of pregnancy-induced health problems were more likely to have depressive symptoms (aOR = 2.16; CI: 1.00-4.66) and subjective feelings of stress (aOR = 3.86; CI: 1.84-4.66) than mothers who did not. The number of post-partum mothers experiencing depressive symptoms was high; almost one-third of the participants reported having them. Pregnancy-induced health problems and subjective feelings of stress during pregnancy in the post-partum period were found to be associated with depressive symptoms among these women. Screening of depressive symptoms should be included in routine antenatal and postnatal care services for early identification and prevention.
Kettunen, Pirjo; Koistinen, Eeva; Hintikka, Jukka
Postpartum depression (PPD) is a common illness, but due to the underlying processes and the diversity of symptoms, some variability is exhibited. The risk of postpartum depression is great if the mother has previously suffered from depression, but there is some evidence that a certain subgroup of women only experience depression during the postpartum period. The study group consisted of 104 mothers with postpartum major depression and a control group of 104 postpartum mothers without depression. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) was used for data collection. The severity of depression and other mental symptoms were assessed using several validated rating scales. A history of past depression (82%), including depression during pregnancy (42%) and during the postpartum period (53%), was very common in those with current PPD. Eighteen per cent of mothers with current PPD had previously not had any depressive episodes and four per cent had experienced depression only during the postpartum period. Therefore, pure PPD was rare. The onset of PPD was usually (84%) within six weeks of childbirth. Obsessive-compulsive symptoms, phobic anxiety, paranoid ideation, depressed mood, diminished pleasure/interest, decreased energy, and psychomotor agitation/retardation were common with all kinds of depression histories. Pure PPD was the most similar to the first depressive episode. Nevertheless, the severity of depression, the level of hopelessness, somatisation, interpersonal sensitivity, anxiety, hostility, psychoticism, sleep disturbance, and suicidal ideation were lower, appetite changed less, and concentration was better than in other recurrent depressions. According to this study, PPD is not a homogenous disorder. The time of onset, severity, symptoms, level of hopelessness, and the course of depression vary. Recurrent depression is common. All mothers must be screened during the sixth week postpartum at the latest. Screening alone is not
Fox, Molly; Sandman, Curt A; Davis, Elysia Poggi; Glynn, Laura M
An issue of critical importance for psychiatry and women's health is whether postpartum depression (PPD) represents a unique condition. The Diagnostic and Statistical Manual of Mental Disorders asserts that major depressive disorder (MDD) may present with peripartum onset, without suggesting any other differences between MDD and PPD. The absence of any distinct features calls into question the nosologic validity of PPD as a diagnostic category. The present study investigates whether symptom profiles differ between PPD and depression occurring outside the postpartum phase. In a prospective, longitudinal study of parturient women (N = 239), we examine the manifestation of depression symptoms. We assess factor structure of symptom profiles, and whether factors are differentially pronounced during and after the postpartum period. Factors were revealed representing: Worry, Emotional/Circadian/Energetic Dysregulation, Somatic/Cognitive, Appetite, Distress Display, and Anger symptoms. The factor structure was validated at postpartum and after-postpartum timepoints. Interestingly, the Worry factor, comprising anxiety and guilt, was significantly more pronounced during the postpartum timepoint, and the Emotional/Circadian/Energetic Dysregulation factor, which contained sadness and anhedonia, was significantly less pronounced during the postpartum period. These results suggest that PPD may be a unique syndrome, necessitating research, diagnosis, and treatment strategies distinct from those for MDD. Results indicate the possibility that Worry is an enhanced feature of PPD compared to depression outside the postpartum period, and the crucial role of sadness/anhedonia in MDD diagnosis may be less applicable to PPD diagnosis. © 2018 Wiley Periodicals, Inc.
Iliadis, Stavros I.; Comasco, Erika; Sylvén, Sara; Hellgren, Charlotte; Sundström Poromaa, Inger; Skalkidou, Alkistis
Background The biology of peripartum depression remains unclear, with altered stress and the Hypothalamus-Pituitary-Adrenal axis response having been implicated in its pathophysiology. Methods The current study was undertaken as a part of the BASIC project (Biology, Affect, Stress, Imaging, Cognition), a population-based longitudinal study of psychological wellbeing during pregnancy and the postpartum period in Uppsala County, Sweden, in order to assess the association between evening salivary cortisol levels and depressive symptoms in the peripartum period. Three hundred and sixty-five pregnant women from the BASIC cohort were recruited at pregnancy week 18 and instructed to complete a Swedish validated version of the Edinburgh Postnatal Depression Scale at the 36th week of pregnancy as well as the sixth week after delivery. At both times, they were also asked to provide evening salivary samples for cortisol analysis. A comprehensive review of the relevant literature is also provided. Results Women with postpartum EPDS score ≥ 10 had higher salivary evening cortisol at six weeks postpartum compared to healthy controls (median cortisol 1.19 vs 0.89 nmol/L). A logistic regression model showed a positive association between cortisol levels and depressive symptoms postpartum (OR = 4.1; 95% CI 1.7–9.7). This association remained significant even after controlling for history of depression, use of tobacco, partner support, breastfeeding, stressful life events, and sleep problems, as possible confounders (aOR = 4.5; 95% CI 1.5–14.1). Additionally, women with postpartum depressive symptoms had higher postpartum cortisol levels compared to both women with depressive symptoms antenatally and controls (p = 0.019 and p = 0.004, respectively). Conclusions Women with depressive symptoms postpartum had higher postpartum cortisol levels, indicating an altered response of the HPA-axis in postpartum depression. PMID:26322643
Alhasanat, Dalia; Giurgescu, Carmen
The purpose of this review was to evaluate studies that examined the relationship between acculturation and postpartum depression (PPD) among immigrant and/or refugee women in the United States. A systematic, computer-assisted search of quantitative, English-language, peer-reviewed, published research articles was conducted in the Scopus, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Maternity and Infant Care databases using the keyword terms of "postpartum depression" and "perinatal depression" in combination with "acculturation." Studies were included if they were conducted in the United States. Seven studies met inclusion criteria. Three studies used longitudinal designs and four used cross-sectional designs. All were conducted with Hispanic women. Only one study used a diagnostic tool to measure PPD; the remaining studies used screening tools to measure postpartum depressive symptoms. Most studies used country of birth, country of residence, and language preferences to measure acculturation. Five studies reported acculturation was positively related to risk of postpartum depressive symptoms, and two studies reported no relationship. Higher levels of acculturation were related to higher risk of postpartum depressive symptoms in Hispanic women living in the United States. Nurses should have an understanding of stressors of immigrant women to guide their assessment and screening for postpartum depressive symptoms and make appropriate referrals. More research is needed to confirm the relationship between acculturation and PPD among immigrant women from different cultural backgrounds.
Kozyrskyj, A L; Letourneau, N L; Kang, L J; Salmani, M
Affecting 19% of women, postpartum depression is a major concern to the immediate health of mothers and infants. In the long-term, it has been linked to the development of early-onset asthma at school entry, but only if the depression persists beyond the postnatal period. No studies have tested whether associations with postpartum depressive symptoms and early-onset asthma phenotypes persist into later school age. To determine associations between maternal postpartum depressive symptoms and childhood asthma between the ages of 5-10 by using a nested longitudinal design. Data were drawn from the 1994-2004 administrations of the Canadian National Longitudinal Survey of Children and Youth, which tracks the health of a nationally representative sample of children in Canada. Child asthma was diagnosed by a health professional, and maternal depressive symptoms were assessed by the Centre for Epidemiological Studies Depression scale. Analyses were conducted by using a multilevel modelling approach, in which longitudinal assessments of asthma in 1696 children were nested within the exposure of postpartum depression. Postpartum depressive symptoms had a 1.5-fold significant association with childhood asthma between the ages 6-8. This was independent of male sex, maternal asthma, non-immigrant status, low household socioeconomic status, being firstborn, low birthweight, low family functioning and urban-rural residence, of which the first 4 covariates elevated the risk of asthma. Statistical significance was lost at age 8 when maternal prenatal smoking replaced urban-rural residence as a covariate. At ages 9-10, an association was no longer evident. Women affected by postpartum depressive symptoms are concerned about long-term health effects of their illness on their infants. Although postpartum depressive symptoms were associated with school-age asthma at ages 6 and 7, this association diminished later. Both home and school life stress should be considered in future studies
Wójcik, Jacek; Dudek, Dominika; Schlegel-Zawadzka, Małgorzata; Grabowska, Mariola; Marcinek, Antoni; Florek, Ewa; Piekoszewski, Wojciech; Nowak, Rafał J; Opoka, Włodzimierz; Nowak, Gabriel
In the present study, we investigated the relationship between depressive symptoms and serum zinc and magnesium level in antepartum and postpartum women. All women received standard vitamin, zinc and magnesium supplementation. Sixty-six pregnant women in the Czerwiakowski Hospital in Kraków were assessed for prepartum depressive symptoms using the Beck Depression Inventory (BDI). Sixty-two and fifty-eight women were also assessed for postpartum depressive symptoms (using Edinburgh Postnatal Depression Rating Scale, EPDRS) at 3 and 30 days after delivery, respectively. Serum zinc and magnesium levels were also determined at these time points, however, the number of examined subjects were diminished. A significantly higher EPDRS score (by 45%), indicating severity of depressive symptoms, was found on the 3rd day after childbirth compared with the 30th postpartum day. Moreover, the early post-delivery period (3rd day) was characterized by a 24% lower serum zinc concentration than that found on the 30th day after childbirth. BDI scores assessed a month before childbirth revealed mild depressive symptoms, which was accompanied by a serum zinc concentration similar to that found on the 3rd day after delivery. No significant alterations were found in the magnesium levels between these time points. The present results demonstrated a relationship between severity of depressive symptoms and decreased serum zinc (but not magnesium) concentration in a very specific type of affective disorder, the postpartum depression.
Vanessa Agustinho Cardillo
Full Text Available The study objectives were to determine the prevalence of depressive symptoms in adolescent mothers and to characterize them regarding sociodemographic, behavioral and mental health aspects. An observational study, descriptive and cross-sectional, developed in health units with 72 adolescent mothers through the Edinburgh Postnatal Depression Scale (EPDS and the Hamilton Rating Scale for Depression (HAM-D. Within the participants, 20.8% presented depressive symptoms by the EPDS. The most frequent questions referred to the feelings of guilt, anxiety, and ideas to self-harm. We highlighted the feelings of guilt (60% and feelings of not being worth living (40%. Most participants (73.3% did not recognize to be depressed. The results show the importance to have an individualized prenatal, when is possible to know vulnerabilities, psychosocial and family aspects, to include tracking of depressive symptoms in the anamnesis and, to use it the attention network, the reference and the counter-reference.
Randal G. Ross
Full Text Available Understanding parental psychopathology interaction is important in preventing negative family outcomes. This study investigated the effect of paternal psychiatric history on maternal depressive symptom trajectory from birth to 12 months postpartum. Maternal Edinburgh Postpartum Depression screens were collected at 1, 6 and 12 months and fathers’ psychiatric diagnoses were assessed with the Structured Clinical Interview for DSM-IV from 64 families. There was not a significant difference in the trajectory of maternal depressive symptoms between mothers with partners with history of or a current psychiatric condition or those without a condition. However, mothers with partners with substance abuse history had higher levels of depressive symptoms relative to those affected by mood/anxiety disorders or those without a disorder. Our results call for a closer look at paternal history of substance abuse when treating postpartum maternal depression.
D'Anna-Hernandez, Kimberly L; Zerbe, Gary O; Hunter, Sharon K; Ross, Randal G
Understanding parental psychopathology interaction is important in preventing negative family outcomes. This study investigated the effect of paternal psychiatric history on maternal depressive symptom trajectory from birth to 12 months postpartum. Maternal Edinburgh Postpartum Depression screens were collected at 1, 6 and 12 months and fathers' psychiatric diagnoses were assessed with the Structured Clinical Interview for DSM-IV from 64 families. There was not a significant difference in the trajectory of maternal depressive symptoms between mothers with partners with history of or a current psychiatric condition or those without a condition. However, mothers with partners with substance abuse history had higher levels of depressive symptoms relative to those affected by mood/anxiety disorders or those without a disorder. Our results call for a closer look at paternal history of substance abuse when treating postpartum maternal depression.
Background: In three academic articles, this PhD thesis investigates maternal postpartum depression (PPD) as a risk factor for the infant-mother attachment and infant development. Previous studies have been contradictory with respect to the question of whether PPD can have long term effects...... on offspring. This may be due to not differing between when PPD is only occurring in the postpartum period and when effects are also due to ongoing or recurrent depression. However, it may also be due to viewing maternal depression as a unitary construct, and not considering underlying maternal psychological...... difficulties which may moderate potential adverse effects. The present thesis investigates two potential maternal moderators of risk:. Comorbid personality disorder and adult attachment insecurity. Moreover, the question of early environmental effects of PPD versus effects of later or ongoing depression...
Cheng, C Y; Pickler, R H
Stress and fatigue are common complaints of pregnant and postpartum women as is depression. These symptoms may be related to immunomodulation. However, few studies have examined these relationships. The aim of this study was to examine the relationships among stress, fatigue, depression, and cytokines as markers of immune modulation in prenatal and postpartum women. Women completed questionnaires and gave blood samples during late pregnancy and again at 4-6 weeks postpartum. Blood was analyzed for cytokines as measures of immune modulation. Stress, fatigue, and depression were experienced at moderately high levels, with higher levels of fatigue and depression in the postpartum but higher stress in the prenatal period. Levels of several cytokines were increased in the postpartum over the prenatal period. Stress and depression were related in the prenatal period and stress, depression, and fatigue were related in the postpartum. While various cytokines were related to each other in both periods, only stress was related to MIP-1β, a cytokine that may be important for childbirth processes. More studies, especially longitudinal and interventional studies, are needed to increase our knowledge about etiology, patterns, symptoms, factors, and management of maternal distress. The search for reliable biomarkers for at-risk mothers remains a priority.
Wosu, Adaeze C; Gelaye, Bizu; Williams, Michelle A
The objective of this review is to summarize the literature (and to the extent possible, report the magnitude and direction of the association) concerning history of childhood sexual abuse (CSA) and depression or depressive symptoms among pregnant and postpartum women. Publications were identified through literature searches of seven databases (PubMed, EMBASE, PyscINFO, CINAHL, Web of Science, BIOSIS, and Science Direct) using keywords including "child abuse," "depression," "pregnancy," "prenatal," "pregnancy," and "postpartum." The literature search yielded seven eligible studies on the prenatal period and another seven studies on the postpartum period. All but one prenatal study observed statistically significant positive associations of CSA with depression or depressive symptoms during pregnancy. Findings on the association of CSA with postpartum depression or depressive symptoms were inconsistent; pooled unadjusted and adjusted odds ratios were 1.82 (95 % confidence interval (CI) 0.92, 3.60) and 1.20 (95 % CI 0.81, 1.76). In sum, findings suggest a positive association of history of CSA with depression and depressive symptoms in the prenatal period. Findings on the postpartum period were inconsistent. Clinical and public health implications of evidence from the available literature are discussed, as are desirable study design characteristics of future research.
Cherif, R; Feki, I; Gassara, H; Baati, I; Sellami, R; Feki, H; Chaabene, K; Masmoudi, J
The objective of our study was to estimate the prevalence of the post-partum depressive symptomatology in a sample of Tunisian women, to study associated factors and to assess its relationship to quality of life. This is a prospective study carried out in two stages: during the first week (T1), then between sixth and eighth week post-partum (T2). Depressive symptomatology and quality of life were assessed respectively by the Edinburgh Postnatal Depression Scale and the World Health Organization Quality of Life scale. In the first stage, the prevalence of depressive symptomatology in the total sample (150 women) was 14.7% and was related to age above 35 years, low school level, personal psychiatric history, multiparity, caesarean delivery or forceps in the previous pregnancy and unplanned pregnancy. This prevalence was 19.8% among the 126 women reviewed in T2 and was correlated with the exaggerated sympathetic signs during pregnancy, namely perversion of taste and fatigue. Quality of life was strongly correlated with depressive symptoms in T1 and T2. Post-partum depressive symptoms were common in our sample and were correlated with quality of life. Therapeutic measures should be proposed for women with post-partum depressive symptoms and particularly with several risk factors in order to improve their quality of life. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Shahar, Golan; Herishanu-Gilutz, Shirley; Holcberg, Gershon; Kofman, Ora
Symptoms of both depression and Post-Traumatic Stress Disorder (PTSD) are prevalent among first-time mothers following birth. However, the direction of the association between the two types of symptoms is unclear. Ninety six first-time mothers giving birth via vaginal delivery (N=38), emergency C-Section (N=27) and planned C-Section (N=21) were assessed for depression and PTSD twice: Six weeks post-partum and six-weeks later. Cross-lagged Structural Equation Modeling (SEM) analyses revealed a prospective effect of depressive symptoms on PTSD symptoms. No moderating factors were identified. A relatively modest sample size and only two assessment waves. An early detection and intervention with symptoms of post-partum depression might also prevent the development of PTSD symptoms. Copyright © 2015 Elsevier B.V. All rights reserved.
Rebelo, Fernanda; Farias, Dayana R; Struchiner, Claudio J; Kac, Gilberto
Some authors have described an inverse association between adiponectin and depression, but this association has not yet been investigated during the perinatal period. To evaluate the association between the plasma adiponectin levels and symptoms of depression in women from early pregnancy to 30-45 days postpartum. A prospective cohort of 235 women was analyzed, with four waves of follow-up: 5-13th, 22-26th, and 30-36th gestational weeks and 30-45 days postpartum. Depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS; cutoff ≥ 11). The plasma adiponectin concentrations were measured using an enzyme-linked immunosorbent assay. The statistical analyses included linear mixed effects regressions to model the association between these time-dependent variables. The prevalence of depressive symptoms was 35.5%, 22.8%, 21.8%, and 16.9% and the median (µg/mL) adiponectin levels were 4.8, 4.7, 4.4, and 7.5 in the 1st, 2nd, and 3rd trimesters and the postpartum period, respectively. Women who remained non-depressed throughout the study tended to have higher values of adiponectin throughout pregnancy and the postpartum period compared to those who had depressive symptoms at least once, but this difference was not statistically significant (β=-0.14; p=0.071). There was no statistically significant association between the plasma adiponectin levels and the EPDS scores in the multiple model (β=-0.07; p=0.320). Losses to follow-up, different procedures for the blood draws at the prenatal and postpartum visits, and the presence of a nested clinical trial with omega-3 supplementation. The plasma adiponectin levels were not associated with depressive symptoms during the perinatal period. Copyright © 2016 Elsevier B.V. All rights reserved.
Iwata, Hiroko; Mori, Emi; Tsuchiya, Miyako; Sakajo, Akiko; Maehara, Kunie; Ozawa, Harumi; Morita, Akiko; Maekawa, Tomoko; Aoki, Kyoko; Makaya, Miyuki; Tamakoshi, Koji
The number of older primiparas is increasing in Japan. These women have been shown to be more vulnerable to post-partum depression. This study aimed to identify factors for predicting post-partum depressive symptoms during hospitalization after childbirth in Japanese primiparas aged 35 years and over. The present authors used the data of 479 primiparas aged 35 years and over from a prospective cohort study. Data were collected using self-report questionnaires on the day before hospital discharge. The questionnaire consisted of: demographics and background information; depressive symptoms; fatigue; maternal confidence and maternal satisfaction; child-care values; physical symptoms; perceptions of daily life during hospitalization; concerns about child care and daily life; and infant feeding. Additionally, vital records data were obtained from the hospitals. A stepwise logistic regression analysis was performed on the binary outcome variable of depressive symptoms, measured by the Japanese version of the Edinburgh Postnatal Depression Scale. Women who scored 9 or more were considered to be at high risk for post-partum depression. The authors obtained informed consent from all participants and institutional ethics approvals before initiating the study. The following six variables reliably predicted the risk of post-partum depression: emergency cesarean section, lower satisfaction with birth experience, higher physical burden in daily life, long-term complications with the newborn, more concerns about newborn caretaking after discharge, and more concerns about one's own life after discharge. Recognition of women with these factors will help nurses to identify those at risk for developing post-partum depression and to provide appropriate care during hospitalization after childbirth. © 2015 The Authors. Japan Journal of Nursing Science © 2015 Japan Academy of Nursing Science.
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Fagan, Jay; Lee, Yookyong
This study examined the associations between adolescent mothers' postpartum depressive symptoms and their perceptions of amount of father care giving and satisfaction with father involvement with the baby. The sample included 100 adolescent mothers (ages 13-19; mainly African-American and Latina) whose partners were recruited for a randomized…
Gressier, F; Letranchant, A; Cazas, O; Sutter-Dallay, A L; Falissard, B; Hardy, P
Does medically assisted conception increase the risk of post-partum depressive symptoms? Our literature review and meta-analysis showed no increased risk of post-partum depressive symptoms in women after medically assisted conception. Women who conceive with medically assisted conception, which can be considered as a stressful life event, could face an increased risk of depressive symptoms. However, no previous meta-analysis has been performed on the association between medically assisted conception and post-partum depressive symptoms. A systematic review with electronic searches of PubMed, ISI Web of Knowledge and PsycINFO databases up to December 2014 was conducted to identify articles evaluating post-partum depressive symptoms in women who had benefited from medically assisted conception compared with those with a spontaneous pregnancy. Meta-analyses were also performed on clinically significant post-partum depressive symptoms according to PRISMA guidelines. From 569 references, 492 were excluded on title, 42 on abstract and 17 others on full-text. Therefore, 18 studies were included in the review and 8 in the meta-analysis (2451 women) on clinically significant post-partum depressive symptoms after medically assisted conception compared with a spontaneous pregnancy. A sensitivity meta-analysis on assisted reproductive technologies and spontaneous pregnancy (6 studies, 1773 women) was also performed. The quality of the studies included in the meta-analyses was evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology Statement for observational research. The data were pooled using RevMan software by the Cochrane Collaboration. Heterogeneity between studies was assessed from the results of the χ(2) and I(2) statistics. Biases were assessed with funnel plots and Egger's test. A fixed effects model was used for the meta-analyses because of the low level of heterogeneity between the studies. The systematic review of studies examining
Chien, Li-Yin; Tai, Chen-Jei; Yeh, Mei-Chiang
Domestic decision-making power is an integral part of women's empowerment. No study has linked domestic decision-making power and social support concurrently to postpartum depression and compared these between immigrant and native populations. The aim of this study was to examine domestic decision-making power and social support and their relationship to postpartum depressive symptoms among immigrant and native women in Taiwan. This cross-sectional survey included 190 immigrant and 190 native women who had delivered healthy babies during the past year in Taipei City. Depression was measured using the Edinburgh Postnatal Depression Scale, with a cutoff score of 10. Logistic regression was used to determine the factors associated with postpartum depression symptoms. Immigrant mothers had significantly higher prevalence of postpartum depression symptoms (41.1% vs. 8.4%) and had significantly lower levels of domestic decision-making power and social support than native mothers did. Logistic regression showed that insufficient family income was associated with an increased risk of postpartum depression symptoms, whereas social support and domestic decision-making power levels were associated negatively with postpartum depression symptoms. After accounting for these factors, immigrant women remained at higher risk of postpartum depression symptoms than native women did, odds ratio = 2.59, 95% CI [1.27, 5.28]. Domestic decision-making power and social support are independent protective factors for postpartum depression symptoms among immigrant and native women in Taiwan. Social support and empowerment interventions should be tested to discover whether they are able to prevent or alleviate postpartum depression symptoms, with special emphasis on immigrant mothers.
Hoedjes, Meeke; Berks, Durk; Vogel, Ineke; Franx, Arie; Bangma, Meike; Darlington, Anne-Sophie E.; Visser, Willy; Duvekot, Johannes J.; Habbema, J. Dik F.; Steegers, Eric A. P.; Raat, Hein
Objective: To describe the prevalence of postpartum depressive symptoms after preeclampsia, to assess the extent to which the prevalence of postpartum depressive symptoms differs after mild and severe preeclampsia, and to investigate which factors contribute to such differences. Methods: Women
Simpson, William; Steiner, Meir; Coote, Marg; Frey, Benicio N
Perinatal depressive symptoms often co-occur with other inflammatory morbidities of pregnancy. The goals of our study were 1) to examine whether changes in inflammatory markers from the third trimester of pregnancy to 12 weeks postpartum were associated with changes in depressive symptoms; 2) to examine whether third trimester inflammatory markers alone were predictive of postpartum depressive symptoms; and 3) to examine the relationship between inflammatory markers and depressive symptoms during the third trimester of pregnancy and at 12 weeks postpartum. Thirty-three healthy pregnant women were recruited from the Women's Health Concerns Clinic at St. Joseph's Healthcare in Hamilton, Canada. The impact of depressive symptoms on the levels of interleukin (IL)-6, IL-10, tumor necrosis factor alpha (TNF-α), and C-reactive protein (CRP) at the third trimester of pregnancy, at 12 weeks postpartum, and across time was assessed using linear and mixed-model regression. Regression analysis revealed no significant association between depressive symptoms and any of the candidate biomarkers during pregnancy, at 12 weeks postpartum, or over time. Pregnancy depressive symptoms (p > 0.001), IL-6 (p = 0.025), and IL-10 (p = 0.006) were significant predictors of postpartum Edinburgh Perinatal Depression Scale (EPDS) score. Our study supports previous reports from the literature showing no relationship between inflammatory biomarkers and depressive symptoms during late pregnancy, early postpartum, or across time. Our study is the first to observe an association between late pregnancy levels of IL-6 and IL-10 and postpartum depressive symptoms. Further studies with larger samples are required to confirm these findings.
Full Text Available Objective: Perinatal depressive symptoms often co-occur with other inflammatory morbidities of pregnancy. The goals of our study were 1 to examine whether changes in inflammatory markers from the third trimester of pregnancy to 12 weeks postpartum were associated with changes in depressive symptoms; 2 to examine whether third trimester inflammatory markers alone were predictive of postpartum depressive symptoms; and 3 to examine the relationship between inflammatory markers and depressive symptoms during the third trimester of pregnancy and at 12 weeks postpartum. Methods: Thirty-three healthy pregnant women were recruited from the Women’s Health Concerns Clinic at St. Joseph’s Healthcare in Hamilton, Canada. The impact of depressive symptoms on the levels of interleukin (IL-6, IL-10, tumor necrosis factor alpha (TNF-α, and C-reactive protein (CRP at the third trimester of pregnancy, at 12 weeks postpartum, and across time was assessed using linear and mixed-model regression. Results: Regression analysis revealed no significant association between depressive symptoms and any of the candidate biomarkers during pregnancy, at 12 weeks postpartum, or over time. Pregnancy depressive symptoms (p > 0.001, IL-6 (p = 0.025, and IL-10 (p = 0.006 were significant predictors of postpartum Edinburgh Perinatal Depression Scale (EPDS score. Conclusions: Our study supports previous reports from the literature showing no relationship between inflammatory biomarkers and depressive symptoms during late pregnancy, early postpartum, or across time. Our study is the first to observe an association between late pregnancy levels of IL-6 and IL-10 and postpartum depressive symptoms. Further studies with larger samples are required to confirm these findings.
Papamarkou, Maria; Sarafis, Pavlos; Kaite, Charis P; Malliarou, Maria; Tsounis, Andreas; Niakas, Dimitris
The onset of a major depressive episode is experienced by a large number of women in the weeks or months following delivery. Postpartum depression may deem those women experiencing it incapable of taking care for themselves, their family and their infants, while at the same time it could negatively affect their quality of life. The present study assessed the quality of life of a sample of mothers in Greece, in order to investigate the association between postpartum depression and quality of life (QoL). 145 women in a Private-General Obstetrics and Pediatric Clinic in Greece completed the Edinburgh Postnatal Depression scale (EPDS) and SF-36 questionnaire on the third and fourth day after delivery (caesarean or normal childbirth). The data were analyzed using SPSS version 17.0. Linear and logistic regression analysis was performed in order to find the independent factors related to the quality of life and postpartum depression symptoms. 9.9% of the participants experienced postpartum depression symptoms. Significant associations were found between the place of residence and symptoms of postpartum depression, and more specifically, women outside of Attica indicated higher levels of postpartum depression symptoms (p = 0.008) than women living in Attica. The level of education was also found to be significantly associated with postpartum depression symptoms, since women with Primary and Secondary education experienced higher levels of postpartum depression symptoms (p = 0.005) than those with a tertiary education. Concerning quality of life, women with postpartum depression symptoms scored 24.27 lower in «Role-Physical», 15.60 lower in «Bodily pain», 11.45 lower in «General Health», 14.18 lower in dimension of «Vitality», 38.25 lower in Role - Emotional and 16.82 lower in dimension of mental health, compared to those without depression symptoms. Postpartum depression symptoms are associated with the quality of life of women after pregnancy, and
Katon, Wayne; Russo, Joan; Gavin, Amelia
To examine sociodemographic factors, pregnancy-associated psychosocial stress and depression, health risk behaviors, prepregnancy medical and psychiatric illness, pregnancy-related illnesses, and birth outcomes as risk factors for post-partum depression (PPD). A prospective cohort study screened women at 4 and 8 months of pregnancy and used hierarchical logistic regression analyses to examine predictors of PPD. The study sample include 1,423 pregnant women at a university-based high risk obstetrics clinic. A score of ≥10 on the Patient Health Questionnaire-9 (PHQ-9) indicated clinically significant depressive symptoms. Compared with women without significant postpartum depressive symptoms, women with PPD were significantly younger (pdepressive symptoms (pdepression case finding for pregnant women.
Izumi, Mie; Manabe, Emiko; Uematsu, Sayo; Watanabe, Ayako; Moritani, Toshio
We investigated the association between autonomic nervous system (ANS) activity and symptoms of anxiety and depression for the first 2 years postpartum. A total of 108 participants within 2 years postpartum underwent physiological measurements of ANS activity using the heart rate variability (HRV) power spectrum and self-reported questionnaires (14-item Hospital Anxiety and Depression Score). The cutoff points for anxiety and depressive symptom scores in this questionnaire were as follows: 7 or less, non-cases; 8-10, doubtful cases; 11 or more, definite cases. This study was conducted from 2012 to 2014 at University Hospital in Kyoto Prefectural University of Medicine and a nearby obstetrics and gynecology department clinic in Japan. Anxiety and depression non-cases accounted for 67.6% (n = 73) of subjects, anxiety non-cases and depression doubtful and definite cases 7.4% (n = 8), anxiety doubtful and definite cases and depression non-cases 8.3% (n = 9), and anxiety and depression doubtful and definite cases 16.7% (n = 18). Findings were similar for women with anxiety or depression, with total power (TP), low-frequency (LF) and high-frequency (HF) components of HRV among doubtful and definite cases significantly lower than among non-cases for both anxiety (p = 0.006, 0.034, 0.029, respectively) and depression (p = 0.001, 0.004, 0.007). Significant correlations were observed between TP, LF and HF and anxiety and depression scores (respective values for anxiety: rs = -0.331, p <0.001; rs = -0.286, p = 0.003; rs = -0.269, p = 0.005; and depression: rs = -0.389, rs = -0.353, rs = -0.337, all p <0.001). The present study demonstrated that mothers with anxiety or depressive symptoms had significantly lower HRV (HF, LF and TP) than those without.
Edhborg, Maigun; Carlberg, Magdalena; Simon, Fia; Lindberg, Lene
Swedish fathers are largely involved in their infant's care, and Sweden has a generous parental leave, with 2 months especially assigned for fathers. The prevalence of depressive symptoms postpartum for fathers appears to be similar as for mothers in Sweden. This study aimed to describe fathers' experiences of the first year postpartum, when they showed depressive symptoms 3 to 6 months postpartum. Semistructured interviews with 19 fathers were conducted and analyzed with content analysis. The fathers experienced loss of control and powerlessness due to discrepancies between their expectations and the reality they met after birth. They found the everyday-life turbulent, with much stress and worries for the infant, conflicts between family and work, and lack of support in everyday life. In addition, the fathers struggled with impaired partner-relationship, losses, and contradictory messages from both the society and their partners. These findings indicate that the fathers had difficulties to balance the competing demands of family, work, and their own needs. Thus, it is important to identify fathers with depressive symptoms at the Child Health Care Centers and attend to fathers' needs of support and acknowledge them as parents equal to mothers. © The Author(s) 2015.
Buttner, Melissa M; Mott, Sarah L; Pearlstein, Teri; Stuart, Scott; Zlotnick, Caron; O'Hara, Michael W
Postpartum depression (PPD) is a significant public health concern with prevalence of major and minor depressions reaching 20 % in the first three postpartum months. Sociodemographic and psychopathology correlates of PPD are well established; however, information on the relationship between premenstrual disorders and the development of PPD is less well established. Thus, the aim of this study was to examine the role of premenstrual syndrome (PMS)/premenstrual dysphoric disorder (PMDD) as a risk factor for PPD. Premenstrual symptoms were assessed retrospectively using the premenstrual symptoms screening tool (PSST) and depression was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria and assessed using the Hamilton Depression Rating Scale (HDRS). A two-stage screening procedure was applied. In the first stage, the Patient Health Questionnaire (PHQ-9) was employed. In the second stage, women endorsing ≥5 symptoms on the PHQ-9 were administered the Structured Clinical Interview for DSM-IV, HDRS, and PSST. Hierarchical linear regression showed that history of depression and PMS/PMDD contributed an additional 2 % of the variance (p PMS/PMDD and PPD (OR = 1.97). The findings of this study suggest that PMS/PMDD is an important risk factor for PPD. Women endorsing a history of PMS/PMDD should be monitored during the perinatal period.
Figueiredo, Bárbara; Conde, Ana
This study aimed to investigate both anxiety and depression symptoms from early pregnancy to 3-months postpartum, comparing women and men and first and second-time parents. A sample of 260 Portuguese couples (N=520), first or second-time parents, recruited in an Obstetrics Out-patients Unit, filled in the State-Anxiety Inventory (STAI-S) and the Edinburgh Post-Natal Depression Scale (EPDS) at the 1st, 2nd and 3rd pregnancy trimesters, childbirth, and 3-months postpartum. A decrease in anxiety and depression symptoms from early pregnancy to 3-months postpartum was found in both women and men, as well as in first and second-time parents. Men presented less anxiety and depression symptoms than women, but the same pattern of symptoms over time. Second-time parents showed more anxiety and depression symptoms than first-time parents and a different pattern of symptoms over time: an increase in anxiety and depression symptoms from the 3rd trimester to childbirth was observed in first-time parents versus a decrease in second-time parents. The voluntary nature of the participation may have lead to a selection bias; women and men who agreed to participate could be those who presented fewer anxiety and depression symptoms. Moreover, the use of self-report symptom measures does not give us the level of possible disorder in participants. Anxiety and depression symptoms diminish from pregnancy to the postpartum period in all parents. Patterns of anxiety and depression symptoms from early pregnancy to 3-months postpartum are similar in women and men, but somewhat different in first and second-time parents. Second-time parents should also be considered while studying and intervening during pregnancy and the postpartum. Copyright © 2011 Elsevier B.V. All rights reserved.
Beydoun, Hind A; Beydoun, May A; Kaufman, Jay S; Lo, Bruce; Zonderman, Alan B
To date, few systematic reviews of observational studies have been conducted to comprehensively evaluate the co-morbidity of intimate partner violence (IPV) and specific depression outcomes in women. In this systematic review and meta-analysis, we summarize the extant literature and estimate the magnitude of the association between IPV and key depressive outcomes (elevated depressive symptoms, diagnosed major depressive disorder and postpartum depression). PubMed (January 1, 1980-December 31, 2010) searches of English-language observational studies were conducted. Most of the selected 37 studies had cross-sectional population-based designs, focused on elevated depressive symptoms and were conducted in the United States. Most studies suggested moderate or strong positive associations between IPV and depression. Our meta-analysis suggested two to three-fold increased risk of major depressive disorder and 1.5-2-fold increased risk of elevated depressive symptoms and postpartum depression among women exposed to intimate partner violence relative to non-exposed women. A sizable proportion (9%-28%) of major depressive disorder, elevated depressive symptoms, and postpartum depression can be attributed to lifetime exposure to IPV. In an effort to reduce the burden of depression, continued research is recommended for evaluating IPV preventive strategies. Copyright © 2012 Elsevier Ltd. All rights reserved.
Bascom, Erin McElderry; Napolitano, Melissa A
Although postpartum depression is associated with lower breastfeeding initiation rates and shorter breastfeeding duration, the potential mechanisms through which this relationship functions are not well understood. This study examined the breastfeeding behaviors of women with postpartum depressive symptoms (PDS) to identify potential motivations for early breastfeeding cessation. An analysis of quantitative data from the Infant Feeding Practices Study II examined the relationship between PDS and breastfeeding behaviors, including breastfeeding duration and primary reasons for early breastfeeding cessation. Of the women in the sample, 30.9% met criteria for mild PDS. Women with PDS had shorter overall (18.4 vs 21.8 weeks, P = .001) and exclusive breastfeeding duration (3.6 vs 4.7 weeks, P = .012) than women without PDS. A larger proportion of women with PDS stopped breastfeeding before 6 months (68.7% vs 57.2%, P household duties" (OR = 1.90, P = .011) as a primary reason for breastfeeding cessation among women who stopped breastfeeding before 6 months. After controlling for these same covariates, women with PDS had, on average, 2.4 weeks shorter breastfeeding duration than women without PDS (P = .025). There is a high prevalence of depressive symptoms among new mothers, and most do not breastfeed for recommended time periods. Increased PDS screening during prenatal and postpartum visits and promotion of lactation support services may better address the high rates of PDS and suboptimal breastfeeding behavior. © The Author(s) 2015.
Kerstis, Birgitta; Berglund, Anders; Engström, Gabriella; Edlund, Birgitta; Sylvén, Sara; Aarts, Clara
To study whether there is an association between dyadic consensus, depressive symptoms, and parental stress during early parenthood and marital separation 6-8 years after childbirth, among couples in Sweden. At baseline, 393 couples were included. The couples answered three questionnaires, including: Dyadic consensus at 1 week post-partum, depressive symptoms at 3 months post-partum and parental stress at 18 months post-partum. The parents' addresses were followed up after 6-8 years, to study the marital separation rate. We found, 6-8 years after childbirth, that 20% of study couples were separated. Separation was associated with less dyadic consensus (mothers p parental stress (mothers p = 0.002; fathers p = 0.040). The hazard ratio (HR) for marital separation was related to dyadic consensus for fathers (HR 0.51; 95% CI 0.28-0.92), depressive symptoms for mothers (HR 1.69; 95% CI 1.01-2.84) and fathers (HR 1.92; 95% CI 1.12-3.28), and the mother's parental stress (HR 2.16; 95% CI 1.14-4.07). Understanding how dyadic consensus, depressive symptoms and parental stress are associated with marital separation is important for health professionals it could be useful in developing interventions to provide parents with adequate support during pregnancy and early parenthood this knowledge is also important for the public parents should get support in pregnancy and while bringing up children, which may help prevent marital separation and optimize conditions for the children. © 2014 the Nordic Societies of Public Health.
Cunningham, Shayna D; Mokshagundam, Shilpa; Chai, Hannah; Lewis, Jessica B; Levine, Jessica; Tobin, Jonathan N; Ickovics, Jeannette R
Obesity is a risk factor for adverse physical health outcomes during pregnancy. Much less is known about the association between obesity and maternal mental health. Evidence suggests that prenatal depression is associated with excessive weight gain during pregnancy and that this relationship may vary according to pregravid body mass index (BMI). Young women may be particularly vulnerable to postpartum depression. The objective of this study is to examine the association between prepregnancy BMI, gestational weight gain, and postpartum depressive symptoms among adolescents. Participants were 505 pregnant adolescents aged 14 to 21 years followed during pregnancy and 6 months postpartum. Data were collected via interviews and medical record abstraction. Multilevel linear mixed models were used to test the association between excessive gestational weight gain as defined by National Academy of Medicine Guidelines and postpartum depressive symptoms measured via the validated Center for Epidemiologic Studies Depression (CES-D) scale. Analyses controlled for sociodemographic factors (maternal age, race, ethnicity, relationship status), health behaviors (nutrition, physical activity), prenatal depressive symptoms, and postpartum weight retention. Prepregnancy BMI was classified as follows: 11% underweight, 53% healthy weight, 19% overweight, and 18% obese. One-half (50%) of participants exceeded recommended guidelines for gestational weight gain. Adolescents with excessive gestational weight gain who entered pregnancy overweight or obese had significantly higher postpartum depressive symptoms (β, 2.41; SE, 1.06 vs β, 2.58; SE, 1.08, respectively; both P gain. Adolescents who gained gestational weight within clinically recommended guidelines were not at risk for increased depressive symptoms. Adolescents who enter pregnancy overweight or obese and experience excessive weight gain may be at increased risk for postpartum depressive symptoms. Health care providers should
Mathisen, Siv Elin; Glavin, Kari; Lien, Lars; Lagerløv, Per
Introduction Postpartum depression is a prevalent disorder with negative consequences for women, infants, and the family as a whole. Most studies of this disorder have been conducted in Western countries, and studies from developing countries are few. In this paper, we report the first – as far as we are aware – study of the prevalence and risk factors associated with postpartum depressive symptoms in Argentina. Materials and methods The study participants were 86 women attending 6 week checkups, (range 4–12 weeks) postpartum at a private health care center in the metropolitan area of Buenos Aires. The women completed the Edinburgh Postnatal Depression Scale (EPDS) and a questionnaire collecting demographic and obstetric data. Data were described as proportions (percentages). Differences between proportions were assessed with chi-squared tests. To control for possible confounders, we fitted bivariate logistic regression models in which the dependent variable was an EPDS sum score of depressive symptoms. A total of 32 women (37.2%) had an EPDS score of ≥10, 16 (18.6%) had a score between 10 and 12, and 16 (18.6%) had a score of ≥13. In our sample, an EPDS score of ≥10 was significantly associated with multiparity (odds ratio [OR] =3.58; 95% confidence interval [CI]: 1.13–11.30; P=0.030), pregnancy complications (OR =3.40; 95% CI: 1.03–11.26; P=0.045), labor complications (OR =11.43; 95% CI: 1.71–76.61; P=0.012), cesarean section (OR =4.19; 95% CI: 1.10–16.01; P=0.036), and incomplete breast-feeding (OR =5.00; 95% CI: 1.42–17.54; P=0.012). Conclusion Our results indicate that postpartum depression may be prevalent in Argentina, and may be associated with incomplete breast-feeding, cesarean section, perinatal complications and multiparity. The prevalence and risk factors for postpartum depression has not been described previously and is a considerable health-related problem among women. Argentinian health professionals should be aware of the high
Putnam, K.; Robertson-Blackmore, E.; Sharkey, K.; Payne, J.; Bergink, V.; Munk-Olsen, T.; Deligiannidis, K.; Altemus, M.; Newport, J.; Apter, G.; Devouche, E.; Vikorin, A.; Magnusson, P.; Lichtenstein, P.; Penninx, B.W.J.H.; Buist, A.; Bilszta, J.; O'Hara, M.; Stuart, S.; Brock, R.; Roza, S.; Tiemeier, H.; Guille, C.; Epperson, C.N.; Kim, D.; Schmidt, P.; Martinez, P.; Wisner, K.L.; Stowe, Z.; Jones, I.; Rubinow, D.; Sullivan, P.; Meltzer-Brody, S.
Background: Maternal depression in the postpartum period confers substantial morbidity and mortality, but the definition of postpartum depression remains controversial. We investigated the heterogeneity of symptoms with the aim of identifying clinical subtypes of postpartum depression. Methods: Data
Blasio, Paola Di; Camisasca, Elena; Caravita, Simona Carla Silvia; Ionio, Chiara; Milani, Luca; Valtolina, Giovanni Giulio
This study investigated whether an Expressive Writing intervention decreased depression and posttraumatic stress symptoms after childbirth. 113 women (M age = 31.26 yr., SD = 4.42) were assessed at Time 1 for depression (Beck Depression Inventory) and PTS (Perinatal PTSD Questionnaire) in the first days after childbirth, then randomized to either expressive writing or neutral writing conditions and reassessed at Time 2, 3 months later. The results (ANCOVAs, regression models) show that at 3 mo. depressive and posttraumatic symptoms were lower in women who performed the expressive writing task than in the neutral writing group. Moreover, the intervention condition was associated significantly with decreased depression at the high and at the mean levels of baseline depression at Time 1. Regarding PTSD, the results showed that the intervention condition was linked significantly to reductions of the symptoms at all levels of baseline PTSD. Mainly, these outcomes suggest that Expressive Writing can be a helpful early and low-cost universal intervention to prevent postpartum distress for women.
McCurdy, Ashley P; Boulé, Normand G; Sivak, Allison; Davenport, Margie H
To examine the influence of exercise on depressive symptoms and the prevalence of depression in the postpartum period. A structured search of MEDLINE, EMBASE, CINAHL, Sport Discus, Ovid's All EBM Reviews, and ClinicalTrials.gov databases was performed with dates from the beginning of the databases until June 16, 2016. The search combined keywords and MeSH-like terms including, but not limited to, "exercise," "postpartum," "depression," and "randomized controlled trial." Randomized controlled trials comparing postpartum exercise (structured, planned, repetitive physical activity) with the standard care for which outcomes assessing depressive symptoms or depressive episodes (as defined by trial authors) were assessed. Trials were identified as prevention trials (women from the general postpartum population) or treatment trials (women were classified as having depression by the trial authors). Effect sizes with 95% confidence intervals (CIs) were calculated using Hedges' g method and standardized mean differences in postintervention depression outcomes were pooled using a random-effects model. Across all 16 trials (1,327 women), the pooled standardized mean difference was -0.34 (95% CI -0.50 to -0.19, I=37%), suggesting a small effect of exercise among all postpartum women on depressive symptoms. Among the 10 treatment trials, a moderate effect size of exercise on depressive symptoms was found (standardized mean difference-0.48, 95% CI -0.73 to -0.22, I=42%). In six prevention trials, a small effect (standardized mean difference-0.22, 95% CI -0.36 to -0.08, I=2%) was found. In women with depression preintervention, exercise increased the odds of resolving depression postintervention by 54% (odds ratio 0.46, Mantel-Haenszel method, 95% CI 0.25-0.84, I=0%). The trials included in this meta-analysis were small and some had methodologic limitations. Light-to-moderate intensity aerobic exercise improves mild-to-moderate depressive symptoms and increases the likelihood that
Felder, Jennifer N; Roubinov, Danielle; Bush, Nicole R; Coleman-Phox, Kimberly; Vieten, Cassandra; Laraia, Barbara; Adler, Nancy E; Epel, Elissa
We examined whether prenatal mindfulness training was associated with lower depressive symptoms through 18-months postpartum compared to treatment as usual (TAU). A controlled, quasi-experimental trial compared prenatal mindfulness training (MMT) to TAU. We collected depressive symptom data at post-intervention, 6-, and 18-months postpartum. Latent profile analysis identified depressive symptom profiles, and multinomial logistic regression examined whether treatment condition predicted profile. Three depressive symptom severity profiles emerged: none/minimal, mild, and moderate. Adjusting for relevant covariates, MMT participants were less likely than TAU participants to be in the moderate profile than the none/minimal profile (OR = 0.13, 95% CI = 0.03-0.54, p = .005). Prenatal mindfulness training may have benefits for depressive symptoms during the transition to parenthood. © 2018 Wiley Periodicals, Inc.
Baskin, Rachel; Hill, Briony; Jacka, Felice N; O'Neil, Adrienne; Skouteris, Helen
Perinatal depression is a debilitating disorder experienced during pregnancy and/or the first year post-partum. Recently, maternal dietary intake during pregnancy has emerged as a possible area of intervention for the prevention of mental disorders in women and their offspring. However, the relationship between antenatal diet quality and perinatal depressive symptoms remains poorly understood. The current study explored the predictive role of antenatal diet quality for antenatal and post-natal depressive symptoms. Pregnant women (n = 167) were recruited between February 2010 and December 2011. Women completed the Edinburgh Postnatal Depression Scale at time 1 [T1, mean weeks gestation = 16.70, standard deviation (SD) = 0.91], time 2 (T2, mean weeks gestation = 32.89, SD = 0.89) and time 3 (T3, mean weeks post-partum = 13.51, SD = 1.97) and a food frequency questionnaire at T1 and T2. Diet quality was determined by extracting dietary patterns via principal components analysis. Two dietary patterns were identified: 'healthy' (including fruit, vegetables, fish and whole grains) and 'unhealthy' (including sweets, refined grains, high-energy drinks and fast foods). Associations between dietary patterns and depressive symptoms were investigated by path analyses. While both 'healthy' and 'unhealthy' path models showed good fit, only one significant association consistent with study hypotheses was found, an 'unhealthy' diet was associated with increased depressive symptoms at 32 weeks gestation. Given that this association was cross-sectional, it was not possible to make any firm conclusions about the predictive nature of either dietary patterns or depressive symptoms. Dietary intervention studies or larger prospective studies are therefore recommended. © 2015 John Wiley & Sons Ltd.
Occurring in about 12 percent of postpartum women, postpartum depression has been focus of considerable research. Variables that have been correlated with postpartum depression range from biological causes, to lack of social support, to relationship with husband, to attributional styles, to psychodynamic explanations. There is need for more…
Tietz, A; Zietlow, A-L; Reck, C
Hardly any research has examined the link between postpartum anxiety disorder and maternal bonding. This study examined if postpartum anxiety disorder and maternal bonding are related in the postpartum period. Thereby, subclinical depressive symptoms and specific aspects of an anxious symptomatology were also taken into consideration. The German sample of N = 78 mother-infant dyads is composed of n = 30 mothers with postpartum anxiety disorders but without major or minor depression according to the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) and n = 48 healthy mothers. Subjects were interviewed with the Structured Clinical Interview for DSM-IV Disorders at an average infant age of M = 4.1 months. Moreover, mothers filled out the Postpartum Bonding Questionnaire-16. The Anxiety Cognitions Questionnaire, the Body Sensations Questionnaire and the Mobility Inventory were chosen to assess different aspects of anxious symptomatology. To control for concurrent subclinical depressive symptoms, we used the German Edinburgh-Postnatal-Depression Scale. Mothers with postpartum anxiety disorder reported significantly lower bonding than healthy mothers. However, in a linear regression analysis, concurrent subclinical depressive symptoms and avoidance of anxiety-related situations in company explained 27 % of the overall variance in maternal bonding. The perceived lower bonding of mothers with anxiety disorder could be due to aspects of a concurrent subclinical depressive symptomatology. This notion emphasizes the need to target even mild depressive symptoms in the treatment of postpartum anxiety disorders. The outcomes also underline that the severity of anxious symptomatology, reflected by avoidance behaviour in company, puts the mother-infant bond at risk.
... professionals for help. With support and treatment, new mothers with depression can go on to be healthy, happy parents. ... or two, talk to your doctor. A new mother who feels like giving up, who feels that life is not ... depression can last for several months or even longer ...
Alkozei, Anna; McMahon, Erin; Lahav, Amir
This study examined whether particular maternal and infant factors can identify mothers at risk for increased stress upon admission to the neonatal intensive care unit (NICU). Eighty-five mothers of preterm infants (25-34 weeks gestation) were assessed using the Parental Stressor Scale (PSS:NICU) and the Edinburgh Postnatal Depression Scale (EPDS) within 3.24 ± 1.58 d postpartum. Hierarchical linear regression models were used to determine the extent to which maternal stress is influenced by individual factors. Fifty-two percent of mothers experienced increased stress (PSS:NICU score ≥3) and 38% had significant depressive symptoms (EPDS score ≥10). Stress related to alterations in parental role was the most significant source of stress among NICU mothers. Distance from the hospital and married marital status were significant predictors for stress related to alterations in parental role (p = 0.003) and NICU sights and sounds (p = 0.01), respectively. Higher stress levels were associated with higher depressive scores (p = 0.001). Maternal mental health factors, demographic factors, pregnancy factors and infant characteristics were not associated with increased stress. Elevated stress levels and depressive symptoms are already present in mothers of preterm infants upon NICU admission. Being married or living long distance from the hospital is associated with higher stress. Future work is needed to develop effective interventions for alleviating stress in NICU mothers and preventing its potential development into postnatal depression.
Thomson, Michael; Sharma, Verinder
Postpartum depression is a prevalent disorder affecting many women of reproductive age. Despite increasing public awareness, it is frequently underdiagnosed and undertreated leading to significant maternal morbidity and adverse child outcomes. When identified, postpartum depression is usually treated as major depressive disorder. Many studies have identified the postpartum as a period of high risk for first presentations and relapses of bipolar disorder. Areas covered: This article reviews the acute and prophylactic treatment of postpartum major depressive disorder, bipolar depression and major depressive disorder with mixed features. The safety of antidepressant and mood stabilizing medications in pregnancy and breastfeeding will also be reviewed. Expert commentary: Differentiating postpartum major depressive disorder and postpartum bipolar depression can be difficult given their clinical similarities but accurate identification is vital for initiating proper treatment. Antidepressants are the mainstay of drug treatment for postpartum major depressive disorder, yet randomized controlled trials have shown conflicting results. A paucity of evidence exists for the effectiveness of antidepressant prophylaxis in the prevention of recurrences of major depressive disorder. Mood stabilizing medications reduce the risk of postpartum bipolar depression relapse but no randomized controlled trials have examined their use in the acute or prophylactic treatment of postpartum bipolar depression.
... or guilty. These emotions can affect a woman’s self-esteem and how she deals with stress. Fatigue—Many ... FAQs Exercise After Pregnancy (FAQ131) Depression (FAQ106) Patient Education FAQs Resources & Publications Committee Opinions Practice Bulletins Patient ...
Gambadauro, Pietro; Iliadis, Stavros; Bränn, Emma; Skalkidou, Alkistis
To study whether conception by means of in vitro fertilization (IVF) is associated with maternal depressive symptoms during pregnancy or postpartum. Longitudinal observational study. University hospital. A total of 3,283 women with singleton pregnancies receiving antenatal care and delivering in Uppsala from 2010 to 2015. A web-based self-administered structured questionnaire including sociodemographic, clinical and pregnancy-related items, and the Edinburgh Postnatal Depression Scale (EPDS) was delivered at 17 and 32 gestational weeks and at 6 weeks and 6 months postpartum. Prevalence of significant depressive symptoms (EPDS ≥12) and EPDS scores. A total of 167 women (5%) had conceived via IVF and 3,116 (95%) had a spontaneous pregnancy. IVF mothers were more frequently ≥35 years of age (46.1% vs. 22.6%) and primiparous (71.7% vs. 49.9%) and had a higher cesarean delivery rate (22.4% vs. 14.2%). Demographic and clinical characteristics were otherwise similar between the two groups. Significant depressive symptoms were reported by 12.8%, 12.4%, 13.8%, and 11.9% of women at 17 and 32 gestational weeks and 6 weeks and 6 months postpartum, respectively. The prevalence of depressive symptoms and the EPDS scores during pregnancy and postpartum were similar between women conceiving spontaneously or through IVF. The mode of conception was not associated with significant depressive symptoms at any time point, even when adjusting for several possible confounders in multivariable logistic regression analysis. Despite the psychologic distress characterizing subfertility and its treatment, conception by means of IVF is not associated with maternal depressive symptoms during pregnancy or postpartum. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Kawai, Emiko; Takagai, Shu; Takei, Nori; Itoh, Hiroaki; Kanayama, Naohiro; Tsuchiya, Kenji J
We investigated the potential relationship between maternal depressive symptoms during the postpartum period and non-verbal communication skills of infants at 14 months of age in a birth cohort study of 951 infants and assessed what factors may influence this association. Maternal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale, and non-verbal communication skills were measured using the MacArthur-Bates Communicative Development Inventories, which include Early Gestures and Later Gestures domains. Infants whose mothers had a high level of depressive symptoms (13+ points) during both the first month postpartum and at 10 weeks were approximately 0.5 standard deviations below normal in Early Gestures scores and 0.5-0.7 standard deviations below normal in Later Gestures scores. These associations were independent of potential explanations, such as maternal depression/anxiety prior to birth, breastfeeding practices, and recent depressive symptoms among mothers. These findings indicate that infants whose mothers have postpartum depressive symptoms may be at increased risk of experiencing delay in non-verbal development. Copyright © 2016 Elsevier Inc. All rights reserved.
Raes, Filip; Smets, Jorien; Wessel, Ineke; Van Den Eede, Filip; Nelis, Sabine; Franck, Erik; Jacquemyn, Yves; Hanssens, Myriam
OBJECTIVE: Maladaptive response styles to negative affect have been shown to be associated with prospective (postpartum) depression. Whether maladaptive styles to positive affect are also critically involved is understudied, even though anhedonia (a correlate of low positive affectivity) is a
Gosselin, P; Chabot, K; Béland, M; Goulet-Gervais, L; Morin, A J S
Fear of childbirth is common in women who are pregnant with their first child and is associated with important consequences such as abortions and miscarriages. Twenty percent of nulliparous women seem to exhibit a mild or moderate fear, while 6% present an excessive and irrational fear known as tocophobia. Tocophobia is suggested to be associated with many negative consequences such as postpartum depression (PPD) and Post-traumatic stress (PTS). However, there is little empirical evidence to support these relationships. Recently, Fairbrother and Woody (2007) did not observe a link between the fear of childbirth and symptoms of PPD and PTS in nulliparous women. Some results, near the significance level, could be explained by a lack of statistical power. The present study focused on the link between the fear of childbirth and the process of delivery, the perception of pain, PPD and PTS. More specifically, it aimed to test three hypotheses: (i) fear of childbirth will be linked to the process of delivery, especially regarding the perception of pain, the use of anaesthesia and the use of Caesarean section; (ii) a high level of fear of childbirth will be associated with more negative postpartum consequences (namely PPD/PTS symptoms); (iii) the process of delivery and pain will also be related to post-delivery symptoms. Mediation effects were tested. Data from a longitudinal study were used to meet the hypotheses. A total of 176 nulliparous pregnant women responded to questionnaires at two time measurements (during pregnancy and at 5weeks postpartum). Fear of childbirth is related to the perception of pain at birth among women delivering vaginally, in the absence of anaesthesia. It is also linked to symptoms of PPD and PTS, regardless of whether or not anaesthesia was used. Fear of childbirth also appears to be strongly associated to symptoms of PTS in women who have experienced an unplanned caesarean section. Thus, symptoms of postpartum PTS could play a mediating role
Iwata, Hiroko; Mori, Emi; Tsuchiya, Miyako; Sakajo, Akiko; Maehara, Kunie; Ozawa, Harumi; Morita, Akiko; Maekawa, Tomoko; Aoki, Kyoko; Tamakoshi, Koji
Older maternal age has become more common in Japan. Studies suggest that older maternal age and primiparity are associated with post-partum depression. The present study aimed to identify predictors of post-partum depression in older Japanese primiparas at 1 month post-partum. Participants were 479 primiparas aged 35 years and over, drawn from a prospective cohort study. Data were collected using self-report questionnaires. Depression was measured with the Japanese version of the Edinburgh Postnatal Depression Scale. Stepwise logistic regression analysis was conducted on binary outcome variables of depression at 1 month post-partum, along with a stratified analysis based on the risk status of depression. Five predictors were identified: (i) the depression score during hospital stay; (ii) financial burden; (iii) dissatisfaction with appraisal support; (iv) physical burden in daily life; and (v) concerns about infant caretaking. Stratified analysis identified dissatisfaction with instrumental support in the low-risk group, and the Child-care Value Scale score as unique predictors in the high-risk group. These results highlight the importance of early assessment of depressive symptoms and the provision of continuous care. © 2015 Japan Academy of Nursing Science.
Pfost, Karen S.; And Others
Notes that women are particularly vulnerable to depression during the postpartum period. Distinguishes postpartum depression from normal postpartum adjustment, postpartum blues, and postpartum psychosis. Describes biological, psychodynamic, and diathesis-stress perspectives on postpartum depression. Encourages counselors to fashion individualized…
Meijer, J. L.; Beijers, C.; van Pampus, M. G.; Verbeek, T.; Stolk, R. P.; Milgrom, J.; Bockting, C. L. H.; Burger, H.
ObjectiveTo investigate whether the 10-item Edinburgh Postnatal Depression Scale (EPDS) administered antenatally is accurate in predicting postpartum depressive symptoms, and whether a two-item EPDS has similar predictive accuracy. DesignProspective cohort study. SettingObstetric care in the
Ruyak, Sharon L; Flores-Montoya, Angelina; Boursaw, Blake
To examine which psychosocial risk factors are predictors of symptoms of postpartum depression (PPD) and whether home visit services are associated with decreased reports of symptoms of PPD. Secondary analysis of observational data from the 2012 to 2013 Pregnancy Risk Assessment Monitoring System (PRAMS). A national sample with data from more than 30,000 births from 41 states. To account for unequal probabilities of selection, PRAMS-produced survey weights were incorporated in all percentage estimates, all chi-square tests, and an overall logistic regression model for maternal characteristics as predictors of symptoms of PPD. The effect of interventions on PPD was assessed using statistical techniques that adjusted for the likelihood of receiving the intervention. Stressors (odds ratio [OR] = 2.6 for three to five stressors; OR = 3.1 for six or more stressors), physical abuse (OR = 1.8), and history of depression (OR = 3.0) were associated with PPD in the logistic regression model. Using propensity score analysis, the average treatment effect of home visiting on PPD, during or after pregnancy, was nonsignificant. However, the propensity score analysis did identify a group of high-risk women for whom receiving a home visit was associated with nearly 40% lower odds (OR = 0.6) of experiencing PPD symptoms. Findings highlight the effect home visits during pregnancy may have on the odds of at-risk women developing symptoms of PPD. Future research is indicated to assess the extent to which targeted interventions during these home visits can enhance effectiveness by mitigating psychosocial stress in pregnancy to prevent PPD. Copyright © 2017 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.
Park, Jeong-Hwan; Karmaus, Wilfried; Zhang, Hongmei
Prenatal depression is a significant predictor for postpartum depression. However, there is a lack of research on risk factors for Korean women related to prenatal depression and the relationship between prenatal depression during the three trimesters and postpartum depression. Therefore, aims of this study were (1) to identify the prevalence of depression during all three trimesters and the postpartum period, (2) to evaluate the relationship between prenatal depression in each trimester and postpartum depression, and (3) to identify the relationship and differences in prenatal depression based on sociodemographic factors in Korean women. One hundred and fifty three Korean women were recruited from three maternity clinics in Korea. Prenatal and postpartum depressions were evaluated in the first, second (24-26 weeks), third (32-34 weeks) trimester and 4 weeks postpartum with the Edinburgh Postnatal Depression Scale-Korean. The prevalence of depression in the prenatal and postpartum period ranged from 40.5% to 61.4%. Depression in the second and the third trimester was significantly correlated with depression in the postpartum period. Unemployment and household income were risk factors for prenatal depression in the first and second trimesters. To assist women suffering from postpartum depression and prevent its effects, women should be screened for prenatal depression during all three trimesters. For Korean women with high risk factors for prenatal depression, we suggest that the Korean government establish healthcare policies related to depression screening as routine prenatal care and mental health referral systems. Copyright © 2015. Published by Elsevier B.V.
Leung, B.M.; Kaplan, B.J.; Field, C.J.; Tough, S.; Eliasziw, M.; Gomez, M.F.; McCargar, L.J.; Gagnon, L.; APrON Study Team, the; Pop, V.J.M.
Background Postpartum depression is a serious problem for women and their offspring. Micronutrient supplements are recommended for pregnant women because of their documented protective effects for the offspring, but their potential beneficial effects on maternal mental health are unknown. This study
Murray, Lynne, Ed.; Cooper, Peter J., Ed.
Only recently has the research on postpartum depression dealt with the disorder's effects on child development. This book explores the impact of postpartum depression on mother-infant interaction and child development, its treatment, and postpartum psychosis. The chapters are: (1) "The Nature of Postpartum Depressive Disorders" (Michael…
Christian, Lisa M; Mitchell, Amanda M; Gillespie, Shannon L; Palettas, Marilly
Brain-derived neurotrophic factor (BDNF) is implicated as a causal factor in major depression and is critical to placental development during pregnancy. Longitudinal data on BDNF across the perinatal period are lacking. These data are of interest given the potential implications for maternal mood and fetal growth, particularly among Black women who show ∼2-fold greater risk for delivering low birth weight infants. Serum BDNF, serum cortisol, and depressive symptoms (per CES-D) were assessed during each trimester and 4-11 weeks postpartum among 139 women (77 Black, 62 White). Low birth weight (BDNF declined considerably from 1st through 3rd trimesters (ps≤0.008) and subsequently increased at postpartum (pBDNF during the 1st trimester, 2nd trimester, and postpartum (ps≤0.032) as well as lower serum cortisol during the 2nd and 3rd trimester (ps≤0.01). Higher serum cortisol was concurrently associated with lower serum BDNF in the 2nd trimester only (pBDNF at both the 2nd and 3rd trimester was negatively associated with 3rd trimester depressive symptoms (ps≤0.02). In addition, women delivering low versus healthy weight infants showed significantly lower serum BDNF in the 3rd trimester (p=0.004). Women delivering low versus healthy weight infants did not differ in depressive symptoms at any time point during pregnancy (ps≥0.34). Serum BDNF declines considerably across pregnancy in Black and White women, with overall higher levels in Blacks. Lower serum BDNF in late pregnancy corresponds with higher depressive symptoms and risk for low birth weight in Black and White women. However, the predictive value of serum BDNF in pregnancy is specific to within-race comparisons. Potential links between racial differences in serum BDNF and differential pregnancy-related cortisol adaptation require further investigation. Copyright © 2016 Elsevier Ltd. All rights reserved.
Thang Van Vo
Full Text Available IntroductionPostpartum depression (PPD among women is a common mental health concern. It occurs at a time of major life change, coupled with the increased responsibilities associated with the care of a newborn infant. In Vietnam, the prevalence of depressive symptoms after giving birth has not been fully investigated. Research in the Northern provinces, in Ho Chi Minh City, and in Hue suggests postnatal depressive symptoms among women are common. This research aims to (1 estimate the prevalence of PPD symptoms among married women in one Vietnam city (Danang and (2 identify the social and personal factors associated with postpartum depressive symptoms.MethodsThis cross-sectional study was conducted from July 2013 to August 2014 in 10 wards of Hai Chau District, Danang. A total of 600 mothers who gave birth 4 weeks to 6 months prior to being interviewed were recruited. Interviews were conducted using structured questionnaires, which included several dimensions: demographics, family living arrangements, expectations of pregnancy, expectations of infant gender, the woman’s relationship with her husband, exercise after birth, infant health, and anxiety about matters other than the birth. The Edinburgh Postpartum Depression Scale (EPDS was used to examine PPD symptoms, with a cutoff point of 12/13.ResultsEPDS scores indicated the prevalence of PPD symptoms was 19.3% (95% CI: 16.16–22.50. Among women with PPD symptoms, 37.9% had suicidal thoughts in the previous seven days. Multivariate logistic regression indicated that the following key factors were significantly associated with PPD symptoms: Not being able to rely on their husband for help, having a husband who does not spend time to discuss problems, having anxiety about matters other than the birth, not exercising after giving birth, and having an ill baby.ConclusionThese findings should be interpreted in relation to other recent research in Vietnam. A consistent pattern of prevalence
Wang, Sai-Ying; Duan, Kai-Ming; Tan, Xiao-Fang; Yin, Ji-Ye; Mao, Xiao-Yuan; Zheng, Wei; Wang, Chun-Yan; Yang, Mi; Peng, Cheng; Zhou, Hong-Hao; Liu, Zhao-Qian
New conceptualizations of depression have emphasized the role of the kynurenine pathway (KP) in the pathogenesis of postpartum depressive symptoms (PDS). Kynurenine 3-monooxygenase (KMO) is a rate-limiting enzyme of the KP, where it catalyzes the conversion of kynurenine (KYN) to 3-hydroxykynurenine (3-HK). Previous work indicates that KMO is closely linked to the pathophysiology of depressive disorders. The purpose of this study is to investigate whether variations in the KMO gene affect PDS development after cesarean section. A total of 710 Chinese women receiving cesarean section were enrolled in this study. PDS was determined by an Edinburgh Postnatal Depression Scale (EPDS) score ≥13. Subsequently, 24 women with PDS and 48 matched women without PDS were randomly selected for investigation of perinatal serum concentrations of KYN, 3-HK and the 3-HK/KYN ratio. The 3-HK/KYN ratio indicates the activity of KMO. In addition, 6 single nucleotide polymorphisms of the KMO gene were examined. Following this genotyping, 36 puerperant women carrying the KMO rs1053230 AG genotype and 72 matched puerperant women carrying the KMO rs1053230 GG genotype were selected for comparisons of KYN, 3-HK and 3-HK/KYN ratio levels. The results show the incidence of PDS in the Chinese population to be 7.3%, with PDS characterized by increased serum 3-HK concentration and 3-HK/KYN ratio, versus matched postpartum women without PDS (PKMO rs1053230 are significantly associated with the incidence of PDS (PKMO rs1053230 AG genotype are significantly higher than those in matched postpartum women carrying the KMO rs1053230 GG genotype. The presented data highlight the contribution of alterations in the KP to the pathogenesis of postpartum depression. Heightened KMO activity, including as arising from KMO rs1053230 G/A genetic variations, are indicated as one possible mechanism driving the biological underpinnings of PDS. Copyright © 2017 Elsevier B.V. All rights reserved.
Dáu, Ana Luísa B T; Callinan, Laura S; Mayes, Linda C; Smith, Megan V
This study examined the relationship between self-reported depressive symptoms, directly observed maternal sensitivity, and the content and themes of pictures posted on a mobile application. Data on 20 participants were analyzed. Results suggested that mothers' scoring as more intrusive on the maternal sensitivity scale tended to post a higher proportion of photos of themselves interacting with their babies. An association between higher levels of maternal depressive symptoms and a lower proportion of posts of baby smiling photos was also suggested.
Ramachandran Pillai, Raji; Wilson, Anand Babu; Premkumar, Nancy R.; Kattimani, Shivanand; Sagili, Haritha
Postpartum depression (PPD) is a psychiatric complication of childbirth affecting 10–20% of new mothers and has negative impact on both mother and infant. Serum lipid levels have been related to depressive disorders, but very limited literatures are available regarding the lipid levels in women with postpartum depression. The present study is aimed to examine the association of serum lipids with the development of postpartum depressive symptoms. This is a cross sectional study conducted at a tertiary care hospital in South India. Women who came for postpartum check-up at 6th week post-delivery were screened for PPD (September 2014-October 2015). Women with depressive symptoms were assessed using EPDS (Edinburgh Postnatal Depression Scale). The study involved 186 cases and 250 controls matched for age and BMI. Serum levels of lipid parameters were estimated through spectrophotometry and the atherogenic indices were calculated in all the subjects. Low serum levels of Total Cholesterol (TC) and High Density Lipoprotein cholesterol (HDL-c) were significantly low in PPD women with severe depressive symptoms. The study recorded a significant negative correlation between HDL-c and the EPDS score in PPD women (r = -0.140, p = 0.05). Interestingly, the study also observed a significant negative correlation between Body Mass Index (BMI) and EPDS scores in case group (r = -0.146, p = 0.047), whereas a positive correlation between the same in controls (r = 0.187, p = 0.004). Our study demonstrated that low levels of serum HDL-c is correlated with the development of severe depressive symptoms in postpartum women. Study highlights the role of lipids in the development of postpartum depressive symptoms. PMID:29444162
Raji Ramachandran Pillai
Full Text Available Postpartum depression (PPD is a psychiatric complication of childbirth affecting 10-20% of new mothers and has negative impact on both mother and infant. Serum lipid levels have been related to depressive disorders, but very limited literatures are available regarding the lipid levels in women with postpartum depression. The present study is aimed to examine the association of serum lipids with the development of postpartum depressive symptoms. This is a cross sectional study conducted at a tertiary care hospital in South India. Women who came for postpartum check-up at 6th week post-delivery were screened for PPD (September 2014-October 2015. Women with depressive symptoms were assessed using EPDS (Edinburgh Postnatal Depression Scale. The study involved 186 cases and 250 controls matched for age and BMI. Serum levels of lipid parameters were estimated through spectrophotometry and the atherogenic indices were calculated in all the subjects. Low serum levels of Total Cholesterol (TC and High Density Lipoprotein cholesterol (HDL-c were significantly low in PPD women with severe depressive symptoms. The study recorded a significant negative correlation between HDL-c and the EPDS score in PPD women (r = -0.140, p = 0.05. Interestingly, the study also observed a significant negative correlation between Body Mass Index (BMI and EPDS scores in case group (r = -0.146, p = 0.047, whereas a positive correlation between the same in controls (r = 0.187, p = 0.004. Our study demonstrated that low levels of serum HDL-c is correlated with the development of severe depressive symptoms in postpartum women. Study highlights the role of lipids in the development of postpartum depressive symptoms.
Kehler, Heather; Austin, Marie-Paule; Mughal, Muhammad Kashif; Wajid, Abdul; Vermeyden, Lydia; Benzies, Karen; Brown, Stephanie; Stuart, Scott; Giallo, Rebecca
Background Most evidence of the association between maternal depression and children’s development is limited by being cross-sectional. To date, few studies have modelled trajectories of maternal depressive symptoms from pregnancy through the early postpartum years and examined their association with social emotional and behavior functioning in preschool children. The objectives of this study were to: 1) identify distinct groups of women defined by their trajectories of depressive symptoms across four time points from mid-pregnancy to one year postpartum; and 2) examine the associations between these trajectories and child internalizing and externalizing behaviors. Methods We analyzed data from the All Our Families (AOF) study, a large, population based pregnancy cohort of mother-child dyads in Alberta, Canada. The AOF study is an ongoing pregnancy cohort study designed to investigate relationships between the prenatal and early life period and outcomes for children and mothers. Maternal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. Children’s behavioral functioning at age 3 was assessed using the Behavior Scales developed for the Canadian National Longitudinal Survey of Children and Youth. Longitudinal latent class analysis was conducted to identify trajectories of women’s depressive symptoms across four time points from pregnancy to 1 year postpartum. We used multivariable logistic regression to assess the relationship between trajectories of maternal depressive symptoms and children’s behavior, while adjusting for other significant maternal, child and psychosocial factors. Results 1983 participants met eligibility criteria. We identified four distinct trajectories of maternal depressive symptoms: low level (64.7%); early postpartum (10.9%); subclinical (18.8%); and persistent high (5.6%). In multivariable models, the proportion of children with elevated behavior symptoms was highest for children whose mothers had
Guo, Chaohui; Moses-Kolko, Eydie L; Phillips, Mary L; Stepp, Stephanie D; Hipwell, Alison E
Abstract Postpartum depression may disrupt socio-affective neural circuitry and compromise provision of positive parenting. Although work has evaluated how parental response to negative stimuli is related to caregiving, research is needed to examine how depressive symptoms during the postpartum period may be related to neural response to positive stimuli, especially positive faces, given depression’s association with biased processing of positive faces. The current study examined the association between neural response to adult happy faces and observations of maternal caregiving and the moderating role of postpartum depression, in a sample of 18- to 22-year old mothers (n = 70) assessed at 17 weeks (s.d. = 4.7 weeks) postpartum. Positive caregiving was associated with greater precuneus and occipital response to positive faces among mothers with lower depressive symptoms, but not for those with higher symptoms. For mothers with higher depressive symptoms, greater ventral and dorsal striatal response to positive faces was associated with more positive caregiving, whereas the opposite pattern emerged for mothers with lower symptoms. There was no association between negative caregiving and neural response to positive faces or negative faces. Processing of positive stimuli may be an important prognostic target in mothers with depressive symptoms, given its link with healthy caregiving behaviors. PMID:29048603
Jeong-hwan Park, PhD, RN
Conclusions: To assist women suffering from postpartum depression and prevent its effects, women should be screened for prenatal depression during all three trimesters. For Korean women with high risk factors for prenatal depression, we suggest that the Korean government establish healthcare policies related to depression screening as routine prenatal care and mental health referral systems.
Sockol, Laura E.; Epperson, C. Neill; Barber, Jacques P.
This meta-analysis assessed the efficacy of a wide range of preventive interventions designed to reduce the severity of postpartum depressive symptoms or decrease the prevalence of postpartum depressive episodes. A systematic review identified 37 randomized or quasi-randomized controlled trials in which an intervention was compared to a control condition. Differences between treatment and control conditions in the level of depressive symptoms and prevalence of depressive episodes by 6 months postpartum were assessed in separate analyses. Depressive symptoms were significantly lower at post-treatment in intervention conditions, with an overall effect size in the small range after exclusion of outliers (Hedges' g = 0.18). There was a 27% reduction in the prevalence of depressive episodes in intervention conditions by 6 months postpartum after removal of outliers and correction for publication bias. Later timing of the postpartum assessment was associated with smaller differences between intervention and control conditions in both analyses. Among studies that assessed depressive symptoms using the EPDS, higher levels of depressive symptoms at pre-treatment were associated with smaller differences in depressive symptoms by 6 months postpartum. These findings suggest that interventions designed to prevent postpartum depression effectively reduce levels of postpartum depressive symptoms and decrease risk for postpartum depressive episodes. PMID:24211712
Papamarkou, Maria; Sarafis, Pavlos; Kaite, Charis P.; Malliarou, Maria; Tsounis, Andreas; Niakas, Dimitris
Background The onset of a major depressive episode is experienced by a large number of women in the weeks or months following delivery. Postpartum depression may deem those women experiencing it incapable of taking care for themselves, their family and their infants, while at the same time it could negatively affect their quality of life. The present study assessed the quality of life of a sample of mothers in Greece, in order to investigate the association between postpartum depression and q...
Marín-Morales, Dolores; Toro-Molina, Susana; Peñacoba-Puente, Cecilia; Losa-Iglesias, Marta; Carmona-Monge, Francisco Javier
Objectives The aims of this study were to evaluate the predictive relationship between psychological symptomatology 24 h postpartum and depression 4 months postpartum, and analyze the relationship between estradiol and postpartum mood. Methods Two hundred women participated in an assessment 24 h postpartum and gave a blood sample for estradiol analysis. One hundred eleven of these women completed the second assessment 4 months postpartum. The Beck Depression Inventory II and the Scale of State-Trait Anxiety were used to assess psychological symptoms. Results At 24 h postpartum, symptoms of depression, trait anxiety, and state anxiety were all significantly correlated with each other. Depression at 24 h postpartum was the only significant independent predictor of depression at 4 months postpartum, explaining 28.7% of the variance. No statistically significant relationship was found between levels of estradiol and mood. Symptoms of depression immediately postpartum thus appear to be a predictor of postpartum depression. Conclusions for Practice These results suggest that early postpartum psychological evaluation of the mother, and intervention as warranted, might prevent or lessen postpartum depression.
Kraus, Mary Ann; Redman, E. Scott
Postpartum depression is conceptualized as a predictable developmental, family crisis, which occurs when the natural difficulties of childbirth are benignly mishandled. Tactics are illustrated for interdicting maladaptive interpersonal spirals, including normalizing conflicting complaints; reframing depression as positive but costly; regulating…
Full Text Available Manual of Mental Disorders (DSM-IV, postpartum depression may include any nonpsychotic depressive disorder during the first four weeks of postpartum, according to research criteria during the first year after birth. The exact cause of postpartum depression is not yet known, and most researchers believe that postpartum depression is a bio-psycho-social problem. So far, the biological aspect of the disease is explained by changing the levels of estrogen and progesterone during pregnancy, and by decrease of hormone levels after birth. Psychological correlates are often associated with low selfesteem, pessimism as a personality trait, bad strategies of coping with stress, mood swings and emotional reactions. The social aspect of the disease is associated with the existential conditions of pregnant woman, support of partners and education level. This paper will include issues like hereditary causes and possible psychological factors of postpartum depression prevention. Nowadays, it is estimated that on average 15% of women, regardless of the pregnancy outcome, are suffering from postpartum depression. However, this information includes only those women who were diagnosed with postpartum depression and who themselves reported about it. Almost every woman receives basic care during pregnancy to prevent complications in the physiological level. This paper has shown possible psychological factors of postpartum depression prevention, the impact of optimism, self-esteem and coping skills.
Strelow, Brittany; Fellows, Nicole; Fink, Stephanie R; OʼLaughlin, Danielle J; Radke, Gladys; Stevens, Joy; Tweedy, Johanna M
Postpartum depression, which affects 10% to 20% of women in the United States, can significantly harm the health and quality of life for mother, child, and family. This article reviews the risk factors, pathophysiology, clinical manifestations, diagnosis, and treatment of postpartum depression with specific focus on women of advanced maternal age.
Abrams, Laura S.; Curran, Laura
Low-income mothers in the U.S. are more likely to experience postpartum depression (PPD) and less likely to seek treatment than their middle-class counterparts. Despite this knowledge, prior research has not provided an in-depth understanding of PPD symptoms as they are experienced by low-income mothers. Through in-depth interviews, this study…
Carla Fonseca Zambaldi
Full Text Available A depressão pós-parto é o transtorno afetivo mais prevalente no puerpério. O seu quadro clínico apresenta algumas peculiaridades sintomatológicas, podendo uma delas ser a presença mais freqüente de obsessões e compulsões. Relatamos seis casos identificados pela análise de prontuários de puérperas atendidas no Programa de Saúde Mental da Mulher do Hospital das Clínicas da Universidade Federal de Pernambuco. Todas elas tinham diagnóstico de depressão através do Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I e apresentavam concomitantemente sintomas obsessivo-compulsivos. Nos relatos, abordamos o período de aparecimento desses sintomas nas mulheres deprimidas, assim como o seu conteúdo, duração e resposta ao tratamento. Em duas mulheres, os sintomas obsessivo-compulsivos precederam os depressivos, e em outras duas, deu-se o inverso. Houve exacerbação de obsessões e compulsões preexistentes em duas puérperas. O conteúdo mais freqüente foi de pensamentos agressivos contra o bebê. Os sintomas tenderam a diminuir juntamente com a melhora da depressão.Postpartum depression is the most common affective disorder in the puerperium. There are some particular symptoms in its clinical presentation, and one might be the higher frequency of obsessions and compulsions. We report six cases identified from the analysis of medical charts of puerperal women receiving care at the Women's Mental Health Program, Hospital das Clínicas, Universidade Federal de Pernambuco, Brazil. All the women were diagnosed with postpartum depression using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I and had associated obsessive-compulsive symptoms. We report time of onset, topics, course and treatment response of these symptoms. Obsessive-compulsive symptoms preceded depressive symptoms in two women, and were succeeded in two other women. There was exacerbation of preexisting obsessions and compulsions in two
Are symptom features of depression during pregnancy, the postpartum period and outside the peripartum period distinct? Results from a nationally representative sample using item response theory (IRT).
Hoertel, Nicolas; López, Saioa; Peyre, Hugo; Wall, Melanie M; González-Pinto, Ana; Limosin, Frédéric; Blanco, Carlos
Whether there are systematic differences in depression symptom expression during pregnancy, the postpartum period and outside these periods (i.e., outside the peripartum period) remains debated. The aim of this study was to use methods based on item response theory (IRT) to examine, after equating for depression severity, differences in the likelihood of reporting DSM-IV symptoms of major depressive episode (MDE) in women of childbearing age (i.e., aged 18-50) during pregnancy, the postpartum period and outside the peripartum period. We conducted these analyses using a large, nationally representative sample of women of childbearing age from the United States (n = 11,256) who participated in the second wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). The overall 12-month prevalence of all depressive criteria (except for worthlessness/guilt) was significantly lower in pregnant women than in women of childbearing age outside the peripartum period, whereas the prevalence of all symptoms (except for "psychomotor symptoms") was not significantly different between the postpartum and the nonperipartum group. There were no clinically significant differences in the endorsement rates of symptoms of MDE by pregnancy status when equating for levels of depression severity. This study suggests that the clinical presentation of depressive symptoms in women of childbearing age does not differ during pregnancy, the postpartum period and outside the peripartum period. These findings do not provide psychometric support for the inclusion of the peripartum onset specifier for major depressive disorder in the DSM-5. © 2014 Wiley Periodicals, Inc.
Goyal, Deepika; Park, Van Ta; McNiesh, Susan
To explore Asian Indian mothers' perspectives of postpartum depression (PPD) and mental health help-seeking behavior. Qualitative exploratory design. Using convenience sampling, postpartum mothers were recruited through flyers posted in public places and on social media sites. Postpartum depression risk was assessed with the Edinburgh Postnatal Depression Scale (EPDS) prior to qualitative interviews. Content analysis methods were used to extract themes from participant narratives. Twelve self-identified, married, Asian Indian mothers, aged between 29 and 40 years, living in Northern California, who gave birth to a healthy infant within the last 12 months, took part in this study. Scores on the EPDS indicated two participants were at an increased risk for developing PPD. Content analysis revealed two emerging themes: (1) Culture-specific postpartum practices and ceremonies and their role in maternal-infant postpartum recovery; and (2) Maternal mental health help-seeking behavior. Nurses taking care of women during the extended prenatal and postpartum period have the unique opportunity to build rapport with their patients which can offer a window of opportunity to educate and help dispel myths about PPD symptoms and treatment. To promote successful maternal-infant outcomes, PPD education should be initiated at the first prenatal appointment, continue during the pregnancy, and be incorporated into well-baby visits through the first postpartum year. Education should include signs and symptoms of PPD as well as importance of timely mental-health help-seeking.
Sockol, Laura E; Epperson, C Neill; Barber, Jacques P
Two studies examined the relationship between maternal attitudes and symptoms of depression and anxiety during pregnancy and the early postpartum period. In the first study, a measure of maternal attitudes, the Attitudes Toward Motherhood Scale (AToM), was developed and validated in a sample of first-time mothers. The AToM was found to have good internal reliability and convergent validity with cognitive biases and an existing measure of maternal attitudes. Exploratory and confirmatory factor analyses determined that the measure comprises three correlated factors: beliefs about others' judgments, beliefs about maternal responsibility, and maternal role idealization. In the second study, we used the AToM to assess the relationship between maternal attitudes and other psychological variables. The factor structure of the measure was confirmed. Maternal attitudes predicted symptoms of depression and anxiety, and these attitudes had incremental predictive validity over general cognitive biases and interpersonal risk factors. Overall, the results of these studies suggest that maternal attitudes are related to psychological distress among first-time mothers during the transition to parenthood and may provide a useful means of identifying women who may benefit from intervention during the perinatal period.
Gauthreaux, Christina; Negron, Jenesis; Castellanos, Daniel; Ward-Peterson, Melissa; Castro, Grettel; Rodr?guez de la Vega, Pura; Acu?a, Juan Manuel
Abstract Postpartum depression (PPD) is a form of major depressive disorder affecting approximately 13% of women worldwide. Unintended pregnancies, reaching close to 50% of the pregnancies in the United States, have become a major health concern. While many physiologic and psychosocial causes have been analyzed, few studies have examined the relationship between unintended pregnancy and symptoms of PPD. A cross-sectional study was conducted using surveillance data from the Centers for Disease...
Schiller, Crystal Edler; Richards, Jenny Gringer; O’Hara, Michael W.; Stuart, Scott
Similar to biological mothers during the postpartum period, women who adopt children experience increased stress and life changes that may put them at risk for developing depression and anxiety. The purpose of the current study was to compare levels of depression and anxiety symptoms between postpartum and adoptive women and, among adoptive women, to examine associations between specific stressors and depressive symptoms. Data from adoptive mothers (n=147), recruited from Holt International, were compared to existing data from postpartum women (n=147). Differences in the level of depression and anxiety symptoms as measured by the Inventory of Depression and Anxiety Symptoms among postpartum and adoptive women were examined. Associations between specific stressors and depressive symptoms were examined among adoptive mothers. Postpartum and adoptive women had comparable levels of depressive symptoms, but adoptive women reported greater well-being and less anxiety than postpartum women. Stressors (e.g., sleep deprivation, history of infertility, past psychological disorder, and less marital satisfaction) were all significantly associated with depressive symptoms among adoptive women. The level of depressive symptoms was not significantly different between the two groups. In contrast, adoptive women experienced significantly fewer symptoms of anxiety and experienced greater well-being. Additionally, adoptive mothers experienced more depressive symptoms during the year following adoption when the stressors were present. Thus, women with these characteristics should be routinely screened for depression and anxiety. PMID:21725836
Full Text Available Abstract Introduction: This study aimed to investigate the relationship between sexual desire, and intimacy with the depression symptoms and marital satisfaction in 3 month- 2 year postpartum women in Mahshahr. Methods In this correlational cross-sectional study, 107 women participated who referred to health centers of Mahshahr (Iran with their babies aged three months to two years. The study sample was selected via convenience sampling method, who were required to complete the libido (SIDI, intimacy (PAIR, depression (CES-D questionnaires. The collected data were analyzed using the Pearson correlation and multivariate regression. Results: As the study results indicated, a negative relationship was detected between intimacy and sexuality with the depressive symptoms (P≤0.01, whereas a positive relationship was observed between intimacy and sexual and marital satisfaction (P≤0.01. In addition, intimacy and sexuality variables were proved to be significant predictors for postpartum depression symptoms and marital satisfaction obtained after delivery. Depression symptoms explained 62% of the variation, and marital satisfaction explained 63% of depression symptoms. Conclusion: The findings of the present study demonstrated that after birth when childbirth creates some changes in the lives of couples, and women's marital satisfaction and emotional mood may be affected, couples can use intimacy and sexuality in order to predict depression and marital satisfaction.
Misri, Shaila; Burgmann, Allan J.F.
Adjusting to the role of mother, a creative and joyous change for most women, combines with simultaneous physiological and psychological changes to develop into psychiatric problems in some women. Three common syndromes during the postpartum period are postpartum blues, postpartum depression, and postpartum psychosis. Any postpartum condition should be diagnosed rapidly to prevent short- and long-term disorders.
De Venter, Maud; Smets, Jorien; Raes, Filip; Wouters, Kristien; Franck, Erik; Hanssens, Myriam; Jacquemyn, Yves; Sabbe, Bernard G C; Van Den Eede, Filip
Studies on the impact of childhood trauma on postpartum depression show inconsistencies and methodological limitations. The present study examines the effect of childhood trauma on depression 12 and 24 weeks after childbirth, while controlling for history of depression, depression symptoms during pregnancy and type D personality. During the third trimester of pregnancy, 210 women completed self-report questionnaires assessing depression (current and/or past episodes), childhood trauma and type D personality, of whom 187 participated in the postpartum follow-up, with depression symptoms being reassessed at 12 and 24 weeks after delivery with three depression outcome measures. Eventually, 183 participants were retained for analysis. Results indicated no predictive value of childhood trauma on postpartum depression in the univariate analyses, nor after controlling for previous depression, depression symptoms during pregnancy and type D personality. However, past depression and depression symptoms during pregnancy did independently and convincingly predict postpartum depression, especially at 12 weeks and to a lesser extent at 24 weeks following childbirth. Overall, we found no significant association between childhood trauma and postpartum depression. Past depression and depression symptoms during pregnancy are more relevant factors to assess before childbirth.
Abstract Introduction: This study aimed to investigate the relationship between sexual desire, and intimacy with the depression symptoms and marital satisfaction in 3 month- 2 year postpartum women in Mahshahr. Methods In this correlational cross-sectional study, 107 women participated who referred to health centers of Mahshahr (Iran) with their babies aged three months to two years. The study sample was selected via convenience sampling method, who were required to complete the libid...
Women who were physically active after delivery were characterized by higher health awareness and more frequent return to pre-pregnancy weight. Physical activity may be important for reducing the risk of postnatal depression.
Sood, Mamta; Sood, A K
This prospective study was carried out in a service hospital, with the aim to study the prevalence and incidence of depression in pregnancy and postpartum period. Eighty Four consecutive patients attending the antenatal outpatient in the Obstetrics & Gynaecology department in their last trimester of pregnancy were recruited for the study. They were assessed on Beck Depression Inventory thrice viz. during third trimester of pregnancy, within 3 days of delivery (early postpartum period) & within 4-8 weeks of delivery (late postpartum period).The prevalence of depression was 8.3%, 20% and 12.8% respectively at three ratings. The incidence was 16% and 10% in the early & late postpartum period respectively. Further analysis revealed that depression in pregnancy correlated significantly with depression in early postpartum period, but not with late postpartum period. Depression in early postpartum period correlated with depression in late postpartum period.These findings have implications for early detection and care of women at risk for developing depression.
Becker, Madeleine; Weinberger, Tal; Chandy, Ann; Schmukler, Sarah
Depression is a common complication of pregnancy and the postpartum period. There are multiple risk factors for peripartum mood disorders, most important of which is a prior history of depression. Both depression and antidepressant medications confer risk upon the infant. Maternal depression has been associated with preterm birth, low birth weight, fetal growth restriction, and postnatal cognitive and emotional complications. Antidepressant exposure has been associated with preterm birth, reductions in birth weight, persistent pulmonary hypertension, and postnatal adaptation syndrome (PNAS) as well as a possible connection with autism spectrum disorder. Paroxetine has been associated with cardiac malformations. Most antidepressant medications are excreted in low levels in breast milk and are generally compatible with breastfeeding. The use of antidepressants during pregnancy and postpartum must be weighed against the risk of untreated depression in the mother.
terms of physical, cognitive and emotional well-being during crucial stages of ... postpartum depression (PPD).4 Symptoms of maternal depression ... health services and play a productive role in society.6 As depressed ... 45% of those who were depressed had a HIV-positive status.30 In ..... Psychological aspects of nipple.
Sharma, Verinder; Doobay, Minakshi; Baczynski, Christine
Over the past few years there has been a surge of interest in the study of bipolar postpartum depression (PPD); however, questions remain about its prevalence, screening, clinical features, and treatment. Three electronic databases, MEDLINE/PubMed (1966-2016), PsycINFO (1806-2016), and the Cochrane Database of Systematic Reviews, were searched using a combination of the keywords bipolar, depression, postpartum, peripartum, prevalence, screening, diagnosis, treatment, drugs, and psychotherapy. The reference lists of articles identified were also searched. All relevant articles published in English were included. Depending on the population studied, 21.4-54% of women with PPD have a diagnosis of bipolar disorder (BD). Characteristic clinical features include younger age at illness onset, first onset of depression after childbirth, onset immediately after delivery, atypical depressive symptoms, psychotic features, mixed features, and history of BD in first-degree family members. Treatment should be guided by symptom acuity, safety concerns, the patient's response to past treatments, drug tolerability, and breastfeeding preference. In the absence of controlled treatment data, preference should be given to drugs normally indicated for bipolar depression including lithium, quetiapine and lamotrigine. Although antidepressants have been studied in combination with mood stabilizers in bipolar depression, these drugs should be avoided due to likelihood of elevated risk of induction of manic symptoms in the postpartum period. In the postpartum period, bipolar PPD is common, can be differentiated from unipolar PPD, and needs to be identified promptly in order to expedite appropriate treatment. Future studies on pharmacotherapy and psychotherapy should focus on the acute and preventative treatment of bipolar PPD. Copyright © 2017 Elsevier B.V. All rights reserved.
Amankwaa, Linda Clark
The purpose of this paper is to discuss the development of a theory of maternal postpartum role collapse. The influences of traditional role theory and symbolic interactionism are presented. The development of the maternal postpartum role collapse theory emerged from the study of postpartum depression among African-American women (Amankwaa, 2000).…
Summary Background Maternal depression in the postpartum period confers substantial morbidity and mortality, but the definition of postpartum depression remains controversial. We investigated the heterogeneity of symptoms with the aim of identifying clinical subtypes of postpartum depression. Methods Data were aggregated from the international perinatal psychiatry consortium Postpartum Depression: Action Towards Causes and Treatment, which represents 19 institutions in seven countries. 17 912 unique subject records with phenotypic data were submitted. We applied latent class analyses in a two-tiered approach to assess the validity of empirically defined subtypes of postpartum depression. Tier one assessed heterogeneity in women with complete data on the Edinburgh postnatal depression scale (EPDS) and tier two in those with postpartum depression case status. Findings 6556 individuals were assessed in tier one and 4245 in tier two. A final model with three latent classes was optimum for both tiers. The most striking characteristics associated with postpartum depression were severity, timing of onset, comorbid anxiety, and suicidal ideation. Women in class 1 had the least severe symptoms (mean EPDS score 10·5), followed by those in class 2 (mean EPDS score 14·8) and those in class 3 (mean EPDS score 20·1). The most severe symptoms of postpartum depression were significantly associated with poor mood (mean EPDS score 20·1), increased anxiety, onset of symptoms during pregnancy, obstetric complications, and suicidal ideation. In class 2, most women (62%) reported symptom onset within 4 weeks postpartum and had more pregnancy complications than in other two classes (69% vs 67% in class 1 and 29% in class 3). Interpretation PPD seems to have several distinct phenotypes. Further assessment of PPD heterogeneity to identify more precise phenotypes will be important for future biological and genetic investigations. Funding Sources of funding are listed at the end of the
Kornfeind, Katelin R; Sipsma, Heather L
Postpartum depression affects a substantial proportion of new mothers in the United States. Although most employed women return to paid work after birth, the association between duration of maternity leave and postpartum depression is unclear. We therefore aimed to explore this relationship among mothers in the United States. Data included 177 mothers from a national survey who had returned to work full time after having a baby. Multivariable logistic regression was used to explore the independent association between duration of maternity leave and experiencing of postpartum depressive symptoms in the 2 weeks preceding the postpartum survey completion. Overall, duration of maternity leave was not significantly associated with experiencing postpartum depression symptoms (odds ratio [OR], 0.90; 95% confidence interval [CI], 0.80-1.01). This effect, however, varied by duration of maternity leave. Among women who took maternity leaves of 12 weeks or less, every additional week of leave was associated with a lesser odds of experiencing postpartum depressive symptoms (OR, 0.58; 95% CI, 0.40-0.84). Among women who took maternity leaves longer than 12 weeks, leave duration was not associated with postpartum depression symptoms (OR, 0.97; 95% CI, 0.73-1.29). Maternity leaves equaling 12 weeks or less may contribute additional risk for postpartum depressive symptoms, possibly because mothers are juggling employment alongside of important physical and emotional changes during this period. This association underscores the importance of ensuring that mothers have at least 12 weeks of leave from full-time employment after the birth of a baby. Copyright © 2018 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
Räisänen, Sari; Lehto, Soili M; Nielsen, Henriette Svarre
To study how reproductive risks and perinatal outcomes are associated with postpartum depression treated in specialised healthcare defined according to the International Classification of Diseases (ICD)-10 codes, separately among women with and without a history of depression....
Full Text Available Postpartum Depression is the most common complicationof the delivery and affects approximately 10%-15% ofwomen who had just gave birth. During a period in whichwomen believe that they should be happy, the depressivemood experienced by most women leads to feelings ofguilt, hiding the symptoms, and postpartum depressionto be overlooked. Although the incidence of serious psychiatricdisorders during pregnancy is low, it is reportedthat the incidence shows a dramatic increase during thepostpartum period and this risky period may continue upto six months, one year or even two years.As the onset of postpartum depression is insidious it caneasily be overlooked if the patient’s seeking help is notsupported, especially when the severity of postpartum depressionis mild or moderate. In these cases, postpartumdepression may persist for a long time and at last it can beso severe that hospitalization would be needed. Therefore,early diagnose is very important and primary carephysicians and other health care workers should be alert.Postpartum Depression should be diagnosed using reliabledescriptive methods in puerperant women. Thescales such as Postnatal Depression Screening Scale,Beck Depression Inventory, Edinburgh Postnatal DepressionScale and State-Trait Anxiety Inventory, all of whichwere tested for validity and reliability in our country can beused during follow-up of pregnant and puerperal women.Key words: Postpartum depression, screening methods,primary health care professionals
Małus, Aleksandra; Szyluk, Justyna; Galińska-Skok, Beata; Konarzewska, Beata
The childbirth constitutes a significant event in a woman's life and in the marital/ couple dyad. The changes which follow childbirth require re-organization of previous coping styles and development of new methods of adaptation, which proves difficult. The current study evaluated to what extent the development of postpartum depression symptoms in new mothers was associated with their level of satisfaction in marital relationship. The study included 100 women in their first month after delivery. The women completed questionnaires regarding postpartum depression (Postpartum Depression Screening Scale) and marital relationship quality (Marital Compatibility Questionnaire). There was a significant correlation between the level of postpartum depression and relationship quality. A greater severity of postpartum depression symptoms (sleeping/ eating disturbances, anxiety/insecurity, emotional lability, mental confusion, loss of self, guilt/ shame, suicidal thoughts) occurred in women who were less satisfied with their relationship, i.e., those who experienced a decreased level of intimacy, self-fulfillment and partner similarity, as well as a deeper sense of disillusionment. Women who declared deeper satisfaction with their relationship displayed a greater sense of mental well-being. No correlation was found between the occurrence of postpartum depression and socio-demographic factors (age, education level, place of residence) and factors associated with the subjects' childbearing history (number of children, number of pregnancies, history of miscarriage, family planning, prior diagnosis of depression, type of delivery, newborn's condition following birth, infant feeding method). Patients dissatisfied with the quality of their marital relationship experienced an increased severity of postpartum depression symptoms. Greater satisfaction with relationship quality was expressed by women in formalized relationships.
Maternal supplementation with small-quantity lipid-based nutrient supplements during pregnancy and lactation does not reduce depressive symptoms at 6 months postpartum in Ghanaian women: a randomized controlled trial.
Okronipa, Harriet; Adu-Afarwuah, Seth; Lartey, Anna; Ashorn, Per; Vosti, Stephen A; Young, Rebecca R; Dewey, Kathryn G
We examined the impact on depression at 6 months postpartum of maternal supplementation with small-quantity lipid-based nutrient supplement (SQ-LNS) compared to supplementation with iron and folic acid (IFA) or multiple micronutrients (MMN). In this partially double-blinded randomized controlled trial, pregnant women ≤20 weeks gestation (n = 1320) were recruited from antenatal clinics and randomly assigned to receive either (1) SQ-LNS during pregnancy and for 6 months postpartum, or (2) IFA during pregnancy only, or (3) MMN during pregnancy and for 6 months postpartum. Maternal depressive symptoms were measured at 6 months postpartum using the Edinburgh Postnatal Depression Scale (EPDS). Women who scored 12 or more on the EPDS were considered to show symptoms of depression. One thousand one hundred fifty-one women were included in this analysis (LNS = 382, IFA = 387 and MMN = 382). Characteristics of the three groups were similar at baseline, and there were no significant differences between women who were included in the analysis (n = 1151) and those who were not (n = 169). At 6 months postpartum, 13% of the women overall showed symptoms of depression, and this did not differ by group (LNS = 13.1%, IFA = 11.2% and MMN = 14.7%. P = 0.36). The median (25, 75 percentile) EPDS score did not differ by group (LNS 4.0 (1.0, 8.0), IFA 4.0 (1.0, 8.0), MMN 5.0 (2.0, 9.0), P transformed = 0.13). Adjustment for covariates did not alter these findings. Maternal supplementation with SQ-LNS compared to MMN or IFA did not affect postnatal depressive symptoms in this sample of Ghanaian women.
Wedad Saad Al-Muhaish
Full Text Available Background: The relationship between breastfeeding and postpartum depression is bidirectional. Breastfeeding improves the maternal and neonatal health. There is now growing evidence that it might play a role in the prevention of postpartum depression. Objective: This study explores the relationship between breastfeeding and maternal postpartum depression. It also estimates the prevalence rate of postpartum depression among Saudi women. Methods: This is a cross-sectional study. Three-hundred postpartum women were recruited for this study from various hospitals in the Eastern Province of Saudi Arabia. Likelihood of depression was assessed using the Edinburgh Postpartum Depression Scale (EPDS. Socio-demographic data were collected as well as data regarding breastfeeding duration and intention to breastfeed. Data analysis was done using SPSS version 21, using parametric tests; independent t-test and One-Way ANOVA. Results: Postpartum mothers who intended to breast-feed their babies had a lower EPDS scores compared with those who did not intend to breast-feed. No correlation was found between the duration of breastfeeding and EPDS scores. Prevalence rate of postpartum depression in our sample was 14%. Greater age, having previous babies, intention to breastfeed and vaginal delivery were significantly associated with actual breastfeeding. Conclusion: Screening for mothers in the early postpartum period is essential to detect those who are at risk for postpartum depression. Breastfeeding may help to reduce and prevent the appearance of symptoms of depression. Prevalence rate of postpartum depression in Saudi Arabia, 14%, is similar to the worldwide rate.
Schwab-Reese, Laura M; Ramirez, Marizen; Ashida, Sato; Peek-Asa, Corinne
For new mothers returning to work, the role of the workplace psychosocial environment on maternal mental health has not been fully described. The purpose of this study was to identify the relationship between psychosocial employment characteristics and mothers' postpartum depression, anxiety, and stress symptoms. Ninety-seven women answered survey questions regarding employment, job demand, control, and support, and postpartum depression, anxiety, and stress symptoms soon after live birth and 6 months later. Working and nonworking mothers reported similar mental health symptoms. Psychological characteristics of employment were not associated with increased odds of mental health symptoms. Increased social support provided by coworkers, supervisors, and the organization was associated with reduced odds of anxiety symptoms. Our findings identified lack of workplace social support as a modifiable risk factor for postpartum anxiety. Future evaluations of workplace social support interventions may be explored to improve postpartum mental health symptoms. Am. J. Ind. Med. 60:109-120, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
Vogeli, Jo M; Hooker, Stephanie A; Everhart, Kevin D; Kaplan, Peter S
Accurate postpartum depression screening measures are needed to identify mothers with depressive symptoms both in the postpartum period and beyond. Because it had not been tested beyond the immediate postpartum period, the reliability and validity of the Postpartum Depression Screening Scale (PDSS) and its sensitivity, specificity, and predictive value for diagnoses of major depressive disorder (MDD) were assessed in a diverse community sample of 238 mothers of 4- to 15-month-old infants. Mothers (N = 238; M age = 30.2, SD = 5.3) attended a lab session and completed the PDSS, the Beck Depression Inventory-II (BDI-II), and a structured clinical interview (SCID) to diagnose MDD. The reliability, validity, specificity, sensitivity, and predictive value of the PDSS to identify maternal depression were assessed. Confirmatory factor analysis supported the construct validity of five but not seven content subscales. The PDSS total and subscale scores demonstrated acceptable to high reliability (α = 0.68-0.95). Discriminant function analysis showed the scale correctly provided diagnostic classification at a rate higher than chance alone. Sensitivity and specificity for major depressive disorder (MDD) diagnosis were good and comparable to those of the BDI-II. Even in mothers who were somewhat more diverse and had older infants than those in the original normative study, the PDSS appears to be a psychometrically sound screener for identifying depressed mothers in the 15 months after childbirth. © 2018 Wiley Periodicals, Inc.
Truijens, S.E.M.; Spek, V.R.M.; van Son, M.J.M.; Oei, S.G.; Pop, V.J.M.
Recently, the US Preventive Services Task Force has advocated to screen pregnant and postpartum women for depression. However, we questioned the meaning of a single elevated depression score: does it represent just one episode of depression or do these symptoms persist throughout the entire
Mar 22, 2018 ... 1Department of Psychology, ... The first weeks and months postpartum may be associated with emotional upheaval.2 The nursing ... partum depressive symptoms,14,15,16,17 and marital problems ... reported a significant positive association ... satisfaction, and the importance of mental health promotion.
Zheng, Xujuan; Morrell, Jane; Watts, Kim
There are many parenting problems during infancy for Chinese primiparous women. As an important determinant of good parenting, maternal self-efficacy (MSE) should be paid more attention by researchers. At present, the limitations of previous research examining MSE during infancy are that most studies were conducted with a homogeneous sample and there were few studies with Chinese women. Secondly, the trajectory of change in MSE, postnatal depression symptoms and social support for Chinese primiparous women was not clear during the initial postpartum period in earlier studies. This study aimed to describe changes in MSE, postnatal depression symptoms and social support among Chinese primiparous women in the first three months postnatally. A quantitative longitudinal study using questionnaires was conducted. Obstetric wards at three hospitals in Xiamen City, South-East China. In total, 420 Chinese primiparous women were recruited. Initial baseline questionnaires to measure socio-demographic and clinical characteristics at three days postnatally were distributed to participants face-to-face by the researcher on the postnatal ward. Follow-up questionnaires at six and 12 weeks postnatally were sent via e-mail by the researcher to participants, including the Self-efficacy in Infant Care Scale (SICS), the Edinburgh Postnatal Depression Scale (EPDS) and the Postpartum Social Support Scale (PSSS) to measure MSE, postnatal depression symptoms and social support, respectively. These were returned by participants via e-mail. Quantitative data were analysed using SPSS. The mean MSE score at six weeks postnatally was 74.92 (SD = 11.05), and increased to 77.78 (SD = 11.13) at 12 weeks postnatally. The mean social support scores at six and 12 weeks postnatally were 40.99 (SD = 9.31) and 43.00 (SD = 9.55). The mean EPDS scores decreased from 9.09 (SD = 4.33) at six weeks postnatally to 8.63 (SD = 4.40) at 12 weeks postnatally; the proportion of women with an
Place, Jean Marie S; Billings, Deborah L; Blake, Christine E; Frongillo, Edward A; Mann, Joshua R; deCastro, Filipa
In this article we describe the knowledge frameworks that 61 physicians, nurses, social workers, and psychologists from five public-sector health care facilities in Mexico used to conceptualize postpartum depression. We also demonstrate how providers applied social and behavioral antecedents in their conceptualizations of postpartum depression. Using grounded theory, we identify two frameworks that providers used to conceptualize postpartum depression: biochemical and adjustment. We highlight an emerging model of the function of social and behavioral antecedents within the frameworks, as well as the representation of postpartum depression by symptoms of distress and the perception among providers that these symptoms affected responsibilities associated with motherhood. The results provide a foundation for future study of how providers' conceptualizations of postpartum depression might affect detection and treatment practices and might be useful in the development of training materials to enhance the quality of care for women who experience any form of distress in the postpartum period. © The Author(s) 2014.
Crockenberg, Susan C; Leerkes, Esther M
Mothers (n = 92), fathers (n = 84), and their infants (60% male) participated in a longitudinal study of postpartum depression and maternal sensitivity. Mothers completed questionnaire measures of remembered parental acceptance, depressive symptoms, and infant distress to novelty and limits. Mothers and partners reported on marital aggression and avoidance. Maternal sensitivity was observed in the laboratory at 6 months. Characteristics of mothers, partners, and infants combined to predict postpartum depression and maternal sensitivity. Remembered parental rejection predicted postpartum depressive symptoms with prenatal depression controlled; self-esteem mediated this effect. Paternal acceptance buffered against postpartum depression when infants were highly reactive and when partners were aggressive. Paternal acceptance reduced the impact of postpartum depression on maternal sensitivity; having an aggressive marital partner exacerbated the effect.
Gauthreaux, Christina; Negron, Jenesis; Castellanos, Daniel; Ward-Peterson, Melissa; Castro, Grettel; Rodríguez de la Vega, Pura; Acuña, Juan Manuel
Postpartum depression (PPD) is a form of major depressive disorder affecting approximately 13% of women worldwide. Unintended pregnancies, reaching close to 50% of the pregnancies in the United States, have become a major health concern. While many physiologic and psychosocial causes have been analyzed, few studies have examined the relationship between unintended pregnancy and symptoms of PPD.A cross-sectional study was conducted using surveillance data from the Centers for Disease Control and Prevention's Pregnancy Risk Assessment Monitoring System (PRAMS) from 2009 to 2011. The PRAMS population-based random sample included women who have had recent live births and is representative of 78% of the United States population. The chi-squared test was used to examine bivariate associations. Binary logistic regression was utilized to study unadjusted and adjusted associations between PPD and pregnancy intendedness, as well as other demographic and clinical characteristics of mothers in the sample. Multicollinearity in the adjusted model was evaluated using variance inflation factors. Sampling weights were used to account for PRAMS' complex sampling design.Of the 110,231 mothers included in the sample, only 32.3% reported desiring the pregnancy at the time of conception. Women with pregnancies categorized as mistimed: desired sooner, mistimed: desired later, or unwanted were 20% (adjusted odds ratio [AOR] = 1.2; 95% confidence interval [CI]: 1.1-1.3), 30% (AOR = 1.3; 95% CI: 1.2-1.4), and 50% (AOR = 1.5; 95% CI: 1.3-1.7) more likely to experience symptoms of PPD, respectively, compared to women with desired pregnancies. Other factors found to be associated with experiencing symptoms of PPD were a gestational age of pregnancy (AOR = 1.6; 95% CI: 1.4-2.0).We found that women with mistimed or unwanted pregnancies were more likely to experience symptoms of PPD. Our findings support the current US Preventive Services Task Force and American Academy of
Nugent, J. Kevin; Bartlett, Jessica Dym; Valim, Clarissa
Relationship-based interventions are an effective means for reducing postpartum depression (PPD), but few cost-effective tools that can be administered efficiently in medical and home settings are available or well-studied. This study examines the efficacy of the Newborn Behavioral Observations (NBO), an infant-centered relationship-based…
Brummelte, Susanne; Galea, Liisa A M
This article is part of a Special Issue "Parental Care". Pregnancy and postpartum are associated with dramatic alterations in steroid and peptide hormones which alter the mothers' hypothalamic pituitary adrenal (HPA) and hypothalamic pituitary gonadal (HPG) axes. Dysregulations in these endocrine axes are related to mood disorders and as such it should not come as a major surprise that pregnancy and the postpartum period can have profound effects on maternal mood. Indeed, pregnancy and postpartum are associated with an increased risk for developing depressive symptoms in women. Postpartum depression affects approximately 10-15% of women and impairs mother-infant interactions that in turn are important for child development. Maternal attachment, sensitivity and parenting style are essential for a healthy maturation of an infant's social, cognitive and behavioral skills and depressed mothers often display less attachment, sensitivity and more harsh or disrupted parenting behaviors, which may contribute to reports of adverse child outcomes in children of depressed mothers. Here we review, in honor of the "father of motherhood", Jay Rosenblatt, the literature on postnatal depression in the mother and its effect on mother-infant interactions. We will cover clinical and pre-clinical findings highlighting putative neurobiological mechanisms underlying postpartum depression and how they relate to maternal behaviors and infant outcome. We also review animal models that investigate the neurobiology of maternal mood and disrupted maternal care. In particular, we discuss the implications of endogenous and exogenous manipulations of glucocorticoids on maternal care and mood. Lastly we discuss interventions during gestation and postpartum that may improve maternal symptoms and behavior and thus may alter developmental outcome of the offspring. Copyright © 2015 Elsevier Inc. All rights reserved.
Nakić Radoš, Sandra; Herman, Radoslav; Tadinac, Meri
The researchers' aim was to examine whether it was better to predict new-onset postpartum depression (PPD) during pregnancy or immediately after childbirth. A prospective study conducted in Croatia followed women (N = 272) from the third trimester of pregnancy through the early postpartum period (within the first 3 postpartum days), to 6 weeks postpartum. Questionnaires on depression, anxiety, stress, coping, self-esteem, and social support were administered. Through regression analyses we showed that PPD symptoms could be equally predicted by variables from pregnancy (30.3%) and the early postpartum period (34.0%), with a small advantage of PPD prediction in the early postpartum period.
Ahn, Sukhee; Corwin, Elizabeth J
Research suggests that exclusive breastfeeding may have a stress-protective role in postpartum depression; however, less is known about the underlying mechanisms by which this protection may occur or whether the protective relationship holds for women who mix breast and bottle feeding. To examine patterns of the stress response, inflammation, and depressive symptoms among women predominantly breastfeeding or bottle feeding their infants at 6 months postpartum. A part of a larger longitudinal study across 6 months postpartum investigating the psychoneuroimmunology (PNI) of postpartum depression. Prenatal clinics and community. One hundred nineteen postpartum women who met inclusion/exclusion criteria and followed up from the prenatal period to postpartum 6 months. Data were collected during seven home visits occurring during the 3rd trimester (weeks 32-36) and on postpartum days 7 and 14, months 1, 2, 3, and 6. Women completed stress and depression surveys and provided blood for pro- (IL-1β, IL-6, IL-8, TNF-a, IFN-γ) and anti-inflammatory (IL-10) cytokines, and collected saliva for diurnal cortisol. Self-report of predominant breastfeeding during 6 months postpartum ranged from 91.9% at day 7 to 70.6% at month 6 postpartum. There were no associations between the pattern of feeding and depressive symptoms. Biological differences, however, existed between the groups, with levels of salivary cortisol at 8 AM and 8:30 AM at month 6 higher and levels of IL-6 at month 6 lower in women who primarily breastfed compared to those who primarily bottle fed their infants after controlling for confounding variables. Breastfeeding was not related to postpartum depression however differences in stress and inflammatory markers are apparent at month 6 postpartum. Copyright © 2015 Elsevier Ltd. All rights reserved.
Posmontier, Bobbie; Waite, Roberta
Postpartum depression (PPD), a significant health problem affecting about 19.4% of postpartum women worldwide, may result in long-term cognitive and behavior problems in children, spousal depression, widespread family dysfunction, and chronic and increasingly severe maternal depression. Although current theoretical frameworks provide a rich context for studying PPD,none provides a framework that specifically addresses the dynamic relationship of the inner personal experience with the social and cultural context of PPD. The authors propose the social energy exchange theory for postpartum depression to understand how PPD impedes this dynamic relationship and suggest it as a theoretical framework for the study of interventions that would target intra- and interpersonal disturbance within the social and cultural context.
Whiffen, V E
A strong tradition exists in the psychiatric literature to consider postpartum depression a distinct diagnosis. However, the empirical evidence indicates that, in terms of etiology and relapse rates, postpartum depression is indistinguishable from non-postpartum depression. Symptomatically, postpartum depression seems to involve a milder disturbance, suggesting that it is best seen as an adjustment disorder. This paper summarizes the empirical evidence relevant to the distinct diagnosis quest...
Merkitch, Kristen G; Jonas, Katherine G; O'Hara, Michael W
The literature on the relative risk for depression in the postpartum period has largely focused on state (or episodic) depression, and has not addressed trait depression (a woman's general tendency to experience depressed mood). The present study evaluates the association between childbirth and depression in the postpartum period, taking into account the role of stable differences in women's vulnerability for depression across a 10-year span. Data from the National Longitudinal Survey of Youth 1997 Cohort (N = 4385) were used. The recency of childbirth was used as a predictor of state depression in two models: one that modeled stable depressive symptoms over time (a multi-state single-trait model; LST), and one that did not (an autoregressive cross-lagged model; ARM). Modeling trait depression, in addition to state depression, improved model fit and had the effect of increasing the magnitude of the association between childbirth and state depression in the postpartum period. The secondary nature of the data limited the complexity of analyses (e.g., models with multivariate predictors were not possible), as the data were not collected with the present study in mind. These findings may reflect the fact that some of the covariance between childbirth and episodic depression is obscured by the effect of trait depression, and it is not until trait depression is explicitly modeled that the magnitude of the relationship between childbirth and depression becomes clear. Copyright © 2017 Elsevier B.V. All rights reserved.
Ming, LI; Shinn-Yi, CHOU
The postpartum period is when a host of changes occur at molecular, cellular, physiological and behavioral levels to prepare female humans for the challenge of maternity. Alteration or prevention of these normal adaptions is thought to contribute to disruptions of emotion regulation, motivation and cognitive abilities that underlie postpartum mental disorders, such as postpartum depression. Despite the high incidence of this disorder, and the detrimental consequences for both mother and child, its etiology and related neurobiological mechanisms remain poorly understood, partially due to the lack of appropriate animal models. In recent decades, there have been a number of attempts to model postpartum depression disorder in rats. In the present review, we first describe clinical symptoms of postpartum depression and discuss known risk factors, including both genetic and environmental factors. Thereafter, we discuss various rat models that have been developed to capture various aspects of this disorder and knowledge gained from such attempts. In doing so, we focus on the theories behind each attempt and the methods used to achieve their goals. Finally, we point out several understudied areas in this field and make suggestions for future directions. PMID:27469254
Full Text Available The postpartum period is when a host of changes occur at molecular, cellular, physiological and behavioral levels to prepare female humans for the challenge of maternity. Alteration or prevention of these normal adaptions is thought to contribute to disruptions of emotion regulation, motivation and cognitive abilities that underlie postpartum mental disorders, such as postpartum depression. Despite the high incidence of this disorder, and the detrimental consequences for both mother and child, its etiology and related neurobiological mechanisms remain poorly understood, partially due to the lack of appropriate animal models. In recent decades, there have been a number of attempts to model postpartum depression disorder in rats. In the present review, we first describe clinical symptoms of postpartum depression and discuss known risk factors, including both genetic and environmental factors. Thereafter, we discuss various rat models that have been developed to capture various aspects of this disorder and knowledge gained from such attempts. In doing so, we focus on the theories behind each attempt and the methods used to achieve their goals. Finally, we point out several understudied areas in this field and make suggestions for future directions.
Conclusion: Women’s Job, husband’s job, wanted or unwanted pregnancy from husbands and marital period are associated to postpartum depression. In postpartum depression, TAC, AEA and 2-AG are reduced. So it can be concluded that both antioxidant system and endocannabinoid concentration involved in the development of postpartum depression.
Full Text Available Abeer A Alharbi,1 Hamza Mohammad Abdulghani2 1Department of Family and Community Medicine, 2Department of Medical Education, College of Medicine, King Saud University, Riyadh, Saudi Arabia Introduction: Postpartum depression (PPD is one of the major psychological disorders worldwide that affects both mother and child. The aim of this study was to correlate the risk of PPD with obstetric and demographic variables in Saudi females. Materials and methods: Data were collected by interviewing females 8–12 weeks postpartum. PPD symptoms were defined as present when subjects had an Edinburgh Postnatal Depression Scale score of 10 or higher. Variables included in this study were age, education, occupation, parity, baby's sex, pregnancy period, delivery type, hemoglobin level, anemia, and iron pills taken during pregnancy. Results: Of the 352 postpartum females, the prevalence of PPD symptom risk was 117 (33.2%. Among the PPD symptomatic females, 66 (39.8% had low hemoglobin levels, and 45 (40.5% females were anemic during pregnancy (P≤0.05. These results suggest that early postpartum anemia, indicated by low hemoglobin level, is a significant risk factor for PPD (adjusted odds ratio 1.70, 95% confidence interval 1.05–2.74; P=0.03. Other variables, including age, parity, education, occupation, and delivery type, were not significantly correlated (P=0.15–0.95, but marginally indicative of the risk of depressive symptoms. Conclusion: Low hemoglobin level and anemia during pregnancy were risk factors for PPD in Saudi females. Many other factors may be considered risk factors, such as age, occupation, and parity. Anemic women need more attention and to be checked regarding their PPD, and treated if necessary. Keywords: postpartum depression, hemoglobin level, anemia, EPDS
Check, J H; Jaffe, A
To determine if dextroamphetamine sulfate could improve symptoms of post-partum depression. A woman with severe post-partum depression that was resistant to standard antidepressant therapy and psychotherapy was treated with dextroamphetamine sulfate extended release capsules 15 mg/day. A quick and complete abrogation of the depression ensued along with improvement of migraine headaches, insomnia, and chronic fatigue. Dextr6amphetamine sulfate should be considered as a treatment modality for post-partum depression.
Callister, Lynn Clark; Beckstrand, Renea L; Corbett, Cheryl
The purpose of this article is to describe what the literature has shown about postpartum depression (PPD) in culturally diverse women. The majority of qualitative studies done with women identified as having PPD have been conducted with Western women, with the second largest group focusing on Chinese women. This article reviews the qualitative studies in the literature and discusses how the management of PPD in technocentric and ethnokinship cultures differs. Social support has been shown to be significantly related to fewer symptoms of PPD, and culturally prescribed practices may or may not be cultural mediators in decreasing the incidence of PPD. Nurses should be sensitive to the varied ways in which culturally diverse women perceive, explain, and report symptoms of PPD. Exemplary interventions for culturally diverse women suffering from PPD are examined in this article as well, although it is clear that additional research is needed to develop models for culturally competent interventions for PPD in culturally diverse women and to document the outcomes of such interventions.
Birkeland, Robyn; Thompson, J. Kevin; Phares, Vicky
Adolescent mothers undergo unique personal and social challenges that may contribute to postpartum functioning. In this exploratory investigation completed within a risk and resilience framework, 149 adolescent mothers, ages 15 to 19, who participated in school-based teen parents' programs, completed measures of parental stress (social isolation…
Milena da Rosa Silva
Full Text Available Given the specificities of postpartum maternal depression, the literature recommends that fathers become involved in psychological interventions within this context. This study presents an investigation of the participation of fathers in parent-infant psychotherapy in the context of maternal postpartum depression. Two families participated in this study, both with a child aged between 7 and 8 months old, whose mothers showed depressive symptoms. These families participated in parent-infant psychotherapy lasting approximately 12 sessions. Analysis of the fathers’ participation in psychotherapy showed that their presence during sessions enables the therapy to address aspects of parenthood, and also reduce the feeling of mothers as being the only ones responsible for the family’s process of change. In regard to the technique, the presence of fathers during sessions allows the therapist to see and address the issues concerning mother-father-infant during sessions.
Anna de Magistris
Full Text Available Background: Numerous studies have shown that postpartum depression is a phenomenon that develops in a family, social and economic context capable of influencing its course. A predominant role in the onset of the pathology is played by the relationship of the couple, but up to now few studies have been carried out on the role of the partner of the depressed mother and on the interactions between the two partners, that is, on how maternal depression influences the behaviour of the male partner and is in turn influenced, and how the depression of both parents, and not only that of the mother, influences the neuropsychic development of the child and the interactions between the child and the outside world. Objectives: The objectives are to examine the literature to arrive at an understanding of how the father figure develops during the pregnancy and how postpartum depression impacts on the couple’s relationship and the care of the children by both partners. Materials and methods: This article presents a review of recent literature on the subject through a search for articles in Pubmed and Sciencedirect (keywords: men, postpartum depression, fathers, couple, prediction, detection, and by referring to classic texts in the fields of psychiatry and psychotherapy on the development of the parental figures. Conclusions: Although up to now the literature on the consequences of postpartum depression on the couple is scanty, the data collected allow us to affirm that it is not a problem that concerns only the mother, but one that has an impact on the entire family, on the child and the partner, triggering a chain reaction of maladjustment and distress that may lead to separation and destruction of the family unit with important repercussions on society as a whole.
Factores psicosociales asociados a un alto, medio y bajo riesgo de síntomas depresivos en el posparto inmediato Psychosocial factors associated to low, medium and high risk of depressive symptoms in the immediate postpartum period
Cynthia Inés Paolini
Full Text Available OBJETIVOS: evaluar factores psicosociales asociados a síntomas depresivos en el posparto inmediato. MÉTODOS: 45 mujeres puérperas de un hospital público de Buenos Aires, Argentina, fueron entrevistadas entre el 1er y el 3er día posparto, de marzo-diciembre 2010. La Escala de Depresión Posnatal de Edimburgo (EPDS fue administrada para evaluar síntomas depresivos. La entrevista psicológica perinatal (EPP fue administrada para detectar variables psicosociales. A partir de los resultados obtenidos en la EPDS, se separó la muestra en tres grupos con diferentes grados de riesgo de sintomatología depresiva: "negativas o de bajo riesgo", "positivas de riesgo medio" y "positivas de alto riesgo". Los puntajes de corte utilizados fueron 9 y 19. RESULTADOS: se encontraron diferencias significativas entre los tres grupos con violencia familiar, migración, historia previa de depresión, presencia de síntomas depresivos durante el embarazo y mayor cantidad de estresores. CONCLUSIONES: el establecimiento de los dos puntajes de corte en la EPDS permite una detección temprana de las mujeres que presentan síntomas depresivos. Se sugiere la utilidad del puntaje de corte de 19 para la detección temprana de mujeres con mayor riesgo de desarrollar depresión posparto.OBJECTIVES: evaluate psychosocial factors associated to depressive symptoms during the immediate postpartum period. METHODS: a total of 45 argentine puerperal women hospitalized in a public maternal hospital of Buenos Aires, Argentina, were interviewed on the 1st and 3rd day postpartum from March to December 2010. Aiming to assess the presence of depressive symptoms, the Edinburgh Postnatal Depression Scale (EPDS was administrated. The Perinatal Psychological Interview was administrated to explore psychosocial variables. Based on the scores obtained in the EPDS, the sample was separated in three different groups with increasing risk of depressive symptomatology: "negative or low risk
Nagy, Emese; Molnar, Peter; Pal, Attila; Orvos, Hajnalka
The rapid socioeconomic transition in post-communist Hungary adversely affected the overall morbidity and mortality rates in the 1990s. Prevalence data on depressive disorders from the region are still scarce, however. This study reports the findings of the first epidemiological survey, using the Edinburgh Postnatal Depression Scale (EPDS) and the Beck Depression Inventory (BDI), on the prevalence of post-partum depression and the associated risk factors in Hungary. A total of 1030 mothers who delivered their babies between May and July 1999 in 16 counties in Hungary were screened for depressive symptoms 3-26 weeks post-partum. The survey found that 10.81% of the sample was above the cut-off score of 13, and the EPDS detected post-partum depressive symptoms with 76% (95% confidence interval (CI)=60.5-87.1) sensitivity and 92% (95% CI=90.5-94.1) specificity. In addition, 24 socio-demographic, socio-psychiatric data and personal and obstetric variables were surveyed. Results of a hierarchical logistic regression analysis showed that depression of the mother during pregnancy was the strongest predictor of depressive symptoms post-partum. Depression before pregnancy, housing conditions, marital relationship status and family history of alcohol problems were also identified as predictors for post-partum depressive symptoms. Copyright © 2010 Elsevier Ltd. All rights reserved.
Comasco, Erika; Gulinello, Maria; Hellgren, Charlotte; Skalkidou, Alkistis; Sylven, Sara; Sundström-Poromaa, Inger
The postpartum period is characterized by a post-withdrawal hormonal status, sleep deprivation, and susceptibility to affective disorders. Postpartum mothering involves automatic and attentional processes to screen out new external as well as internal stimuli. The present study investigated sensorimotor gating in relation to sleep duration, depression, as well as catecholaminergic and oxytocinergic genotypes in postpartum women. Prepulse inhibition (PPI) of the startle reflex and startle reactivity were assessed two months postpartum in 141 healthy and 29 depressed women. The catechol-O-methyltransferase (COMT) Val158Met, and oxytocin receptor (OXTR) rs237885 and rs53576 polymorphisms were genotyped, and data on sleep duration were collected. Short sleep duration (less than four hours in the preceding night) and postpartum depression were independently associated with lower PPI. Also, women with postpartum depression had higher startle reactivity in comparison with controls. The OXTR rs237885 genotype was related to PPI in an allele dose-dependent mode, with T/T healthy postpartum women carriers displaying the lowest PPI. Reduced sensorimotor gating was associated with sleep deprivation and depressive symptoms during the postpartum period. Individual neurophysiological vulnerability might be mediated by oxytocinergic genotype which relates to bonding and stress response. These findings implicate the putative relevance of lower PPI of the startle response as an objective physiological correlate of liability to postpartum depression. Copyright © 2016 Elsevier B.V. and ECNP. All rights reserved.
Helmich, Rick C. G.; van Laarhoven, Hanneke W. M.; Schoonderwaldt, Hennie C.; Janssen, Mirian C. H.
Rhabdomyolysis and peripheral neuropathy are two distinct disease entities which are rarely encountered in combination. We present a woman with rhabdomyolysis and peripheral neuropathy 3 weeks postpartum. Her symptoms were caused by bilateral femoral artery thrombosis due to postpartum
Zaers, Stefanie; Waschke, Melanie; Ehlert, Ulrike
This study examined the course of psychological problems in women from late pregnancy to six months postpartum, the rates of psychiatric, especially depressive and post-traumatic stress symptoms and possible related antecedent variables. During late pregnancy, one to three days postpartum, six weeks and six months postpartum, 47 of the 60 participating women completed a battery of questionnaires including the General Health Questionnaire, the State-Trait Anxiety Inventory, the Edinburgh Postnatal Depression Scale, and the PTSD Symptom Scale. In general, most women recovered from psychiatric and somatic problems over the period of investigation. However, depressive and post-traumatic stress symptoms in particular were not found to decline significantly. Six weeks postpartum, 22% of the women had depressive symptoms, with this figure remaining at 21.3% six months postpartum. In addition, 6% of the women studied reported clinically significant PTSD symptoms at six weeks postpartum with 14.9% reporting such symptoms at six months postpartum. The most important predictor for depressive and post-traumatic stress symptoms was the block variable "anxiety in late pregnancy". Other predictors were the variables "psychiatric symptoms in late pregnancy", "critical life events" and the "experience of delivery". The results of our study show a high prevalence rate of psychiatric symptoms in women after childbirth and suggest, besides the experience of the delivery itself, a vulnerability or predisposing history that makes the development of psychiatric symptoms after childbirth more probable.
Sylvén, S M; Thomopoulos, T P; Kollia, N; Jonsson, M; Skalkidou, A
Postpartum depression (PPD) is a common disorder after childbirth. The strongest known predictors are a history of depression and/or a history of PPD. However, for a significant proportion of women, PPD constitutes their first depressive episode. This study aimed to gain further insight into the risk factors for PPD in first time mothers without previous psychiatric contact. Women delivering in Uppsala University Hospital, Sweden, from May 2006 to June 2007, were asked to participate and filled out questionnaires five days and six weeks postpartum, containing inter alia the Edinburgh Postnatal Depression Scale (EPDS). Univariate logistic regression models, as well as a path analysis, were performed to unveil the complex interplay between the study variables. Of the 653 participating primiparas, 10.3% and 6.4% reported depressive symptoms (EPDS≥12 points) five days and six weeks postpartum, respectively. In the path analysis, a positive association between anxiety proneness and depressive symptoms at five days and six weeks postpartum was identified. For depressive symptoms six weeks after delivery, additional risk factors were detected, namely depressive symptoms five days postpartum and subjective experience of problems with the baby. Caesarean section and assisted vaginal delivery were associated with fewer depressive symptoms at 6 six weeks postpartum. Identification of anxiety proneness, delivery mode and problems with the baby as risk factors for self-reported depressive symptoms postpartum in this group of primiparas can be important in helping health care professionals identify women at increased risk of affective disorders in the perinatal period, and provide a base for early intervention. Copyright Â© 2016 Elsevier Masson SAS. All rights reserved.
Michelle P. Judge
Conclusions: Women in the DHA intervention group had fewer symptoms of postpartum depression compared to the placebo group. These results support the notion that the consumption of DHA by pregnant women can be efficacious in preventing depressive symptoms and highlight a need for further larger-scale investigations using the PDSS in tandem with a diagnostic evaluation.
Bolak Boratav, Hale; Toker, Özlem; Küey, Levent
The postpartum period is a window of risk for psychological disturbances and particularly for depressive symptoms. This study explored the relationships between postpartum depression and prepartum depressive symptoms, marital adjustment, support from family, previous depressive symptomology, and pregnancy planning. A total of 128 women who were receiving prenatal care at a state hospital in Istanbul, Turkey, and who were in the last trimester of their pregnancy participated in the first phase of the study. Of these, eighty-seven women also participated in the second phase, during the 3-6 month postpartum period. The results indicated that depressed mood in the last trimester of pregnancy, family support, care and support from spouse, previous depression history, and unplanned pregnancy were significant risk factors for postpartum depressive symptoms; significant differences were found for study variables as a function of women's scores on the Edinburgh Postnatal Depression Scale in pregnancy and in the postpartum period. The recommendation is made to use screening tools, like the Edinburgh Postnatal Depression Scale, in the course of routine prenatal care, and to refer women with Edinburgh Postnatal Depression Scale scores above the cutoff score for further clinical examination.
Ellsworth-Bowers, E. R.; Corwin, E. J.
Postpartum depression (PPD) is a relatively common and often severe mood disorder that develops in women after childbirth. The aetiology of PPD is unclear, although there is emerging evidence to suggest a psychoneuroimmune connection. Additionally, deficiencies in n-3 PUFA, B vitamins, vitamin D and trace minerals have been implicated. This paper reviews evidence for a link between micronutrient status and PPD, analysing the potential contribution of each micronutrient to psychoneuroimmunolog...
Séjourné, N; Beaumé, M; Vaslot, V; Chabrol, H
The aim of this study was to explore the role of the paternity leave in the appearance of the maternal postpartum depression. Fifty-one couples took part in the whole study. Between the second and the fifth day after the childbirth, the mother completed the Edinburgh Postnatal Depression Scale (EPDS), which measures the symptoms of depression and the Multidimensional Scale of Perceived Social Support (MSPSS) which measures the social support the mother has become. The father completed the EPDS. Two months and then the second time four months after the childbirth, the mother received the EPDS, the MSPSS, and questionnaires measuring the temperament of the baby, the maternal skills, the feeling of being a mother and the quality of life postpartum. In order to evaluate the paternal involvement, the father completed the EPDS and questions about paternal skills and involvement. The paternity leave seemed not to have any consequences on the results at the EPDS or other questionnaires. However, lack of paternal involvement was a significant predictor of the intensity of the depressive symptoms of the mothers. It is not the presence of the father wich seems important to take into account for detection and the traitement of postpatum depression but his participation in the care of the baby. Copyright © 2011 Elsevier Masson SAS. All rights reserved.
Abdollahi, Fatemeh; Rezai Abhari, Farideh; Zarghami, Mehran
While studies have shown the disastrous effects of post-partum depression (PPD) on children's behaviors, there is relatively lack of reliable data in Asian countries. This study examined the relative significance of maternal PPD in children's developmental disabilities at age four. In a longitudinal study design (2009), 1801 pregnant women attending in primary health centers of Mazandaran province in the north of Iran provided self-reports of depression from two to twelve postpartum weeks using Edinburgh Postnatal Depression Scale (EPDS). Approximately four years later, the women experiencing PPD and twice as the ones who did not experience this disorder were considered as case (N=204) and control (N=467) groups. The association between maternal depression at different times and childhood developmental disabilities based on Ages and Stages Questionnaire (ASQ) and other health problems reported by the child were analyzed using two-sample t-test, chi-square test, and logistic regression models. The presence of PPD only was not a predictor of child's developmental disabilities at age four. Childhood developmental disabilities in communication, gross motor and personal-social domains of ASQ were associated with the current and concurrent maternal depressive symptoms (OR=2.59, 95% CI=1.16-5.78; OR=4.34, 95% CI=2.10-8.96; OR=5.66, 95% CI=1.94-16.54 and OR=3.35, 95% CI=1.31-8.58; OR=4.15, 95% CI=2.72-13.87; OR=6.17, 95% CI=1.95-19.53 respectively). PPD, the current depressive symptoms, and depression at both occasions were associated with more health problems in children. Childhood developmental disabilities in some domains of ASQ were significantly related to the maternal depression chronicity or recurrence. Also, child's difficulties were more prevalent in association with maternal depression regardless of onset time.
Full Text Available While studies have shown the disastrous effects of post-partum depression (PPD on children's behaviors, there is relatively lack of reliable data in Asian countries. This study examined the relative significance of maternal PPD in children's developmental disabilities at age four. In a longitudinal study design (2009, 1801 pregnant women attending in primary health centers of Mazandaran province in the north of Iran provided self-reports of depression from two to twelve postpartum weeks using Edinburgh Postnatal Depression Scale (EPDS. Approximately four years later, the women experiencing PPD and twice as the ones who did not experience this disorder were considered as case (N=204 and control (N=467 groups. The association between maternal depression at different times and childhood developmental disabilities based on Ages and Stages Questionnaire (ASQ and other health problems reported by the child were analyzed using two-sample t-test, chi-square test, and logistic regression models. The presence of PPD only was not a predictor of child's developmental disabilities at age four. Childhood developmental disabilities in communication, gross motor and personal-social domains of ASQ were associated with the current and concurrent maternal depressive symptoms (OR=2.59, 95% CI=1.16-5.78; OR=4.34, 95% CI=2.10-8.96; OR=5.66, 95% CI=1.94-16.54 and OR=3.35, 95% CI=1.31-8.58; OR=4.15, 95% CI=2.72-13.87; OR=6.17, 95% CI=1.95-19.53 respectively. PPD, the current depressive symptoms, and depression at both occasions were associated with more health problems in children. Childhood developmental disabilities in some domains of ASQ were significantly related to the maternal depression chronicity or recurrence. Also, child's difficulties were more prevalent in association with maternal depression regardless of onset time.
Full Text Available Abstract Background Maternal depression during pregnancy has been studied less than depression in postpartum period. The aims of this study were to find out the prevalence of prepartum and postpartum depression and the risk factors associated in a cohort of Afro-Jamaican pregnant women in Jamaica. Methods The Zung self-rating depression scale instrument was administered to 73 healthy pregnant women at 28 weeks gestation and at 6 weeks postpartum for quantitative measurement of depression. Blood samples were collected at 8, 28, 35 weeks gestation and at day 1 and 6 weeks postpartum to study the thyroid status. Results Study demonstrated depression prevalence rates of 56% and 34% during prepartum and postpartum period, respectively. 94% women suffering depression in both periods were single. There were significant variations in both FT3 and TT4 concentrations which increased from week 8 to week 28 prepartum (p th week (p 3, TT4 and TSH there were no significant between group differences in concentrations. The major determinants of postpartum depression were moderate and severe prepartum depression and change in TT4 hormone concentrations. Conclusion High prevalence of depression was found during pre- and postpartum periods. Single mothers, prepartum depression and changes in TT4 were factors found to be significantly associated with postpartum depression.
Corwin, Elizabeth J; Pajer, Kathleen; Paul, Sudeshna; Lowe, Nancy; Weber, Mary; McCarthy, Donna O
More than 500,000 U.S. women develop postpartum depression (PPD) annually. Although psychosocial risks are known, the underlying biology remains unclear. Dysregulation of the immune inflammatory response and the hypothalamic-pituitary-adrenal (HPA) axis are associated with depression in other populations. While significant research on the contribution of these systems to the development of PPD has been conducted, results have been inconclusive. This is partly because few studies have focused on whether disruption in the bidirectional and dynamic interaction between the inflammatory response and the HPA axis together influence PPD. In this study, we tested the hypothesis that disruption in the inflammatory-HPA axis bidirectional relationship would increase the risk of PPD. Plasma pro- and anti-inflammatory cytokines were measured in women during the 3rd trimester of pregnancy and on Days 7 and 14, and Months 1, 2, 3, and 6 after childbirth. Saliva was collected 5 times the day preceding blood draws for determination of cortisol area under the curve (AUC) and depressive symptoms were measured using the Edinburgh Postpartum Depression Survey (EPDS). Of the 152 women who completed the EPDS, 18% were depressed according to EDPS criteria within the 6months postpartum. Cortisol AUC was higher in symptomatic women on Day 14 (p=.017). To consider the combined effects of cytokines and cortisol on predicting symptoms of PPD, a multiple logistic regression model was developed that included predictors identified in bivariate analyses to have an effect on depressive symptoms. Results indicated that family history of depression, day 14 cortisol AUC, and the day 14 IL8/IL10 ratio were significant predictors of PPD symptoms. One unit increase each in the IL8/IL10 ratio and cortisol AUC resulted in 1.50 (p=0.06) and 2.16 (p=0.02) fold increases respectively in the development of PPD. Overall, this model correctly classified 84.2% of individuals in their respective groups. Findings
Alexander C Tsai
Full Text Available Violence against women by intimate partners remains unacceptably common worldwide. The evidence base for the assumed psychological impacts of intimate partner violence (IPV is derived primarily from studies conducted in high-income countries. A recently published systematic review identified 13 studies linking IPV to incident depression, none of which were conducted in sub-Saharan Africa. To address this gap in the literature, we analyzed longitudinal data collected during the course of a 3-y cluster-randomized trial with the aim of estimating the association between IPV and depression symptom severity.We conducted a secondary analysis of population-based, longitudinal data collected from 1,238 pregnant women during a 3-y cluster-randomized trial of a home visiting intervention in Cape Town, South Africa. Surveys were conducted at baseline, 6 mo, 18 mo, and 36 mo (85% retention. The primary explanatory variable of interest was exposure to four types of physical IPV in the past year. Depression symptom severity was measured using the Xhosa version of the ten-item Edinburgh Postnatal Depression Scale. In a pooled cross-sectional multivariable regression model adjusting for potentially confounding time-fixed and time-varying covariates, lagged IPV intensity had a statistically significant association with depression symptom severity (regression coefficient b = 1.04; 95% CI, 0.61-1.47, with estimates from a quantile regression model showing greater adverse impacts at the upper end of the conditional depression distribution. Fitting a fixed effects regression model accounting for all time-invariant confounding (e.g., history of childhood sexual abuse yielded similar findings (b = 1.54; 95% CI, 1.13-1.96. The magnitudes of the coefficients indicated that a one-standard-deviation increase in IPV intensity was associated with a 12.3% relative increase in depression symptom severity over the same time period. The most important limitations of our study
Lin, Ping-Zhen; Xue, Jiao-Mei; Yang, Bei; Li, Meng; Cao, Feng-Lin
Previous studies have reported different effect sizes for self-help interventions designed to reduce postpartum depression symptoms; therefore, a comprehensive quantitative review of the research was required. A meta-analysis was conducted to examine the effectiveness of self-help interventions designed to treat and prevent postpartum depression, and identified nine relevant randomized controlled trials. Differences in depressive symptoms between self-help interventions and control conditions, changes in depressive symptoms following self-help interventions, and differences in postintervention recovery and improvement rates between self-help interventions and control conditions were assessed in separate analyses. In treatment trials, depression scores continued to decrease from baseline to posttreatment and follow-up assessment in treatment subgroups. Changes in treatment subgroups' depression scores from baseline to postintervention assessment were greater relative to those observed in prevention subgroups. Self-help interventions produced larger overall effects on postpartum depression, relative to those observed in control conditions, in posttreatment (Hedges' g = 0.51) and follow-up (Hedges' g = 0.32) assessments; and self-help interventions were significantly more effective, relative to control conditions, in promoting recovery from postpartum depression. Effectiveness in preventing depression did not differ significantly between self-help interventions and control conditions.The findings suggested that self-help interventions designed to treat postpartum depression reduced levels of depressive symptoms effectively and decreased the risk of postpartum depression.
Choi, Karmel W; Sikkema, Kathleen J; Vythilingum, Bavi; Geerts, Lut; Faure, Sheila C; Watt, Melissa H; Roos, Annerine; Stein, Dan J
Women who have experienced childhood trauma may be at risk for postpartum depression, increasing the likelihood of negative outcomes among their children. Predictive pathways from maternal childhood trauma to child outcomes, as mediated by postpartum depression, require investigation. A longitudinal sample of South African women (N=150) was followed through pregnancy and postpartum. Measures included maternal trauma history reported during pregnancy; postpartum depression through six months; and maternal-infant bonding, infant development, and infant physical growth at one year. Structural equation models tested postpartum depression as a mediator between maternal experiences of childhood trauma and children's outcomes. A subset of women (N=33) also participated in a lab-based emotional Stroop paradigm, and their responses to fearful stimuli at six weeks were explored as a potential mechanism linking maternal childhood trauma, postpartum depression, and child outcomes. Women with childhood trauma experienced greater depressive symptoms through six months postpartum, which then predicted negative child outcomes at one year. Mediating effects of postpartum depression were significant, and persisted for maternal-infant bonding and infant growth after controlling for covariates and antenatal distress. Maternal avoidance of fearful stimuli emerged as a potential affective mechanism. Limitations included modest sample size, self-report measures, and unmeasured potential confounders. Findings suggest a mediating role of postpartum depression in the intergenerational transmission of negative outcomes. Perinatal interventions that address maternal trauma histories and depression, as well as underlying affective mechanisms, may help interrupt cycles of disadvantage, particularly in high-trauma settings such as South Africa. Copyright © 2017. Published by Elsevier B.V.
Dørheim, Signe K.; Bjorvatn, Bjørn; Eberhard-Gran, Malin
Background Insomnia and depression are strongly interrelated. This study aimed to describe changes in sleep across childbirth, and to evaluate whether insomnia in pregnancy is a predictor of postpartum depression. Methods A longitudinal, population-based study was conducted among perinatal women giving birth at Akershus University Hospital, Norway. Women received questionnaires in weeks 17 and 32 of pregnancy and eight weeks postpartum. This paper presents data from 2,088 of 4,662 women with complete data for insomnia and depression in week 32 of pregnancy and eight weeks postpartum. Sleep times, wake-up times and average sleep durations were self-reported. The Bergen Insomnia Scale (BIS) was used to measure insomnia. The Edinburgh Postnatal Depression Scale (EPDS) was used to measure depressive symptoms. Results After delivery, sleep duration was reduced by 49 minutes (to 6.5 hours), and mean sleep efficiency was reduced from 84% to 75%. However, self-reported insomnia scores (BIS) improved from 17.2 to 15.4, and the reported prevalence of insomnia decreased from 61.6% to 53.8%. High EPDS scores and anxiety in pregnancy, fear of delivery, previous depression, primiparity, and higher educational level were risk factors for both postpartum insomnia and depression. Insomnia did not predict postpartum depression in women with no prior history of depression, whereas women who recovered from depression had residual insomnia. Limitations Depression and insomnia were not verified by clinical interviews. Women with depressive symptoms were less likely to remain in the study. Conclusions Although women slept fewer hours at night after delivery compared to during late pregnancy, and reported more nights with nighttime awakenings, their self-reported insomnia scores improved, and the prevalence of insomnia according to the DSM-IV criteria decreased. Insomnia in pregnancy may be a marker for postpartum recurrence of depression among women with previous depression. PMID
Gjerdingen, Dwenda; McGovern, Patricia; Attanasio, Laura; Johnson, Pamela Jo; Kozhimannil, Katy Backes
The purpose of this study was to characterize the relationship between maternal depressive symptoms and employment and whether it is mediated by social support. We used data from a nationally representative sample of 700 US women who gave birth in 2005 and completed 2 surveys in the Listening to Mothers series, the first in early 2006, an average of 7.3 months postpartum, and the second an average of 13.4 months postpartum. A dichotomous measure of depressive symptoms was calculated from the 2-item Patient Health Questionnaire, and women reported their employment status and levels of social support from partners and others. We modeled the association between maternal employment and depressive symptoms using multivariate logistic regression, including social support and other control variables. Maternal employment and high support from a nonpartner source were both independently associated with significantly lower odds of depressive symptoms (adjusted odds ratio [AOR], 0.35 and P = .011, and AOR, 0.40, P = .011, respectively). These relationships remained significant after controlling for mothers' baseline mental and physical health, babies' health, and demographic characteristics (AOR, 0.326 and P = .015, and AOR, 0.267 and P = .025, respectively). Maternal employment and strong social support, particularly nonpartner support, were independently associated with fewer depressive symptoms. Clinicians should encourage mothers of young children who are at risk for depression to consider ways to optimize their employment circumstances and "other" social support.
S Hairston, Ilana; E Handelzalts, Jonathan; Assis, Chen; Kovo, Michal
Despite decades of research demonstrating the role of adult attachment styles and early mother-infant bonding in parenting behaviors and maternal mental health, these constructs have seldom been studied together. The present study aimed to investigate the relationship between attachment styles and specific bonding difficulties of mothers. In addition, as postpartum depression and childbirth-related posttraumatic stress symptoms have been associated with both constructs, we explored their possible mediation effect. One hundred fourteen mothers, 4 to 12 weeks' postpartum, completed a demographic questionnaire, the Adult Attachment Style Questionnaire (M. Mikulincer, V. Florian, & A. Tolmacz, 1990), the Postpartum Bonding Questionnaire (L.F. Brockington, C. Fraser, & D. Wilson, 2006), the Modified Perinatal Posttraumatic Stress Disorder Questionnaire (J.L. Callahan, S.E. Borja, & M.T. Hynan, 2006), and the Edinburgh Postnatal Depression Scale (J.L. Cox, G. Chapman, D. Murray, & P. Jones, 1996), using an online survey system. As predicted, insecure attachment styles were associated with bonding difficulties wherein anxious/ambivalent attachment was associated with greater infant-focused anxiety, mediated by postpartum depression but not childbirth-related PTSD symptoms. In contrast, greater avoidant attachment style was associated with greater rejection and anger, mediated by childbirth-related posttraumatic stress disorder (PTSD), but not depression symptoms. The current study confirmed the association of different attachment styles with bonding as well as the mediating roles of childbirth-related PTSD and postpartum depression symptoms. Future psychological interventions may utilize such evidence to target interventions for bonding disorders in accordance with individual differences. © 2018 Michigan Association for Infant Mental Health.
Kammerer, Martin; Marks, Maureen N; Pinard, Claudia; Taylor, Alyx; von Castelberg, Brida; Künzli, Hansjörg; Glover, Vivette
Pregnancy and the postpartum may affect symptoms of depression. However it has not yet been tested how the symptoms used for the DSM IV diagnosis of depression discriminate depressed from non depressed women perinatally. A modified version of the Structured Clinical Interview for DSM IV (SCID interview) was used that allowed assessment of all associated DSM IV symptoms of depression with depressed and non depressed women in pregnancy and the postpartum period. Loss of appetite was not associated with depression either ante or postnatally. The antenatal symptom pattern was different from the postnatal. The sensitivity of the symptoms ranged from 0.7% to 51.6%, and specificity from 61.3% to 99.1%. The best discriminating symptoms were motor retardation/agitation and concentration antenatally, and motor retardation/agitation, concentration and fatigue postnatally. Depression in pregnancy and postpartum depression show significantly different symptom profiles. Appetite is not suitable for the diagnosis of depression in the perinatal period.
Lewis, Carol A.; Byers, Alison Daly; Malard, Sarah Deann; Dawson, Gregory A.
With recent media attention and a growing awareness in popular culture, the appropriate treatment for postpartum depression has taken center stage as a prevalent women's health issue. There is little agreement on the definition, existence and treatment of postpartum depression. Contributing to this factor is the lack of research that exists to…
Background: Postpartum depression is a common and disabling disorder seen in new mothers having many deleterious effects on the new mother, the new infant, the father, the family and the society at large. This study determined the prevalence and socio-demographic correlates of postpartum depression among new ...
Context: Postpartum depression adversely affects mothers, their newborn infants, their partners and the society. Its timely diagnosis is highly desirable. Objective: To assess the prevalence and associated sociodemographic variables of Postpartum depression among women of Igbo Ethnic origin attending an urban mission ...
Albuja, Analia F; Lara, M Asunción; Navarrete, Laura; Nieto, Lourdes
Women who lack social support tend to have a higher risk of postpartum depression. The present study examined the traditional female role, understood here as the adoption of passive and submissive traits specific to Mexican women, as another risk factor for postpartum depressive symptomatology that interacts with social support. Using two waves of data from a longitudinal study of 210 adult Mexican women (20-44 years-old, M age = 29.50 years, SD = 6.34), we found that lacking social support during the third trimester of their pregnancy was associated with greater depressive symptoms at 6 months in the postpartum, although this relationship depended on the level of endorsement of the traditional female role during pregnancy. Lower social support during pregnancy predicted greater postpartum depressive symptoms for women with higher endorsement of the traditional female role, even when accounting for prenatal depressive symptoms. These results suggest that Mexican women's experience of social support may depend on their individual adherence to gender roles. Understanding the association between women's traditional roles and social support in the risk for postpartum depression can improve prevention and educational programs for women at risk.
Amankwaa, Linda Clark
The purpose of this qualitative study was to describe the nature of postpartum depression (PPD) among African-American women. Twelve women, who had experienced PPD within the last three years, were interviewed for approximately one hour at two intervals. Nudist-4 software and the constant comparative method were used to analyze the data. Five themes "Stressing Out," "Feeling Down," "Losing It," "Seeking Help," and "Feeling Better" represented aspects of PPD as experienced by the participants. The last theme, "Dealing with It," represented the cultural ways in which African-American mothers managed their depression. These included Keeping the Faith, Trying to Be a Strong Black Woman, Living with Myths, and Keeping Secrets. Suggestions for future directions in nursing research are included.
Full Text Available AbstractAbstractObjectives: This study examined what percentage of Chinese mothers during a three-year postpartum period were screened for postpartum depression and explored the correlation between postpartum depression and various socio-demographic, psychological, and cultural factors. Study design: Cross-sectional survey.Methods: A total of 506 mothers 23 years of age and older who were within three years postpartum completed the online survey. The survey collected information such as family economic status, a history of depression, preparation for pregnancy, relationships with husbands and family members, adult attachment types (Adult Attachment Scale, AAS, and depression (The Center for Epidemiologic Studies Depression Scale, CESD.Results: Approximately 30% of mothers 1–3 years postpartum reported symptoms above the CESD cut-off score (≥16 scores associated with the risk for depression (28.0% in the first year, 30.8% in the second year, and 31.8% in the third year. Factors significantly associated with depression in participants in the correlation analysis were education level; family income; preparation for pregnancy; a history of depression; amount of time spent with their husbands; relationships with husbands, parents, and parents-in-law; and a close, dependent, and/or anxious attachment style. Multiple regression analyses revealed that a history of depression; less preparation for pregnancy; poorer relationships with husbands, parents, and parents-in-law; and a more anxious attachment style were strongly related to a higher risk of postpartum depression. Conclusions: The overall percentage of mothers after delivery who were vulnerable to depression in China remains high. Various factors were significant predictors of postpartum depression. The research findings have several valuable implications for intervention practices. For example, attachment styles and depression history in the assessments of perinatal depression could improve
The voices of women suffering from postpartum depression are often silent. Women are reluctant to reveal to others that they are unhappy after the birth of their babies. Much has been written on possible causes, risk factors, and treatments for postpartum depression, but little has been done to investigate why women take so long to seek help. Early detection and treatment are key to a full recovery. Childbirth educators are in the position to offer anticipatory guidance on possible complications of the postpartum period, including postpartum depression. This article explores why women with postpartum depression choose to suffer in silence and suggests how childbirth educators can help new mothers find their voices. PMID:20190853
Full Text Available Postpartum depression is a frequent and disabling condition whose pathophysiology is still unclear. In recent years, the study of the neural correlates of mental disorders has been increasingly approached using magnetic resonance techniques. In this review we synthesize the results from studies on postpartum depression in the context of structural, functional, and spectroscopic magnetic resonance studies of major depression as a whole. Compared to the relative wealth of data available for major depression, magnetic resonance studies of postpartum depression are limited in number and design. A systematic literature search yielded only eleven studies conducted on about one hundred mothers with postpartum depression overall. Brain magnetic resonance findings in postpartum depression appear to replicate those obtained in major depression, with minor deviations that are not sufficient to delineate a distinct neurobiological profile for this condition, due to the small samples used and the lack of direct comparisons with subjects with major depression. However, it seems reasonable to expect that studies conducted in larger populations, and using a larger variety of brain magnetic resonance techniques than has been done so far, might allow for the identification of neuroimaging signatures for postpartum depression.
Booth, Leigh; Wedgeworth, Monika; Turner, Adeline
According to the World Health Organization, 10% to 13% of postpartum women develop a mental disorder, mainly depression. This number is higher in developing countries. This percentage increases in adolescents and symptoms in adolescents tend to be overlooked. These disorders can be treated successfully if detected early, which will in turn prevent more severe symptoms from developing. This article provides evidence-based clinical best practices for the assessment and early recognition of postpartum depression, specifically in adolescents. In addition, suggestions for integration into practice and recommendations for interprofessional collaboration are discussed. Copyright © 2018 Elsevier Inc. All rights reserved.
Denis, Anne; Luminet, Olivier
OBJECTIVES: The objective was to assess the impact of cognitive factors on post-partum depression (PPD) symptoms. Because most of the literature data concern the immediate post-partum period or the first year post-partum, we notably sought to assess the longer term impact of cognitive factors on the symptoms of PPD. METHODS: Two studies were performed. In a pilot study, 1-month post-partum, 63 women filled out a sociodemographic information sheet and completed the abbreviated, revised Eysenck...
Løvlie, Astrid Louise; Madar, Ahmed Ali
Postpartum depression (PPD) has been described as the most common complication experienced postpartum, affecting about 10-15 % of all new mothers. Factors like a history of mental illness, and experienced recent adverse life events has been associated with an increased risk for developing PPD. Immigrant women in Western countries have been found to have a marked higher prevalence of PPD compared to the general population. In Norway the prevalence of PPD in the general population has been found to be around 8-10 %, and among Pakistani immigrants a rate of 7.6 % was found. Somali people in Norway are the second largest immigrant group in Norway with a non-Western background. No study on PPD and associated factors among Somali women has been found in the literature. The aim of the study was to assess PPD and associated factors among Somali women in greater Oslo region, Norway. A cross-sectional survey was conducted; recruiting new mothers through all maternity wards in the Oslo region. Data was collected with interview-administrated questionnaires. PPD was assessed using Edinburgh Postnatal Depression Scale (EPDS), defining those scoring ≥10 to have a possible PPD. Of the 80 eligible women identified, 39 (49 %) consented to participate, and completed the study. Of the 39 respondents 3 (7.7 %) were assessed to have a possible PPD. Most important associated factors found were history of mental illness, having experienced technical assistance during delivery, self-rated health and experienced economical problems last 12 months. A low prevalence of PPD was found, and both the prevalence and its associated factors should be interpreted with caution. The associated factors do not have enough power to give any strength to the associations. However, some of the results can be used in develop new hypotheses with regard to PPD among Somali women as immigrants in a Western society.
Youn, HyunChul; Lee, Suji; Han, Sung Won; Kim, Log Young; Lee, Tae-Seon; Oh, Min-Jeong; Jeong, Hyun-Ghang; Cho, Geum Joon
Postpartum depression is related to many adverse effects in both mothers and their children; therefore, proper screening and early interventions are needed. This study aims to identify the risk factors of postpartum depression. Our primary focus is on obstetric risk factors. This study is a cross-sectional study which we extracted the data of women who gave birth between January 1st, 2010 and December 31st, 2012 from the Health Insurance Review and Assessment service (HIRA) database. We analyzed the data using multivariable logistic regression models. A total of 17,483 (1.4%) women suffered from depression during the postpartum period. Younger (depression, peripartum hysterectomy, uterine artery embolization, preterm delivery, placental abruption, cesarean delivery, induced labor, and preeclampsia were found to increase the likelihood of having depression after delivery. Our findings suggest that there are several risk factors that lead women to postpartum depression. Therefore, early detection and well-management of the symptoms and risk factors for postpartum depression along with social support can help both physical and psychological conditions of women after childbirth. Copyright © 2017 Elsevier Inc. All rights reserved.
N. A. Kornetov
Full Text Available Perinatal mental health of the mother occupies a central position in healthcare, the same as caring for a newborn baby. Maternal depression is the lead pathology of postpartum period. Despite the high prevalence and importance to the overall development of children, most cases of depression are unappreciated, unrecognized and untreated. Inattention to issues which are related to physical and mental health of women, leads to severe negative social and economic consequences for society. Statistical comparison of the total number of pregnant women, the number of births in the United States in 2007, excluding cases of fetal loss, including still-births and miscarriages with similar Russian data allowed to calculate the approximate prevalence of postpartum depression in the same period. Presumable probability of postpartum depression is 15% in different regions of the world, and the diagnostic criteria of DSM-IV for postpartum depression are representative for comparison. Considering these assumptions, according to 2007 each year about 260,000 out of 1 mln. 600,000 of Russian women in childbirth may suffer from post-natal depression. The results have a probabilistic character. For the mothers the consequences of unrecognized and untreated depression after childbirth are the most frequent. It should be seen as a depressive episode or recurrent depressive disorder which has a singular coloring due to the appearance in the peak period of reproductive age of women. Postpartum depression may increase the possibility of occurrence of relapse of a depressive disorder as well as the transition to a state of chronic depression. Alcoholism or drug use is a common complication of depression; the risk of suicide increases, especially during the time of reducing the severity of the most severe symptoms of depression, though it is below the prevalence of suicide among the population. Particular attention should be paid to such symptoms as instability in mood and
Whisman, Mark A; Davila, Joanne; Goodman, Sherryl H
The associations between relationship adjustment and symptoms of depression and anxiety were evaluated in a sample of pregnant married or cohabiting women (N = 113) who were at risk for perinatal depression because of a prior history of major depression. Women completed self-report measures of relationship adjustment, depressive symptoms, and anxiety symptoms monthly during pregnancy and for the first six months following the birth of their child. Multilevel modeling was used to examine concurrent and time-lagged within-subjects effects for relationship adjustment and depressive and anxiety symptoms. Results revealed that (a) relationship adjustment was associated with both depressive symptoms and anxiety symptoms in concurrent analyses; (b) relationship adjustment was predictive of subsequent anxiety symptoms but not subsequent depressive symptoms in lagged analyses; and (c) depressive symptoms were predictive of subsequent relationship adjustment in lagged analyses with symptoms of depression and anxiety examined simultaneously. These results support the continued investigation into the cross-sectional and longitudinal associations between relationship functioning and depressive and anxiety symptoms in women during pregnancy and the postpartum period. 2011 APA, all rights reserved
Iliadis, S I; Comasco, E; Hellgren, C; Kollia, N; Sundström Poromaa, I; Skalkidou, A
This study examined the association between a single nucleotide polymorphism in the hydroxysteroid (11-beta) dehydrogenase 1 gene and neuroticism, as well as the possible mediatory role of neuroticism in the association between the polymorphism and postpartum depressive symptoms. 769 women received questionnaires containing the Edinburgh Postnatal Depression Scale (EPDS) at six weeks postpartum and demographic data at pregnancy week 17 and 32 and at six weeks postpartum, as well as the Swedish universities Scales of Personality at pregnancy week 32. Linear regression models showed an association between the GG genotype and depressive symptoms. When neuroticism was introduced in the model, it was associated with EPDS score, whereas the association between the GG genotype and EPDS became borderline significant. A path analysis showed that neuroticism had a mediatory role in the association between the polymorphism and EPDS score. The use of the EPDS, which is a self-reporting instrument. Neuroticism was associated with the polymorphism and had a mediatory role in the association between the polymorphism and postpartum depression. This finding elucidates the genetic background of neuroticism and postpartum depression. Copyright © 2016 Elsevier B.V. All rights reserved.
Dam, van R.M.; Schuit, A.J.; Schouten, E.G.; Vader, H.L.; Pop, V.J.M.
We examined the relation between total serum cholesterol decline and depression in the postpartum period in a prospective study of 266 Dutch women, who were followed until 34 weeks after delivery. The decline in serum cholesterol between week 32 of pregnancy and week 10 postpartum was similar for
van Dam, R M; Schuit, A.J.; Schouten, E G; Vader, H L; Pop, V.J.
We examined the relation between total serum cholesterol decline and depression in the postpartum period in a prospective study of 266 Dutch women, who were followed until 34 weeks after delivery. The decline in serum cholesterol between week 32 of pregnancy and week 10 postpartum was similar for
Introduction: Postpartum depression is an uncommon and frequently undocumented issue that impacts negatively on maternal and child health. Methods: The study was carried out among mothers who attended postpartum clinics from two teaching hospitals and three private hospitals all in Enugu metropolis.
Ramachandran Pillai, R; Sharon, Leena; Premkumar, Nancy R; Kattimani, Shivanand; Sagili, Haritha; Rajendiran, Soundravally
Post-partum depression (PPD) is the common adverse outcome of child bearing which affects the wellbeing of both mother and newborn and has long-term effects. Hence, reliable potential biological tests for early detection of PPD are essential. Follicle stimulating hormone (FSH) and luteinizing hormone (LH) were associated with depressive disorders and the present study estimated the levels of serum FSH, LH in postpartum depression and explored them as predictive biomarkers in the development of PPD. In this nested case control study done at a tertiary care hospital in South India, 450 postpartum women were screened at 6th week post-delivery for PPD. Socio-demographic and clinical data were recorded and depressive symptoms were assessed using Edinburgh Postnatal Depression Scale (EPDS). Out of 450 subjects screened, 100 women with depressive symptoms were categorized as cases and 100 controls were selected from the remaining subjects matching for age and BMI with cases. Serum levels of FSH and LH were measured using direct competitive immunoassay by chemiluminescene technology. Serum LH/FSH ratio was found to be significantly (p=0.02) low in PPD women when compared to normal postpartum subjects. We also found a significant negative correlation between LH/FSH ratio and EPDS scores. Based on the receiver operating characteristic curve, the optimal cut-off value for serum of LH/FSH levels in predicting postpartum depression was estimated to be 0.22mlU/mL with an AUC of 0.598 (95%CI, 0.291-0.859). Our study demonstrated that low LH/FSH ratio after delivery was associated with increased risk for the development of PPD. Low LH/FSH ratio at six-week post delivery can be used as a robust biochemical predictor of post-partum depression. Copyright Â© 2016 Elsevier Inc. All rights reserved.
Full Text Available George Anderson,1 Michael Maes21CRC Clincial Research Centre/Communications, Glasgow, Scotland; 2Department of Psychiatry, Chulalongkorn University, Bangkok, ThailandAbstract: Postpartum depression (PPD is common, occurring in 10%–15% of women. Due to concerns about teratogenicity of medications in the suckling infant, the treatment of PPD has often been restricted to psychotherapy. We review here the biological underpinnings to PPD, suggesting a powerful role for the tryptophan catabolites, indoleamine 2,3-dixoygenase, serotonin, and autoimmunity in mediating the consequences of immuno-inflammation and oxidative and nitrosative stress. It is suggested that the increased inflammatory potential, the decreases in endogenous anti-inflammatory compounds together with decreased omega-3 poly-unsaturated fatty acids, in the postnatal period cause an inflammatory environment. The latter may result in the utilization of peripheral inflammatory products, especially kynurenine, in driving the central processes producing postnatal depression. The pharmacological treatment of PPD is placed in this context, and recommendations for more refined and safer treatments are made, including the better utilization of the antidepressant, and the anti-inflammatory and antioxidant effects of melatonin.Keywords: SSRI, kynurenine, IDO, TDO, melatonin
Alhasanat, Dalia; Fry-McComish, Judith; Yarandi, Hossein N
Postpartum depression (PPD) affects approximately 14% of women in the United States and 10% to 37% of Arabic women in the Middle East. Evidence suggests that immigrant women experience higher rates, but information on PPD among immigrant women of Arabic descent in the United States is nonexistent. A cross-sectional descriptive feasibility study was conducted to assess the practicality of implementing a larger proposed research study to examine predictors of PPD in US immigrant women of Arabic descent residing in Dearborn, Michigan. Fifty women were recruited from an Arab community center and completed demographic data, the Arabic version of the Edinburgh Postpartum Depression Scale (EPDS), and the Postpartum Depression Predictors Inventory-Revised (PDPI-R). Among participants, 36% were considered at high risk for developing PPD. Lack of social support, antenatal anxiety, antenatal depression, maternity blues (feeling depressed during the first 4 weeks postpartum), and life stress were significantly related to risk for PPD. Multiple regression analysis revealed that social support (t = -3.77, P postpartum depressive symptoms. Findings of this study describe the prevalence of PPD in a sample of US immigrant women of Arabic descent and support the feasibility of a larger and more in-depth understanding of their immigration and acculturation experiences. Study participants reported high risk for PPD. Maternity blues and lack of social support were significant predictors to the risk for PPD. Future research tailored to this minority group is recommended. © 2017 by the American College of Nurse-Midwives.
Pope, Carley J.; Mazmanian, Dwight
Emerging research suggests that a relationship exists between breastfeeding and postpartum depression; however, the direction and precise nature of this relationship are not yet clear. The purpose of this paper is to provide an overview of the relationship between breastfeeding and postpartum depression as it has been examined in the empirical literature. Also, the potential mechanisms of action that have been implicated in this relationship are also explored. PubMed and PsycINFO were searched using the keywords: breastfeeding with postpartum depression, perinatal depression, postnatal depression. Results of this search showed that researchers have examined this relationship in diverse ways using diverse methodology. In particular, researchers have examined the relationships between postpartum depression and breastfeeding intention, initiation, duration, and dose. Due to a number of methodological differences among past studies we make some recommendations for future research that will better facilitate an integration of findings. Future research should (1) use standardized assessment protocols; (2) confirm diagnosis through established clinical interview when possible; (3) provide a clear operationalized definition for breastfeeding variables; (4) clearly define the postpartum period interval assessed and time frame for onset of symptoms; (5) be prospective or longitudinal in nature; and (6) take into consideration other potential risk factors identified in the empirical literature. PMID:27148457
Carley J. Pope
Full Text Available Emerging research suggests that a relationship exists between breastfeeding and postpartum depression; however, the direction and precise nature of this relationship are not yet clear. The purpose of this paper is to provide an overview of the relationship between breastfeeding and postpartum depression as it has been examined in the empirical literature. Also, the potential mechanisms of action that have been implicated in this relationship are also explored. PubMed and PsycINFO were searched using the keywords: breastfeeding with postpartum depression, perinatal depression, postnatal depression. Results of this search showed that researchers have examined this relationship in diverse ways using diverse methodology. In particular, researchers have examined the relationships between postpartum depression and breastfeeding intention, initiation, duration, and dose. Due to a number of methodological differences among past studies we make some recommendations for future research that will better facilitate an integration of findings. Future research should (1 use standardized assessment protocols; (2 confirm diagnosis through established clinical interview when possible; (3 provide a clear operationalized definition for breastfeeding variables; (4 clearly define the postpartum period interval assessed and time frame for onset of symptoms; (5 be prospective or longitudinal in nature; and (6 take into consideration other potential risk factors identified in the empirical literature.
Knowledge of Postpartum Depression and its Associated Risk Factors ... affects many women and if ignored can have long-term adverse consequences, for both ... who are the first point of contact during antenatal, labour and post natal period.
Iapichino, Elena; Quartieri Bollani, Marta; Cauli, Gilla; Gala, Costanzo
The aim of this paper is to describe the presence of anxious-depressive symptoms and risk factors and discuss the method of intervention used with women in pregnancy and post-partum. The mood of the woman was assessed by the Edinburgh Postnatal Depression Scale (EPDS) and the Beck Depression Inventory (BDI), personality traits with the Vulnerable Personality Style Questionnaire (VPSQ) and social support through the Social Provisions Scale (PPS). 50 women have completed the evaluation. In line with the international literature, the presence of anxiety-depressive symptoms is accompanied by the presence of multiple risk factors, in particular the familiar seems to be a predisposing factor.
Sampson, McClain; Villarreal, Yolanda; Rubin, Allen
Postpartum Depression (PPD) occurs at higher rates among impoverished mothers than the general population. Depression during pregnancy is one of the strongest predictors of developing PPD. Research indicates that non-pharmacological interventions are effective in reducing depressive symptoms but engaging and retaining low-income mothers remains a…
Full Text Available ... few days. It is a serious illness that affects many people. Symptoms can vary, but many depressed ... suffer from depression trying to learn why it affects some people but not others. Treatments for depression ...
Full Text Available ... 3 items) Institute Announcements (24 items) Symptoms and Treatment of Depression February 1, 2010 People with depression ... why it affects some people but not others. Treatments for depression do work. One type of effective ...
Gutiérrez-Zotes, Alfonso; Labad, Javier; Martín-Santos, Rocío; García-Esteve, Luisa; Gelabert, Estel; Jover, Manuel; Guillamat, Roser; Mayoral, Fermín; Gornemann, Isolde; Canellas, Francesca; Gratacós, Mónica; Guitart, Montserrat; Roca, Miguel; Costas, Javier; Ivorra, Jose Luis; Navinés, Ricard; de Diego-Otero, Yolanda; Vilella, Elisabet; Sanjuan, Julio
The transition to motherhood is stressful as it requires several important changes in family dynamics, finances, and working life, along with physical and psychological adjustments. This study aimed at determining whether some forms of coping might predict postpartum depressive symptomatology. A total of 1626 pregnant women participated in a multi-centric longitudinal study. Different evaluations were performed 8 and 32 weeks after delivery. Depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS) and the structured Diagnostic Interview for Genetic Studies (DIGS). The brief Coping Orientation for Problem Experiences (COPE) scale was used to measure coping strategies 2-3 days postpartum. Some coping strategies differentiate between women with and without postpartum depression. A logistic regression analysis was used to explore the relationships between the predictors of coping strategies and major depression (according to DSM-IV criteria). In this model, the predictor variables during the first 32 weeks were self-distraction (OR 1.18, 95 % CI 1.04-1.33), substance use (OR 0.58, 95 % CI 0.35-0.97), and self-blame (OR 1.18, 95 % CI 1.04-1.34). In healthy women with no psychiatric history, some passive coping strategies, both cognitive and behavioral, are predictors of depressive symptoms and postpartum depression and help differentiate between patients with and without depression.
Venkatesh, Kartik K.; Zlotnick, Caron; Triche, Elizabeth W.; Ware, Crystal
OBJECTIVE: To evaluate the accuracy of the Edinburgh Postnatal Depression Scale (EPDS) and 3 subscales for identifying postpartum depression among primiparous adolescent mothers. METHODS: Mothers enrolled in a randomized controlled trial to prevent postpartum depression completed a psychiatric diagnostic interview and the 10-item EPDS at 6 weeks, 3 months, and 6 months postpartum. Three subscales of the EPDS were assessed as brief screening tools: 3-item anxiety subscale (EPDS-3), 7-item depressive symptoms subscale (EPDS-7), and 2-item subscale (EPDS-2) that resemble the Patient Health Questionnaire-2. Receiver operating characteristic curves and the areas under the curves for each tool were compared to assess accuracy. The sensitivities and specificities of each screening tool were calculated in comparison with diagnostic criteria for a major depressive disorder. Repeated-measures longitudinal analytical techniques were used. RESULTS: A total of 106 women contributed 289 postpartum visits; 18% of the women met criteria for incident postpartum depression by psychiatric diagnostic interview. When used as continuous measures, the full EPDS, EPDS-7, and EPDS-2 performed equally well (area under the curve >0.9). Optimal cutoff scores for a positive depression screen for the EPDS and EPDS-7 were lower (≥9 and ≥7, respectively) than currently recommended cutoff scores (≥10). At optimal cutoff scores, the EPDS and EPDS-7 both had sensitivities of 90% and specificities of >85%. CONCLUSIONS: The EPDS, EPDS-7, and EPDS-2 are highly accurate at identifying postpartum depression among adolescent mothers. In primary care pediatric settings, the EPDS and its shorter subscales have potential for use as effective depression screening tools. PMID:24344102
De Wilde, Katrien S; Trommelmans, Leen C; Laevens, Hans H; Maes, Lea R; Temmerman, Marleen; Boudrez, Hedwig L
Relationships among feelings of depression, smoking behavior, and educational level during pregnancy have been documented. Feelings of depression may contribute to persistent smoking during pregnancy. No longitudinal studies assessing feelings of depression in women with different antepartum and postpartum smoking patterns are available. The aim was to determine relationships between depressive symptoms, sociodemographic characteristics, and smoking pattern during and after pregnancy. An observational, prospective, noninterventional study was conducted. Data were collected during two stages of pregnancy (T0: postpartum (T2: >6 weeks) in 523 Flemish women. Feelings of depression (measured using the Beck Depression Inventory [BDI]), smoking behavior, and sociodemographic variables were analyzed using a general linear mixed model implemented in SAS Proc MIXED. Smokers and initial smokers reported significantly more depressive symptoms at all time points compared with recent ex-smokers, nonsmokers, and initial nonsmokers (p postpartum. Smoking patterns were associated with depression and showed complex interactions with educational level. Assessment and intervention for both smoking and depression are needed throughout the perinatal period to support the health of mothers, their infants, and families.
Çelik, Sercan Bulut; Bucaktepe, Gamze Erten; Uludağ, Ayşegül; Bulut, İbrahim Umud; Erdem, Özgür; Altınbaş, Kürşat
Mixed depression is a clinical condition accompanied by the symptoms of (hypo)mania and is considered to be a predictor for bipolar disorder. Compared to pure major depression, mixed depression is worse in progress. There are limited data on the prevalence of mixed depression since it is a relatively new entity. Therefore, the present study aimed to investigate the prevalence of mixed depression during the postpartum period which is risky for mood disorders. The study included 63 postpartum women. The participants were administered Beck Depression Scale, Edinburgh Postnatal Depression Scale (EPDS), Mood Disorders Questionnaire (MDQ), and Modified Hypomania Symptom Checklist-32 (mHCL-32). The MDQ scores of the women with expected depression according to the EPDS cut-off scores, were significantly higher than the women with lower EPDS scores (t=-4.968; pdepression scores compared to the women under EPDS cut-off scores (t=-4.713; pdepression, respectively. In addition, 3 (4.8%) women require additional clinical examination for bipolar disorder. The scores for the first item of MDQ were above the cut-off value in 11 (17.5%) women. According to the mHCL-32 results, 50 (79.4%) women had at least 1 symptom, 45 (71.4%) women had at least 3 symptoms, and 43 (68.3%) women had at least 5 symptoms of mixed depression. Postpartum mixed depression should be promptly diagnosed by using appropriate diagnostic tools, particularly by primary health care physicians. Patients with mixed depression should be closely monitored to avoid manic switch. Copyright © 2016 Elsevier Inc. All rights reserved.
Post-partum depression affects 10-13% of Japanese women, but many do not receive appropriate treatment or support. This intervention study evaluated the effectiveness of home visits by mental health nurses for Japanese women with post-partum depression. Eighteen post-partum women met the inclusion criteria and were randomly allocated into the intervention (n = 9) or control (n = 9) group at 1-2 months after giving birth. The intervention group received four weekly home visits by a mental health nurse. Control group participants received usual care. Two women in the intervention group did not complete the study. Depressive symptoms and quality of life were measured at 1 and 6 weeks' postintervention. In addition, participants completed an open-ended questionnaire on satisfaction and meaning derived from the home visits. Women in the intervention group had significant amelioration of depressive symptoms over time and reported positive benefits from the home visits, but there were no statistically significant differences between groups. Significant differences (P post-partum depression. A larger trial is warranted to test this approach to care.
Hinkle, Stefanie N; Buck Louis, Germaine M; Rawal, Shristi; Zhu, Yeyi; Albert, Paul S; Zhang, Cuilin
Depression and glucose intolerance commonly co-occur among non-pregnant individuals; however, the temporal relationship between gestational diabetes (GDM) and depression during pregnancy and the postpartum period is less understood. Our objective was to assess longitudinal associations between depression early in pregnancy and GDM risk, as well as GDM and subsequent risk of postpartum depression. Data came from the prospective National Institute of Child Health and Human Development Fetal Growth Studies-Singleton cohort (2009-2013), and had been collected at 12 US clinical centres. Pregnant women without psychiatric disorders, diabetes or other chronic conditions before pregnancy were followed throughout pregnancy (n = 2477). Only women with GDM and matched controls were followed up at 6 weeks postpartum (n = 162). GDM was ascertained by a review of the medical records. Depression was assessed in the first (8-13 gestational weeks) and second (16-22 weeks) trimesters and at 6 weeks postpartum using the Edinburgh Postnatal Depression Scale. Postpartum depression was defined as a depressive symptom score ≥10 or antidepressant medicine use after delivery. RR and 95% CI were adjusted for pre-pregnancy BMI and other risk factors. GDM was considered to be the outcome for the first set of analyses, with depression in the first and second trimesters as the exposures. Postpartum depression was considered as the outcome for the second set of analyses, with GDM as the exposure. Overall, comparing the highest and lowest quartiles of first-trimester depression scores, the scores from the highest quartile were associated with a significant twofold (95% CI 1.06, 3.78) increased risk of GDM, but this was attenuated to 1.72-fold (95% CI 0.92, 3.23) after adjustment; the second-trimester results were similar. The risk was stronger and significant in both trimesters among non-obese women (p for trend 0.02 and 0.01, respectively), but null for obese women. Women with
Veen, Cato; Myint, Aye Mu; Burgerhout, Karin M; Schwarz, Markus J; Schütze, Gregor; Kushner, Steven A; Hoogendijk, Witte J; Drexhage, Hemmo A; Bergink, Veerle
Women are at very high risk for the first onset of acute and severe mood disorders the first weeks after delivery. Tryptophan breakdown is increased as a physiological phenomenon of the postpartum period and might lead to vulnerability for affective psychosis (PP) and severe depression (PD). The aim of the current study was to investigate alterations in tryptophan breakdown in the physiological postpartum period compared to patients with severe postpartum mood disorders. We included 52 patients (29 with PP, 23 with PD), 52 matched healthy postpartum women and 29 healthy non-postpartum women. Analyzes of serum tryptophan metabolites were performed using LC-MS/MS system for tryptophan, kynurenine, 3-hydroxykynurenine, kynurenic acid and 5-hydroxyindoleacetic acid. The first two months of the physiological postpartum period were characterized by low tryptophan levels, increased breakdown towards kynurenine and a downstream shift toward the 3-OH-kynurenine arm, away from the kynurenic acid arm. Kynurenine was significantly lower in patients with PP and PD as compared to healthy postpartum women (p=0.011 and p=0.001); the remaining tryptophan metabolites demonstrated few differences between patients and healthy postpartum women. Low prevalence of the investigated disorders and strict exclusion criteria to obtain homogenous groups, resulted in relatively small sample sizes. The high kynurenine levels and increased tryptophan breakdown as a phenomenon of the physiological postpartum period was not present in patients with severe postpartum mood disorders. No differences were observed in the levels of the 'neurotoxic' 3-OH-kynurenine and the 'neuroprotective' kynurenic acid arms between patients and healthy postpartum women. Copyright © 2015 Elsevier B.V. All rights reserved.
Girardi, Paolo; Pompili, Maurizio; Innamorati, Marco; Serafini, Gianluca; Berrettoni, Claudia; Angeletti, Gloria; Koukopoulos, Alexia; Tatarelli, Roberto; Lester, David; Roselli, Domenico; Primiero, Francesco M
The aim of the authors in this study was to assess the prevalence of postpartum depression and evaluate the association of affective temperaments with emotional disorders in a sample of 92 pregnant women consecutively admitted for delivery between March and December 2009. In the first few days postpartum, women completed the Suicidal History Self-rating Screening Scale, the Beck Hopelessness Scale, the Edinburgh Postnatal Depression Scale, the Temperament Evaluation of the Memphis, Pisa, Paris and San Diego Autoquestionnaire, and the Gotland Male Depression Scale. Fifty percent of the women reported an Edinburgh Postnatal Depression Scale score of 9 or higher, and 23% a score of 13 or higher. Women with a dysphoric-dysregulated temperament had higher mean scores on the Beck Hopelessness Scale (p Depression Scale (p Depression Scale (p Depression Scale was significantly associated with temperament when controlling for the presence of other variables. Women with a dysphoric-dysregulated temperament were 1.23 times as likely to have higher depressive symptom scores. Future studies should evaluate the effectiveness of psychiatric screening programs in the postpartum period as well as factors associated with depression and suicidality during the same period.
Kuk Jennifer L
Full Text Available Abstract Background This study aims to look at the prevalence and characteristics of postpartum depression symptomatology (PPDS among Canadian women. Studies have found that in developed countries, 10-15% of new mothers were affected by major postpartum depression. Mothers who suffer from postpartum depression may endure difficulties regarding their ability to cope with life events, as well as negative clinical implications for maternal-infant attachment. Methods An analysis based on 6,421 Canadian women, who had a live birth between 2005 and 2006 and were part of the Maternity Experience Survey (MES, was performed. PPDS was measured based on the Edinburgh Postnatal Depression Scale. Various factors that assessed socio-economic status, demographic factors, and maternal characteristics were considered for the multinomial regression model. Results The national prevalence of minor/major and major PPDS was found to be 8.46% and 8.69% respectively. A mother's stress level during pregnancy, the availability of support after pregnancy, and a prior diagnosis of depression were the characteristics that had the strongest significant association with the development of PPDS. Conclusions A significant number of Canadian women experience symptoms of postpartum depression. Findings from this study may be useful to increase both the attainment of treatment and the rate at which it can be obtained among new mothers. Interventions should target those with the greatest risk of experiencing PPDS, specifically immigrant and adolescent mothers.
Shivakumar, Geetha; Johnson, Neysa L; McIntire, Donald D; Leveno, Kenneth
The purpose of this pilot study was to investigate major depressive symptoms among a high-risk group of pregnant women managed at a tertiary care setting. The study prospectively evaluated pregnant women who met DSM-IV criteria for a major depressive episode (MDE). Psychiatric measures for depression, anxiety and social impairment were administered at monthly intervals during pregnancy and immediate postpartum period. Twenty-four women provided longitudinal data from mid pregnancy to 2 months of postpartum period. 86% of women were clinically symptomatic at the beginning of study during pregnancy and only 32% remained clinically symptomatic at 2 months following delivery reaching. This difference reached a statistical significance level p depression, comorbid anxiety disorder, histories of domestic violence, and those with uninvolved spouse or partners were more at-risk to be clinically symptomatic in the immediate postpartum period. In a group consisting of largely Latina women at a tertiary care setting, progression of major depression when treated with antidepressant medication(s) is that of an improvement from pregnancy to immediate postpartum period. Further longitudinal studies are needed to assess impact of clinical characteristics and treatment on major depression in larger diverse obstetric group.
Full Text Available The aim of this study was to analyse the influence of personality factors and antenatal depressive symptomatology in postnatal depression. A prospective ex post facto design was carried out. The sample consisted of 116 women, recruited in their first trimester of pregnancy and followed up until four months postpartum. The measurement instruments used were the Edinburg Postnatal Depression Scale (EPDS to assess postpartum depression, the NEO-Five Factor Inventory (NEO-FFI to analyse personality traits and the depression subscale of the Symptoms Check List 90 (SCL-90-R to assess depressive symptomatology in the first half of pregnancy. Socio-demographic variables (age, parity, educational level, employment status, and planned pregnancy and clinical variables (neonatal Apgar score and mode of delivery were also taken into account. A positive correlation was found between postpartum depression and depressive symptomatology in the first trimester; however after the regression analysis neuroticism was the only factor that predicted postpartum depressive symptoms, explaining 24.8% of the variance. Neuroticism significantly influences psychological health during life events such as motherhood. Due to its stable condition, personality could be assessed from the beginning of pregnancy, contributing to the care of pregnant women with high scores in neuroticism, to prevent, detect and treat early postnatal depression.
Bodnar-Deren, Susan; Benn, E K T; Balbierz, Amy; Howell, E A
Objective To measure stigma associated with four types of postpartum depression therapies and to estimate the association between stigma and the acceptance of these therapies for black and white postpartum mothers. Methods Using data from two postpartum depression randomized trials, this study included 481 black and white women who gave birth in a large urban hospital and answered a series of questions at 6-months postpartum. Survey items included socio demographic and clinical factors, attitudes about postpartum depression therapies and stigma. The associations between race, stigma, and treatment acceptability were examined using bivariate and multivariate analyses. Results Black postpartum mothers were less likely than whites to accept prescription medication (64 vs. 81%, p = 0.0001) and mental health counseling (87 vs. 93%, p = 0.001) and more likely to accept spiritual counseling (70 vs. 52%, p = 0.0002). Women who endorsed stigma about receipt of postpartum depression therapies versus those who did not were less likely to accept prescription medication, mental health and spiritual counseling for postpartum depression. Overall black mothers were less likely to report stigma associated with postpartum depression therapies. In adjusted models, black women versus white women remained less likely to accept prescription medication for postpartum depression (OR = 0.42, 95% CI 0.24-0.72) and stigma did not explain this difference. Conclusions Although treatment stigma is associated with lower postpartum depression treatment acceptance, stigma does not explain the lower levels of postpartum depression treatment acceptance among black women. More research is needed to understand treatment barriers for postpartum depression, especially among black women.
Buckingham-Howes, Stacy; Oberlander, Sarah E; Wang, Yan; Black, Maureen M
This study examines potential mechanisms linking maternal depressive symptoms over 2 years postpartum with child behavior problems at school-age in a sample of adolescent mothers and their first-born child. Potential mechanisms include: mother-reported caregiving engagement at 6 months; observed parental nurturance and control, and child competence and affect at 24 months; and mother-reported resilience at 7 years based on achievement of adult developmental tasks. One hundred eighteen low-income African American adolescent mothers were recruited at delivery and followed through child age 7 years. Maternal depressive symptom trajectories over 24 months were estimated (low, medium, and high) based on mother-reported depressive symptoms. Direct and indirect associations between depressive symptom trajectories with 7-year maternal depressive symptoms and child behavior problems were examined. The high maternal depressive symptom trajectory was associated with 7-year maternal depressive symptoms (b = 5.52, SE = 1.65, p child internalizing problems (b = 7.60, SE = 3.12, p = .02) and externalizing problems (b = 6.23, SE = 3.22, p = .05). Caregiving engagement among high depressive symptom trajectory mothers was significantly associated with observed child affect (b = -0.21, SE = 0.11, p = 0.05). Parental nurturance in toddlerhood mediated the association between high maternal depressive symptom trajectory and child internalizing problems at 7 years (indirect effect b = 2.33, 95% CI: 0.32-5.88). Findings suggest that family based interventions to promote parenting and adolescent resiliency strengthening may be beneficial in this population. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Full Text Available ... Information Health Information Home Mental Health Information Statistics Consumer Health Publications Help for Mental Illnesses Clinical Trials ... Symptoms and Treatment of Depression February 1, 2010 People with depression discuss how they got help. & ...
Full Text Available ... Symptoms and Treatment of Depression February 1, 2010 People with depression discuss how they got help. & ... I felt like I was such an awful person that there was no real reason for me ...
Full Text Available ... a serious illness that affects many people. Symptoms can vary, but many depressed people lose interest in ... lot of weight. NARRATOR : A person with depression can feel irritable and restless, and have sleep problems. ...
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Kwon, Jung Hye; Lee, Jeong Jae
Purpose To examine the efficacy of cognitive-behavioral therapy (CBT) for the prevention of postpartum depression (PPD) in "at risk" women. Materials and Methods We recruited 927 pregnant women in 6 obstetric and gynecology clinics and screened them using Beck Depression Inventory (BDI). Ninety-nine of the screened women who had significantly high scores in BDI (a score above 16) were selected for the study. They were contacted through by telephone, and 27 who had consented to participate in the study were interviewed via SCID-IV-I. Twenty-seven eligible women were randomly assigned to the CBT intervention (n = 15) and control condition (n = 12). All participants were required to complete written questionnaires, assessing demographic characteristics, depressive symptoms, negative thoughts, dyadic communication satisfaction, and global marital satisfaction prior to treatment and approximately 1 month postpartum. The 15 women in the CBT condition received 9 bi-weekly 1-hour individual CBT sessions, targeting and modifying negative patterns of thinking and behaviors occurring in the context of the dyadic relationship. Results The analysis of covariance (ANCOVA) showed that there were significant differences in all postpartum measures between the 2 groups, indicating that our antenatal intervention with CBT was effective in reducing depressive symptoms and improving marital satisfaction, which lasted until the postpartum period. Conclusion Our pilot study has provided preliminary empirical evidence that antenatal CBT intervention can be an effective preventive treatment for PPD. Further study in this direction was suggested. PMID:18729297
Tanner Stapleton, Lynlee R.; Guardino, Christine M.; Hahn-Holbrook, Jennifer; Schetter, Christine Dunkel
Postpartum depression (PPD) adversely affects the health and well being of many new mothers, their infants, and their families. A comprehensive understanding of biopsychosocial precursors to PPD is needed to solidify the current evidence base for best practices in translation. We conducted a systematic review of research published from 2000 through 2013 on biological and psychosocial factors associated with PPD and postpartum depressive symptoms. Two hundred fourteen publications based on 199 investigations of 151,651 women in the first postpartum year met inclusion criteria. The biological and psychosocial literatures are largely distinct, and few studies provide integrative analyses. The strongest PPD risk predictors among biological processes are hypothalamic-pituitary-adrenal dysregulation, inflammatory processes, and genetic vulnerabilities. Among psychosocial factors, the strongest predictors are severe life events, some forms of chronic strain, relationship quality, and support from partner and mother. Fully integrated biopsychosocial investigations with large samples are needed to advance our knowledge of PPD etiology. PMID:25822344
Goodman, Janice H
Maternal postpartum depression (PPD) has been shown to negatively influence mother-infant interaction; however, little research has explored how fathers and father-infant interaction are affected when a mother is depressed. This study examined the influence of maternal PPD on fathers and identified maternal and paternal factors associated with father-infant interaction in families with depressed as compared with nondepressed mothers. A convenience sample of 128 mother-father-infant triads, approximately half of which included women with significant symptoms of PPD at screening, were recruited from a screening sample of 790 postpartum women. Mothers and fathers completed measures of depression, marital satisfaction, and parenting stress at 2 to 3 months' postpartum and were each videotaped interacting with their infants. Results indicate that maternal PPD is associated with increased paternal depression and higher paternal parenting stress. Partners of depressed women demonstrated less optimal interaction with their infants, indicating that fathers do not compensate for the negative effects of maternal depression on the child. Although mother-infant interaction did not influence father-infant interaction, how the mother felt about her relationship with the infant did, even more so than maternal depression. The links between maternal PPD, fathers, and father-infant interaction indicate a need for further understanding of the reciprocal influences between mothers, fathers, and infants. Copyright © 2008 Michigan Association for Infant Mental Health.
Smith-Nielsen, Johanne; Tharner, Anne; Steele, Howard
Findings on effects of Postpartum depression (PPD) on infant-mother attachment have been contradictory. This may be due to not considering maternal interpersonal difficulties, for example co-morbid personality disorder (PD). We examined the role of PD in the association between postpartum...... depression and infant-mother attachment. Mothers were recruited either during pregnancy (non-clinical group, n=56) or eight weeks postpartum (PPD-group, n=29). Infants of mothers with PPD only or in combination with PD were compared with infants of mothers with no psychopathology. Depression and PD were...... assessed with questionnaires and clinical interviews. Infant-mother attachment was assessed when infants were 13 months using Strange Situation Procedure. Mothers with PPD were more likely to have co-morbid PD compared with non-clinical mothers. PPD was associated with attachment insecurity only...
Rogathi, Jane J.; Manongi, Rachael; Mushi, Declare
Depression Scale (EPDS) and self-reported IPV experiences were assessed using structured questions adopted from the WHO's Multi-country Study on Women's Health and Domestic Violence; 3) Assessment for postpartum depression using EPDS was repeated at 40 days post-partum. Data were analyzed using bivariate......BACKGROUND: Post-partum depression (PPD) in many low-income countries, including Tanzania, is not well recognized, and the underlying predictors and causes of PPD remain unclear. Results from previous studies suggest that PPD is associated with intimate partner violence (IPV) experienced during.......10; 95% CI: 2.04-4.40) as compared to those women who were not exposed to IPV during their pregnancy. Stratified analyses showed that this risk of PPD was highest among younger women (aged 18-24 years) who were exposed to physical violence (AOR=3.75; 95% CI: 1.21-11.67). Among women exposed to emotional...
McDonald, Sheila; Wall, Jennifer; Forbes, Kaitlin; Kingston, Dawn; Kehler, Heather; Vekved, Monica; Tough, Suzanne
Post-partum depression (PPD) is the most common complication of pregnancy in developed countries, affecting 10-15% of new mothers. There has been a shift in thinking less in terms of PPD per se to a broader consideration of poor mental health, including anxiety after giving birth. Some risk factors for poor mental health in the post-partum period can be identified prenatally; however prenatal screening tools developed to date have had poor sensitivity and specificity. The objective of this study was to develop a screening tool that identifies women at risk of distress, operationalized by elevated symptoms of depression and anxiety in the post-partum period using information collected in the prenatal period. Using data from the All Our Babies Study, a prospective cohort study of pregnant women living in Calgary, Alberta (N = 1578), we developed an integer score-based prediction rule for the prevalence of PPD, as defined as scoring 10 or higher on the Edinburgh Postnatal Depression Scale (EPDS) at 4-months postpartum. The best fit model included known risk factors for PPD: depression and stress in late pregnancy, history of abuse, and poor relationship quality with partner. Comparison of the screening tool with the EPDS in late pregnancy showed that our tool had significantly better performance for sensitivity. Further validation of our tool was seen in its utility for identifying elevated symptoms of postpartum anxiety. This research heeds the call for further development and validation work using psychosocial factors identified prenatally for identifying poor mental health in the post-partum period. © 2012 Blackwell Publishing Ltd.
Mawson, Anthony R; Xueyuan, Wang
Postpartum depression (PPD) is an international public health problem affecting at least 1 in 8 mothers. Known risk factors include: giving birth to a preterm or low birth weight infant, babies with greater symptoms of illness at age 4-6 weeks, formula feeding, younger maternal age, smoking, and fatigue. Prolonged breastfeeding is associated with a reduced risk of PPD but the mechanisms are not well understood. Interventions for PPD focusing on psychosocial risk factors have been largely unsuccessful, suggesting that the condition has a mainly biological basis. The hypothesis proposed for consideration is that breastfeeding protects against PPD by maintaining endogenous retinoids (vitamin A-related compounds) below a threshold concentration. In fact, breast milk is rich in retinoids; pregnant women accumulate retinoids in liver and breast in preparation for lactation; there is increasing evidence that retinoids in higher concentration are associated with cognitive disturbances and mood disorders, including depression and suicide; and prolonged lactation reduces maternal stores of retinoids. Consistent with this hypothesis, it is estimated that an amount of vitamin A is transferred from mother to infant during the first six months of exclusive breastfeeding equivalent to 76% of a dose known to cause acute vitamin A poisoning in an adult. Breastfeeding may thus have evolutionary-adaptive functions for both mother and infant, transferring vital nutrients to an infant unable to feed itself, yet at the same time providing a natural means of reducing potentially toxic concentrations of retinoids in the mother. © 2013 Elsevier B.V. All rights reserved.
Vliegen, Nicole; Luyten, Patrick; Besser, Avi; Casalin, Sara; Kempke, Stefan; Tang, Eileen
This prospective longitudinal study investigated the role of the personality dimensions of dependency and self-criticism in the course of depressive symptoms in a sample of inpatient severely postpartum depressed mothers (n = 55). Depressive symptoms and personality were measured during hospitalization and on average 3 1/2 years later. In line with previous research, a considerable subgroup of mothers (39%) reported moderate to severe symptoms of depression at time 2. In addition, although these mothers did not exhibit more depressive episodes during follow-up period compared with mothers with a less chronic course of depression, their depressive episodes were considerably longer, and they had higher levels of severity of depression as well as of dependency and self-criticism at Time 1. Finally, self-criticism, but not dependency, assessed at Time 1, predicted both depression diagnosis and levels of depression at follow-up, supporting a vulnerability model positing that self-criticism confers vulnerability for depression over time.
Roberts, Timothy A; Hansen, Shana
Studies have demonstrated an association between hormonal contraception use with subsequent depression and antidepressant use. This association has not been assessed among postpartum women. This study is a secondary analysis of insurance records from 75,528 postpartum women enrolled in the US military medical system, who delivered between October 2012 and September 2014. Our analyses excluded women who used antidepressants or had a diagnosis of depression in the 24months prior to delivery. We assessed the relationship of hormonal contraception use with subsequent antidepressant use or diagnosis with depression in the first 12months postpartum using Cox proportional hazards regression, with a time dependent covariate measuring exposure to hormonal contraception. Antidepressants were prescribed to 7.8% of women and 5.0% were diagnosed with depression. In multivariable analysis adjusting for demographics, both antidepressant use and diagnosis with depression were associated with: younger age, lower socioeconomic status, and a history of military service. Compared to women with no hormonal contraceptive use, use of etonogestrel containing contraception was associated with a higher risk of antidepressant use (Implant: adjHR:1.22(95%CI:1.06-1.41), pdepression diagnosis (0.56(0.49-0.64), pdepression diagnoses (0.65(0.52-0.82), pdepression diagnosis and antidepressant use in the postpartum period varies with the type of hormonal contraception used. Further research is required to describe the mechanisms of these relationships. Published by Elsevier Inc.
Conclusions: The findings of this research confirm marriage interpersonal psychotherapy on the depression recovery and the increasing marriage satisfaction of women suffering from postpartum depression.
McKay, Judith; Shaver-Hast, Laura; Sharnoff, Wendy; Warren, Mary Ellen; Wright, Harry
Postpartum depression (PPD) has an impact on the entire family. The authors describe a model of intervention that emphasizes the family system and includes mothers, fathers, and children in the treatment of PPD. The intervention is provided by a multidisciplinary team consisting of a psychiatrist, social worker, child psychologist, and therapists.…
Recently, methodologists interested in examining problems associated with measuring change have suggested that developmental researchers should focus upon assessing change at both intra-individual and inter-individual levels. This study used an application of individual growth curve analysis to the problem of maternal postpartum depression.…
Conclusions: Studies demonstrate that breastfeeding can protect mothers from postpartum depression, and are starting to clarify which biological and psychological processes may explain this protection. However, there are still equivocal results in the literature that may be explained by the methodological limitations presented by some studies.
Abstract. Background Postpartum depression is a common psychiatric complication of childbearing among women. The increasing rate in addition to poor clinical diagnosis is attributable to poor health care services and inadequate medical attention. The implication is the high morbidity with adverse social and medical ...
Background: Major depression is a common and disabling complication of the postpartum period in women. It is thought to occur three times more commonly in the developing than in developed countries. Objectives: The objectives of this study were to determine the prevalence of and factors associated with major ...
Fairbrother, Nichole; Woody, Sheila R
This prospective study examined psychological and obstetrical predictors of enduring postpartum symptoms of depression and post-traumatic stress disorder. Contrary to prediction, prenatal fear of childbirth did not significantly predict symptoms of depression or post-traumatic stress disorder at one month postpartum, but anxiety sensitivity was an unexpected predictor that merits further investigation. Several obstetrical and neonatal variables significantly predicted symptoms of post-traumatic disorder, but not depression.
Turan, Bulent; Stringer, Kristi L; Onono, Maricianah; Bukusi, Elizabeth A; Weiser, Sheri D; Cohen, Craig R; Turan, Janet M
Background While studies have suggested that depression and HIV-related stigma may impede access to care, a growing body of literature also suggests that access to HIV care itself may help to decrease internalized HIV-related stigma and symptoms of depression in the general population of persons living with HIV. However, this has not been investigated in postpartum women living with HIV. Furthermore, linkage to care itself may have additional impacts on postpartum depression beyond the effect...
Uguz, Faruk; Akman, Cemal; Sahingoz, Mine; Kaya, Nazmiye; Kucur, Rahim
Long-term follow-up and risk factors of persistent post-partum depression (PPD) are fairly unknown compared with its prevalence in the developing countries. In this study, we did a follow-up measure of PPD and examined the factors, which were associated with PPD 1-year post-partum. Our sample comprised of 34 women. Depressive symptoms were assessed by the Edinburgh post-natal depression scale (EPDS) 6 weeks post-partum, and women with scores >12 on this scale was categorised as depressed. Personality disorders were determined at the same occasion by means of the Structured Clinical Interview for DSM-III-R personality disorders (SCID-II). One year post-partum EPDS was completed. The rate of PPD 1-year post-partum was 32.4%, and it was unrelated to age at assessment, primiparity, number of children, employment status, economical status and educational level. Women depressed 1-year post-partum had significantly higher basal scores of EPDS and more often also a diagnosis of any axis II disorder; and specifically dependent and obsessive-compulsive personality disorders. In our sample, the predictors of 1-year post-partum PPD were having higher basal score of EPDS and the existence of a personality disorder. This study suggests that women with PPD, scoring high in the EPDS scale 6 weeks post-partum and having a personality disorder, run a higher risk for depression at 1-year follow-up.
Hutchens, Bridget F; Kearney, Joan; Kennedy, Holly Powell
An integrative review was performed to explore the relationship between a maternal history of child maltreatment and subsequent postpartum depression (PPD) symptoms. Six electronic databases were used to explore the literature, including PubMed, CINAHL, MEDLINE, PsycINFO, Embase, and Scopus. Studies were included that used victims of child maltreatment as one of the independent variables and PPD symptoms as one of the dependent variables. Studies were excluded if they focused only on women with adult intimate partner violence or women with PPD who were perpetrators of child abuse rather than survivors. The studies were required to be original research, and there was no limit to years or language. The search yielded 589 studies, 16 of which were included in the final sample. These studies were assessed for quality, and a data display matrix was developed to extract the sample, design, methods, operational definitions for independent and dependent variables of interest, major findings with effect sizes, and limitations. Using the data display matrix, the studies' methods and findings were synthesized for divergent and convergent patterns. Studies were varied in their designs, samples, and operational definitions of child maltreatment and PPD, and were low to moderate in quality. Results were inconsistent, but a majority suggest a positive association between a maternal history of child maltreatment and subsequent symptoms of PPD. Child maltreatment and PPD are complex issues that require careful screening by women's health care providers and clearly defined operational definitions in future research. Implications for clinical practice and research are discussed. © 2017 by the American College of Nurse-Midwives.
Roomruangwong, Chutima; Anderson, George; Berk, Michael; Stoyanov, Drozdstoy; Carvalho, André F; Maes, Michael
A large body of evidence indicates that major affective disorders are accompanied by activated neuro-immune, neuro-oxidative and neuro-nitrosative stress (IO&NS) pathways. Postpartum depression is predicted by end of term prenatal depressive symptoms whilst a lifetime history of mood disorders appears to increase the risk for both prenatal and postpartum depression. This review provides a critical appraisal of available evidence linking IO&NS pathways to prenatal and postpartum depression. The electronic databases Google Scholar, PubMed and Scopus were sources for this narrative review focusing on keywords, including perinatal depression, (auto)immune, inflammation, oxidative, nitric oxide, nitrosative, tryptophan catabolites (TRYCATs), kynurenine, leaky gut and microbiome. Prenatal depressive symptoms are associated with exaggerated pregnancy-specific changes in IO&NS pathways, including increased C-reactive protein, advanced oxidation protein products and nitric oxide metabolites, lowered antioxidant levels, such as zinc, as well as lowered regulatory IgM-mediated autoimmune responses. The latter pathways coupled with lowered levels of endogenous anti-inflammatory compounds, including ω3 polyunsaturated fatty acids, may also underpin the pathophysiology of postpartum depression. Although increased bacterial translocation, lipid peroxidation and TRYCAT pathway activation play a role in mood disorders, similar changes do not appear to be relevant in perinatal depression. Some IO&NS biomarker characteristics of mood disorders are found in prenatal depression indicating that these pathways partly contribute to the association of a lifetime history of mood disorders and perinatal depression. However, available evidence suggests that some IO&NS pathways differ significantly between perinatal depression and mood disorders in general. This review provides a new IO&NS model of prenatal and postpartum depression. Copyright © 2017 Elsevier Inc. All rights reserved.
Catarine S. Silva
Full Text Available Abstract Objective: To investigate the association between postpartum depression and the occurrence of exclusive breastfeeding. Method: This is a cross-sectional study conducted in the states of the Northeast region, during the vaccination campaign in 2010. The sample consisted of 2583 mother-child pairs, with children aged from 15 days to 3 months. The Edinburgh Postnatal Depression Scale was used to screen for postpartum depression. The outcome was lack of exclusive breastfeeding, defined as the occurrence of this practice in the 24 h preceding the interview. Postpartum depression was the explanatory variable of interest and the covariates were: socioeconomic and demographic conditions; maternal health care; prenatal, delivery, and postnatal care; and the child's biological factors. Multivariate logistic regression analysis was conducted to control for possible confounding factors. Results: Exclusive breastfeeding was observed in 50.8% of the infants and 11.8% of women had symptoms of postpartum depression. In the multivariate logistic regression analysis, a higher chance of exclusive breastfeeding absence was found among mothers with symptoms of postpartum depression (OR = 1.67; p < 0.001, among younger subjects (OR = 1.89; p < 0.001, those who reported receiving benefits from the Bolsa Família Program (OR = 1.25; p = 0.016, and those started antenatal care later during pregnancy (OR = 2.14; p = 0.032. Conclusions: Postpartum depression contributed to reducing the practice of exclusive breastfeeding. Therefore, this disorder should be included in the prenatal and early postpartum support guidelines for breastfeeding, especially in low socioeconomic status women.
Hipwell, Alison E.; Stepp, Stephanie D.; Moses-Kolko, Eydie L.; Xiong, Shuangyan; Paul, Elena; Merrick, Natalie; McClelland, Samantha; Verble, Danielle; Keenan, Kate
Purpose Symptoms of depression and anxiety in pregnancy have been linked to later impaired caregiving. However, mood symptoms are often elevated in pregnancy and may reflect motherhood-specific concerns. In contrast, little is known about the effects of pre-pregnancy depression and anxiety on postpartum caregiving. Understanding these developmental risk factors is especially important when childbearing also occurs during adolescence. Methods The sample comprised 188 adolescent mothers (ages 12–19 years) who had participated in a longitudinal study since childhood. Mothers were observed in face-to-face interaction with the infant at 4 months postpartum, and caregiving behaviors (sensitivity, hostile-intrusive behavior and mental state talk) were coded independently. Data on self-reported depression and anxiety gathered in the five years prior to childbirth were drawn from the large-scale longitudinal study. Results Parallel process latent growth curve models revealed unique effects of distal anxiety and slow decline in anxiety over time on lower levels of maternal mental state talk after accounting for the overlap with depression symptom development. Depressive symptoms showed significant stability from distal measurement to the postpartum period, but only concurrent postpartum mood was associated with poorer quality of maternal speech. Conclusions The results highlight specific targets for well-timed preventive interventions with vulnerable dyads. PMID:26971266
Full Text Available ... give up. Read more about depression on this Web page. If the symptoms fit, get help now. ... Contact Us U.S. Department of Health and Human Services National Institutes of Health USA.gov The National ...
Full Text Available ... for Mental Illnesses Clinical Trials Outreach Outreach Home Stakeholder Engagement Outreach Partnership Program Alliance for Research Progress ... Symptoms can vary, but many depressed people lose interest in activities they normally enjoyed, have feelings of ...
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Full Text Available ... a minute really to do anything that took deep concentration. I tried a journal and I tried ... give up. Read more about depression on this Web page. If the symptoms fit, get help now. ...
Full Text Available ... to recovery. Depression treatment can take time to work, so don't give up. Read more about depression on this Web page. If the symptoms fit, get help ... Mental Health Information Summaries of Scientific Meetings Information about NIMH ...
Full Text Available ... few days. It is a serious illness that affects many people. Symptoms can vary, but many depressed people lose interest in ... I did have depression. NARRATOR : Medications called antidepressants can ... to figuring out exactly how these medications work, who benefits from them the ...
Full Text Available ... to recovery. Depression treatment can take time to work, so don't give up. Read more about depression on this Web page. If the symptoms fit, get help now. ... of Scientific Meetings Information about NIMH RePORTER : Research Portfolio Online ...
Karraker, Katherine Hildebrandt; Young, Marion
Relations between night waking in infants and depressive symptoms in their mothers at 6 months postpartum were examined using the data from the National Institute for Child Health and Human Development Study of Early Child Care. Although more depressive symptoms were only weakly correlated with a higher frequency of infant waking, longer wake…
Full Text Available Background & aim: Childbirth is a stressful event in women’s lives, and if a mother perceives it as an unpleasant event, it can influence her postpartum mental health. Depression is a common mental disorder, which can has serious consequences depending on its severity. Therefore, this study aimed to investigate the effect of debriefing and brief cognitive-behavioral therapy on postpartum depression in traumatic childbirth. Methods: This clinical trial was performed on 179 mothers who experienced a traumatic childbirth and were admitted in postnatal ward of Nohom Dey Hospital in Torbat-e Heydarieh, North East of Iran in 2016. The subjects were randomly allocated into three groups, including two intervention groups of debriefing and brief cognitive-behavioral counseling and a control group. The intervention groups received appropriate counseling for 40-60 minutes in the first 48 postpartum hours and the control group received the routine postpartum care. Edinburgh Postnatal Depression Scale was used to evaluate postpartum depression 4-6 weeks and also three months after the intervention. Post-traumatic stress symptoms in were compared in three groups using t-test, chi-square test, and repeated measures analysis of variance. Results: No significant differences were observed between the mean depression scores of the two intervention groups and that of the control group 4-6 weeks after childbirth. However, three months after delivery, the mean depression scores of the two intervention groups was lower than the control group (P
Grekin, Rebecca; Brock, Rebecca L; O'Hara, Michael W
Research suggests that trauma exposure is associated with perinatal depression; however, little is known about the nature of the relation between trauma history and trajectory of depression, as well as the predictive power of trauma history beyond other risk factors. Additionally, more research is needed in at-risk samples that are likely to experience severe traumatic exposure. Secondary data analysis was conducted using demographic and depression data from the Healthy Start and Empowerment Family Support programs in Des Moines, Iowa. Hierarchical linear modeling was used to examine trajectories of perinatal depressive symptoms, from pregnancy to 24 months postpartum, and clarify whether trauma exposure, relationship status, and substance use uniquely contribute to trajectories of symptoms over time. On average, depressive symptoms decreased from pregnancy to 24 months postpartum; however, trajectories varied across women. Single relationship status, substance use, and trauma history were each predictors of higher depression levels at several points in time across the observed perinatal period. Single relationship status was also associated with decline in depressive symptoms followed by a rebound of symptoms at 22 months postpartum. These data were not collected for research purposes and thus did not undergo the rigorous data collection strategies typically implemented in an established research study. History of trauma, substance use and single relationship status represent unique risk factors for perinatal depression. For single women, depressive symptoms rebound late in the postpartum period. Single women are at greater risk for substance use and traumatic exposure and represent a sample with cumulative risk. Eliciting social support may be an important intervention for women presenting with these risk factors. Copyright © 2017 Elsevier B.V. All rights reserved.
Choi, Mi Son; Lee, Eun Ja
To identify the effects of foot reflexology massage on fatigue, stress and depression of postpartum women. A nonequivalent control group pre-post design was used. A total of 70 women in a postpartum care center were recruited and were assigned to the experimental group (35) or control group (35). Foot reflexology massage was provided to the experimental group once a day for three days. Data were collected before and after the intervention program which was carried out from December, 2013 to February, 2014. Data were analyzed using Chi-square test, Fisher's exact test, and t-test. The level of fatigue in the experimental group was significantly lower than the control group (t=-2.74, p=.008). The level of cortisol in the urine of women in the experimental group was significantly lower than the control group (t=-2.19, p=.032). The level of depression in the experimental group was significantly lower than the control group (t=-3.00, p=.004). The results show that the foot reflexology massage is an effective nursing intervention to relieve fatigue, stress, and depression for postpartum women.
Paris, Ruth; Bolton, Rendelle E; Weinberg, M Katherine
To date, few studies have examined suicidality in women with postpartum depression. Reports of suicidal ideation in postpartum women have varied (Lindahl et al. Arch Womens Ment Health 8:77-87, 2005), and no known studies have examined the relationship between suicidality and mother-infant interactions. This study utilizes baseline data from a multi-method evaluation of a home-based psychotherapy for women with postpartum depression and their infants to examine the phenomenon of suicidality and its relationship to maternal mood, perceptions, and mother-infant interactions. Overall, women in this clinical sample (n = 32) had wide ranging levels of suicidal thinking. When divided into low and high groups, the mothers with high suicidality experienced greater mood disturbances, cognitive distortions, and severity of postpartum symptomotology. They also had lower maternal self-esteem, more negative perceptions of the mother-infant relationship, and greater parenting stress. During observer-rated mother-infant interactions, women with high suicidality were less sensitive and responsive to their infants' cues, and their infants demonstrated less positive affect and involvement with their mothers. Implications for clinical practice and future research directions are discussed.
Full Text Available AbstrakLatar belakang: Ibu yang melahirkan diharapkan tidak mengalami rasa sedih pasca persalinan yang berdampak jangka panjang antara lain menyebabkan gangguan pertumbuhan dan perkembangan anak. Tujuan analisis ini untuk mengidentifikasi beberapa faktor terhadap rasa sedih pasca melahirkan.Metode: Analisis ini merupakan sebagian data Riset Kesehatan Dasar (Riskesdas 2010 yang dilaksanakan di seluruh Indonesia dengan sampling bertahap. Analisis dilakukan terhadap wanita yang menikah atau pernah menikah berumur 13-49 tahun yang melahirkan bayi antara 1 January 2005 sampai 31 August 2010. Analisis mempergunakan regresi logistik.Hasil:Prevalensi rasa sedih pasca persalinan sebesar 2,32% (440/18937. Wanita yang melahirkan bayi dengan ukuran sangat kecil berisiko tertinggi mengalami (4,8-lipat rasa sedih pasca persalinan [rasio odds suaian (ORa=4,84; 95% interval kepercayaan (CI=2,89-8,12], dan yang mempunyai bayi kecil 67% lebih besar mengalami rasa sedih pasca persalinan (ORa=1,67; 95% CI =1,20-2,33. Selain itu wanita yang mengalami komplikasi pasca persalinan berisiko lebih besar mengalami rasa sedih pasca persalinan. Dibandingkan dengan yang tidak mengalami komplikasi, wanita yang mengalami pecah ketuban dini mengalami risiko lebih tinggi 6 kali lipat (ORa=6,02; 95% CI=4,63-7,83, disusul yang mengalami partus macet (ORa=5.75; 95% CI=3,05-10,85.Kesimpulan:Wanita yang mengalami komplikasi selama persalinan atau mempunyai besar bayi tidak rata-rata berisiko lebih besar mengalami rasa sedih pasca persalinan.(Health Science Indones 2012;1:3-8Kata kunci: post partum, rasa sedih, komplikasi, besar bayi, IndonesiaAbstractBackground:A mother’s postpartum depression may have long-term impacts on a child’s growth and development. This analysis aimed to identify several risk factors related to postpartum depression.Methods:The data analyzed originated from a cross-sectional Basic Health Survey (Riskesdas 2010 of Indonesia which provided specific
Full Text Available In this study we review recent research literature focused on relationship between unemployment and depression, and theories emphasizing the mechanisms by which unemployment may contribute to increased levels of depression. Our research investigated depressive symptomatology and its predictors among unemployed people (N = 453 varying in length of unemployment. Results showed that self - mastery, self - esteem, financial strain, gender, intensity of job - seek behavior and length on unemployment were significant predictors of depressive symptoms. Results are discussed in light of current theories of unemployment and mental health and recommendations are made for practice.
Cordes, Katharina; Smith-Nielsen, Johanne; Tharner, Anne
, and thus maternal psychopathology after birth, such as postpartum depression (PPD) and Personality Disorder (PD), may not only affect the mother’s socioemotional functioning but also the development of the child. However, little is known about mentalizing abilities of PPD mothers, and mothers with PPD...... and comorbid PD. Therefore, the aim of this study was to evaluate RF in women presenting symptoms of PPD (n = 13), and women with PPD symptoms and comorbid PD (n = 14) compared with a nonclinical group (n = 52). Women were interviewed with the Adult Attachment Interview (AAI) before birth (nonclinical group...
Thombs, Brett D.; Arthurs, Erin; Coronado-Montoya, Stephanie; Roseman, Michelle; Delisle, Vanessa C.; Leavens, Allison; Levis, Brooke; Azoulay, Laurent; Smith, Cheri; Ciofani, Luisa; Coyne, James C.; Feeley, Nancy; Gilbody, Simon; Schinazi, Joy; Stewart, Donna E.; Zelkowitz, Phyllis
Objective: Clinical practice guidelines disagree on whether health care professionals should screen women for depression during pregnancy or postpartum. The objective of this systematic review was to determine whether depression screening improves depression outcomes among women during pregnancy or
Johns, Alexis L; Hershfield, Jennifer A; Seifu, Netsanet Mulugeta; Haynes, Karla A
This study describes postpartum depression rates and risk factors for mothers with infants with cleft lip and/or palate as postpartum depression has been associated with a range of negative maternal and child outcomes. A retrospective chart review from August 2009 to May 2015 included medical diagnoses, demographics, receipt of prenatal diagnosis, and the Edinburgh Postnatal Depression Scale (EPDS). Mothers (N = 206) had infants (59.2% male; mean age in weeks 5.1 ± 6.9) with isolated cleft lip (18%), cleft palate (22.8%), or cleft lip and palate (59.2%). Mothers ranged from 16 to 45 years old (mean age 29 ± 6.2) and half had received a prenatal diagnosis. Patients mostly had public insurance (57.8%) and represented diverse ethnicities. Based on the EPDS, 11.7% of mothers met the depression cutoff of 10 or higher. The majority endorsed self-blame (68.9%), difficulty coping (59.2%), and feeling anxious (57.3%). Mothers of infants with cleft lip or cleft lip and palate who did not receive a prenatal diagnosis had higher total EPDS scores, anxiety, and incidence of feeling scared. Higher EPDS scores were predicted by not having a prenatal diagnosis and by older maternal age. Mothers of infants with a cleft had similar rates of postpartum depression as the general population; however, those who were older and who did not receive a prenatal diagnosis endorsed more symptoms. Prenatal diagnosis may contribute to positive maternal postpartum adjustment. Providers should incorporate screening for risk factors into their evaluation and treatment planning.
Aswathi, A; Rajendiren, Soundravally; Nimesh, Archana; Philip, R Ravi; Kattimani, Shivanand; Jayalakshmi, D; Ananthanarayanan, P H; Dhiman, Pooja
In view of the reported cases of mood disorders that occur in mothers following childbirth and believing that sex steroid hormones contribute to mood and behavioral changes, this study has been aimed to explore the role of sex steroid hormones as an etiological factor for postpartum depression (PPD). This study was conducted at JIPMER, Puducherry, India between January 2010 and 2011. 103 women were recruited in the study after childbirth, out of which 62 women who were believed to be suffering from PPD were categorized as cases and the remaining 41 with no mood changes as controls, using Edinburgh Postpartum Depression Scale (EPDS) (cases had EPDS score ≥10 at 24-28h, controls had score postpartum). The hormones estimated in these two groups included estradiol, progesterone and testosterone, and their levels were compared between these two groups. A significantly high testosterone levels were observed in cases with PPD at 24-28h when compared to controls. Estradiol and progesterone levels did not show significant difference between cases and controls. ROC analysis done at 24-28h showed that testosterone levels beyond 42.71ng/mL predict the development of PPD with 79% sensitivity, 63% specificity, 68% positive predictive value, 74% negative predictive value with AUC being 0.708. This study shows that there is an association between persistent high serum testosterone level in women following childbirth and PPD. Copyright © 2015 Elsevier B.V. All rights reserved.
Safadi, Reema R; Abushaikha, Lubna A; Ahmad, Muayyad M
This cross-sectional correlational study examined post-partum depression and its relationship with demographic, maternal, and infant health problems in urban Jordanian women. Participants (n = 315) were selected from five maternal child healthcare centers and one major hospital in Amman, Jordan. Patient Health Questionnaire-9 was used to measure post-partum depression within 12 weeks of birth. A number of socio-demographic and health problems were examined for an association with post-partum depression. Results showed that 25% of post-partum women suffered moderate to severe depression and 50% of the sample had mild depression. None of the socio-demographic variables (age, education, employment, income) were significantly related to post-partum depression; however, two obstetric/infant variables (mode of birth and breastfeeding), were significantly associated with post-partum depression. There was a significant association between post-partum depression and 15 health problems of obstetric, gynecologic (i.e. episiotomy pain, infection), and general health conditions (i.e. fatigue, headache). Nurses and midwives need to emphasize post-partum depression screening, follow-up, and proper management of maternal and infant health factors predisposing to post-partum depression rather than merely focusing on women's inherent demographic factors. © 2015 Wiley Publishing Asia Pty Ltd.
Misri, Shaila; Swift, Elena
Comorbid generalized anxiety disorder (GAD) and major depressive disorder (MDD) in perinatal women is often under-diagnosed, resulting in suboptimal treatment and leading to significant maternal dysfunction. We describe a prospective, longitudinal study of the course, treatment outcomes, and quality of life (QoL) in pregnant and postpartum women with MDD and anxiety disorders. Two separate cohorts of women were recruited through the Reproductive Mental Health Program, Women's and Children's Hospital, Vancouver, British Columbia, for pharmacotherapy of depressed mood. One cohort was recruited during pregnancy and followed to one month postpartum; the other cohort was recruited postpartum and followed for 12 weeks. All women met the DSM-5 criteria for MDD and anxiety disorders. This non-lactating perinatal population completed measures of depression, anxiety, worry symptoms, and QoL at multiple study visits. Depressed women with GAD or excessive worry were compared to those without GAD in each cohort. Analysis revealed that despite the majority of women with MDD having remission of symptoms with treatment, those with postpartum GAD displayed a poorer quality of life, with persistent worry symptoms, and their illness was slower to remit. Pregnant depressed women with uncontrollable worry (a GAD indicator) showed a lower probability of achieving remission of symptoms with treatment than those without uncontrollable worry. All pregnant and postpartum women with GAD and MDD responded to pharmacotherapy, and the majority attained complete remission of MDD. However, their GAD symptoms persisted, and their QoL was compromised. Given the chronic debilitating course of concomitant MDD and GAD in the perinatal population, it is essential to focus on adjunctive therapies to aim for full recovery.
Kersten-Alvarez, Laura E.; Hosman, Clemens M. H.; Riksen-Walraven, J. Marianne; van Doesum, Karin T. M.; Smeekens, Sanny; Hoefnagels, Cees
Previous studies of the long-term effects of maternal postpartum depression (PPD) on child development have mostly focused on a limited set of outcomes, and have often not controlled for risk factors associated with maternal depression. The present study compared children of postpartum depressed mothers (n = 29) with children from a community…
Logsdon, M. Cynthia; Foltz, Melissa Pinto; Scheetz, James; Myers, John A.
Based upon the Self-Efficacy Theory, this study examined the relationship between self-efficacy, self-efficacy-related variables, and postpartum depression teaching behaviors of hospital-based perinatal nurses. Findings revealed that teaching new mothers about postpartum depression is related to a perinatal nurse's self-efficacy in postpartum-depression teaching, self-esteem, and the following self-efficacy-related variables: social persuasion (supervisor's expectations for teaching); mastery...
Varela, Pinelopi; Spyropoulou, Areti C; Kalogerakis, Zacharias; Vousoura, Eleni; Moraitou, Martha; Zervas, Iannis M
Aim The aim of the present study was to assess the association of gestational diabetes mellitus (GDM) with prenatal and postnatal depressive symptoms in a sample of pregnant women in Greece. Earlier research supports a relationship between depression and diabetes, but only a few studies have examined the relationship between GDM and perinatal depressive symptomatology. A total of 117 women in their third trimester of pregnancy participated in the study. Demographic and obstetric history data were recorded during women's third trimester of pregnancy. Depressive symptoms were assessed with the validated Greek version of the Edinburg Postnatal Depression Scale (EPDS) at two time points: on the third trimester of pregnancy and on the first week postpartum. Findings Prevalence of GDM was 14.5%. Probable diagnosis of depression occurred for 12% of the sample during the antenatal assessment and 15.1% in the postpartum assessment. In the first week postpartum, women with GDM had significantly higher postpartum (but no antenatal) EPDS scores compared with the non-GDM cohort. In conclusion, GDM appears to be associated with depressive symptoms in the first week postpartum. Clinical implications and recommendations for future research are discussed, emphasizing the importance of closely monitoring women with GDM who seem more vulnerable to developing depressive symptomatology during the postnatal period.
Mandelli, Laura; Souery, Daniel; Bartova, Lucie; Kasper, Siegfried; Montgomery, Stuart; Zohar, Joseph; Mendlewicz, Julien; Serretti, Alessandro
There is evidence for a bipolar diathesis in postpartum depression (PPD) and women presenting with a first PPD frequently receive a diagnosis of bipolar type II disorder (BD-II). However formal evidence for an association between BD-II and PPD has not yet been reported. In the present study we tested a potential association between BD-II and PPD. Parous women with a diagnosis of bipolar type I disorder (BD-I) (n=93), BD-II (n=36) or major depressive disorder (MDD) (n=444) were considered in the present study. All women were retrospectively evaluated for history of PPD (DSM-IV criteria) and other clinical and socio-demographic features. Women with a history of PDD (n=139, 24%) were younger, younger at illness onset and had more family history for BD compared to women without history of PPD (n=436, 75.9%). Half of BD-II women reported PPD (50%), compared to less than one-third of BD-I and MDD women (respectively 27.5% and 21.6%) (p=0.004). Limitations include the retrospective assessment of PPD and no available data about the timing of postpartum episodes, illness onset or psychiatric care before or after childbirth, and the number of postpartum episodes. BD-II may confer a remarkable risk for PPD, which may be even higher than that of women affected by BD-I disorder. Careful monitoring of BD-II women during the pregnancy and postpartum period, as well as assessment of bipolar features in women with a PPD without a current diagnosis of BD are recommended. Copyright © 2016 Elsevier B.V. All rights reserved.
Savarimuthu, R J S; Ezhilarasu, P; Charles, H; Antonisamy, B; Kurian, S; Jacob, K S
Post-partum depression, although heterogeneous, is often considered a medical disease when viewed from the biomedical perspective. However, recent reports from the Indian subcontinent have documented psychosocial causal factors. This study employed qualitative methodology in a representative sample of women in rural South India. Women in the post-partum period were assessed using the Tamil versions of the Short Explanatory Model Interview, the Edinburgh Postnatal Depression Scale and a semi-structured interview to diagnose ICD 10 depression. Socio-demographic and clinical details were also recorded. Some 137 women were recruited and assessed, of these, 26.3% were diagnosed to have post-partum depression. The following factors were associated with post-partum depression after adjusting for age and education: age less than 20 or over 30 years, schooling less than five years, thoughts of aborting current pregnancy, unhappy marriage, physical abuse during current pregnancy and after childbirth, husband's use of alcohol, girl child delivered in the absence of living boys and a preference for a boy, low birth weight, and a family history of depression. Post-partum depression was also associated with an increased number of causal models of illness, a number of non-medical models, treatment models and non-medical treatment models. Many social and cultural factors have a major impact on post-partum depression. Post-partum depression, when viewed from a biomedical framework, fails to acknowledge the role of context in the production of emotional distress in the post-partum period.
McDonagh, Marian S; Matthews, Annette; Phillipi, Carrie; Romm, Jillian; Peterson, Kim; Thakurta, Sujata; Guise, Jeanne-Marie
To evaluate the comparative benefits and harms in both mother and child of antidepressant treatment for depression in pregnant or postpartum women. MEDLINE, the Cochrane Library, CINAHL, Scopus, ClinicalTrials.gov (inception to July 2013), manufacturers, and reference lists. Two reviewers independently selected studies of pregnant women with depression comparing antidepressants with each other, placebo or no treatment, or nondrug treatments. Studies making comparisons among women taking antidepressants for any reason and those not taking antidepressants (depression status unknown) were used to fill gaps in the evidence. Dual study data extraction and quality assessment were used. Six randomized controlled trials and 15 observational studies provided evidence. Low-strength evidence suggested neonates of pregnant women with depression taking selective serotonin reuptake inhibitors had higher risk of respiratory distress than did neonates of untreated women (13.9% compared with 7.8%; Pdepression status unknown) suggested future research should focus on congenital anomalies and autism spectrum and attention deficit disorders in the child. In postpartum depression, low-strength evidence suggested symptom response was not improved when sertraline was added to psychotherapy or when cognitive-behavioral therapy was added to paroxetine. Evidence was insufficient for other outcomes, including depression symptoms, functional capacity, breastfeeding, and infant and child development. A serious limitation is the lack of study populations of exclusively depressed pregnant and postpartum women. Evidence about the comparative benefits and harms of pharmacologic treatment of depression in pregnant and postpartum women was largely inadequate to allow informed decisions about treatment. Considering the prevalence of depression, filling this gap is essential.
Full Text Available Lin Lin, Xiao-mei Chen, Rong-hua Liu Department of Obstetrics and Gynecology, Linyi People’s Hospital, Shandong, People’s Republic of China Background: Postpartum depression (PPD could affect ~10% of women and impair the quality of mother–infant interactions. Currently, there are no objective methods to diagnose PPD. Therefore, this study was conducted to identify potential biomarkers for diagnosing PPD.Materials and methods: Morning urine samples of PPD subjects, postpartum women without depression (PPWD and healthy controls (HCs were collected. The gas chromatography-mass spectroscopy (GC-MS-based urinary metabolomic approach was performed to characterize the urinary metabolic profiling. The orthogonal partial least-squares-discriminant analysis (OPLS-DA was used to identify the differential metabolites. The logistic regression analysis and Bayesian information criterion rule were further used to identify the potential biomarker panel. The receiver operating characteristic curve analysis was conducted to evaluate the diagnostic performance of the identified potential biomarker panel.Results: Totally, 73 PPD subjects, 73 PPWD and 74 HCs were included, and 68 metabolites were identified using GC-MS. The OPLS-DA model showed that there were 22 differential metabolites (14 upregulated and 8 downregulated responsible for separating PPD subjects from HCs and PPWD. Meanwhile, a panel of five potential biomarkers – formate, succinate, 1-methylhistidine, a-glucose and dimethylamine – was identified. This panel could effectively distinguish PPD subjects from HCs and PPWD with an area under the curve (AUC curve of 0.948 in the training set and 0.944 in the testing set.Conclusion: These results demonstrated that the potential biomarker panel could aid in the future development of an objective diagnostic method for PPD. Keywords: postpartum depression, gas chromatography-mass spectroscopy, biomarker, metabolomics
Schwab-Reese, Laura M; Schafer, Ellen J; Ashida, Sato
Poor maternal mental health during the postpartum period can have significant effects on the health of mothers, infants, and families. The findings from cross-sectional studies suggest that stress and social support are related to maternal mental health. This study contributes to the literature through the use of longitudinal data, and examines moderation and mediation among these factors. In 2012-2013, mothers completed surveys assessing stress, social support, and depressive and anxiety symptoms following birth (n = 125), and 3 months (n = 110) and 6 months (n = 99) after birth. The authors examined temporal associations, moderation, and mediation of social support on the relationship between stress and postpartum depressive and anxiety symptoms using modified Poisson regression models and the counterfactual approach to mediation. Current levels of stress and social support were associated with depressive and anxiety symptoms, both independently and when considered together at multiple time points. Social support did not strongly moderate or mediate the relationships between stress and maternal mental health. Interventions to reduce current perceptions of stress and increase social support for mothers during the postpartum period may help improve maternal mental health symptoms. Efforts are needed to assess the current needs of mothers continuously.
Robert H. Keefe
Full Text Available The Patient Protection and Affordable Care Act (ACA mandates ongoing research on postpartum depression; however, very little research has been published in social work journals and in advanced-level textbooks on this topic. This article describes the problem of postpartum depression and argues that social work educators and researchers must pay greater attention to this issue in light of the ACA mandates, so that social workers can provide effective services to postpartum mothers and their children. The Council on Social Work Education’s recently published Educational Policy and Accreditation Standards are considered while making curriculum recommendations on postpartum depression for social work educators.
Rich-Edwards, J. W.; Mohllajee, A. P.; Kleinman, K.; Hacker, M. R.; Majzoub, J.; Wright, R. J.; Gillman, M. W.
Context: Elevated hypothalamic CRH has been implicated in melancholic major depression in nonpregnant individuals, but the role of placental CRH in maternal prenatal and postpartum depression is largely unexplored.
Maloni, Judith A; Przeworski, Amy; Damato, Elizabeth G
Nearly one million women each year have pregnancy complications that cause antepartum and postpartum anxiety and depression. This exploratory study determined 1) feasibility of using social media to recruit women with depressive symptoms following high risk pregnancy, 2) women's barriers to treatment, 3) use of online resources for assistance with PPD, and 4) preferences for internet treatment. Among a national sample of 53 women, nearly 70% had major depression. Common barriers were lack of time and stigma. Over 90% of women would use the internet to learn coping strategies for PPD. Women expressed interest in web-based PPD treatment and identified desired characteristics of an intervention. Copyright © 2013 Elsevier Inc. All rights reserved.
Verbeek, Tjitte; Bockting, Claudi L H; van Pampus, Mariëlle G; Ormel, Johan; Meijer, Judith L; Hartman, Catharina A; Burger, Huibert
BACKGROUND: Postpartum depression (PPD) follows 5-15% of the life births and forms a major threat to the child's mental health and psychosocial development. However, the nature, continuance, and mediators of the association of postpartum depression (PPD) with the child's mental health are not well
Van Der Zee-Van Den Berg, Angarath I.; Boere-Boonekamp, Magda M.; Groothuis-Oudshoorn, Catharina G.M.; IJzerman, Maarten J.; Haasnoot-Smallegange, Riet M.E.; Reijneveld, Sijmen A.
OBJECTIVES: Postpartum depression often remains unaddressed. Screening in well-child care (WCC) may improve early detection, promote maternal recovery, and reduce effects on child development. We assessed the effectiveness of screening for postpartum depression in WCC compared with care as usual
van der Zee-van den Berg, Angarath I; Boere-Boonekamp, Magda M; Groothuis-Oudshoorn, Catharina G M; IJzerman, Maarten J; Haasnoot-Smallegange, Riet M E; Reijneveld, Sijmen A
OBJECTIVES: Postpartum depression often remains unaddressed. Screening in well-child care (WCC) may improve early detection, promote maternal recovery, and reduce effects on child development. We assessed the effectiveness of screening for postpartum depression in WCC compared with care as usual
Nylen, Kimberly J.; O'Hara, Michael W.; Brock, Rebecca; Moel, Joy; Gorman, Laura; Stuart, Scott
Objective: We examined the course and predictors of postpartum depression in the 18 months following interpersonal psychotherapy (IPT). Method: We enrolled 120 community women with major depression in a 12-week randomized trial of individual IPT during the postpartum period (O'Hara, Stuart, Gorman, & Wenzel, 2000). At 6, 12, and 18 months…
Davis-Gage, Darcie; Kettmann, Julie Jenks; Moel, Joy
During the developmental lifeline for women, some individuals are affected by postpartum depression. This article describes the treatment of a Latina woman experiencing postpartum depression. The authors illustrate the feminist approach using counseling interventions that incorporate the client's developmental level, cultural background, and…
Hassert, Silva; Kurpius, Sharon E. Robinson
Breastfeeding, additional children, and partner relationship predicted postpartum depression among 59 Latinas who had an infant who was 6 months old or younger. The most powerful predictor was conflict with partner. Counselors working with Latinas experiencing postpartum depression should explore the partner relationship, particularly relationship…
Hamdan, Aisha; Tamim, Hani
Limited research has been conducted in the United Arab Emirates in relation to postpartum depression. The purpose of this study was to investigate the risk and protective factors of postpartum depression in women in Sharjah, United Arab Emirates. We carried out a prospective study in which we followed women from the second trimester of pregnancy until 4 months postpartum. Data were collected during the second and third trimesters and then at 2- and 4- months postpartum. The risk/protective factors that were investigated included: depression and anxiety during pregnancy, stressful life events, breastfeeding, employment status following delivery, religiosity, and socio-demographic variables. The Edinburgh Postnatal Depression Scale (screening) and the Mini International Neuropsychiatric Inventory (diagnostic) were used as outcome variables. Using the Mini International Neuropsychiatric Inventory (diagnostic), 10% of the 137 participants in the study were diagnosed with postpartum depression. The following variables were found to be predictive of postpartum depression: depression during pregnancy in both the second and third trimesters: number of children, religion, and use of formula for feeding. Several factors were of borderline significance including educational level of mother, lack of breastfeeding, personal stressful life events, and employment status following delivery. These risk factors are important as they indicate potential areas for early identification. Screening of pregnant women during pregnancy and in the postpartum phase would be important. This study forms the foundation for further research and development related to prevention and intervention for postpartum depression in this Arab context.
Kalita, Kamal Narayan
Background: Postpartum period is associated with higher rates for depression, blues and psychosis. Anxiety is also significant. These disorders may have serious implications in the cognitive development of the infant. There is relative lack of data in this area. So we tried to estimate postpartum anxiety and depression in a group of women and…
The role of oxytocin in the treatment of postpartum depression has been a topic of growing interest. This subject carries important implications, given that postpartum depression can have detrimental effects on both the mother and her infant, with life long consequences for infant socioemotional and...
Miller, Renée L; Pallant, Julie F; Negri, Lisa M
Postnatal depression has received considerable research and clinical attention, however anxiety and stress in the postpartum has been relatively ignored. Along with the widespread use of the Edinburgh Postnatal Depression Scale (EPDS), depression has become the marker for postnatal maladjustment. Symptoms of anxiety tend to be subsumed within diagnoses of depression, which can result in anxiety being minimized or overlooked in the absence of depression. Some researchers have identified the need to distinguish between postnatal depression and anxiety, and to discern cases where depression and anxiety co-exist. The aim of this study was to assess the prevalence of postnatal distress using the EPDS and the Depression Anxiety Stress Scales (DASS-21). As part of a larger cross-sectional study, the EPDS and DASS-21 were administered to a convenience sample of 325 primiparous mothers, who ranged in age from 18 to 44 years (M = 32 years). Recruited through mother's groups and health centres in Melbourne Australia, inclusion was limited to mothers whose babies were aged between 6 weeks and 6 months. Analyses included comparisons between the classifications of women according to the EPDS and the DASS-21, and an exploration of the extent to which the EPDS identified anxious-depressed women. The EPDS identified 80 women (25%) as possibly depressed (using a cut-off of over 9), of which the DASS-21 corroborated 58%. In the total sample, 61 women (19%) were classified by the DASS-21 to be depressed. Using broader criteria for distress, it was revealed by the DASS-21 that a further 33 women (10%) showed symptoms of anxiety and stress without depression. A total of 41 women (13%) had symptoms of anxiety either in isolation or in combination with depression. The DASS-21 identified 7% of the sample as being both anxious and depressed. This at-risk sub-group had higher mean EPDS and DASS-depression scores than their depressed-only counterparts. The prevalence of anxiety and stress in
Pallant Julie F
Full Text Available Abstract Background Postnatal depression has received considerable research and clinical attention, however anxiety and stress in the postpartum has been relatively ignored. Along with the widespread use of the Edinburgh Postnatal Depression Scale (EPDS, depression has become the marker for postnatal maladjustment. Symptoms of anxiety tend to be subsumed within diagnoses of depression, which can result in anxiety being minimized or overlooked in the absence of depression. Some researchers have identified the need to distinguish between postnatal depression and anxiety, and to discern cases where depression and anxiety co-exist. The aim of this study was to assess the prevalence of postnatal distress using the EPDS and the Depression Anxiety Stress Scales (DASS-21. Method As part of a larger cross-sectional study, the EPDS and DASS-21 were administered to a convenience sample of 325 primiparous mothers, who ranged in age from 18 to 44 years (M = 32 years. Recruited through mother's groups and health centres in Melbourne Australia, inclusion was limited to mothers whose babies were aged between 6 weeks and 6 months. Analyses included comparisons between the classifications of women according to the EPDS and the DASS-21, and an exploration of the extent to which the EPDS identified anxious-depressed women. Results The EPDS identified 80 women (25% as possibly depressed (using a cut-off of over 9, of which the DASS-21 corroborated 58%. In the total sample, 61 women (19% were classified by the DASS-21 to be depressed. Using broader criteria for distress, it was revealed by the DASS-21 that a further 33 women (10% showed symptoms of anxiety and stress without depression. A total of 41 women (13% had symptoms of anxiety either in isolation or in combination with depression. The DASS-21 identified 7% of the sample as being both anxious and depressed. This at-risk sub-group had higher mean EPDS and DASS-depression scores than their depressed
Roberts, Sarah L; Bushnell, John A; Collings, Sunny C; Purdie, Gordon L
To compare the psychological health of men with partners who have post-partum depression (PPD; index group) with that of men with partners without PPD (comparison group). Using a cross-sectional survey, psychological symptoms and disturbances of index group men (n = 58) and comparison group men (n = 116) were compared. Validated self-report measures were used to assess five key areas of mental health: depression, anxiety, non-specific psychological impairment, aggression and alcohol use. Index group men had more symptoms of depression, aggression and non-specific psychological impairment, and had higher rates of depressive disorder, non-specific psychological problems and problem fatigue than comparison group men. Index group men were also more likely to have three or more comorbid psychological disturbances. There was no difference between the groups on measures of anxiety and alcohol use. Although many men in the postnatal period experience a variety of mental health problems, those who have a partner with PPD are themselves at increased risk for experiencing psychological symptoms and disturbances. Differentiation of psychological syndromes is important; higher rates of depressive disorder, non-specific psychological problems and problem fatigue were found, but rates of anxiety disorder and hazardous alcohol use did not differ between the groups. More attention from health professionals to men's mental health in the postnatal period may be beneficial to the entire family system.
Denis, Anne; Luminet, Olivier
The objective was to assess the impact of cognitive factors on post-partum depression (PPD) symptoms. Because most of the literature data concern the immediate post-partum period or the first year post-partum, we notably sought to assess the longer term impact of cognitive factors on the symptoms of PPD. Two studies were performed. In a pilot study, 1-month post-partum, 63 women filled out a sociodemographic information sheet and completed the abbreviated, revised Eysenck Personality Questionnaire, the Ruminative Responses Scale, the Maternal Self-Report Inventory, and the Edinburgh Post-Natal Depression Scale. In the main study, 124 women additionally completed the Toronto Alexithymia Scale. The main study population was divided into 2 subgroups: women in the first year post-partum (n = 74) and those in the second year post-partum (n = 50). In the pilot study performed 1-month post-partum, brooding rumination and low self-esteem were significant predictors of the PPD symptom intensity. Neuroticism, brooding rumination, and low maternal self-esteem were also significant predictors of the PPD symptoms reported in the first year post-partum. Lastly, ruminative thoughts and alexithymia were significant predictors of the PPD symptoms reported in the second year post-partum. Our results suggest that alexithymia may be an important predictor of the incidence of this condition. The observation of differences in the PPD models as a function of the post-partum period may open up opportunities for developing novel PPD prevention/treatment programs. Copyright © 2017 John Wiley & Sons, Ltd.
Micali, Nadia; Simonoff, Emily; Treasure, Janet
This study investigated the effect of past depression, past and current eating disorders (ED) on perinatal anxiety and depression in a large general population cohort of pregnant women, the Avon Longitudinal Study of Parents and Children (ALSPAC). Anxiety and depression were measured during and after pregnancy in 10,887 women using the Crown-Crisp Experiential Inventory and Edinburgh Postnatal Depression Scale. Women were grouped according to depression and ED history: past ED with (n = 123) and without past depression (n = 50), pregnancy ED symptoms with (n = 77) and without past depression (n = 159), past depression only (n = 818) and controls (n = 9,660). We compared the course of depression and anxiety with linear mixed-effect regression models; and probable depressive and anxiety disorders using logistic regression. Women with both past depression and past/current ED had high anxiety and depression across time perinatally; this was most marked in the group with pregnancy ED symptoms and past depression (b coefficient:5.1 (95% CI: 4.1-6.1), p depressive and anxiety disorder compared to controls. At 8 months post-partum pregnancy ED symptoms and/or past depression conferred the highest risk for a probable depressive and anxiety disorder. Data were based on self-report. There was some selective attrition. Pregnancy ED symptoms and past depression have an additive effect in increasing the risk for depression and anxiety perinatally. Screening at risk women for anxiety and depression in the perinatal period might be beneficial. Copyright © 2010 Elsevier B.V. All rights reserved.
Silveira, Marushka L; Ertel, Karen A; Dole, Nancy; Chasan-Taber, Lisa
Maternal depression increases risk of adverse perinatal outcomes, and recent evidence suggests that body image may play an important role in depression. This systematic review identifies studies of body image and perinatal depression with the goal of elucidating the complex role that body image plays in prenatal and postpartum depression, improving measurement, and informing next steps in research. We conducted a literature search of the PubMed database (1996-2014) for English language studies of (1) depression, (2) body image, and (3) pregnancy or postpartum. In total, 19 studies matched these criteria. Cross-sectional studies consistently found a positive association between body image dissatisfaction and perinatal depression. Prospective cohort studies found that body image dissatisfaction predicted incident prenatal and postpartum depression; findings were consistent across different aspects of body image and various pregnancy and postpartum time periods. Prospective studies that examined the reverse association found that depression influenced the onset of some aspects of body image dissatisfaction during pregnancy, but few evaluated the postpartum onset of body image dissatisfaction. The majority of studies found that body image dissatisfaction is consistently but weakly associated with the onset of prenatal and postpartum depression. Findings were less consistent for the association between perinatal depression and subsequent body image dissatisfaction. While published studies provide a foundation for understanding these issues, methodologically rigorous studies that capture the perinatal variation in depression and body image via instruments validated in pregnant women, consistently adjust for important confounders, and include ethnically diverse populations will further elucidate this association.
Suri, Rita; Stowe, Zachary N; Cohen, Lee S; Newport, D Jeffrey; Burt, Vivien K; Aquino-Elias, Ana R; Knight, Bettina T; Mintz, Jim; Altshuler, Lori L
Risk factors for postpartum depression in euthymic pregnant women with histories of major depressive disorder (MDD) were evaluated. From April 2003 to March 2009, 343 pregnant women with a history of Structured Clinical Interview for DSM-IV (SCID)-diagnosed major depressive disorder were prospectively assessed from the third trimester into the postpartum period using the SCID mood module and 17-item Hamilton Depression Rating Scale (HDRS). Data from 300 subjects who completed at least 2 mood module assessments (1 within 60 days before and the other within 60 days after delivery) were analyzed for predictive associations between variables assessed in the third trimester and the development of a postpartum depression. The majority of women were euthymic in pregnancy by SCID criteria. Women with third trimester SCID-diagnosed depression (n = 45) versus euthymia (n = 255) had a significantly higher risk for having depression after delivery (24% vs 11%, P = .013). For pregnant euthymic women, third trimester total HDRS scores significantly predicted postpartum depression (P postpartum depression. Antidepressant use in the third trimester in euthymic women did not confer protection against the onset of postpartum depression. Among women with a history of MDD who are euthymic in the third trimester, 3 HDRS items-work activities, early insomnia, and suicidality-may be useful as screening items for clinicians working with pregnant women with histories of MDD to identify a group at risk for developing postpartum depression. Additionally, in euthymic women with a history of MDD, antidepressant use in the third trimester may not reduce the risk of developing postpartum depression. © Copyright 2017 Physicians Postgraduate Press, Inc.
McDonald, Sarah; Slade, Pauline; Spiby, Helen; Iles, Jane
This study examined the prevalence of childbirth-related post-traumatic stress (PTS) symptoms at 2 years postpartum and the relationship between such symptoms and both self-reported parenting stress and perceptions of the mother-child relationship. 81 women completed measures of childbirth-related PTS symptoms at 6 weeks and 3 months postpartum; these results were used in an exploration of their predictive links with mother-child relationship and parenting measures at 2 years. 17.3% of respondents reported some PTS symptoms at a clinically significant level at 2 years postpartum. However, these symptoms were only weakly linked to parenting stress and were not related to mothers' perceptions of their children. However earlier PTS symptoms within 3 months of childbirth did show limited associations with parenting stress at 2 years but no association with child relationship outcomes once current depression was taken into account. Implications for clinical practice and the concept of childbirth-related post-traumatic stress disorder are discussed.
Full Text Available Abstract Background Neonatal anxiety and depression and breastfeeding cessation are significant public health problems. There is an association between maternal symptoms of anxiety and depression and early breastfeeding cessation. In earlier studies, the causality of this association was interpreted both ways; symptoms of anxiety and depression prepartum significantly impacts breastfeeding, and breastfeeding cessation significantly impacts symptoms of anxiety and depression. First, we aimed to investigate whether breastfeeding cessation is related to an increase in symptoms of anxiety and depression from pregnancy to six months postpartum. Second, we also investigated whether the proposed symptom increase after breastfeeding cessation was disproportionately high for those women already suffering from high levels of anxiety and depression during pregnancy. Methods To answer these objectives, we examined data from 42 225 women in the Norwegian Mother and Child Cohort Study (MoBa. Subjects were recruited in relation to a routine ultra-sound examination, and all pregnant women in Norway were eligible. We used data from the Medical Birth Registry of Norway and questionnaires both pre and post partum. Symptoms of anxiety and depression at six months postpartum were predicted in a linear regression analysis by WHO-categories of breastfeeding, symptoms of anxiety and depression prepartum (standardized score, and interaction terms between breastfeeding categories and prepartum symptoms of anxiety and depression. The results were adjusted for cesarean sections, primiparity, plural births, preterm births, and maternal smoking. Results First, prepartum levels of anxiety and depression were related to breastfeeding cessation (β 0.24; 95% CI 0.21-0.28, and breastfeeding cessation was predictive of an increase in postpartum anxiety and depression ( β 0.11; 95%CI 0.09-0.14. Second, prepartum anxiety and depression interacted with the relation between
Wesseloo, Richard; Kamperman, Astrid M; Bergink, Veerle; Pop, Victor J M
During the postpartum period, women are at risk for the new onset of both auto-immune thyroid disorders and depression. The presence of thyroid peroxidase antibodies (TPO-ab) during early gestation is predictive for postpartum auto-immune thyroid dysfunction. The aim of this study was to investigate the association between TPO-ab status during early gestation and first-onset postpartum depression. Prospective cohort study (n = 1075) with follow-up during pregnancy up to one year postpartum. Thyroid function and TPO-ab status were measured during early gestation. Depressive symptomatology was assessed during each trimester and at four time points postpartum with the Edinburgh Depression Scale (EDS). Women with antenatal depression were not eligible for inclusion. Self-reported postpartum depression was defined with an EDS cut-off of ≥ 13. The cumulative incidence of self-reported first-onset depression in the first postpartum year was 6.3%. A positive TPO-ab status was associated with an increased risk for self-reported first-onset depression at four months postpartum (adjusted OR 3.8; 95% CI 1.3-11.6), but not at other postpartum time points. Prevalence rates of self-reported postpartum depression declined after four months postpartum in the TPO-ab positive group, but remained constant in the TPO-ab negative group. Depression was defined with a self-rating questionnaire (EDS). Women with an increased TPO-ab titer during early gestation are at increased risk for self-reported first-onset depression. The longitudinal pattern of self-reported postpartum depression in the TPO-ab positive group was similar to the typical course of postpartum TPO-ab titers changes. This suggests overlap in the etiology of first-onset postpartum depression and auto-immune thyroid dysfunction. Thyroid function should be evaluated in women with first-onset postpartum depression. Copyright © 2017 Elsevier B.V. All rights reserved.
Haim, Achikam; Sherer, Morgan; Leuner, Benedetta
Postpartum depression (PPD) is a common complication following childbirth experienced by one in every five new mothers. Pregnancy stress enhances vulnerability to PPD and has also been shown to increase depressive-like behavior in postpartum rats. Thus, gestational stress may be an important translational risk factor that can be used to investigate the neurobiological mechanisms underlying PPD. Here we examined the effects of gestational stress on depressive-like behavior during the early/mid and late postpartum periods and evaluated whether this was accompanied by altered structural plasticity in the nucleus accumbens (NAc), a brain region that has been linked to PPD. We show that early/mid (PD8) postpartum female rats exhibited more depressive-like behavior in the forced swim test as compared to late postpartum females (PD22). However, two weeks of restraint stress during pregnancy increased depressive-like behavior regardless of postpartum timepoint. In addition, dendritic length, branching, and spine density on medium spiny neurons in the NAc shell were diminished in postpartum rats that experienced gestational stress although stress-induced reductions in spine density were evident only in early/mid postpartum females. In the NAc core, structural plasticity was not affected by gestational stress but late postpartum females exhibited lower spine density and reduced dendritic length. Overall, these data not only demonstrate structural changes in the NAc across the postpartum period, they also show that postpartum depressive-like behavior following exposure to gestational stress is associated with compromised structural plasticity in the NAc and thus may provide insight into the neural changes that could contribute to PPD. PMID:25359225
Letourneau, N; Duffett-Leger, L; Dennis, C-L; Stewart, M; Tryphonopoulos, P D
The purpose of this pilot study was to describe the experiences, support needs, resources, and barriers to support for fathers whose partners had post-partum depression (PPD) in preparation for a larger study. Qualitative methods and community-based research approaches were used in this exploratory/descriptive multi-site study, conducted in New Brunswick and Alberta. Telephone interviews were conducted with a total of 11 fathers in New Brunswick (n= 7) and Alberta (n= 4). Fathers experienced a number of depressive symptoms including: anxiety, lack of time and energy, irritability, feeling sad or down, changes in appetite, and thoughts of harm to self or baby. The most common barriers for fathers were lack of information regarding PPD resources and difficulty seeking support. This pilot study establishes the feasibility of the larger-scale exploration of fathers' experiences in supporting their spouses affected by PPD. © 2010 Blackwell Publishing.
Xie, Ri-Hua; Yang, Jianzhou; Liao, Shunping; Xie, Haiyan; Walker, Mark; Wen, Shi Wu
Inadequate social support is an important determinant of postpartum depression (PPD). Social support for pregnant women consists of supports from various sources and can be measured at different gestation periods. Differentiating the effects of social support from different sources and measured at different gestation periods may have important implications in the prevention of PPD. In the family centred Chinese culture, family support is likely to be one of the most important components in social support. The aim of this study was to assess the association of prenatal family support and postnatal family support with PPD. A prospective cohort study was conducted between February and September 2007 in Hunan, China. Family support was measured with social support rating scale at 30-32 weeks of gestation (prenatal support) and again at 2 weeks of postpartum visit (postnatal support). PPD was defined as Edinburgh Postnatal Depression Scale (EPDS) score > or =13. A total of 534 pregnant women were included, and among them, 103 (19.3%) scored 13 or more on the EPDS. PPD was 19.4% in the lowest tertile versus 18.4% in the highest quartile (adjusted odds ratio: 1.04, 95% confidence interval 0.60, 1.80) for prenatal support from all family members, and PPD was 39.8% in the lowest tertile versus 9.6% in the highest tertile (adjusted odds ratio: 4.4, 95% confidence interval 2.3, 8.4) for postnatal support from all family members. Among family members, support from husband had the largest impact on the risk of developing PPD. Lack of postnatal family support, especially the support from husband, is an important risk factor of PPD.
Letourneau, Nicole; Tryphonopoulos, Panagiota D; Duffett-Leger, Linda; Stewart, Miriam; Benzies, Karen; Dennis, Cindy-Lee; Joschko, Justin
The effect of postpartum depression (PPD) on mothers has been extensively studied. But even though up to 50% of men whose partners suffer from PPD also have depressive symptoms, little is known about the impact of maternal PPD on fathers. Depressive symptoms are likely to decrease fathers' ability to provide maternal support. Children with 2 depressed parents are at significantly greater risk for poor developmental outcomes than those with 1 affected parent. The objective of this Canada-wide exploratory/descriptive study was to describe the support needs and preferences for support of fathers whose partners have had PPD. Qualitative methods and community-based research approaches were used, and one-to-one telephone interviews were conducted between 2009 and 2011 with a total of 40 fathers. Fathers desired support from both formal (professional) and informal (friends and family) sources and noted that ideal support interventions should cover a number of key topics including information on PPD and practical tips on how to cope with their partner's PPD. Fathers reported that the ideal PPD intervention program does not favor any one setup and, to reach the full spectrum of parents, the program must be multitiered, accessible, and as flexible as funding allows.
Stepanikova, Irena; Kukla, Lubomir
Objectives The role of perceived discrimination in postpartum depression is largely unknown. We investigate whether perceived discrimination reported in pregnancy contributes to postpartum depression, and whether its impact varies by education level. Methods Prospective data are a part of European Longitudinal Study of Pregnancy and Childhood, the Czech Republic. Surveys were collected in mid-pregnancy and at 6 months after delivery. Depression was measured using Edinburgh Postnatal Depression Scale. Generalized linear models were estimated to test the effects of perceived discrimination on postpartum depression. Results Multivariate models revealed that among women with low education, discrimination in pregnancy was prospectively associated with 2.43 times higher odds of postpartum depression (p discrimination was not linked to postpartum depression among women with high education. Conclusions Perceived discrimination is a risk factor for postpartum depression among women with low education. Screening for discrimination and socio-economic disadvantage during pregnancy could benefit women who are at risk for mental health problems.
Zhang, Zhuan; Hong, Juan; Zhang, Suyun; Zhang, Tingting; Sha, Sha; Yang, Rong; Qian, Yanning; Chen, Ling
Postpartum estrogen withdrawal is known to be a particularly vulnerable time for depressive symptoms. Ovariectomized adult mice (OVX-mice) treated with hormone-simulated pregnancy (HSP mice) followed by a subsequent estradiol benzoate (EB) withdrawal (EW mice) exhibited depression- and anxiety-like behaviors, as assessed by forced swim, tail suspension and elevated plus-maze, while HSP mice, OVX mice or EB-treated OVX mice (OVX/EB mice) did not. The survival and neurite growth of newborn neurons in hippocampal dentate gyrus were examined on day 5 after EW. Compared with controls, the numbers of 28-day-old BrdU(+) and BrdU(+)/NeuN(+) cells were increased in HSP mice but significantly decreased in EW mice; the numbers of 10-day-old BrdU(+) cells were increased in HSP mice and OVX/EB mice; and the density of DCX(+) fibers was reduced in EW mice and OVX mice. The phosphorylation of hippocampal NMDA receptor (NMDAr) NR2B subunit or Src was increased in HSP mice but decreased in EW mice. NMDAr agonist NMDA prevented the loss of 28-day-old BrdU(+) cells and the depression- and anxiety-like behaviors in EW mice. NR2B inhibitor Ro25-6981 or Src inhibitor dasatinib caused depression- and anxiety-like behaviors in HSP mice with the reduction of 28-day-old BrdU(+) cells. The hippocampal BDNF levels were reduced in EW mice and OVX mice. TrkB receptor inhibitor K252a reduced the density of DCX(+) fibers in HSP mice without the reduction of 28-day-old BrdU(+) cells, or the production of affective disorder. Collectively, these results indicate that postpartum estrogen withdrawal impairs hippocampal neurogenesis in mice that show depression- and anxiety-like behaviors. Copyright © 2016 Elsevier Ltd. All rights reserved.
Nutt, David; Wilson, Sue; Paterson, Louise
Links between sleep and depression are strong. About three quarters of depressed patients have insomnia symptoms, and hypersomnia is present in about 40% of young depressed adults and 10% of older patients, with a preponderance in females. The symptoms cause huge distress, have a major impact on quality of life, and are a strong risk factor for suicide. As well as the subjective experience of sleep symptoms, there are well-documented changes in objective sleep architecture in depression. Mechanisms of sleep regulation and how they might be disturbed in depression are discussed. The sleep symptoms are often unresolved by treatment, and confer a greater risk of relapse and recurrence. Epidemiological studies have pointed out that insomnia in nondepressed subjects is a risk factor for later development of depression. There is therefore a need for more successful management of sleep disturbance in depression, in order to improve quality of life in these patients and reduce an important factor in depressive relapse and recurrence.
van den Berg, Angarath; Boere-Boonekamp, Magdalena M.; IJzerman, Maarten Joost; Haasnoot-Smallegange, Riet M.E.; Reijneveld, Sijmen A.
Introduction Postpartum depression (PPD) is a mental health problem frequently experienced by mothers in the first year postpartum. Early detection and treatment can help to reduce its negative effect on the development of the newborn child. Well-baby care (WBC) is a promising screening setting for
van der Zee-van den Berg, Angarath I.; Boere-Boonekamp, Magda M.; IJzerman, Maarten J; Haasnoot-Smallegange, Riet M. E.; Reijneveld, Sijmen A.
Introduction Postpartum depression (PPD) is a mental health problem frequently experienced by mothers in the first year postpartum. Early detection and treatment can help to reduce its negative effect on the development of the newborn child. Well-baby care (WBC) is a promising screening setting for
Souza, Rosely Almeida; Desani da Costa, Gislaine; Yamashita, Cintia Hitomi; Amendola, Fernanda; Gaspar, Jaqueline Correa; Alvarenga, Márcia Regina Martins; Faccenda, Odival; Oliveira, Maria Amélia de Campos
To classify families of elderly with depressive symptoms regarding their functioning and to ascertain the presence of an association between these symptoms, family functioning and the characteristics of the elderly. This was an observational, analytical, cross-sectional study performed with 33 teams of the Family Health Strategy in Dourados, MS. The sample consisted of 374 elderly divided into two groups (with and without depressive symptoms). The instruments for data collection were a sociodemographic instrument, the GeriatricDepression Scale (15 items) and the Family Apgar. An association was observed between depressive symptoms and family dysfunction, female gender, four or more people living together, and physical inactivity. The functional family may represent effective support for the elderly with depressive symptoms, because it offers a comfortable environment that ensures the well-being of its members. The dysfunctional family can barely provide necessary care for the elderly, which can exacerbate depressive symptoms.
Petkus, A. J.; Beam, C. R.; Johnson, W.
that genetic factors play a larger part in the association between depressive symptoms and physical illness for men than for women. For both sexes, across all ages, physical illness may similarly trigger social and health limitations that contribute to depressive symptoms.......Background Numerous factors influence late-life depressive symptoms in adults, many not thoroughly characterized. We addressed whether genetic and environmental influences on depressive symptoms differed by age, sex, and physical illness. Method The analysis sample included 24 436 twins aged 40......-90 years drawn from the Interplay of Genes and Environment across Multiple Studies (IGEMS) Consortium. Biometric analyses tested age, sex, and physical illness moderation of genetic and environmental variance in depressive symptoms. Results Women reported greater depressive symptoms than men. After age 60...
Rosely Almeida Souza
Full Text Available Objective: To classify families of elderly with depressive symptoms regarding their functioning and to ascertain the presence of an association between these symptoms, family functioning and the characteristics of the elderly. Method: This was an observational, analytical, cross-sectional study performed with 33 teams of the Family Health Strategy in Dourados, MS. The sample consisted of 374 elderly divided into two groups (with and without depressive symptoms. The instruments for data collection were a sociodemographic instrument, the GeriatricDepression Scale (15 items and the Family Apgar. Results: An association was observed between depressive symptoms and family dysfunction, female gender, four or more people living together, and physical inactivity. Conclusion: The functional family may represent effective support for the elderly with depressive symptoms, because it offers a comfortable environment that ensures the well-being of its members. The dysfunctional family can barely provide necessary care for the elderly, which can exacerbate depressive symptoms.
Stuart, Scott; Clark, Elizabeth
Perinatal depression is a prevalent disorder with a high degree of morbidity for both mother and infant. There are now empirically validated treatments for both postpartum depression and depression during pregnancy. Among these is Interpersonal Psychotherapy (IPT), which has been shown to be effective for postpartum depression across the spectrum of mild to severe depression. In fact, the limited evidence of efficacy for medication and concern about medication side effects have led some to suggest that IPT should be the first line treatment for depressed breastfeeding women. There are similar concerns about medication usage during pregnancy. Recent clinical and research experience also suggest that Interpersonal Counseling (IPC) may be effective for selected postpartum women as well. IPC, an abbreviated form of IPT, appears to be effective for mild to moderate depression, and has the potential advantage of being more amenable to delivery in primary care or OB settings.
Suh, Elizabeth Y; Ma, Ping; Dunaway, Lauren Futrell; Theall, Katherine P
Postpartum depression is associated with negative physical and mental health outcomes for both the mother and infant. This study examines the relationship between a mother and/or her partner's pregnancy intentions and reported post-partum depressive symptoms (PPDs). Using Louisiana pregnancy risk assessment monitoring system, 2000-2003, a secondary cross-sectional analysis was conducted on 5549 mothers, stratified by race, who delivered a singleton, live birth and whose infant was still alive at the time of the survey. Bivariate and multivariable logistic regressions were conducted, taking into account the complex survey design. In multivariable models, unwanted pregnancies were associated with severe PPDs (aOR 1.76, 95 % CI 1.23-2.53). Furthermore, the association between husbands/partners' who did not want or care about the pregnancy and mild PPDs remained for White women (aOR 1.32, 95 % CI 1.02-1.69); while among Black women, neither parent's pregnancy intention were associated with mild or severe PPDs. This study supports existing research demonstrating the association between pregnancy intention and PPDs. This study contributes to the limited information on the role that partner pregnancy intention plays on maternal mental health outcomes, however further discussion is needed on the impact of this role across races. Findings can be used in programs aiming to reduce adverse mental health outcomes among high-risk mothers.
Full Text Available "nBackground: Postpartum depression is a mood disorder that has harmful effects on mothers, infants, family and relationships. Acute decrease of progesterone after delivery has been proposed as a cause for postpartum depression. This hormone can affect neurotransmitters' function. Zinc (Zn and magnesium (Mg as trace elements exert their antidepressant effects through neurotransmitter pathways. On the other hand, thiamin (Vit B1 deficiency leads to depression in animal models. The aim of this study was to evaluate effects of combination of zinc, magnesium and thiamine on postpartum depression and role of nitrergic system. "n"nMethods: One hundred ten female mice in five groups were used. Postpartum depression was conducted using progesterone injections. Combinations of Zinc chloride, magnesium chloride and thiamine HCL were administered 30 minutes before open field and forced swimming test (FST. In order to investigate role of nitrergic system, L-arginine and LNAME were administered. "n"nResults: All treatment groups spent less immobility time than the control group (p< 0.05. Combined administration of Zn+ Mg+ Vit B1 caused the most reduction in immobility time. Administration of L-NAME in Zn+ Mg+ Vit B1 group caused reduction in immobility time while administration of L-arginine caused increase in immobility time in the same group. "nConclusion: Zinc, magnesium and thiamine can improve depressive symptoms by nitrergic pathway. These elements as supplement compounds could be alternatives for antidepressants in postpartum period.
These findings underscores the importance of assessing postpartum women for depression. There is ... Thus integration into social networks and provision of high levels of social support are key to mental health, well-being and improved ...
Kuijpens, J. L.; Vader, H. L.; Drexhage, H. A.; Wiersinga, W. M.; van Son, M. J.; Pop, V. J.
Depression is not adequately diagnosed in many cases. Therefore, the question arises as to whether markers exist for depression. We investigated whether the presence of thyroperoxidase antibodies (TPOAbs) during pregnancy can be regarded as a marker for depression in the first year postpartum,
Corrigan, Catherine P.; Kwasky, Andrea N.; Groh, Carla J.
Transition into motherhood is generally a joyful life event; for some women, however, it is marked by emotional turmoil. Lack of support can be associated with postpartum depression and can compromise both the mother and infant. A descriptive, cross-sectional study (N = 61) was conducted to explore the relationship between social support and postpartum depression and to determine whether mothers overwhelmed with childcare, or overwhelmed with life in general since becoming a mother, sought pr...
Full Text Available Objectivet: To determine the prevalence and risk factors of postpartum depression among women living in Zabol, a city in South-East of Iran. Method: 2 to 8 weeks after delivery, 408 women were assessed for depression and some of its risk factors. Results: The prevalence of postpartum depression was (40.4 %. Risk factors for the onset of post-partum depression included younger age, low income families, unemployment, history of depression, lack of family support, formula feeding, relationship difficulties with spouse, parents or parents-in-law. Type of delivery, number of pregnancy, number of delivery, satisfaction with sex of the baby, and number of children, were not associated with occurrence of PPD. Conclusion: Depression occurs frequently after childbirth. The findings have implications for policies concerning maternal and childcare programs.
Wang Ying; Fu Zheng
The relationship of the changes of hormone in patients with postpartum depressive disorder on 28-32 weeks of pregnancy, 1 week and 4 weeks postpartum was studied. Depress affection and anxious affections were measured in 200 postpartum women by self-rating depression scale and self-rating anxiety scale. Serum estradiol (E 2 ) and progesterone (P) levels in postpartum women were measured by RIA with control group. Results showed that the prevalence rate of depress affection was 11% and that of anxious affection was 14%. The serum levels of P on the 1 week postpartum, E 2 in antepartum were showed higher in the depressed group compared with control group. There was a significant difference in the changes of serum E 2 before and after delivery between the depressed group and control group (P 2 and P levels in the patients with postpartum depression after delivery. (authors)
Kim, Kiwon; Hong, Jin Pyo; Cho, Maeng Je; Fava, Maurizio; Mischoulon, David; Lee, Dong-Woo; Heo, Jung-Yoon; Jeon, Hong Jin
Postpartum depression (PPD) is a type of clinical depression that can affect women after childbirth. Few previous studies have explored the association of depressive and physical symptoms among women with PPD in a nationwide community study. A total of 18,807 adults, randomly selected, completed a face-to-face interview using the Korean version of Composite International Diagnostic Interview (K-CIDI) (response rate 80.2%). PPD was defined as a major depressive episode that began within 4 weeks after delivery. Of 679 female subjects with major depressive disorder (MDD), 14.0% (n=95) experienced PPD. Subjects with PPD were significantly more likely to have higher income, education, and reside in an urban area, compared to those with non-PPD. No significant differences were found in number of children. Multiple logistic regression revealed that the loss of sexual interest was the only symptom among 23 depressive symptoms that was significantly associated with depressive episodes among individuals with PPD (AOR=1.91, 95% CI 1.01-3.60) when compared with non-PPD. Loss of sexual interest was also significantly associated with the subjects with lifetime PPD regardless of depressive episode (AOR=1.93, 95% CI 1.12-3.31). Conversely, loss of confidence and loss of pleasure were less frequent in subjects with PPD. Premenstrual mood change (χ(2)=5.57, p=0.0036) and comorbid alcohol use disorder (χ(2)=5.11, p=0.031) showed a valid association with PPD. Loss of sexual interest and premenstrual mood change were associated with women with PPD, whereas those with non-PPD were not, thereby suggesting the possible link between sexual hormones and PPD. Copyright © 2015 Elsevier B.V. All rights reserved.
Recent data has highlighted the association of a bipolar disorder (BD) with an increased risk of post-partum psychosis and depression. It is suggested that genetic- and environmental-induced decrease in the levels of melatonin in BD contributes to post-partum disorders. Melatonin may also have some efficacy in the treatment of BD, especially in decreasing the side-effects associated with lithium and the neuroleptics. It is proposed that the optimization of melatonin levels, perhaps in conjunction with optimized vitamin D3 level, would decrease post-partum psychosis and depression associated with BD.
Sönmez, Nasrettin; Røssberg, Jan Ivar; Evensen, Julie
AIMS: The present study examined if any patient characteristics at baseline predicted depressive symptoms at 10 years and whether patients prone to depressive symptoms in the first year of treatment had a different prognosis in the following years. METHOD: A total of 299 first-episode psychosis...
Liberto, Terri L
The purposes of this integrated review are to examine the literature on screening for depression and help-seeking behaviors by postpartum women during pediatric well-baby visits; to identify gaps in the literature relating to depression and help-seeking behaviors; and to discuss implications for practice and future research. An extensive search of primary source documents was conducted in Academic Search Premier, CINAHL, MEDLINE, Mental Measurements Yearbook, PsycINFO, PsycARTICLES, and Women's Studies International using the key words postpartum, postpartum depression (PPD), help seeking, and pediatric setting or pediatrician. Thirty-five articles relevant to help seeking, PPD, and screening in the pediatric setting were included in this review. Research studies included both quantitative and qualitative articles. PPD affects 10% to 15% of all women after birth. Postpartum women generally do not seek help for depression. Untreated PPD has significant adverse affects on parenting, maternal bonding, and the infant's emotional and behavioral development. Interaction with the woman's obstetric provider ends shortly after the baby's birth. However, interactions with the pediatric office are initiated and continue throughout the infant's first two years of life. Early recognition of PPD and appropriate treatment are imperative for positive maternal-infant outcomes. A majority of women do not seek help for depression from any source. Because mothers have routine interactions with pediatric office staff during the first few years after giving birth, pediatric nurse practitioners and pediatricians have the perfect opportunity to screen and educate women regarding symptoms, treatment, and available resources for PPD. Copyright Â© 2012 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.
Adriaanse, M C; Dekker, J M; Nijpels, G
AIMS/HYPOTHESIS: The association between depression and insulin resistance has been investigated in only a few studies, with contradictory results reported. The aim of this study was to determine whether the association between symptoms of depression and insulin resistance varies across glucose...... established type 2 diabetes mellitus. Main outcome measures were insulin resistance defined by the homeostasis model assessment for insulin resistance (HOMA-IR) and symptoms of depression using the Centre for Epidemiologic Studies Depression Scale (CES-D). RESULTS: In the total sample, we found a weak.......942). The association between depressive symptoms and insulin resistance was similar for men and women. CONCLUSIONS/INTERPRETATION: We found only weak associations between depressive symptoms and insulin resistance, which did not differ among different glucose metabolism subgroups or between men and women....
Shi, Peixia; Ren, Hui; Li, Hong; Dai, Qin
Maternal depression has been intensively explored; however, less attention has been paid to maternal suicide. No studies to date have observed maternal depression and suicide at immediate prenatal and early postpartum stages. In total, 213 Chinese women were recruited in hospitals after they were admitted for childbirth. All completed a short-term longitudinal survey at perinatal stages. Women reported lower depression scores (6.65) and higher suicidal ideation incidence (11.74%) after childbirth. Prenatal depression raised the possibility of prenatal suicidal ideation, while prenatal depression and suicidal ideation increased postpartum depression and suicidal ideation. At immediate prenatal stage, marital satisfaction protected women from depression, while miscarriage experiences and self-esteem increased the risk. At early postpartum stage, in contrast, being first-time mother, marital satisfaction, and harmony with mother-in-law prevented them from depression. Our study is among the first to confirm that women have decreased depression but increased suicidal ideation at early postpartum, and a causal relationship between them, which are worthy of public attention. Potential protective (marital satisfaction, being first-time mother, and harmony with mother-in-law) or risk factors (miscarriage experiences and self-esteem) of maternal depression and suicidal ideation are identified at perinatal stages. This offers reliable guidance for clinical practice of health care. Copyright © 2018 Elsevier B.V. All rights reserved.
Kirkan, Tulay Sati; Aydin, Nazan; Yazici, Esra; Aslan, Puren Akcali; Acemoglu, Hamit; Daloglu, Ali Gokhan
This was a follow-up study to determine postpartum depression (PPD) and its causes in a population previously evaluated in the first trimester of pregnancy. The study sample consisted of pregnant women who were evaluated in the first trimester and 360 women who were re-evaluated in the postpartum period. Detailed sociodemographic data were obtained from the women, and depression was assessed with the Edinburgh Postpartum Depression scale (EPDS) and Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM) Axis I Disorders (SCID-I). In this follow-up study, the prevalence of PPD was 35% (n = 126). A depressive disorder in the first trimester of pregnancy, previous mental disorder, somatic disorder, exposure to domestic violence during pregnancy, baby's staying in the incubator and not breastfeeding were predictors of PPD. Exposure to violence and a history of previous depression predicted depression both in pregnancy and in the postpartum period. Depression rates are high in Eastern Turkey. Exposure to violence during pregnancy and the existence of a previous mental disorder were risk factors for perinatal depression in this study. Performing screening tests can identify women at risk of pregnancy-related depression. Prevention programs should be established in areas where the prevalence of depression is high. © The Author(s) 2014.
Karen Amaral Tavares Pinheiro
Full Text Available OBJECTIVE: We describe the prevalence of depressive and bipolar spectrum episodes in fathers in antenatal and postnatal periods, as well as at 12 months after childbirth. METHOD: A longitudinal follow-up study was conducted with a representative sample of 739 fathers whose children were born between April 2007 and May 2008 in maternity wards in the city of Pelotas, southern Brazil. Paternal psychopathology was measured with the Mini Neuropsychiatric Interview (MINI across three time points: between 28 and 34 weeks of pregnancy (T1, 30 to 60 days postpartum (T2, and 12 months after childbirth (T3. RESULTS: The prevalence of depressive episodes was 5.0% at T1, 4.5% at T2, and 4.3% at T3. Mixed episodes were present in 3%, 1.7%, and 0.9% of subjects, respectively, and accounted for 61.1% of the cases of depression in the antenatal period, 37.5% in postpartum, and 21.4% at 12 months. Depressive and manic/hypomanic episodes were significantly associated during pregnancy and in postpartum, but not at 12 months after childbirth. CONCLUSION: Bipolar episodes were common in men with depressive symptoms during their partner's pregnancy in the postpartum period and, to a lesser extent, 12 months after childbirth. Therefore, this population should be carefully investigated for manic and hypomanic symptoms.OBJETIVO: Verificar a prevalência dos episódios depressivos e bipolares em homens no período pré e pós-natal, assim como 12 meses após o parto. MÉTODO: Estudo longitudinal com amostra de pais cujas crianças nasceram entre abril de 2007 e maio de 2008 em maternidades da cidade de Pelotas-RS, no sul do Brasil. Episódios depressivos e maníacos/hipomaníacos foram mensurados com o Mini Neuropsychiatric Interview em três tempos diferentes: entre a 28ª e 34ª semanas de gestação (T1, 30 a 60 dias após o parto (T2 e 12 meses após o nascimento da criança. RESULTADOS: A prevalência de episódios depressivos foi 5,0% em T1, 4,5% em T2 e 4,3% em T3
Binder, Elisabeth B; Newport, D Jeffrey; Zach, Elizabeth B; Smith, Alicia K; Deveau, Todd C; Altshuler, Lori L; Cohen, Lee S; Stowe, Zachary N; Cubells, Joseph F
Peripartum major depressive disorder (MDD) is a prevalent psychiatric disorder with potential detrimental consequences for both mother and child. Despite its enormous health care relevance, data regarding genetic predictors of peripartum depression are sparse. The aim of this study was to investigate associations of the serotonin-transporter linked polymorphic region (5-HTTLPR) genotype with peripartum MDD in an at-risk population. Two hundred and seventy four women with a prior history of MDD were genotyped for 5-HTTLPR and serially evaluated in late pregnancy (gestational weeks 31-40), early post-partum (week 1-8) and late post-partum (week 9-24) for diagnosis of a current major depressive episode (MDE) and depressive symptom severity. 5-HTTLPR S-allele carrier status predicted the occurrence of a MDE in the early post-partum period only (OR=5.13, p=0.017). This association persisted despite continued antidepressant treatment. The 5-HTTLPR genotype may be a clinically relevant predictor of early post-partum depression in an at-risk population. Peripartum major depressive disorder is a prevalent psychiatric disorder with potential detrimental consequences for both mother and child. Despite its enormous health care relevance, data regarding genetic predictors of peripartum depression are sparse. The aim of this study was to investigate associations of the serotonin-transporter linked polymorphic region (5-HTTLPR) genotype with peripartum MDD in an at-risk population. Copyright 2009 Elsevier Ltd. All rights reserved.
Jin, Qiongai; Mori, Emi; Sakajo, Akiko
The purpose of this mixed-method design study was to examine factors contributing to depression among immigrant Chinese women (primipara and multipara) (n = 22) delivering a child for the first time in Japan. Data were obtained just after hospital discharge by using the Edinburgh Postnatal Depression Scale (EPDS), the Social Support Scale, a new scale to measure cross-cultural stressors in the postpartum setting and a visual analogue scale for stress and a demographic survey. The average EPDS score was 9.0 (SD ± 3.7) at 1-3 weeks postpartum; yet, more than half of the subjects (n = 12; 54.5%) were high risk for depression (EPDS ≥ 10). Low household income and primiparous status were associated with depression scores. New mothers with depression also reported more general stress and more cross-cultural stress in the postpartum setting, although social support appeared to mediate cross-cultural stressors. Semi-structured interviews were held with two immigrant women at high risk for depression; these new mothers described additional stress because they could not follow Zuoyuezi, an important postpartum Chinese tradition, in the Japanese hospital. These findings suggest that immigrant Chinese women are at higher risk for postpartum depression when they give birth for the first time in Japan. © 2016 John Wiley & Sons Australia, Ltd.
Goyal, Deepika; Wang, Elsie J; Shen, Jeremy; Wong, Eric C; Palaniappan, Latha P
To identify the clinical diagnosis rate of postpartum depression (PPD) in Asian American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese) compared to non-Hispanic Whites. Cross-sectional study using electronic health records (EHR). A large, outpatient, multiservice clinic in Northern California. A diverse clinical population of non-Hispanic White (N = 4582), Asian Indian (N = 1264), Chinese (N = 1160), Filipino (N = 347), Japanese (N = 124), Korean (N = 183), and Vietnamese (N = 147) mothers. Cases of PPD were identified from EHRs using physician diagnosis codes, medication usage, and age standardized for comparison. The relationship between PPD and other demographic variables (race/ethnicity, maternal age, delivery type, marital status, and infant gender) were examined in a multivariate logistic regression model. The PPD diagnosis rate for all Asian American mothers in aggregate was significantly lower than the diagnosis rate in non-Hispanic White mothers. Moreover, of the six Asian American subgroups, PPD diagnosis rates for Asian Indian, Chinese, and Filipino mothers were significantly lower than non-Hispanic White mothers. In multivariate analyses, race/ethnicity, age, and cesarean were significant predictors of PPD. In this insured population, PPD diagnosis rates were lower among Asian Americans, with variability in rates across the individual Asian American subgroups. It is unclear whether these lower rates are due to underreporting, underdiagnosis, or underutilization of mental health care in this setting. © 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.
Alhammadi, Salwa M; Hashem, Lien Abou; Abusbeih, Zainah R; Alzaabi, Fatima S; Alnuaimi, Salama N; Jalabi, Ala F; Nair, Satish C; Carrick, Frederick R; Abdulrahman, Mahera
Postpartum depression (PPD) is a significant public health problem adversely affecting mothers, their newborns, and other members of the family. Although PPD is common and potentially dangerous, only a minority of the cases are identified in primary health care settings during routine care, and the majority of depressed mothers in the community lies unrecognized and therefore untreated. In this study, a total of 1500 mothers were approached randomly, 808 accepted to participate, and 504 were within the inclusion criteria (women who had a birth of a singleton full-term healthy infant, had an uncomplicated pregnancy, and were within their one week to six months postpartum). The participants completed the Edinburgh Postnatal Depression Scale. A total of 168 women had an EPDS score ≥10, yielding a crude prevalence rate of 33%. The prevalence of suicidal ideation was 14 out of 504 (3%), among which 11 (79%) had EPDS score of ≥10. We fitted multiple linear regression models to evaluate the predictors of variables measured on the EPDS scale. This model was statistically significant pemployment status, baby's birth weight, stressful life event and marital conflict were statistically significant predictors. The findings of this study are anticipated to entail the government and policy makers in the region to pay more attention to the apparently high prevalence of unrevealed PPD in the community. It is crucial to enhance screening mechanisms for early detection, providing interventions to manage symptoms, and at the same time mandating local guidelines to address the PPD pathology as a high priority for the UAE population.
Badr, Lina Kurdahi; Ayvazian, Nelly; Lameh, Salma; Charafeddine, Lama
Although the negative consequences of maternal depression on infants has been documented in several Western societies, similar studies have not been conducted in Middle-Eastern countries where cultural norms and traditions may differ. The main objective of this study was to determine the risk factors for postpartum depression (PPD) and its relationship to mother -infant bonding in a Lebanese population. One hundred and fifty participants were administered the Edinburgh Postpartum Depression Scale (EPDS), and the social support scale at 2-3 days postpartum. At 10-12 weeks mother-infant bonding using the Postpartum Bonding Questionnaire (PBQ) and depression using the Beck Inventory (BDI-II) were assessed during a telephone interview. The prevalence of depression was 19% with an average score of 10.9 ± 6.02 on the EPDS. At 10-12 weeks 2.7% of the whole sample was depressed with an average score of 18.60 ± 16.87 on the BDI-II. Risk factors of PPD on the EPDS were; history of alcohol use, complications during pregnancy, not a good marital relationship, baby admitted to an intensive care unit, history of depression and low social support. Risk factors for impaired bonding were age, history of depression, BDI-II scores above 20 and low social support. The multiple regression analysis found that impaired bonding was associated with older age, history of depression and low social support, which explained 39% of the variance, F = 7.12, p = 0.02. The prevalence of PPD was higher than previously reported at day 2-3 post-delivery, but lower at 10-12 weeks postpartum. Impaired mother- infant bonding was associated older mothers, history of depression, low social support and BDI-II scores above 20 which should alert practitioner to assessing these factors in post-partum mothers. Copyright © 2018. Published by Elsevier Inc.
Garthus-Niegel, S; Ayers, S; Martini, J; von Soest, T; Eberhard-Gran, M
Against the background of very limited evidence, the present study aimed to prospectively examine the impact of maternal postpartum post-traumatic stress disorder (PTSD) symptoms on four important areas of child development, i.e. gross motor, fine motor, communication and social-emotional development. This study is part of the large, population-based Akershus Birth Cohort. Data from the hospital's birth record as well as questionnaire data from 8 weeks and 2 years postpartum were used (n = 1472). The domains of child development that were significantly correlated with PTSD symptoms were entered into regression analyses. Interaction analyses were run to test whether the influence of postpartum PTSD symptoms on child development was moderated by child sex or infant temperament. Postpartum PTSD symptoms had a prospective relationship with poor child social-emotional development 2 years later. This relationship remained significant even when adjusting for confounders such as maternal depression and anxiety or infant temperament. Both child sex and infant temperament moderated the association between maternal PTSD symptoms and child social-emotional development, i.e. with increasing maternal PTSD symptom load, boys and children with a difficult temperament were shown to have comparatively higher levels of social-emotional problems. Examining four different domains of child development, we found a prospective impact of postpartum PTSD symptoms on children's social-emotional development at 2 years of age. Our findings suggest that both boys and children with an early difficult temperament may be particularly susceptible to the adverse impact of postpartum PTSD symptoms. Additional studies are needed to further investigate the mechanisms at work.
Moses-Kolko, Eydie L; Price, Julie C; Wisner, Katherine L; Hanusa, Barbara H; Meltzer, Carolyn C; Berga, Sarah L; Grace, Anthony A; di Scalea, Teresa Lanza; Kaye, Walter H; Becker, Carl; Drevets, Wayne C
The early postpartum period is associated with increased risk for affective and psychotic disorders. Because maternal dopaminergic reward system function is altered with perinatal status, dopaminergic system dysregulation may be an important mechanism of postpartum psychiatric disorders. Subjects included were non-postpartum healthy (n=13), postpartum healthy (n=13), non-postpartum unipolar depressed (n=10), non-postpartum bipolar depressed (n=7), postpartum unipolar (n=13), and postpartum bipolar depressed (n=7) women. Subjects underwent 60 min of [11C]raclopride–positron emission tomography imaging to determine the nondisplaceable striatal D2/3 receptor binding potential (BPND). Postpartum status and unipolar depression were associated with lower striatal D2/3 receptor BPND in the whole striatum (p=0.05 and p=0.02, respectively) that reached a maximum of 7–8% in anteroventral striatum for postpartum status (p=0.02). Unipolar depression showed a nonsignificant trend toward being associated with 5% lower BPND in dorsal striatum (p=0.06). D2/3 receptor BPND did not differ significantly between unipolar depressed and healthy postpartum women or between bipolar and healthy subjects; however, D2/3 receptor BPND was higher in dorsal striatal regions in bipolar relative to unipolar depressives (p=0.02). In conclusion, lower striatal D2/3 receptor BPND in postpartum and unipolar depressed women, primarily in ventral striatum, and higher dorsal striatal D2/3 receptor BPND in bipolar relative to unipolar depressives reveal a potential role for the dopamine (DA) system in the physiology of these states. Further studies delineating the mechanisms underlying these differences in D2/3 receptor BPND, including study of DA system responsivity to rewarding stimuli, and increasing power to assess unipolar vs bipolar-related differences, are needed to better understand the affective role of the DA system in postpartum and depressed women. PMID:22257897
Full Text Available Background. Adolescence represents a challenging transitional period where changes in biological, emotional, cognitive and social domains can increase the risk of developing internalised problems including subthreshold depression. Adolescent-parent attachment style, perceived support and family functioning may increase risk for depressive symptoms or may reduce such risk. Adolescent-parent attachment, adolescent-perceived support from parents and family functioning were examined as correlates of depressive symptom presentation within this age group. Methods. Participants included a maternal parent and an adolescent (65.5% female from each family. Adolescents were in Grade 7 (n=175 or Grade 10 (n=31. Data were collected through home interviews. The Self-Report of Family Inventory (SFI, Experiences of Close Relationships Scale (ECR, Network of Relationships Inventory (NRI, Children’s Depression Inventory (CDI and Child Behavior Checklist (CBCL were used to assess depression, parental support and attachment. Results. Two models were examined: one with adolescent report of depressive symptoms as the outcome and a second with parent report of adolescent internalising symptoms as the outcome. The model predicting adolescent-reported depressive symptoms was significant with older age, higher levels of avoidant attachment, and higher levels of youth-reported dysfunctional family interaction associated with more depressive symptomatology. In the model predicting parent report of adolescent internalising symptoms only higher levels of dysfunctional family interaction, as reported by the parent, were associated with higher levels of internalising symptoms. Conclusion. Positive family communication, cohesion and support predictive of a secure parent-adolescent attachment relationship reduced the risk of a depressive symptom outcome. Secure adolescents were able to regulate their emotions, knowing that they could seek out secure base attachment relations
Full Text Available Introduction & Objective: Pregnancy and childbirth are significant developmental excitable for most women. Physical, intrapersonal and relational adaptations are needed to adjust successfully to pregnancy and delivery. Postpartum depression is a serious psychiatric disorder and the adverse impact on infants has been noted. The purpose of this study was to detect postpartum depression in referents to medical and health centers in Hamadan city.Materials & Methods: A descriptive and cross-sectional study involving 400 women completed the Beck Depression Inventory (BDI within 2-8 weeks of delivery was conducted in urban health centers in Hamadan city, Iran. Data were collected through interviews with women in the clinics in the health centers. Data processing and statistical analysis were performed using SPSS 10.0.Results: The results revealed that majority of women (68.0% were considered normal. Depression was detected in 32.0% of women. Out of these 19.0, 4.0 and 9.0% were mild, moderate and severe depression, respectively. There were statistically significant differences between postpartum depression and age, number of delivery, education, job and husband's job (P=0.000.Conclusion: Nearly 32.0% of selected women had depression. Therefore, it is important for medical personnel to be well versed in the course and treatment of postpartum depression. Post partum depression should be screened and treated as early as possible for several reasons. It can cause significant suffering for the woman who experiences it, and it can have deleterious consequences for the newborn.
Rahim, Twana; Rashid, Roshe
This study exclusively aimed to clinically assess which symptom pattern discriminates primary depression from depression-secondary to-schizophrenia. A total of 98 patients with primary depression and 71 patients with secondary-to-schizophrenia depression were assessed for identifying the clinical phenomena of depression. Diagnosis of schizophrenia was confirmed by Mini International Neuropsychiatric Interview. Each participant was, however, assessed by Patient Health Questionnaire-9 as well as Calgary Depression Scale for Schizophrenia (CDSS) for possible concurrent depressive symptoms. Depressed mood, loss of interest, reduced energy and pathological guilt were more common in primary depression, whereas sleep disturbance and guilty ideas of reference were more amounting towards the diagnosis of depression secondary-to-schizophrenia. It is clinically hard to differentiate primary from secondary-to-schizophrenia depression, especially in the absence of obvious psychotic symptoms. However, the classical symptoms of depression like subjective depressed mood, anhedonia, reduced energy and pathological guilt are more prominent in the primary depression.
Parry, Barbara L; Meliska, Charles J; Sorenson, Diane L; Lopez, Ana M; Martinez, Luis F; Nowakowski, Sara; Elliott, Jeffrey A; Hauger, Richard L; Kripke, Daniel F
The purpose of this study was to test the hypothesis that disturbances in levels of plasma melatonin differentiate pregnant and postpartum women with major depression from matched pregnant and postpartum healthy comparison women. Participants were 25 pregnant women (10 with major depression, 15 healthy) and 24 postpartum women (13 with major depression, 11 healthy). Healthy comparison women were matched on the number of weeks pregnant or postpartum. Plasma melatonin levels for each subject were measured every 30 minutes, in dim light (melatonin levels were log-transformed, and calculations were determined for the following measures: baseline and synthesis onset and offset times, duration, peak concentration, and area under the curve. Groups were compared by analyses of covariance, with age, number of weeks pregnant or postpartum, breast-feeding status, and body mass index as covariates. Morning melatonin levels from 2:00 a.m. to 11:00 a.m. were significantly lower in pregnant women with major depression relative to healthy pregnant women. However, these levels were significantly higher in postpartum women with major depression across time intervals relative to postpartum healthy women. Pregnant but not postpartum women with a personal or family history of depression, regardless of their current diagnosis, had significantly earlier melatonin synthesis and baseline offset times relative to women without a family history of depression. In pregnant healthy women but not pregnant women with major depression, melatonin levels increased during the course of pregnancy. This association was not found among postpartum women with major depression or postpartum healthy women. Plasma nocturnal melatonin concentrations, particularly during morning hours, were lower in depressed pregnant women but elevated in depressed postpartum women relative to matched healthy comparison women. In addition, melatonin timing measures were advanced in pregnant women with a personal or family
Full Text Available ... Disorder (3 items) Depression (32 items) Eating Disorders (9 items) Panic Disorder (1 item) Post-Traumatic Stress ... Disorder (3 items) Depression (32 items) Eating Disorders (9 items) Panic Disorder (1 item) Post-Traumatic Stress ...
Full Text Available ... reason for me to do anything for myself. NARRATOR : Depression is more than just a feeling of ... at all. I gained a lot of weight. NARRATOR : A person with depression can feel irritable and ...
Full Text Available ... Hyperactivity Disorder (ADHD) (3 items) Autism (13 items) Bipolar Disorder (2 items) Borderline Personality Disorder (3 items) Depression ( ... Hyperactivity Disorder (ADHD) (3 items) Autism (13 items) Bipolar Disorder (2 items) Borderline Personality Disorder (3 items) Depression ( ...
Full Text Available ... Autism (13 items) Bipolar Disorder (2 items) Borderline Personality Disorder (3 items) Depression (32 items) Eating Disorders (9 ... Autism (13 items) Bipolar Disorder (2 items) Borderline Personality Disorder (3 items) Depression (32 items) Eating Disorders (9 ...
Full Text Available ... suffer from depression trying to learn why it affects some people but not others. Treatments for depression do work. One type of effective psychotherapy is called cognitive ...
Full Text Available ... for depression do work. One type of effective psychotherapy is called cognitive behavioral therapy or CBT. CBT ... For many people, a combination of medication and psychotherapy may be the best choice. Depression can be ...
Full Text Available ... Autism (13 items) Bipolar Disorder (2 items) Borderline Personality Disorder (3 items) Depression (32 items) Eating Disorders ( ... Autism (13 items) Bipolar Disorder (2 items) Borderline Personality Disorder (3 items) Depression (32 items) Eating Disorders ( ...
Full Text Available ... Borderline Personality Disorder (3 items) Depression (32 items) Eating Disorders (9 items) Panic Disorder (1 item) Post- ... Borderline Personality Disorder (3 items) Depression (32 items) Eating Disorders (9 items) Panic Disorder (1 item) Post- ...
Barr, Jennieffer Anne
With 10-15 percent of mothers experiencing postpartum depression this mental health problem is a significant public health issue. One concern is that normal infant development is at risk. Understanding how Postpartum depression impacts on mothering is important knowledge in managing this health problem. To: Explore what is it like to become a mother, and examine how postpartum depression impacts on maternal adaptation. A hermeneutic approach was used guided by the philosophical works of Heidegger and Gadamer A relatively affluent metropolitan area, including surrounding rural areas within Australia. Via purposeful, maximum variation sampling, eleven women who had been medically diagnosed with postpartum depression following childbirth but who were not experiencing psychosis participated in the study. In-depth interviews and reflective journaling. Mothers with postpartum depression become "stuck" in a liminal state, an incomplete process of the rite of passage. Therefore, adaptation to the social role of a mother was found to be delayed. Additionally, a delay in becoming competent in parenting skills was evident. A lack of maternal-infant attachment was noted, however, mothers continued to care for their infants but in an unthinking manner that was labelled "mechanical infant caring". The distress caused by the delay in adapting to being a mother could be addressed by providing a mentor to at-risk women. The mentor should be a mother who has previously recovered from postpartum depression and would act as a symbol of hope. Additionally, on-going education and the insight that occurs during the liminal phase can facilitate mothers with postpartum depression to adapt appropriately.
Stone, Kristen C; Salisbury, Amy L; Miller-Loncar, Cynthia L; Mattera, Jennifer A; Battle, Cynthia L; Johnsen, Dawn M; O'Grady, Kevin E
This study examined the course of antidepressant use, sleep quality, and depression severity from pregnancy through 6-month postpartum in women with and without a depressive disorder during pregnancy. Women (N = 215) were interviewed during pregnancy, 1- and 6-month postpartum. Mixed linear models were used to examine the longitudinal course and inter-relationships for the time-varying variables of antidepressant use, subjective sleep quality, and depression severity. Pregnant women with a depressive disorder who did not use antidepressants had more variable depression severity over time with improvements in depression severity by 6-month postpartum. In contrast, the depression severity of their medicated counterparts remained stable and high throughout. Pregnant women without a depressive disorder had worse sleep quality when using antidepressants compared with when they were not. Antidepressant use significantly strengthened the magnitude of the effect of sleep quality on depression severity in women with a depressive disorder during pregnancy. When prenatally depressed women use antidepressants, their sleep disturbance is more highly linked to depression severity than when they do not. Furthermore, antidepressants are not adequately treating the sleep disturbance of these women or their remitted counterparts, leaving both groups vulnerable to significant negative mental and physical health outcomes.
Narayanan, Martina K; Nærde, Ane
While there is substantial empirical work on maternal depression, less is known about how mothers' and fathers' depressive symptoms compare in their association with child behavior problems in early childhood. In particular, few studies have examined unique relationships in the postpartum period by controlling for the other parent, or looked at longitudinal change in either parent's depressive symptoms across the first living years as a predictor of child problems. We examined depressive symptoms in parents at 6, 12, 24, 36 and 48 months following childbirth, and child behavior problems at 48 months. Linear growth curve analysis was used to model parents' initial levels and changes in symptoms across time and their associations with child outcomes. Mothers' depressive symptoms at 6 months predicted behavior problems at 48 months for all syndrome scales, while fathers' did not. Estimates for mothers' symptoms were significantly stronger on all subscales. Change in fathers' depressive symptoms over time was a significantly larger predictor of child aggressive behavior than corresponding change in mothers'. No interaction effects between parents' symptoms on behavior problems appeared, and few child gender differences. Child behavior was assessed once precluding tests for bidirectional effects. We only looked at linear change in parental symptoms. Mothers' postpartum depressive symptoms are a stronger predictor for early child behavior problems than fathers'. Change in fathers' depressive symptoms across this developmental period was uniquely and strongly associated with child aggressive problems, and should therefore be addressed in future research and clinical practice. Copyright © 2016 Elsevier B.V. All rights reserved.
Souza, Karina Junqueira de; Rattner, Daphne; Gubert, Muriel Bauermann
To investigate the association between institutional violence in obstetrics and postpartum depression (PP depression) and the potential effect of race, age, and educational level in this outcome. This is a cross-sectional study about the health care conditions for the maternal and child population of the Federal District, Brazil, carried out in 2011. The study has used a probabilistic sample of 432 women, whose children were aged up to three months, stratified by clusters. Indicators of institutional violence and demographic characteristics have been used in a logistic regression model to estimate the probability of occurrence of postpartum depression. The model has identified a high prevalence of postpartum depression, being it higher among non-white women and adolescent females, besides having a strong positive association between the several indicators of obstetric violence and postpartum depression. Positive interactions on a multiplicative scale have also been observed between: violence by negligence by health care professionals and race and age; physical violence from health care professionals and age; and, verbal violence from health care professionals and race. The indicators adopted to reflect institutional violence in obstetric care are positively associated with postpartum depression, which calls for a reflection on the need to make the health care protocols adequate to the precepts of the Brazilian humanization of childbirth care policies and changes in the obstetric care model.
Karina Junqueira de Souza
Full Text Available ABSTRACT OBJECTIVE To investigate the association between institutional violence in obstetrics and postpartum depression (PP depression and the potential effect of race, age, and educational level in this outcome. METHODS This is a cross-sectional study about the health care conditions for the maternal and child population of the Federal District, Brazil, carried out in 2011. The study has used a probabilistic sample of 432 women, whose children were aged up to three months, stratified by clusters. Indicators of institutional violence and demographic characteristics have been used in a logistic regression model to estimate the probability of occurrence of postpartum depression. RESULTS The model has identified a high prevalence of postpartum depression, being it higher among non-white women and adolescent females, besides having a strong positive association between the several indicators of obstetric violence and postpartum depression. Positive interactions on a multiplicative scale have also been observed between: violence by negligence by health care professionals and race and age; physical violence from health care professionals and age; and, verbal violence from health care professionals and race. CONCLUSIONS The indicators adopted to reflect institutional violence in obstetric care are positively associated with postpartum depression, which calls for a reflection on the need to make the health care protocols adequate to the precepts of the Brazilian humanization of childbirth care policies and changes in the obstetric care model.
Li, Lezhi; Liu, Fang; Zhang, Huilin; Wang, Li; Chen, Xiaofang
Postpartum depression is an important public health problem in China. Although 10%-20% of Chinese women having recently given birth are affected by postpartum depression, only 10% receive treatment due to the lack of proper screening. The aims of this study were to translate the Postpartum Depression Screening Scale into Chinese (C-PDSS) and establish the psychometric properties of the C-PDSS. The study was undertaken in three phases, composed of forward and backward translation of the Postpartum Depression Screening Scale into Chinese, examination of content validity, and field testing to establish the reliability, validity, and optimal cutoff score of the C-PDSS along with its sensitivity, specificity, and predictive values. A total sample of 387 mothers within 12 weeks postpartum participated in the study. Each mother was asked to complete the C-PDSS and the Chinese version of the Edinburgh Postnatal Depression Scale and then was interviewed by an experienced researcher using the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision. The Cronbach's alpha coefficient was .96 for the total C-PDSS, and the overall intraclass correlation was .79. Factor analysis of the scale revealed that it was composed of 7 factors with eigenvalues >1, accounting for 74.25% of the total variance. There was a significantly positive correlation between the C-PDSS and the Chinese version of the Edinburgh Postnatal Depression Scale (r = .66, p confirmatory factor analysis and generalization of the C-PDSS to a different sample in China.
Alves, Stephanie; Fonseca, Ana; Canavarro, Maria Cristina; Pereira, Marco
Introduction Postpartum depression (PPD) is a prevalent condition with a serious impact. The early identification of women at risk for developing PPD allows for primary prevention and the delivery of timely appropriate referrals. This study investigated the validity and reliability of the postnatal version of the Postpartum Depression Predictors Inventory-Revised (PDPI-R), an instrument widely studied internationally, in Portuguese women. Methods The sample consisted of 204 women who participated in an online cross-sectional survey. Participants completed the European Portuguese versions of the PDPI-R, the Edinburgh Postnatal Depression Scale (EPDS), and the Postnatal Negative Thoughts Questionnaire at 1-2 months postpartum. Additionally, ROC analyses were performed to conduct an exploratory analysis of the instruments' predictive validity. Results The prevalence rates of clinical postpartum depressive symptoms were 27.5 and 14.2% using the cut-off scores of 9 and 12, respectively, on the EPDS. The European Portuguese postnatal version of the PDPI-R demonstrated acceptable reliability and satisfactory construct and convergent validity. When using the EPDS > 9 cut-off score, the exploratory analyses yielded a sensitivity of 76.8% and a specificity of 73.0% with a cut-off score of 5.5 [area under the curve = 0.816]. Discussion These preliminary findings encourage the use of the postnatal version of the PDPI-R as a screening tool to identify Portuguese women at high risk for developing PPD. Subsequent assessments are needed to support the routine application of the PDPI-R both in research and for clinical purposes.
Smith-Nielsen, Johanne; Tharner, Anne; Krogh, Marianne Thode
This study examined early and long-term effects of maternal postpartum depression on cognitive, language, and motor development in infants of clinically depressed mothers. Participants were 83 mothers and their full-term born children from the urban region of Copenhagen, Denmark. Of this group, 28...... mothers were diagnosed with postnatal depression three to four months postpartum in a diagnostic interview. Cognitive, language, and motor development was assessed with the Bayley Scales of Infant and Toddler Development third edition, when the infants were 4 and 13 months of age. We found that maternal...... postpartum depression was associated with poorer cognitive development at infant age four months, the effect size being large (Cohen’s d = 0.8) and with similar effects for boys and girls. At 13 months of age infants of clinical mothers did not differ from infants of non-clinical mothers. At this time most...
Ginsburg, Golda S.; Barlow, Allison; Goklish, Novalene; Hastings, Ranelda; Baker, Elena Varipatis; Mullany, Britta; Tein, Jenn-Yun; Walkup, John
Background: Postpartum depression is a devastating condition that affects a significant number of women and their offspring. Few preventive interventions have targeted high risk youth, such as American Indians (AIs). Objective: To evaluate the feasibility of a depression prevention program for AI adolescents and young adults. Methods: Expectant AI…
Defelipe, Renata P.; Bussab, Vera S. R.; Vieira, Mauro L.
Postpartum depression (PPD) is a mood disorder which can adaptively alter maternal socialisation strategies. Our objective was to investigate differences in ethnotheories and childrearing practices of mothers with low (N = 46) and high (N = 45) intensity of PPD. The Brazilian version of Edinburgh Postnatal Depression Scale was applied at 3, 8 and…
Cutrona, Carolyn E.; Troutman, Beth R.
Infant temperamental difficulty was strongly related to mothers' level of postpartum depression, both directly and through the mediation of parenting self-efficacy. Social support appeared to function protectively against depression, primarily through self-efficacy. Practical and theoretical implications are discussed. (Author/RH)
Leuner, Benedetta; Fredericks, Peter J.; Nealer, Connor; Albin-Brooks, Christopher
Postpartum depression, which affects approximately 15% of new mothers, is associated with impaired mother-infant interactions and deficits in cognitive function. Exposure to stress during pregnancy is a major risk factor for postpartum depression. However, little is known about the neural consequences of gestational stress. The medial prefrontal cortex (mPFC) is a brain region that has been linked to stress, cognition, maternal care, and mood disorders including postpartum depression. Here we examined the effects of chronic gestational stress on mPFC function and whether these effects might be linked to structural modifications in the mPFC. We found that in postpartum rats, chronic gestational stress resulted in maternal care deficits, increased depressive-like behavior, and impaired performance on an attentional set shifting task that relies on the mPFC. Furthermore, exposure to chronic stress during pregnancy reduced dendritic spine density on mPFC pyramidal neurons and altered spine morphology. Taken together, these findings suggest that pregnancy stress may contribute to postpartum mental illness and its associated symptoms by compromising structural plasticity in the mPFC. PMID:24594708
Full Text Available Postpartum depression, which affects approximately 15% of new mothers, is associated with impaired mother-infant interactions and deficits in cognitive function. Exposure to stress during pregnancy is a major risk factor for postpartum depression. However, little is known about the neural consequences of gestational stress. The medial prefrontal cortex (mPFC is a brain region that has been linked to stress, cognition, maternal care, and mood disorders including postpartum depression. Here we examined the effects of chronic gestational stress on mPFC function and whether these effects might be linked to structural modifications in the mPFC. We found that in postpartum rats, chronic gestational stress resulted in maternal care deficits, increased depressive-like behavior, and impaired performance on an attentional set shifting task that relies on the mPFC. Furthermore, exposure to chronic stress during pregnancy reduced dendritic spine density on mPFC pyramidal neurons and altered spine morphology. Taken together, these findings suggest that pregnancy stress may contribute to postpartum mental illness and its associated symptoms by compromising structural plasticity in the mPFC.
Paola Di Blasio; Sarah Miragoli; Elena Camisasca; Angela Maria Di Vita; Rosalia Pizzo; Laura Pipitone
Childbirth for some women is a negative experience associated with depressive and post-traumatic symptoms. The preventive actions focusing on helping mothers to cope with negative emotions experienced after childbirth are strongly recommended. It is also recommended both to intervene early and on all women to avoid the risk that these symptoms can worsen in the months after childbirth. The intervention described in the current study is focalized on the elaboration of post-partum negative thou...
Ohoka, Harue; Koide, Takayoshi; Goto, Setsuko; Murase, Satomi; Kanai, Atsuko; Masuda, Tomoko; Aleksic, Branko; Ishikawa, Naoko; Furumura, Kaori; Ozaki, Norio
Postnatal depression has demonstrated long-term consequences on child cognitive and emotional development; however, the link between maternal and child pathology has not been clearly identified. We conducted a prospective study using self-rating questionnaires to clarify the association between bonding disorder and maternal mood during pregnancy and after childbirth. A total of 389 women participated in this study and completed questionnaires. Participants were asked to complete the Edinburgh Postnatal Depression Scale (EPDS) and the Mother-to-Infant Bonding Scale four times during pregnancy and the postpartum period. We found statistically significant weak to moderate correlations (r = 0.14-0.39) between the EPDS and Mother-to-Infant Bonding Scale scores at each testing period. Women who experienced low mood tended to have stronger bonding disorder. Furthermore, the effectiveness of attachment between the mother and child was closely related to the mood of the mother as measured by the EPDS. We observed different patterns of bonding and maternal mood. Distinct subtypes regarding maternal mood and formation of mother-to-infant attachment suggests that analysis of bonding disorder should be performed considering the course of maternal depressive symptoms. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.
Kouros, Chrystyna D.; Garber, Judy
The current prospective study investigated transactional relations between maternal depressive symptoms and children's depressive and externalizing symptoms. Participants included 240 children (M age = 11.86 years, SD = 0.56; 53.9% female) and their mothers who were part of a 6-year longitudinal study. Measures of maternal depression (Beck…
Vliegen, Nicole; Luyten, Patrick
This study investigates the role of self-criticism and dependency in inpatient post-partum depressed women (n = 55) and non-depressed controls (n = 37) as well as the relationship between both personality dimensions and severity of depression and anxiety. As expected, mothers with post-partum depression showed not only increased levels of depression but also anxiety compared with non-depressed mothers. Furthermore, they had significantly higher levels of self-criticism, but not of dependency. In the post-partum depressed mothers, both personality dimensions were positively associated with severity of depression. However, in non-depressed mothers, self-criticism was positively associated with depression, while there was an inverse relationship between dependency and severity of depression. In both samples, self-criticism, but not dependency, was related to state anxiety. The cross-sectional nature of this study limits the ability to draw causal conclusions. The study was based on self-report and conducted in relatively small samples.
Lara-Cinisomo, Sandraluz; McKenney, Kathryn; Di Florio, Arianna; Meltzer-Brody, Samantha
Postpartum depression (PPD), often comorbid with anxiety, is the leading medical complication among new mothers. Latinas have elevated risk of PPD, which has been associated with early breastfeeding cessation. Lower plasma oxytocin (OT) levels have also been associated with PPD in non-Latinas. This pilot study explores associations between PPD, anxiety, breastfeeding, and OT in Latinas. Thirty-four Latinas were enrolled during their third trimester of pregnancy and followed through 8 weeks postpartum. Demographic data were collected at enrollment. Depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS) at each time point (third trimester of pregnancy, 4 and 8 weeks postpartum). The Spielberger State-Trait Anxiety Inventory (STAI) was administered postpartum and EPDS anxiety subscale was used to assess anxiety at each time point. Breastfeeding status was assessed at 4 and 8 weeks postpartum. At 8 weeks, OT was collected before, during, and after a 10-minute breast/bottle feeding session from 28 women who completed the procedures. Descriptive statistics are provided and comparisons by mood and breastfeeding status were conducted. Analyses of variance were used to explore associations between PPD, anxiety, breastfeeding status, and OT. Just under one-third of women were depressed at enrollment. Prenatal depression, PPD, and anxiety were significantly associated with early breastfeeding cessation (i.e., stopped breastfeeding before 2 months) (p < 0.05). There was a significant interaction between early breastfeeding cessation and depression status on OT at 8 weeks postpartum (p < 0.05). Lower levels of OT were observed in women who had PPD at 8 weeks and who had stopped breastfeeding their infant by 8 weeks postpartum. Future studies should investigate the short- and long-term effects of lower OT levels and early breastfeeding cessation on maternal and child well-being.
Ahmadpanah, Mohammad; Nazaribadie, Marzieh; Aghaei, Elham; Ghaleiha, Ali; Bakhtiari, Azade; Haghighi, Mohammad; Bahmani, Dena Sadeghi; Akhondi, Amineh; Bajoghli, Hafez; Jahangard, Leila; Holsboer-Trachsler, Edith; Brand, Serge
Ten to 15% of mothers experience postpartum depression (PPD). If untreated, PPD may negatively affect mothers' and infants' mental health in the long term. Accordingly, effective treatments are required. In the present study, we investigated the effect of detached mindfulness (DM) and stress management training (SMT) as adjuvants, compared to pharmacologic treatment only, on symptoms of depression in women with PPD. Forty-five primiparae (mean age: M = 24.5 years) with diagnosed PPD and treated with an SSRI (citalopram; CIT) took part in the study. At baseline, they completed questionnaires covering socio-demographic data and symptoms of depression. Experts rated also symptoms of depression. Next, participants were randomly assigned to one of the following study conditions: adjuvant detached mindfulness (CIT+DM); adjuvant stress management training (CIT+SMT); control condition (CIT). Self- and experts' ratings were completed at the end of the study 8 weeks later, and again at 8 weeks follow-up. Symptoms of depression decreased significantly over time, but more so in the CIT+DM and CIT+SMT group, compared to the control condition. The pattern of results remained stable at follow-up. In primiparae with PPD and treated with a standard SSRI, adjuvant psychotherapeutic interventions led to significant and longer-lasting improvements.
Zaidi, Farheen; Nigam, Aruna; Anjum, Ruby; Agarwalla, Rashmi
Postpartum Depression (PPD) is a known entity affecting not only the women but the whole family. It affects women more harshly and chronically due to their increased stress sensitivity, maladaptive coping strategies and multiple social roles in the community. To estimate the commonly associated risk factors of PPD among the women coming to a tertiary hospital in New Delhi, India. It was a longitudinal study conducted at the antenatal clinic for a period of one year. Total 260 women were screened at > 36 weeks of gestation, of which 149 postnatal women completed the questionnaire for PPD at six weeks of their delivery. The inform consent, demographical data and obstetrical details from each participant was taken before commencing the screening. Various risk factors and their association were determined by odds-ratio and significant association was accepted at order to identify the most important confounding variables, logistic regression analysis was used. PPD is a common mental health problem seen among the postnatal women as it was found in 12.75% (19 out of 149) of subjects at six weeks of their delivery. Moreover, it has significant association with the young maternal age (p-value=0.040), birth of the female child (p-value=0.015), previous stressful life events (p-value= 0.003), low self-esteem and feeling of loneliness (p-value=0.007). This study provides important information regarding the risk factors associated with development of PPD in this region of India. Female sex of the new born and the younger age play an important role in the development of PPD.
Reck, C; Zietlow, A-L; Müller, M; Dubber, S
Research investigating maternal bonding and parenting stress in the course of postpartum depression is lacking. Aim of the study was to investigate the development and potential mediation of both constructs in the course of postpartum depression. n = 31 mothers with postpartum depression according to DSM-IV and n = 32 healthy controls completed the German version of the Postpartum Bonding Questionnaire and the Parenting Stress Index at two measuring times: acute depression (T1) and remission (T2). At T1, the clinical group reported lower bonding and higher parenting stress. Bonding was found to partially mediate the link between maternal diagnosis and parenting stress. Furthermore, the clinical group reported lower bonding and higher parenting stress averaged over both measurement times. However, at T2, the clinical group still differed from the controls even though they improved in bonding and reported less parenting stress. A significant increase of bonding was also observed in the control group. Maternal bonding seems to buffer the negative impact of postpartum depression on parenting stress. The results emphasize the need for interventions focusing on maternal bonding and mother-infant interaction in order to prevent impairment of the mother-child relationship.
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alcohol disorder can both serve to initiate the other. ... (unlike that previously identified), and a J-shaped association between binge drinking frequency and depressive symptoms and ..... O'Donnell K, Wardle J, Dantzer C, Steptoe A. Alcohol.
Seth, Sunaina; Lewis, Andrew J; Galbally, Megan
Perinatal depression has a significant impact on both mother and child. However, the influence of hormonal changes during pregnancy and the postpartum period remains unclear. This article provides a systematic review of studies examining the effects of maternal cortisol function on perinatal depression. A systematic search was conducted of six electronic databases for published research on the relationship between cortisol and perinatal depression. The databases included; MEDLINE complete, PsychINFO, SCOPUS, Psychology and Behavioural Sciences, Science Direct and EBSCO, for the years 1960 to May 2015. Risk of bias was assessed and data extraction verified by two investigators. In total, 47 studies met criteria and studies showed considerable variation in terms of methodology including sample size, cortisol assays, cortisol substrates, sampling processes and outcome measures. Those studies identified as higher quality found that the cortisol awakening response is positively associated with momentary mood states but is blunted in cases of major maternal depression. Furthermore, results indicate that hypercortisolemia is linked to transient depressive states while hypocortisolemia is related to chronic postpartum depression. Future research should aim to improve the accuracy of cortisol measurement over time, obtain multiple cortisol samples in a day and utilise diagnostic measures of depression. Future studies should also consider both antenatal and postnatal depression and the differential impact of atypical versus melancholic depression on cortisol levels, as this can help to further clarify the relationship between perinatal depression and maternal cortisol function across pregnancy and the postpartum period.
Kothari, Catherine L; Liepman, Michael R; Shama Tareen, R; Florian, Phyllis; Charoth, Remitha M; Haas, Suzanne S; McKean, Joseph W; Moe, Angela; Wiley, James; Curtis, Amy
Objective This study examined whether socioeconomic status moderated the association between intimate partner violence (IPV) and postpartum depression among a community-based sample of women. Defining the role of poverty in the risk of postpartum depression for IPV victims enables prioritization of health promotion efforts to maximize the effectiveness of existing maternal-infant resources. Methods This cross-sectional telephone-survey study interviewed 301 postpartum women 2 months after delivery, screening them for IPV and depression [using Edinburgh Postnatal Depression Scale (EPDS)]. Socioeconomic status was defined by insurance (Medicaid-paid-delivery or not). This analysis controlled for the following covariates, collected through interview and medical-record review: demographics, obstetric history, prenatal health and additional psychosocial risk factors. After adjusting for significant covariates, multiple linear regression was conducted to test whether socioeconomic status confounded or moderated IPV's relationship with EPDS-score. Results Ten percent of participants screened positive for postpartum depression, 21.3 % screened positive for current or previous adult emotional or physical abuse by a partner, and 32.2 % met poverty criteria. IPV and poverty were positively associated with each other (χ(2) (1) = 11.76, p < .001) and with EPDS score (IPV: beta 3.2 (CI 2.0, 4.5) p < .001, poverty: beta 1.3 (CI 0.2, 2.4) p = .017). In the multiple linear regression, IPV remained significantly associated, but poverty did not (IPV: adjusted beta 3.1 (CI 1.8, 4.3) p < .001, poverty: adjusted beta 0.8 (CI -0.3, 1.9) p = .141), and no statistically significant interaction between IPV and poverty was found. Conclusions Study findings illustrated that IPV was strongly associated with postpartum depression, outweighing the influence of socioeconomic status upon depression for postpartum women.
Figueiredo, Bárbara; Conde, Ana
To investigate high-anxiety and depression in women and men from early pregnancy to 3-months postpartum, 260 Portuguese couples (N = 520) filled in the State-Anxiety Inventory (STAI-S) and the Edinburgh Post-Natal Depression Scale (EPDS) at the first, second, and third pregnancy trimesters, childbirth, and 3-months postpartum. Rates for high-anxiety (STAI-S ≥ 45) in women (13.1%; 12.2%; 18.2%; 18.6%; 4.7%) and men (10.1%; 8.0%, 7.8%; 8.5%; 4.4%) and for depression (EPDS ≥ 10) in women (20.0%, 19.6%, 17.4%, 17.6%; 11.1%) and men (11.3%; 6.6%; 5.5%; 7.5%; 7.2%) were high. Rates for depression were higher than rates for high-anxiety only in women during early pregnancy and the postpartum, but not at the third pregnancy trimester and childbirth. Rates for high-anxiety and depression were higher in women than in men during pregnancy/childbirth, but not at 3-months postpartum. Rates for high-anxiety but not rates for depression were higher during pregnancy/childbirth compared to 3-months postpartum and only in women. Considering that 15.9% of the parents-to-be were highly anxious and/or depressed during pregnancy-comparing to 9.3% at 3-months postpartum-particular attention should be drawn to both women's and men's mental health early in pregnancy.
Full Text Available ... Borderline Personality Disorder (3 items) Depression (32 items) Eating Disorders (9 items) Panic Disorder (1 item) Post-Traumatic ... Borderline Personality Disorder (3 items) Depression (32 items) Eating Disorders (9 items) Panic Disorder (1 item) Post-Traumatic ...
Full Text Available ... Depression (32 items) Eating Disorders (9 items) Panic Disorder (1 item) Post-Traumatic Stress Disorder (7 items) Schizophrenia (3 items) Social Phobia ( ... Depression (32 items) Eating Disorders (9 items) Panic Disorder (1 item) Post-Traumatic Stress Disorder (7 items) Schizophrenia (3 items) Social Phobia ( ...
Full Text Available ... items) Autism (13 items) Bipolar Disorder (2 items) Borderline Personality Disorder (3 items) Depression (32 items) Eating Disorders (9 ... items) Autism (13 items) Bipolar Disorder (2 items) Borderline Personality Disorder (3 items) Depression (32 items) Eating Disorders (9 ...
Full Text Available ... Disorder (2 items) Borderline Personality Disorder (3 items) Depression (32 items) Eating Disorders (9 items) Panic Disorder (1 item) Post-Traumatic ... Disorder (2 items) Borderline Personality Disorder (3 items) Depression (32 items) Eating Disorders (9 items) Panic Disorder (1 item) Post-Traumatic ...
Full Text Available ... alone. NARRATOR : If you have depression, telling friends, family, or someone you trust, and finding a doctor or therapist are the first steps on the road to recovery. Depression treatment can take time to work, so don't give up. Read more about ...
Full Text Available ... why. Scientists at the National Institute of Mental Health are studying brain images of people who suffer from depression trying to learn why it affects some people but not others. Treatments for depression do work. One type of effective psychotherapy is called cognitive ...
Full Text Available ... depression do work. One type of effective psychotherapy is called cognitive behavioral therapy or CBT. CBT can help you change ways of thinking and behaving that may be damaging or contribute to depression. RODOLFO : I had one really good therapist and through her I think I started ...
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Lívia Maria Santiago
Full Text Available OBJECTIVE To estimate the prevalence of depressive symptoms among institutionalized elderly individuals and to analyze factors associated with this condition. METHODS This was a cross-sectional study involving 462 individuals aged 60 or older, residents in long stay institutions in four Brazilian municipalities. The dependent variable was assessed using the 15-item Geriatric Depression Scale. Poisson’s regression was used to evaluate associations with co-variables. We investigated which variables were most relevant in terms of presence of depressive symptoms within the studied context through factor analysis. RESULTS Prevalence of depressive symptoms was 48.7%. The variables associated with depressive symptoms were: regular/bad/very bad self-rated health; comorbidities; hospitalizations; and lack of friends in the institution. Five components accounted for 49.2% of total variance of the sample: functioning, social support, sensory deficiency, institutionalization and health conditions. In the factor analysis, functionality and social support were the components which explained a large part of observed variance. CONCLUSIONS A high prevalence of depressive symptoms, with significant variation in distribution, was observed. Such results emphasize the importance of health conditions and functioning for institutionalized older individuals developing depression. They also point to the importance of providing opportunities for interaction among institutionalized individuals.
Purandare, N.; Oude Voshaar, R.C.; Hardicre, J.; Byrne, J.; McCollum, C.N.; Burns, A.
BACKGROUND: The vascular depression hypothesis and our recent findings of increased frequency of spontaneous cerebral emboli in dementia suggest that such emboli may be involved in the causation of depressive symptoms in dementia. AIMS: To evaluate the association between spontaneous cerebral emboli
Taylor, Julie Lounds; Warren, Zachary E.
The current study examined depressive symptoms, concerning the week following autism spectrum diagnosis and an average of 1.4 years later, in mothers (n = 75) of young children diagnosed with an autism spectrum disorder (ASD). Over three-quarters of mothers (78.7%) provided retrospective reports of clinically significant depressive symptoms…
Lobato, Gustavo; Moraes, Claudia L; Dias, Alessandra S; Reichenheim, Michael E
This study aimed at estimating the prevalence of postpartum depression (PPD) according to postpartum periods and sub-groups in public primary health care settings in Rio de Janeiro, Brazil. A cross-sectional survey was carried out in five primary health care units and included 811 participants randomly selected among mothers of children up to five postpartum months. Women were classified as depressed and given scores on Edinburgh Postnatal Depression Scale (EPDS) above 11. The overall estimate of PPD was 24.3% (95% CI, 21.4-27.4). However, estimates were not homogeneous during the first 5 months postpartum (p value = 0.002). There was a peak of depressive symptoms around 3 months postpartum, when 128 women (37.5%, 95% CI, 29.1-46.5) disclosed scores above 11 on EPDS. Regarding the magnitude of PPD according to some maternal and partners' characteristics, it was consistently higher among women with low schooling, without a steady partner, and whose partners misused alcohol or used illicit drugs. The prevalence of PPD among women attending primary health care units in Rio de Janeiro seems to be higher than general estimates of 10-15%, especially among mothers with low schooling and that receive little (if any) support from partners. Also, the "burden" of PPD may be even higher around 3 months postpartum. These results are particularly relevant for public health policies. Evaluation of maternal mental health should be extended at least until 3 to 4 months postpartum, and mothers presenting a high-risk profile deserve special attention.
Bina, Rena; Barak, Adi; Posmontier, Barbara; Glasser, Saralee; Cinamon, Tali
Research on evidence-based practice (EBP) implementation in social work often neglects to include evaluation of application barriers. This qualitative study examined social workers' perspectives of provider- and organisational-related barriers to implementing a brief eight-session interpersonal therapy (IPT) intervention, a time-limited EBP that addresses reducing depressive symptoms and improving interpersonal functioning. Implementation took place in a primary care setting in Israel and was aimed at treating women who have postpartum depression (PPD) symptoms. Using purposeful sampling, 25 primary care licensed social workers were interviewed between IPT training and implementation regarding their perceived barriers to implementing IPT in practice. Data analysis was facilitated using a phenomenological approach, which entails identifying the shared themes and shared experiences of research participants regarding barriers to implementing IPT. Three themes emerged from the analysis of interviews: Perceived lack of flexibility of IPT intervention in comparison with more familiar methods social workers previously applied, specifically regarding the number of sessions and therapeutic topics included in the IPT protocol; insecurity and hesitance to gain experience with a new method of intervention; and organisational barriers, including difficulties with referrals, the perception of HMOs as health facilities not suitable for therapy, and time constraints. Addressing perceived barriers of social workers toward implementing EBPs, such as IPT for postpartum depression, during the training phase is crucial for enabling appropriate implementation. Future training should include examining practitioners' attitudes toward implementation of EBPs, as part of standardised training protocols. © 2017 John Wiley & Sons Ltd.
Sergio Gonçalves Henriques
Full Text Available OBJECTIVE: To investigate the recognition of depressive symptoms of major depressive disorder (MDD by general practitioners. INTRODUCTION: MDD is underdiagnosed in medical settings, possibly because of difficulties in the recognition of specific depressive symptoms. METHODS: A cross-sectional study of 316 outpatients at their first visit to a teaching general hospital. We evaluated the performance of 19 general practitioners using Primary Care Evaluation of Mental Disorders (PRIME-MD to detect depressive symptoms and compared them to 11 psychiatrists using Structured Clinical Interview Axis I Disorders, Patient Version (SCID I/P. We measured likelihood ratios, sensitivity, specificity, and false positive and false negative frequencies. RESULTS: The lowest positive likelihood ratios were for psychomotor agitation/retardation (1.6 and fatigue (1.7, mostly because of a high rate of false positive results. The highest positive likelihood ratio was found for thoughts of suicide (8.5. The lowest sensitivity, 61.8%, was found for impaired concentration. The sensitivity for worthlessness or guilt in patients with medical illness was 67.2% (95% CI, 57.4-76.9%, which is significantly lower than that found in patients without medical illness, 91.3% (95% CI, 83.2-99.4%. DISCUSSION: Less adequately identified depressive symptoms were both psychological and somatic in nature. The presence of a medical illness may decrease the sensitivity of recognizing specific depressive symptoms. CONCLUSIONS: Programs for training physicians in the use of diagnostic tools should consider their performance in recognizing specific depressive symptoms. Such procedures could allow for the development of specific training to aid in the detection of the most misrecognized depressive symptoms.
Hajiheidari, Mahnaz; Sharifi, Marzieh; Khorvash, Fariborz
Regarding high prevalence and injurious consequences of postpartum depression, the aim of the present work is the study of the effect rate of interpersonal psychotherapy on marriage adaptive and postpartum in women. The present study is semi-empiric, and included control group and pre- and post-test groups. Thirty-two women suffering from postpartum depression were selected from among female referents to counseling centers and clinics in Esfahan city by purposive sampling and were placed in two groups (control and test) randomly case group participated in a 10-weeks marriage interpersonal psychotherapy meetings. Beck II depression questionnaire and marriage adaptive scale were completed by two groups at pre-test and post-test steps. Collected data were analyzed using SPSS software and multivariable covariance analysis. The scores of average of depression and marriage adaptive post-test in test group was significantly less than that in the control group (P marriage interpersonal psychotherapy on the depression recovery and the increasing marriage satisfaction of women suffering from postpartum depression.
Symptoms of postpartum depression and early interruption of exclusive breastfeeding in the first two months of life Sintomas de depressão pós-parto e interrupção precoce do aleitamento materno exclusivo nos dois primeiros meses de vida
Maria Helena Hasselmann
Full Text Available This study evaluates the association between postpartum depression and interruption of exclusive breastfeeding in the first two months of life. Cohort study of 429 infants Avaliou-se a associação entre depressão pós-parto e interrupção precoce do aleitamento materno exclusivo nos dois primeiros meses de vida. Estudo de coorte com 429 crianças < 20 dias de idade em quatro unidades de saúde no Rio de Janeiro, Brasil. Considerou-se como interrupção precoce do aleitamento materno exclusivo a introdução de chá, água, suco, leite artificial ou qualquer outro alimento. Na avaliação da depressão pós-parto utilizou-se a Edinburgh Post-natal Depression Scale. Associações foram expressas como razões de prevalências (linha de base e riscos relativos (primeiro e segundo meses de vida e respectivos intervalos de 95% de confiança estimados via regressão de Poisson com variância robusta. Filhos de mulheres com sintomas de depressão pós-parto apresentam maior risco de interrupção precoce do aleitamento materno exclusivo nos dois meses de seguimento (RR = 1,46; IC95%: 0,98-2,17 e RR = 1,21; IC95%: 1,02-1,45, respectivamente. Entre mães que amamentam exclusivamente até o primeiro mês de vida, depressão pós-parto não se associou à interrupção precoce do aleitamento materno exclusivo (RR = 1,44; IC95%: 0,68-3,06. Esses achados apontam para a importância da saúde mental materna no sucesso do aleitamento materno exclusivo.
Full Text Available ... depression can feel irritable and restless, and have sleep problems. RODOLFO : Sometimes I would sleep only 3 hours a night or cause I couldn't sleep for weeks. And then but most of the ...
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Full Text Available ... most, and how to make better, more effective ones. For many people, a combination of medication and psychotherapy may be the best choice. Depression can be successfully treated in many ...
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Full Text Available ... problems. RODOLFO : Sometimes I would sleep only 3 hours a night or cause I couldn't sleep ... happened, where I would sleep 10, 12, 15 hours a day even. NARRATOR : People who are depressed ...
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Full Text Available ... I felt like I was such an awful person that there was no real reason for me ... I gained a lot of weight. NARRATOR : A person with depression can feel irritable and restless, and ...
Full Text Available ... to anyone. I didn't really want to do anything for myself because I felt so, I ... there was no real reason for me to do anything for myself. NARRATOR : Depression is more than ...
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Full Text Available ... CBT. CBT can help you change ways of thinking and behaving that may be damaging or contribute ... and through her I think I started really thinking about that I did have depression. NARRATOR : Medications ...
Full Text Available ... for weeks. And then but most of the time the opposite happened, where I would sleep 10, ... depressed can feel numb and tired all the time. In some cases it can even lead to ...
Full Text Available ... with depression are different from those without the illness, but we aren't sure why. Scientists at the National Institute of Mental Health are studying brain images of people who ...
Full Text Available ... people but not others. Treatments for depression do work. One type of effective psychotherapy is called cognitive ... closer to figuring out exactly how these medications work, who benefits from them the most, and how ...
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Full Text Available ... is called cognitive behavioral therapy or CBT. CBT can help you change ways of thinking and behaving that ... I did have depression. NARRATOR : Medications called antidepressants can also help. NIMH researchers are getting closer to figuring out ...
Smith-Nielsen, Johanne; Tharner, Anne; Steele, Howard; Cordes, Katharina; Mehlhase, Heike; Vaever, Mette Skovgaard
Previous studies on effects of postpartum depression (PPD) on infant-mother attachment have been divergent. This may be due to not taking into account the effects of stable difficulties not specific for depression, such as maternal personality disorder (PD). Mothers (N=80) were recruited for a longitudinal study either during pregnancy (comparison group) or eight weeks postpartum (clinical group). Infants of mothers with depressive symptoms only or in combination with a PD diagnosis were compared with infants of mothers with no psychopathology. Depression and PD were assessed using self-report and clinical interviews. Infant-mother attachment was assessed when infants were 13 months using Strange Situation Procedure (SSP). Attachment (in)security was calculated as a continuous score based on the four interactive behavioral scales of the SSP, and the conventional scale for attachment disorganization was used. PPD was associated with attachment insecurity only if the mother also had a PD diagnosis. Infants of PPD mothers without co-morbid PD did not differ from infants of mothers with no psychopathology. These results suggest that co-existing PD may be crucial in understanding how PPD impacts on parenting and infant social-emotional development. Stable underlying factors may magnify or buffer effects of PPD on parenting and child outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.
DeMaris, Alfred; Mahoney, Annette
This study investigates a potential causal effect of mothers' perceptions of the fairness of infant care on their postpartum depression. Based on the tenets of equity theory, it is hypothesized that, net of controls, mothers who see infant care as fairly apportioned between themselves and their husbands will be less depressed than others. We utilize data from a longitudinal study of a nonrandom sample of 178 heterosexual couples experiencing the birth of their first child together. The primary focus variable is the mothers' perception in the first couple of months postpartum that infant care is fair to them. Statistical analysis involved the careful chronological sequencing of response variable and controls, along with regression modeling using propensity scores. We find that a perception of fairness is associated with about a quarter of a standard deviation lower depressive symptomatology, controlling for key covariates. Depressive symptomatology is additionally elevated for mothers experiencing more pre-partum depression, and for those who more generally felt, before the birth, that they were overbenefiting in the marriage. This paper contributes to both equity theory and research on postpartum depression. In a scenario in which it is not practical or ethical to randomly assign people to fairness-in-infant-care conditions, we are able to utilize longitudinal data and a natural "experiment," along with propensity-score modeling to attempt to assess the causal impact of fairness in infant care on postpartum depression. The finding that fairness in this arena appears to reduce postpartum depression emphasizes the importance of encouraging father participation in this critical stage of parenting. Limitations of the study with respect to causal inference are also discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.
Turan, Bulent; Stringer, Kristi L; Onono, Maricianah; Bukusi, Elizabeth A; Weiser, Sheri D; Cohen, Craig R; Turan, Janet M
While studies have suggested that depression and HIV-related stigma may impede access to care, a growing body of literature also suggests that access to HIV care itself may help to decrease internalized HIV-related stigma and symptoms of depression in the general population of persons living with HIV. However, this has not been investigated in postpartum women living with HIV. Furthermore, linkage to care itself may have additional impacts on postpartum depression beyond the effects of antiretroviral therapy. We examined associations between linkage to HIV care, postpartum depression, and internalized stigma in a population with a high risk of depression: newly diagnosed HIV-positive pregnant women. In this prospective observational study, data were obtained from 135 HIV-positive women from eight antenatal clinics in the rural Nyanza Province of Kenya at their first antenatal visit (prior to testing HIV-positive for the first time) and subsequently at 6 weeks after giving birth. At 6 weeks postpartum, women who had not linked to HIV care after testing positive at their first antenatal visit had higher levels of depression and internalized stigma, compared to women who had linked to care. Internalized stigma mediated the effect of linkage to care on depression. Furthermore, participants who had both linked to HIV care and initiated antiretroviral therapy reported the lowest levels of depressive symptoms. These results provide further support for current efforts to ensure that women who are newly diagnosed with HIV during pregnancy become linked to HIV care as early as possible, with important benefits for both physical and mental health.
Evagorou, Olympia; Arvaniti, Aikaterini; Samakouri, Maria
It is a well known fact that postpartum depression (PPD) is a global phenomenon that women may experience, regardless of cultural identity and beliefs. This literature review presents the cultural beliefs and postnatal practices around the world, in each continent and people's origins, looking through the extent to which they contribute positively or negatively to the onset of the disease. 106 articles were used in this research, through a systematic electronic search of Pubmed (Medline) and Scopus. Comparison is also made between the prevalence, the risk factors and the different ways of appearance of the disease around the world and among immigrants. Finally, the initiatives and interventions made so far by the governments and institutions with a view to prevent and address this global problem are presented. The results showed (a) that different cultures share the same risk factors towards the disease (b) significant differences in the prevalence of the disease among both Western and non Western cultures and between the cultures themselves (c) more tendencies for somatization of depressive symptoms in non-Western cultures, (d) different postnatal practices between cultures, which are not always effective (e) the more non-West a culture is, the less interventions concern on mental health; the same phenomenon is observed on populations burdened by immigration. The beliefs held by culture should be taken seriously in detecting of PPD, as well as the assessment of the needs of women who have recently given birth.
Austin, Marie-Paule V; Hadzi-Pavlovic, Dusan; Priest, Susan R; Reilly, Nicole; Wilhelm, Kay; Saint, Karen; Parker, Gordon
The objectives of this study were: (1) to examine Composite International Diagnostic Interview (CIDI) period prevalence and comorbidity for depression and anxiety disorder in a cohort of women assessed during the first 6-8 months postpartum and (2) to examine the benefits of combining the Edinburgh Postnatal Depression Scale (EPDS) with a simple "interval symptom" question to optimize screening postpartum. Women aged over 18 (N = 1,549) were assessed during late pregnancy and reviewed at approximately 2, 4, and 6-8 months postpartum using the EPDS and an "interval symptom" question. The latter asked about any depressive symptoms in the interval since the last EPDS. Women who scored >12 on the EPDS and/or positive on the "interval symptom" question were then administered the CIDI. A further 65 randomly selected women that screened negative were also administered the CIDI. Loss to postnatal follow-up was very significant, and returns rates were inconsistent across the three postnatal time points. Almost 25% of those who screened positive did not complete a CIDI. For screen-positive status, a total of 314 (24.4%) of those that returned questionnaires (N = 1,289) screened positive at least once across the 6- to 8-month interval. Of these, 79 were lost to follow-up; thus, 235 (74.8%) completed a CIDI. In this group, 34.7% had been positive both on the EPDS and the "interval" question, 15.9% on the EPDS alone, and 49.4% on the "interval" question alone. For the CIDI diagnosis and estimated 6- to 8-month period CIDI prevalence, among those 235 women who screened positive and completed a CIDI, 67.2% met the criteria for a CIDI diagnosis, as did 16.9% of those who screened negative. The breakdown in CIDI diagnoses in the 235 women was 32.8% major depression (± anxiety disorder); 26.4% minor depression alone; and 8.1% with a primary anxiety disorder (approximately half with minor depression). Put another way, 20.4% of these women had an anxiety disorder
Medeiros, Gustavo C; Seger, Liliana; Grant, Jon E; Tavares, Hermano
It is estimated that between 1.7 and 2.6 million people have had intermittent explosive disorder (IED) during their life in the United States alone. Co-occurring psychiatric disorders are very common in IED, being major depressive disorder arguably the most common. The objective of this study was to examine the clinical correlates of IED and depressive manifestations in 74 treatment-seeking subjects. After controlling for confounders, there were associations between major depressive disorder and severity of depressive symptoms, and (a) higher assault scores, (b) more severe hostile behavior and (c) worse social adjustment. Management of depressive symptoms may be an important for IED treatment. Copyright © 2018 Elsevier B.V. All rights reserved.
Luk, Jeremy W; Gilman, Stephen E; Haynie, Denise L; Simons-Morton, Bruce G
Sexual orientation disparities in adolescent depressive symptoms are well established, but reasons for these disparities are less well understood. We modeled sexual orientation disparities in depressive symptoms from late adolescence into young adulthood and evaluated family satisfaction, peer support, cyberbullying victimization, and unmet medical needs as potential mediators. Data were from waves 2 to 6 of the NEXT Generation Health Study ( n = 2396), a population-based cohort of US adolescents. We used latent growth models to examine sexual orientation disparities in depressive symptoms in participants aged 17 to 21 years, conduct mediation analyses, and examine sex differences. Relative to heterosexual adolescents, sexual minority adolescents (those who are attracted to the same or both sexes or are questioning; 6.3% of the weighted sample) consistently reported higher depressive symptoms from 11th grade to 3 years after high school. Mediation analyses indicated that sexual minority adolescents reported lower family satisfaction, greater cyberbullying victimization, and increased likelihood of unmet medical needs, all of which were associated with higher depressive symptoms. The mediating role of cyberbullying victimization was more pronounced among male than female participants. Sexual minority adolescents reported higher depressive symptoms than heterosexual adolescents from late adolescence into young adulthood. Collectively, low family satisfaction, cyberbullying victimization, and unmet medical needs accounted for >45% of differences by sexual orientation. Future clinical research is needed to determine if interventions targeting these psychosocial and health care-related factors would reduce sexual orientation disparities in depressive symptoms and the optimal timing of such interventions. Copyright © 2018 by the American Academy of Pediatrics.
Bob, Petr; Fedor-Freybergh, Peter; Jasova, Denisa; Bizik, Gustav; Susta, Marek; Pavlat, Josef; Zima, Tomas; Benakova, Hana; Raboch, Jiri
Dissociative symptoms are traditionally attributed to psychological stressors that produce dissociated memories related to stressful life events. Dissociative disorders and dissociative symptoms including psychogenic amnesia, fugue, dissociative identity-disorder, depersonalization, derealization and other symptoms or syndromes have been reported as an epidemic psychiatric condition that may be coexistent with various psychiatric diagnoses such as depression, schizophrenia, borderline personality disorder or anxiety disorders. According to recent findings also the somatic components of dissociation may occur and influence brain, autonomic and neuroendocrine functions. At this time there are only few studies examining neuroendocrine response related to dissociative symptoms that suggest significant dysregulation of the hypothalamus-pituitary-adrenal (HPA) axis. The aim of the present study is to perform examination of HPA axis functioning indexed by basal cortisol and prolactin and test their relationship to psychic and somatoform dissociative symptoms. Basal cortisol and prolactin and psychic and somatoform dissociative symptoms were assessed in 40 consecutive inpatients with diagnosis of unipolar depression mean age 43.37 (SD=12.21). The results show that prolactin and cortisol as indices of HPA axis functioning manifest significant relationship to dissociative symptoms. Main results represent highly significant correlations obtained by simple regression between psychic dissociative symptoms (DES) and serum prolactin (R=0.55, p=0.00027), and between somatoform dissociation (SDQ-20) and serum cortisol (R=-0.38, p=0.015). These results indicate relationship between HPA-axis reactivity and dissociative symptoms in unipolar depressive patients that could reflect passive coping behavior and disengagement.
Maria Stella Epifanio
Full Text Available Transition to parenthood represents an important life event increasing vulnerability to psychological disorders. Postpartum depression and parenting distress are the most common psychological disturbances and a growing scientific evidence suggests that both mothers and fathers are involved in this developmental crisis. This paper aims to explore maternal and paternal experience of transition to parenthood in terms of parenting distress and risk of postpartum depression. Seventy-five couples of first-time parents were invited to compile the Edinburgh Postnatal Depression Scale and the Parenting Stress Index-Short Form in the first month of children life. Study sample reported very high levels of parenting distress and a risk of postpartum depression in 20.8% of mothers and 5.7% of fathers. No significant correlation between parenting distress and the risk of postpartum depression emerged, both in mothers than in fathers group while maternal distress levels are related to paternal one. The first month after partum represents a critical phase of parents life and it could be considered a developmental crisis characterized by anxiety, stress and mood alterations that could have important repercussions on the child psycho-physical development.
Tani, Franca; Castagna, Valeria
Social relationships provide individuals with a general sense of self-worth, psychological wellbeing, as well as allowing them access to resources during stressful periods and transitions in life. Pregnancy is a time of significant life change for every woman. The aim of this study was to verify the influence of social support perceived by mothers during pregnancy on the quality of their birth experience and post-partum depression. A longitudinal study at three different times was carried out on 179 nulliparous pregnant women. Women completed a Maternal Social Support Questionnaire during the third trimester of their pregnancy. Then, on the first day after childbirth, clinical birth indices were collected. Finally, a month after childbirth, the Edinburgh Postnatal Depression Scale was administered. Post-partum depression was influenced negatively by maternal perceived social support and positively by negative clinical birth indices. In addition to these direct effects, analyses revealed a significant effect of maternal perceived social support on post-partum depression, mediated by the clinical indices considered. Social support perceived by mothers during pregnancy plays a significant role as a protection factor against post-partum depression, both directly and indirectly, reducing the negative clinical aspects of the birth experience.
Song, W; Yu, S
In the period of gestation, delivery and post-delivery, fear and tension produced in puerperae are likely to evolve into depression as they worry too much about delivery pain. In recent years, it has been noted that stressful events during this period aggravate postpartum depression. To discuss the effect of these childbirth-related stressful events on neuroendocrine functions of patients with postpartum depression, 300 full-term puerperae who had been admitted to the Beijing Obstetrics and Gynecology Hospital, Capital Medical University between October, 2011 and October, 2013 and who had suffered from stressful childbirth-related events were enrolled as a study group. This group was divided into six subgroups, i.e., A, B, C, D, E and F, based on the number of stressful events they had suffered which were labeled by numbers 1 to 6. Additionally, 100 puerperae from the same hospital who had not suffered from childbirth-related stressful events were taken as controls. Relevant clinical indexes, including serum adrenocorticotropic hormone (ACTH), plasma 5-hydroxytryptamine (5-HT), noradrenaline ELISA (NE), dopamine (DA) and cortisol level were measured and compared. It was found that incidence probability of postpartum depression was significantly different between the study group (13.67%, 41/300) and the control group (7%, 7/100). Moreover, the incidence probability of postpartum depression of puerperae suffering from no less than 4 childbirth-related stressful events was higher than those suffering from no more than 3, and the difference was statistically significant (Pdepression.
Clout, Danielle; Brown, Rhonda
The purpose of this paper was to evaluate relationships between sociodemographic, pregnancy, obstetric, and postnatal variables and postpartum depression, anxiety and stress levels in new mothers. One-hundred-thirty-nine women completed the baseline questionnaire and 105 completed the follow-up questionnaire at 4-6 months postpartum. Sociodemographic and pregnancy factors were assessed at baseline, birth and postnatal factors were assessed at time 2, and depression, anxiety, and stress were assessed at both time points. Caesarean delivery was associated with high postpartum depression, anxiety, and stress levels. Child sleep problems was related to depression, child health problems were related to anxiety, more SLE related to high stress, and maternal sleep problems were related to PPD. However, the results became non-significant after controlling for antenatal distress levels. Finally, women who underwent caesarean delivery had higher antenatal stress, anxiety, and depression levels, relative to women who did not undergo the procedure. Psychological stress and distress tended to persist in the women from the third-trimester of pregnancy to 4-6 months postpartum. It tended to occur in the context of caesarean delivery, maternal sleep problems, child's health and sleep problems, and stressful life-events. Copyright © 2015 Elsevier B.V. All rights reserved.
Full Text Available ... Sometimes I would sleep only 3 hours a night or cause I couldn't sleep for weeks. And then but most of the time the opposite happened, where I would sleep 10, 12, 15 hours a day even. NARRATOR : People who are depressed can feel ...
Full Text Available ... to do anything for myself because I felt so, I felt like I was such an awful ... out of the house. I was in college so I wouldn't go to classes at all. ... genetic, biological and environmental factors that influence depression so that new and better treatments can be developed. ...
Full Text Available ... depressed can feel numb and tired all the time. In some cases it can even lead to thoughts of suicide. RODOLFO : It was like I had big huge weights on my legs and I was trying to swim and just kept sinking. And I'd get a little ...
Full Text Available ... Borderline Personality Disorder (3 items) Depression (32 items) Eating Disorders (9 items) Panic Disorder (1 item) Post-Traumatic Stress Disorder (7 items) Schizophrenia (3 items) Social Phobia (2 items) Populations Children and Adolescents (26 items) Diversity and Ethnic Groups (4 items) ...
Full Text Available ... problems. RODOLFO : Sometimes I would sleep only 3 hours a night or cause I couldn't sleep for weeks. And then but most of the time the opposite happened, where I would sleep 10, 12, 15 hours a day even. NARRATOR : People who are depressed ...
Full Text Available ... Multimedia by Topic Disorders Anxiety Disorders (5 items) Attention Deficit Hyperactivity Disorder (ADHD) (3 items) Autism (13 items) Bipolar Disorder (2 items) Borderline Personality Disorder (3 items) Depression (32 items) Eating Disorders (9 items) Panic Disorder (1 item) Post- ...
Full Text Available ... Disorder (2 items) Borderline Personality Disorder (3 items) Depression (32 items) Eating Disorders (9 items) Panic Disorder (1 item) Post-Traumatic Stress Disorder (7 items) Schizophrenia (3 items) Social Phobia (2 items) Populations Children and Adolescents (26 items) ...
Aleeca F. Bell
Full Text Available Postpartum depression (PPD affects up to 19% of women, negatively impacting maternal and infant health. Reductions in plasma oxytocin levels have been associated with PPD and heritability studies have established a genetic contribution. Epigenetic regulation of the oxytocin receptor gene (OXTR has been demonstrated and we hypothesized that individual epigenetic variability at OXTR may impact the development of PPD and that such variability may be central to predicting risk. This case-control study is nested within the Avon Longitudinal Study of Parents and Children and included 269 cases with PPD and 276 controls matched on age group, parity, and presence or absence of depressive symptoms in pregnancy as assessed by the Edinburgh Postnatal Depression Scale. OXTR DNA methylation (CpG site -934 and genotype (rs53576 and rs2254298 were assayed from DNA extracted from blood collected during pregnancy. Conditional logistic regression was used to estimate odds ratios (OR and 95% confidence intervals (CI for the association of elevated symptoms of PPD with genotype, methylation, and their interaction adjusted for psychosocial factors (n=500. There was evidence of an interaction between rs53576 and methylation in the OXTR gene amongst women who did not have depression prenatally but developed PPD (p interaction=0.026, adjusted for covariates, n=257. Those women with GG genotype showed 2.63 greater odds of PPD for every 10% increase in methylation level (95% CI: 1.37, 5.03, whereas methylation was unrelated to PPD amongst A carriers (OR=1.00, 95%CI: 0.58, 1.73. There was no such interaction among women with PPD and prenatal depression. These data indicate that epigenetic variation that decreases expression of OXTR in a susceptible genotype may play a contributory role in the etiology of postpartum depression.
Yang, Fuzhong; Gardner, Charles O; Bigdeli, Tim; Gao, Jingfang; Zhang, Zhen; Tao, Ming; Liu, Ying; Li, Youhui; Wang, Gang; Shi, Jianguo; Gao, Chengge; Zhang, Kerang; Li, Kan; Wang, Xumei; Liu, Lanfen; Sun, Jing; Du, Bo; Shi, Shenxun; Zhang, Jingbei; Wu, Wenyuan; Wang, Xueyi; Shen, Jianhua; Liu, Tiebang; Gu, Danhua; Liang, Wei; Deng, Hong; Pan, Jiyang; Yang, Lijun; Jian, Hu; Jiang, Guoqin; Meng, Huaqing; Miao, Guodong; Li, Yi; Hu, Chunmei; Huang, Guoping; Zhang, Yutang; Chen, Yunchun; Ha, Baowei; Gao, Shu; Fang, Xiang; Mei, Qiyi; Hong, Xiaohong; Yang, Donglin; Liu, Tieqiao; Fengyu, Yu; Zhong, Hui; Sang, Hong; Chen, Guibing; Cai, Min; Song, Yan; Dong, Jicheng; Shen, Zhenmin; Zhang, Wei; Wang, Xiaoping; Pan, Runde; Liu, Xiaojuan; Li, Yi; Liu, Zhengrong; Zhang, Qiwen; Li, Gongying; Flint, Jonathan; Kendler, Kenneth S
We sought to investigate the clinical features of and risk factors for recurrent major depression (MD) with history of postpartum episodes (PPD) in Han Chinese women and the differences between first-onset postpartum MD (MD that has its first lifetime depressive episode in the postpartum period) and first-onset non-postpartum MD (MD with history of PPD and has its first lifetime depressive episode in a period other than postpartum). Data were derived from the China, Oxford and Virginia Commonwealth University Experimental Research on Genetic Epidemiology (CONVERGE) study (N=6017 cases) and analyzed in two steps. We first examined the clinical features of and risk factors for MD patients with (N=981) or without (N=4410) a history of PPD. We then compared the differences between first-onset postpartum MD (N=583) and first-onset non-postpartum MD (N=398) in those with a history of PPD. Linear, logistic and multinomial logistic models were employed to measure the associations. A history of PPD was associated with more guilt feelings, greater psychiatric comorbidity, higher neuroticism, earlier onset and more chronicity (OR 0.2-2.8). Severe premenstrual symptoms (PMS) and more childbirths increased the risk of PPD, as did a family history of MD, childhood sexual abuse, stressful life events and lack of social support (OR 1.1-1.3). In the MD with history of PPD subsample, first-onset postpartum MD was associated with fewer recurrent major depressive episodes, less psychiatric comorbidity, lower neuroticism, less severe PMS and fewer disagreements with their husbands (OR 0.5-0.8), but more childbirths (OR 1.2). Data were obtained retrospectively through interview and recall bias may have affected the results. MD with history of PPD in Han Chinese women is typically chronic and severe, with particular risk factors including severe PMS and more childbirths. First-onset postpartum MD and first-onset non-postpartum MD can be partly differentiated by their clinical features
Sonia María López C
Full Text Available Depression has been related with alterations of glucose metabolism, hypertension, hypercholesterolemia, adiposity and dislipidemias, which constitute the metabolic syndrome (m s. Objective: to determine the frequency of depressive symptoms in patients with m s. Material and methods: an observational, descriptive, transverse study was carried out in 101 patients with m s(69 women and 32 men. The Beck inventory for depression was applied. Vasodilatation in the brachial artery and the thickness of the carotid intimae-media were evaluated by means of ultrasonographic measurement. Abdominal perimeter, trygliceridemia, cholesterolemia and insulin resistance were calculated. The statistic treatment was performed by means of descriptive and inferential through mean, standard deviation, and correlation proofs. Insulin resistance was calculated by the h o m a method. Results:prevalence of depressive symptoms: 46.34% between patients with m s (correlation of 0.42 significative at p = 0.05. A higher number of components of the syndrome correlates with higher severity of the depression. Depressive symptoms were associated to a higher insulin resistance, low levels of c- h d l, hypertension and carotid atherosclerosis. Conclusion: depression has a high prevalence in the m s and its associates with a higher number of metabolic and vascular disturbances
Haim, Achikam; Albin-Brooks, Christopher; Sherer, Morgan; Mills, Emily; Leuner, Benedetta
Postpartum depression (PPD) is a common complication following childbirth experienced by one in every five new mothers. Although the neural basis of PPD remains unknown previous research in rats has shown that gestational stress, a risk factor for PPD, induces depressive-like behavior during the postpartum period. Moreover, the effect of gestational stress on postpartum mood is accompanied by structural modifications within the nucleus accumbens (NAc) and the medial prefrontal cortex (mPFC) – limbic regions that have been linked to PPD. Mothers diagnosed with PPD are often prescribed selective serotonin reuptake inhibitor (SSRI) antidepressant medications and yet little is known about their effects in models of PPD. Thus, here we investigated whether postpartum administration of Citalopram, an SSRI commonly used to treat PPD, would ameliorate the behavioral and morphological consequences of gestational stress. In addition, we examined the effects of gestational stress and postpartum administration of Citalopram on structural plasticity within the basolateral amygdala (BLA) which together with the mPFC and NAc forms a circuit that is sensitive to stress and is involved in mood regulation. Our results show that postpartum rats treated with Citalopram do not exhibit gestational stress-induced depressive-like behavior in the forced swim test. In addition, Citalopram was effective in reversing gestational stress-induced structural alterations in the postpartum NAc shell and mPFC. We also found that gestational stress increased spine density within the postpartum BLA, an effect which was not reversed by Citalopram treatment. Overall, these data highlight the usefulness of gestational stress as a valid and informative translational model for PPD. Furthermore, they suggest that structural alterations in the mPFC-NAc pathway may underlie stress-induced depressive-like behavior during the postpartum period and provide much needed information on how SSRIs may act in the
Updegraff, Kimberly A.; Perez-Brena, Norma J.; Umaña-Taylor, Adriana J.; Jahromi, Laudan B.; Harvey-Mendoza, Elizabeth C.
This study draws from a life-course perspective in examining trajectories of mothers’ depressive symptoms across their adolescent daughters’ adjustment to parenthood in 204 Mexican-origin families using latent class growth analysis. Four distinct trajectories were identified based on mothers’ depressive symptoms prior to the birth and 10 and 24 months postpartum. Two trajectories were characterized by stable levels of depressive symptoms but were differentiated in their levels of symptoms (i.e., High/Stable and Low/Stable). The remaining two trajectories were characterized by changes from pre- to post-birth, with one group exhibiting increases in depressive symptoms (i.e., Low/Post-Birth Increase) and the other group characterized by decreases in depressive symptoms (i.e., Low/Post-Birth Decrease). Consistent with a risk and resilience perspective, mothers with more disadvantaged socioeconomic circumstances and fewer intrapersonal resources (i.e., self-esteem, ethnic identity affirmation) were more likely to be members of the High/Stable group. In addition, daughters of mothers in the High/Stable group were more likely to have lower self-esteem as compared to daughters in the other three groups. Collectively, these findings suggested that the High/Stable group was at risk for adjustment difficulties from the third trimester to two years postpartum. In contrast, membership in the Low/Post-Birth Decrease trajectory group was associated with lower depressive symptoms and higher self-esteem for mothers and daughters. Findings point to the need to identify mothers who are at risk for depressive symptoms during their adolescent daughters’ pregnancy and offer prevention and intervention programs that reduce risks and enhance protective factors. PMID:23750520
Secades-Villa, Roberto; Weidberg, Sara; González-Roz, Alba; Reed, Derek D; Fernández-Hermida, José R
Individuals with depression smoke more than smokers without depression. Research has shown that cigarette demand is a useful tool for quantifying tobacco reinforcement and supposes a clinical predictor of treatment outcomes. Despite previous studies examining the relative reinforcing efficacy of nicotine among different populations of smokers, to date, no study has assessed cigarette demand among individuals with elevated depressive symptoms. The aim of this study was to compare cigarette demand among samples of smokers with low and elevated depressive symptoms. Further, it also sought to examine the relationship between depressive symptomatology and the individual CPT demand indices. Participants (80 non-depressed smokers and 85 depressed smokers) completed the 19-item version of the Cigarette Purchase Task (CPT). Depression symptomatology was assessed using the Beck Depression Inventory-Second Edition (BDI-II). Depressed smokers needed to present at least moderate depressive symptoms as indicated by scoring ≥ 20 on the BDI-II. Depressive symptomatology and nicotine dependence were significantly associated with elasticity of demand (R 2 = 0.112; F(2, 155) = 9.756, p = ≤ 0.001). Depressive symptoms, cigarettes per day, and years of regular smoking also predicted breakpoint scores (R 2 = 0.088; F(4, 153) = 3.697, p = 0.007). As smokers with elevated depressive symptoms are less sensitive to increases in cigarette prices than those with low depressive symptomatology, future studies should consider these cigarette demand indices when designing depression-focused smoking cessation treatments. Providing this difficult-to-treat population with interventions that promote both pleasurable and alternative reinforcing activities is highly encouraged.
Nasiri, Saeideh; Kordi, Masoumeh; Gharavi, Morteza Modares
Background: Self-esteem is a determinant factor of mental health. Individuals with low self-esteem have depression, and low self-esteem is one of main symptoms of depression. Aim of this study is to compare the effects of problem-solving skills and relaxation on the score of self-esteem in women with postpartum depression. Materials and Methods: This clinical trial was performed on 80 women. Sampling was done in Mashhad healthy centers from December 2009 to June 2010. Women were randomly divi...
Afnan Hamed-Agbariah; Rosenfeld, Yaakov
Post-partum depression (PPD) is a neurotic condition, which appears usually within two months after the delivery. This is the most common complication of pregnancy and puerperium, affecting about 15 to 20% of the mothers. In Israel, with some 150,000 deliveries annually, this relates to about 20,000 women each year. Routine treatment with psychotherapy (PT), helps about two thirds of these women. Continuation of the maternal symptoms affects the baby's development, and the rest of the family as well. The purpose of this study was to evaluate the additional value of art therapy (AT), compared to standard therapy, with PT alone, to eradicate symptoms of depression. A prospective, randomized controlled study was conducted. During the period 2011-2013, a total of 141 Arab mothers with symptoms of PPD, from the Um-El-Fahem region, were included in the study. A comparison was made between two groups: The control group receiving routine treatment with PT and the intervention group which received, in addition, AT. Both groups demonstrated a reduction in the level of depressive symptoms. In the intervention group, however, the reduction in the level of depressive symptoms was statistically more significant (p depressive state. In a health care system with chronic budgetary constraints, the addition of some cardboard and plasticine to the "Health Basket", coupled with a few hours with a trained therapist, is probably a worthy alternative, considering the scope of the problem and its influence on the mother, the baby, and the family as a whole. The appearance of PPD symptoms is a common and significant medical condition. These attributes make this phenomenon a significant problem from the public health perspective. Routine treatment with PT, helps a lot of women. Many, however, remain symptomatic. The addition of AT enables most of them to resume a normal and healthy course of life.
Full Text Available Elizabeth Fitelson1, Sarah Kim4, Allison Scott Baker3, Kristin Leight21Director, 2Attending Psychiatrist, TheWomen's Program, 3Child and Adolescent Psychiatry Fellow, Division of Child Psychiatry, 4PGY-I Resident in Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY, USAAbstract: Postpartum depression (PPD is a common complication of childbearing, and has increasingly been identified as a major public health problem. Untreated maternal depression has multiple potential negative effects on maternal-infant attachment and child development. Screening for depression in the perinatal period is feasible in multiple primary care or obstetric settings, and can help identify depressed mothers earlier. However, there are multiple barriers to appropriate treatment, including concerns about medication effects in breastfeeding infants. This article reviews the literature and recommendations for the treatment of postpartum depression, with a focus on the range of pharmacological, psychotherapeutic, and other non-pharmacologic interventions. Keywords: postpartum depression, postnatal depression, lactation, antidepressant, hormone therapy, psychotherapy, bright light therapy, omega-3
Kubota, Chika; Okada, Takashi; Aleksic, Branko; Nakamura, Yukako; Kunimoto, Shohko; Morikawa, Mako; Shiino, Tomoko; Tamaji, Ai; Ohoka, Harue; Banno, Naomi; Morita, Tokiko; Murase, Satomi; Goto, Setsuko; Kanai, Atsuko; Masuda, Tomoko; Ando, Masahiko; Ozaki, Norio
The Edinburgh Postnatal Depression Scale (EPDS) is a widely used screening tool for postpartum depression (PPD). Although the reliability and validity of EPDS in Japanese has been confirmed and the prevalence of PPD is found to be about the same as Western countries, the factor structure of the Japanese version of EPDS has not been elucidated yet. 690 Japanese mothers completed all items of the EPDS at 1 month postpartum. We divided them randomly into two sample sets. The first sample set (n = 345) was used for exploratory factor analysis, and the second sample set was used (n = 345) for confirmatory factor analysis. The result of exploratory factor analysis indicated a three-factor model consisting of anxiety, depression and anhedonia. The results of confirmatory factor analysis suggested that the anxiety and anhedonia factors existed for EPDS in a sample of Japanese women at 1 month postpartum. The depression factor varies by the models of acceptable fit. We examined EPDS scores. As a result, "anxiety" and "anhedonia" exist for EPDS among postpartum women in Japan as already reported in Western countries. Cross-cultural research is needed for future research.
Correa-Fernandez, Virmarie; Ji, Lingyun; Castro, Yessenia; Heppner, Whitney L.; Vidrine, Jennifer Irvin; Costello, Tracy J.; Mullen, Patricia Dolan; Cofta-Woerpel, Ludmila; Velasquez, Mary M.; Greisinger, Anthony; Cinciripini, Paul M.; Wetter, David W.
Objective: Based on conceptual models of addiction and affect regulation, this study examined the mechanisms linking current major depressive syndrome (MDS) and anxiety syndrome (AS) to postpartum smoking relapse. Method: Data were collected in a randomized clinical trial from 251 women who quit smoking during pregnancy. Simple and multiple…
Abrams, Laura S.; Curran, Laura
Postpartum depression (PPD) is a major mental health disorder that affects at least 13 percent of new mothers and has detrimental consequences for populations that are of concern to social workers, such as low-income women, women of color, young women, and single mothers. Despite the relevance of PPD to multiple social work problems and…
Villegas, Laura; McKay, Katherine; Dennis, Cindy-Lee; Ross, Lori E.
Purpose: Postpartum depression (PPD) is a significant public health problem, with significant consequences for the mother, infant, and family. Available research has not adequately examined the potential impact of sociodemographic characteristics, such as place of residence, on risk for PPD. Therefore, this systematic review and meta-analysis…
Full Text Available BACKGROUND: The Edinburgh Postnatal Depression Scale (EPDS is a widely used screening tool for postpartum depression (PPD. Although the reliability and validity of EPDS in Japanese has been confirmed and the prevalence of PPD is found to be about the same as Western countries, the factor structure of the Japanese version of EPDS has not been elucidated yet. METHODS: 690 Japanese mothers completed all items of the EPDS at 1 month postpartum. We divided them randomly into two sample sets. The first sample set (n = 345 was used for exploratory factor analysis, and the second sample set was used (n = 345 for confirmatory factor analysis. RESULTS: The result of exploratory factor analysis indicated a three-factor model consisting of anxiety, depression and anhedonia. The results of confirmatory factor analysis suggested that the anxiety and anhedonia factors existed for EPDS in a sample of Japanese women at 1 month postpartum. The depression factor varies by the models of acceptable fit. CONCLUSIONS: We examined EPDS scores. As a result, "anxiety" and "anhedonia" exist for EPDS among postpartum women in Japan as already reported in Western countries. Cross-cultural research is needed for future research.
Objective:To examine relationship of postpartum depression with life events and social support. Methods: Thirty patients with postpartum depression and 32 normal controls were rated by a life events scale and a social support scale. Results: The number of negative life events were found to be higher in patients with postpartum depression as compared to normal controls. Social support of patients with postpartum depression was also found to be lower than their normal counterparts. Conclusion: Negative life events and deficient social support were significantly related to postpartum depression.
Background Depression, as one of the most prevalent mental disorders, is expected to become a leading cause of disability. While evidence-based treatments are not always easily accessible, Internet-based information and self-help appears as a promising approach to improve the strained supply situation by avoiding barriers of traditional offline treatment. User experience in the domain of mental problems therefore emerges as an important research topic. The aim of our study is to investigate the impact of depressive symptoms on subjective and objective measures of web user experience. Method In this two-part online study (Ntotal = 721) we investigate the relationship between depressive symptoms of web users and basic website characteristics (i.e., content, subjective and objective usability, aesthetics). Participants completed search and memory tasks on different fully-functional websites. In addition, they were asked to evaluate the given websites with standardized measures and were screened for symptoms of depression using the PHQ-9. We used structural equation modeling (SEM) to determine whether depression severity affects users’ perception of and performance in using information websites. Results We found significant associations between depressive symptoms and subjective user experience, specifically of website content, usability, and aesthetics, as well as an effect of content perception on the overall appraisal of a website in terms of the intention to visit it again. Small yet significant negative effects of depression severity on all named subjective website evaluations were revealed, leading to an indirect negative effect on the intention to revisit a website via impaired content perceptions. However, objective task performance was not influenced by depressiveness of users. Discussion Depression emerges as capable of altering the subjective perception of a website to some extend with respect to the main features content, usability, and aesthetics. The
Thielsch, Meinald T; Thielsch, Carolin
Depression, as one of the most prevalent mental disorders, is expected to become a leading cause of disability. While evidence-based treatments are not always easily accessible, Internet-based information and self-help appears as a promising approach to improve the strained supply situation by avoiding barriers of traditional offline treatment. User experience in the domain of mental problems therefore emerges as an important research topic. The aim of our study is to investigate the impact of depressive symptoms on subjective and objective measures of web user experience. In this two-part online study ( N total = 721) we investigate the relationship between depressive symptoms of web users and basic website characteristics (i.e., content, subjective and objective usability, aesthetics). Participants completed search and memory tasks on different fully-functional websites. In addition, they were asked to evaluate the given websites with standardized measures and were screened for symptoms of depression using the PHQ-9. We used structural equation modeling (SEM) to determine whether depression severity affects users' perception of and performance in using information websites. We found significant associations between depressive symptoms and subjective user experience, specifically of website content, usability, and aesthetics, as well as an effect of content perception on the overall appraisal of a website in terms of the intention to visit it again. Small yet significant negative effects of depression severity on all named subjective website evaluations were revealed, leading to an indirect negative effect on the intention to revisit a website via impaired content perceptions. However, objective task performance was not influenced by depressiveness of users. Depression emerges as capable of altering the subjective perception of a website to some extend with respect to the main features content, usability, and aesthetics. The user experience of a website is
Meinald T. Thielsch
Full Text Available Background Depression, as one of the most prevalent mental disorders, is expected to become a leading cause of disability. While evidence-based treatments are not always easily accessible, Internet-based information and self-help appears as a promising approach to improve the strained supply situation by avoiding barriers of traditional offline treatment. User experience in the domain of mental problems therefore emerges as an important research topic. The aim of our study is to investigate the impact of depressive symptoms on subjective and objective measures of web user experience. Method In this two-part online study (Ntotal = 721 we investigate the relationship between depressive symptoms of web users and basic website characteristics (i.e., content, subjective and objective usability, aesthetics. Participants completed search and memory tasks on different fully-functional websites. In addition, they were asked to evaluate the given websites with standardized measures and were screened for symptoms of depression using the PHQ-9. We used structural equation modeling (SEM to determine whether depression severity affects users’ perception of and performance in using information websites. Results We found significant associations between depressive symptoms and subjective user experience, specifically of website content, usability, and aesthetics, as well as an effect of content perception on the overall appraisal of a website in terms of the intention to visit it again. Small yet significant negative effects of depression severity on all named subjective website evaluations were revealed, leading to an indirect negative effect on the intention to revisit a website via impaired content perceptions. However, objective task performance was not influenced by depressiveness of users. Discussion Depression emerges as capable of altering the subjective perception of a website to some extend with respect to the main features content, usability, and
Ahmet Tevfik Sünter
Full Text Available PURPOSE: The purpose of this study was to determine the prevalence and the risk factors of postpartum depression (PPD a crosssectional study was conducted in Samsun, in Turkey.\tMETHODS: A cross-sectional study was conducted between March 1 and April 30, 2002 at the all of 20 primary health care centers in Samsun, Turkey. The study included 380 women, gave birth in January 1 - February 28, 2002. Each woman filled Edinburgh\tPostpartum Depression Scale by herself in eighth week postpartum and a syndromal depression point was assessed.\tResultts: The mean age of the participants was 26.9 ± 0.3 yr old and 88(23.1% mothers had PPD. There were statistically significant differences between depressed and non-depressed mothers in social insurance (p\tindependent variables, absence of social insurance [OR=2.0, (1.1-3.5], previous psychiatric disorder [OR=3.6, (1.6-7.9], and vaginal delivery [OR=2.0, (1.1-3.5] were found to be associated with development of PPD.\tCONCLUSION: Leaving depressed mothers untreated not only causes profound suffering, it may also bring about marital estrangement, absenteeism from work, child abuse, cognitive and emotional maldevelopment of the infants, and sometimes, suicides and infanticides. Universal screening for PPD using the EPDS can be successfully implemented in primary care practices and may be associated with a significant increase in the rate of recognition, diagnosis and treatment of PPD.
H Bjørk, Marte; Veiby, Gyri; A Engelsen, Bernt; Gilhus, Nils Erik
To review available data and provide treatment recommendations concerning peripartum depression, anxiety and fear of birth in women with epilepsy (WWE). The PubMed, the LactMed, the DART and the Cochrane database were searched for original articles concerning psychiatric disease in the peripartum period in WWE. Point prevalence of depression from 2nd trimester to 6 months postpartum ranged from 16 to 35% in women with epilepsy compared to 9-12% in controls. The highest estimates were found early in pregnancy and in the perinatal period. Anxiety symptoms 6 months postpartum were reported by 10 and 5%, respectively. Fear of birth symptoms were increased in primiparous WWE compared to controls. Previous psychiatric disease, sexual/physical abuse, antiepileptic drug (AED) polytherapy, and high seizure frequency emerged as strong risk factors. Depressed WWE rarely used antidepressive medication during pregnancy. No evidence was available concerning treatment effects or impact on the developing child. Peripartum depression is frequent in WWE and seldom medically treated. Health personnel should screen WWE for psychiatric disease and risk factors during pre-pregnancy planning, pregnancy and postpartum follow up. Treatment decisions should rely on efficacy and safety data in peripartum patients without epilepsy and non-pregnant people with epilepsy. Consequences of in utero exposure to AED therapy in combination with antidepressants are not known, and non-pharmacological treatment should be tried first. Copyright © 2015. Published by Elsevier Ltd.
Tuohy, Alan; McVey, Cynthia
There has been considerable research and clinical interest in the comorbidity of anxiety and depression in the post-partum period, and specifically in the possibility that the commonly used Edinburgh Postnatal Depression Scale (EPDS) incorporates an anxiety component. We hypothesized that the recommended version of factor analysis (Fabrigar, Wegener, MacCallum, & Strahan, 1999) would identify such covert dimensions more reliably than the commonly used principal components analysis with varimax rotation and eigenvalues greater than 1. Principal axis factor extraction with parallel analysis and oblique (direct quartimin) factor rotation was applied to the 10 EPDS items. The study used a sample of recent mothers recruited and assessed via e-mail and the Internet (N=440). In addition to the EPDS, the Hospital Anxiety and Depression Scale (HADS) and the Positive and Negative Affect Scales (PANAS) were also administered. Three factors were found, which were identified as 'non-specific depressive symptoms', 'anhedonia', and 'anxietal symptoms' subscales, respectively. These subscales were regressed on the HADS anxiety and depression and the PANAS positive and negative affectivity scales, with results substantially consistent with current structural models of the taxonomy of the emotional disorders. The data were obtained from a self-selected non-clinical sample. In addition, it is known that the use of computer-based assessment may tend to inflate self-report scores. It was concluded that there is now sufficient evidence that clinicians should not assume the EPDS to be unidimensional, but should assess all three subscales when screening for susceptibility to post-partum depression and/or post-partum anxiety.
Correa-Fernández, Virmarie; Ji, Lingyun; Castro, Yessenia; Heppner, Whitney L; Vidrine, Jennifer Irvin; Costello, Tracy J; Mullen, Patricia Dolan; Cofta-Woerpel, Ludmila; Velasquez, Mary M; Greisinger, Anthony; Cinciripini, Paul M; Wetter, David W
Based on conceptual models of addiction and affect regulation, this study examined the mechanisms linking current major depressive syndrome (MDS) and anxiety syndrome (AS) to postpartum smoking relapse. Data were collected in a randomized clinical trial from 251 women who quit smoking during pregnancy. Simple and multiple mediation models of the relations of MDS and AS with postpartum relapse were examined using linear regression, continuation ratio logit models, and a bootstrapping procedure to test the indirect effects. Both MDS and AS significantly predicted postpartum smoking relapse. After adjusting for MDS, AS significantly predicted relapse. However, after adjusting for AS, MDS no longer predicted relapse. Situationally based self-efficacy, expectancies of controlling negative affect by means other than smoking, and various dimensions of primary and secondary tobacco dependence individually mediated the effect of both MDS and AS on relapse. In multiple mediation models, self-efficacy in negative/affective situations significantly mediated the effect of MDS and AS on relapse. The findings underscore the negative impact of depression and anxiety on postpartum smoking relapse and suggest that the effects of MDS on postpartum relapse may be largely explained by comorbid AS. The current investigation provided mixed support for affect regulation models of addiction. Cognitive and tobacco dependence-related aspects of negative and positive reinforcement significantly mediated the relationship of depression and anxiety with relapse, whereas affect and stress did not. The findings emphasize the unique role of low agency with respect to abstaining from smoking in negative affective situations as a key predictor of postpartum smoking relapse. © 2012 American Psychological Association
Rhonda C. Boyd
Full Text Available Postpartum depression is a serious and common psychiatric illness. Mothers living in poverty are more likely to be depressed and have greater barriers to accessing treatment than the general population. Mental health utilization is particularly limited for women with postpartum depression and low-income, minority women. As part of an academic-community partnership, focus groups were utilized to examine staff practices, barriers, and facilitators in mental health referrals for women with depression within a community nonprofit agency serving low-income pregnant and postpartum women. The focus groups were analyzed through content analyses and NVIVO-8. Three focus groups with 16 community health workers were conducted. Six themes were identified: (1 screening and referral, (2 facilitators to referral, (3 barriers to referral, (4 culture and language, (5 life events, and (6 support. The study identified several barriers and facilitators for referring postpartum women with depression to mental health services.
Peer support in the early postpartum period is effective in the prevention of postpartum depression among women identified as high-risk. To describe maternal perceptions of peer support received while participating in a trial. Cross-sectional survey of women participating in a randomized controlled trial to evaluate the effect of peer support in the prevention of postpartum depression. Seven health regions across Ontario Canada. 701 women were recruited between November 2004 and September 2006. Women eligible for the study were all mothers with an Edinburgh Postnatal Depression Scale score >9 who were within 2 weeks postpartum, at least 18 years of age, able to speak English, had a live birth, and had been discharged home from the hospital. Exclusion criteria included an infant not discharged home with the mother and current use of antidepressant or antipsychotic medication. Two hundred and twenty-one mothers completed the mailed questionnaire. Women were randomly allocated to receive usual postpartum care (control group) or usual postpartum care plus telephone-based peer support (intervention group). Maternal perceptions of peer support were evaluated at 12 weeks postpartum using the validated Peer Support Evaluation Inventory. Interactions provided by the peer volunteer included the provision of emotional (92.7%), informational (72.4%), and appraisal (72.0%) support. Mothers reported high levels of positive relationship qualities such as trust (83.6%) and perceived acceptance (79.1%). Most (80.5%) mothers indicated they were very satisfied with their peer support experience. Maternal satisfaction was associated with the number and duration of peer volunteer contacts. The majority of mothers perceived their peer volunteer experience positively lending further support to telephone-based peer support as a preventative strategy for postpartum depression. The following program modifications were suggested: (a) adapt training to enhance the provision of appraisal
Full Text Available BACKGROUND Psychological mood changes, depression is very common in Post-partum period ranging from mild and transient “baby blues” experienced by 50-80% of women to postpartum Psychosis which affects 1% of women. AIMS AND OBJECTIVE To evaluate the association of different factors with Post-Partum depression in coastal Karnataka region, (Karwar. MATERIAL & METHODS A Prospective study was conducted in the department of Obstetrics and Gynaecology, KAIMS, Karwar, Karnataka. A total one thousand patients 4-7 Post-partum days were selected and interrogated using Edinburgh Postnatal depression scale (EPDS. Socio-demographic factors (age, Parity, literacy, socio-economic status, marital status and family structure, history of psychiatric disorders and abuse, mode of delivery and the obstetric outcome were recorded. The results were analysed statistically using Chi-square chart. STATISTICAL ANALYSIS AND RESULTS: The incidence of PPD was 22%. Significant association of PPD was seen with low socio-economic status group (P<005, poor literacy (P<0.001, nuclear family structure (P<0.05, single mother (P<0.001, past history of abuse (P<0.05 and poor obstetric outcome (P<0.001. CONCLUSION This study provides useful information about the prevalence of PPD and the association of socio economic, cultural practices prevalent in coastal Karnataka with PPD.
Mänty, Minna; Rantanen, Taina; Era, Pertti
Fatigue is considered an important indicator of aging-related declines in health and functional abilities. Previous studies have indicated strong associations between fatigue and depressive symptoms among younger populations and in patient groups with specific diseases. However, it is not known h...
Preiss, M.; Fráňová, Lenka
Roč. 48, č. 1 (2006), s. 57-67 ISSN 0039-3320 R&D Projects: GA ČR GA406/05/0915 Institutional research plan: CEZ:AV0Z70250504 Keywords : academic achievement * depressive symptoms * intelligence Subject RIV: AN - Psychology Impact factor: 0.410, year: 2006
Ortiz Collado, Maria Assumpta; Saez, Marc; Favrod, Jérôme; Hatem, Marie
Postpartum depression (PPD) and poor childbirth outcomes are associated with poverty; these variables should be addressed by an adapted approach. The aim of this research was to evaluate the impact of an antenatal programme based on a novel psychosomatic approach to pregnancy and delivery, regarding the risk of PPD and childbirth outcomes in disadvantaged women. A multi-centre, randomized, controlled trial comparing a novel to standard antenatal programme. Primary outcome was depressive symptoms (using EPDS) and secondary outcome was preterm childbirth (fewer 37 weeks). The sample comprised 184 couples in which the women were identified to be at PPD risk by validated interview. The study was conducted in three public hospitals with comparable standards of perinatal care. Women were randomly distributed in to an experimental group (EG) or a control group (CG), and evaluated twice: during pregnancy (T1) and four weeks post-partum (T2). At T2, the variables were compared using the chi square test. Data analysis was based on intention to treat. The novel programme used the Tourné psychosomatic approach focusing on body awareness sensations, construction of an individualized childbirth model, and attachment. The 10 group antenatal sessions each lasted two hours, with one telephone conversation between sessions. In the control group, the participants choose the standard model of antenatal education, i.e., 8 to 10 two-hour sessions focused on childbirth by obstetrical prophylaxis. A difference of 11.2% was noted in postpartum percentages of PPD risk (EPDS ≥ 12): 34.3% (24) in EG and 45.5% (27) in CG (p = 0.26). The number of depressive symptoms among EG women decreased at T2 (intragroup p = 0.01). Premature childbirth was four times less in EG women: three (4.4%) compared to 13 (22.4%) among CG women (p = 0.003). Birth weight was higher in EG women (p = 0.01). The decrease of depressive symptoms in women was not conclusive. However, because birth weight was higher and
Rambelli, C; Montagnani, M S; Oppo, A; Banti, S; Borri, C; Cortopassi, C; Ramacciotti, D; Camilleri, V; Mula, M; Cassano, G B; Mauri, M
Although the role of anxiety disorders on the development of Post-partum Depression (PPD) have already been studied in literature, that of individual anxiety disorders has not received specific attention. The aim of this study is to investigate the role of Panic Disorder (PD) and family history for PD as risk factors for PPD. Six hundred women were recruited in a prospective, observational study at the 3rd month of pregnancy and followed up until the 6th month after delivery. At baseline, risk factors for PPD, Axis-I disorders and family history for psychiatric disorders were assessed. We investigated minor and major depression (mMD) occurred at 1st, 3rd and 6th months post-partum. Logistic regression models were used to estimate the association between PD, family history for PD and PPD. Forty women had mMD in the post-partum. PD during pregnancy (RR=4.25; 95%CI:1.48-12.19), a history of PD (RR 2.47; 95%CI:1.11-5.49) and family history for PD (RR=2.1; 95%CI:1.06-4.4) predicted PPD after adjusting for lifetime depression and risk factors for PPD. The response rate is moderately low, but it is similar to other studies. The drop out rate is slightly high, however the 600 women who completed the 6th month follow-up did not differ from the presence of PD at baseline. PD is an independent risk factor for PPD, underscoring need to assess PD symptoms during pregnancy. Furthermore, PD represents an important risk factor for the development of PPD and should be routinely screened in order to develop specific preventive interventions. Copyright 2009 Elsevier B.V. All rights reserved.
Krieger, Tobias; Altenstein, David; Baettig, Isabelle; Doerig, Nadja; Holtforth, Martin Grosse
Self-compassion involves being kind to oneself when challenged with personal weaknesses or hardship and has been claimed to be associated with resilience in various areas. So far, there are only a handful of studies that investigate self-compassion and its relation to clinical depression. Therefore, the principal goals of the present study were (a) to compare self-compassion in clinically depressed patients and never-depressed subjects, (b) to investigate self-compassion and its relation to cognitive-behavioral avoidance and rumination in depressed outpatients, and (c) to investigate rumination and avoidance as mediators of the relationship between self-compassion and depressive symptoms. One hundred and forty-two depressed outpatients and 120 never-depressed individuals from a community sample completed a self-report measure of self-compassion along with other measures. Results indicate that depressed patients showed lower levels of self-compassion than never-depressed individuals, even when controlled for depressive symptoms. In depressed outpatients, self-compassion was negatively related to depressive symptoms, symptom-focused rumination, as well as cognitive and behavioral avoidance. Additionally, symptom-focused rumination and cognitive and behavioral avoidance mediated the relationship between self-compassion and depressive symptoms. These findings extend previous research on self-compassion, its relation to depression, as well as processes mediating this relationship, and highlight the importance of self-compassion in clinically depressed patients. Since depressed patients seem to have difficulties adopting a self-compassionate attitude, psychotherapists are well advised to explore and address how depressed patients treat themselves. Copyright © 2013. Published by Elsevier Ltd.
Wesseloo, R.; Kamperman, A.; Bergink, V.; Pop, V.J.M.
Background During the postpartum period, women are at risk for the new onset of both auto-immune thyroid disorders and depression. The presence of thyroid peroxidase antibodies (TPO-ab) during early gestation is predictive for postpartum auto-immune thyroid dysfunction. The aim of this study was to
R. Wesseloo (Richard); A.M. Kamperman (Astrid); V. Bergink (Veerle); V.J.M. Pop (Victor)
markdownabstract__Background__ During the postpartum period, women are at risk for the new onset of both auto-immune thyroid disorders and depression. The presence of thyroid peroxidase antibodies (TPO-ab) during early gestation is predictive for postpartum auto-immune thyroid dysfunction. The aim
The Edinburgh Postnatal Depression Scale (EPDS), the World Health Organization Quality of Life-BREF-26 (WHOQoL-BREF-26) questionnaire and the Depression Module of the Structured Clinical Interview for DSM-IV axis I Diagnosis (SCID) were used. Results: The studied participants were 531 out which 21.8% with ...
Cassidy-Bushrow, Andrea E; Peters, Rosalind M; Johnson, Dayna A; Li, Jia; Rao, D Sudhaker
Vitamin D deficiency is associated with depression; however, no studies have examined the relationship of vitamin D and antenatal depression. Antenatal depression increases the risk of adverse birth outcomes and poorer postpartum maternal and infant health. African American women are at increased risk for vitamin D deficiency and antenatal depression. Thus, we examined if early pregnancy vitamin D nutrition (VDN) was associated with antenatal depressive symptoms among African American women in the second trimester of pregnancy. Women (n=178) were recruited from obstetrics clinics of a large health system. VDN was assessed by serum 25-hydroxyvitamin D (25-OHD). Depression symptoms were measured with the Center for Epidemiological Studies Depression (CES-D) scale; CES-D≥16 equates with criteria for clinical depression. Logistic regression was used to examine the association of log-transformed 25-OHD and elevated depression symptoms (CES-D≥16). Mean 25-OHD was 13.4±8.4 ng/mL; most women (82.6%, n=147) were vitamin D inadequate or deficient (25-OHD<20 ng/mL). Mean CES-D was 15.2±10.7, and 74 (41.6%) women had a CES-D≥16, suggestive of clinical depression. A significant inverse relationship was found between log (25-OHD) and CES-D≥16 (odds ratio [OR] 0.54, 95% confidence interval [CI] 0.29-0.99, p=0.046). For every 1-unit increase in log (25-OHD) (corresponding to ~2.72 ng/mL increase in 25-OHD), the odds of CES-D≥16 decreased by 46%. African American women with lower VDN exhibit increased depressive symptoms. Research on vitamin D supplementation for reducing antenatal depressive symptoms is needed.
Ho, Shiao-Ming; Heh, Shu-Shya; Jevitt, Cecilia M; Huang, Lian-Hua; Fu, Yu-Ying; Wang, Li-Lin
The effectiveness of a hospital discharge education program including information on postnatal depression was evaluated to reduce psychological morbidity after childbirth. A randomized controlled trial (RCT) was conducted in a regional hospital in Taipei. Two hundred first-time mothers agreed to take part and were randomly allocated to an intervention group (n=100) or control group (n=100). The intervention group received discharge education on postnatal depression provided by postpartum ward nurses. The control group received general postpartum education. The main outcome measure was the Edinburgh Postnatal Depression Scale (EPDS) administered by postal questionnaire at six weeks and three months after delivery. Women who received discharge education intervention on postnatal depression were less likely to have high depression scores when compared to the control group at three months postpartum. A discharge educational intervention including postnatal depression information given to women during the postpartum stay benefits psychological well-being. A postpartum discharge education program including information on postnatal depression should be integrated into postpartum discharge care in general practice. 2009 Elsevier Ireland Ltd.
Hibbeln, Joseph R; Northstone, Kate; Evans, Jonathan; Golding, Jean
Vegetarian diets are associate with cardiovascular and other health benefits, but little is known about mental health benefits or risks. To determine whether self-identification of vegetarian dietary habits is associated with significant depressive symptoms in men. Self-report data from 9668 adult male partners of pregnant women in the Avon Longitudinal Study of Parents and Children (ALSPAC) included identification as vegetarian or vegan, dietary frequency data and the Edinburgh Post Natal Depression Scale (EPDS). Continuous and binary outcomes were assessed using multiple linear and logistic regression taking account of potential confounding variables including: age, marital status, employment status, housing tenure, number of children in the household, religion, family history of depression previous childhood psychiatric contact, cigarette and alcohol consumption. Vegetarians [n = 350 (3.6% of sample)], had higher depression scores on average than non-vegetarians (mean difference 0.96 points [95%CI + 0.53, + 1.40]) and a greater risk for EPDS scores above 10 (adjusted OR = 1.67 [95% CI: 1.14,2.44]) than non-vegetarians after adjustment for potential confounding factors. Vegetarian men have more depressive symptoms after adjustment for socio-demographic factors. Nutritional deficiencies (e.g. in cobalamin or iron) are a possible explanation for these findings, however reverse causation cannot be ruled out. Copyright © 2017. Published by Elsevier B.V.
Knox, Michele; Rosenberger, Ryan; Sarwar, Sajjad; Mangewala, Vikas; Klag, Natalie
Corporal punishment is closely related to physical abuse of children and is associated with several negative characteristics and experiences in children and youths. This study examined the relative unique contribution of 6 variables (social support, socioeconomic status, depression, self-efficacy, knowledge of child development, and history of postpartum depression) to maternal corporal punishment of children. A sample of 76 mothers was dichotomized into those who never spanked or hit with an object and those who have spanked or hit with an object. The mothers were recruited from a community mental health agency, an urban community center, and a court of common pleas. The measures in the present study were administered prior to mothers' participation in a parent training program. Mothers referred by the court of common pleas were mandated to participate in the parent training program, and the mothers from the community mental health agency and the urban community center volunteered to participate in the parent training program. However, all participants voluntarily completed the research measures. Binary logistic regression identified postpartum depression as the only variable to significantly increase the odds of corporal punishment (odds ratio = 6.307, 95% confidence interval = 1.098-36.214, p = .039). The findings demonstrate increased odds of corporal punishment among a high-risk sample of women with postpartum depression. The generalizability of these findings may be limited to low socioeconomic class and White and African American mothers enrolled in parent-training programs. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
Full Text Available Background: The Postpartum depression has a negative effect on the infant’s developmental and behavioral performance, mother-child relationship and mother‘s health, and its etiology is also very complicated. Objectives: This study was conducted to investigate the role of maternal emotional cognitive strategies and newborn gender preference in the postpartum depression in primiparous women. Methods: This descriptive-correlational study was performed on 205 primiparous women referring to health centers in Kerman city the center of Kerman province of Iran from 1April to 31 June 2015. Primiparous women according to presence (n=103 or absence (n=102 of postpartum depression (PPD0.05. Conclusion: According to the results of this study, postpartum depression can be predicted by emotional regulation cognitive strategies.
Auvinen, Piritta; Mäntyselkä, Pekka; Koponen, Hannu; Kautiainen, Hannu; Korniloff, Katariina; Ahonen, Tiina; Vanhala, Mauno
Restless legs syndrome is a sensorimotor disorder and it is associated with several other diseases especially mental illnesses. To analyze the relationship between the symptoms of restless legs syndrome and the severity of depressive symptoms and the prevalence of restless legs symptoms in depression subtypes. A cross-sectional study of primary care patients in the Central Finland Hospital District. The prevalence of restless legs symptoms was studied in 706 patients with increased depressive symptoms and 426 controls without a psychiatric diagnosis by using a structured questionnaire. The depressive symptoms were evaluated with the Beck Depression Inventory (BDI) and the psychiatric diagnosis was confirmed by means of a diagnostic interview (Mini-International Neuropsychiatric Interview). The subjects with increased depressive symptoms were divided into three groups (subjects with depressive symptoms without a depression diagnosis, melancholic depression and non-melancholic depression). In the whole study population, the prevalence of restless legs symptoms increased with the severity of depressive symptoms. The prevalence of restless legs symptoms was highest in the melancholic and non-melancholic depressive patients (52 and 46%, respectively) and then in subjects with depressive symptoms without a depression diagnosis (43.4%), but the prevalence was also substantial (24.6%) in subjects without a psychiatric diagnosis. Restless legs symptoms are very common in primary care among subjects with depression, regardless of the depression type. The prevalence of restless legs symptoms increased with increasing severity of depressive symptoms, regardless of the diagnosis. These findings should be considered in clinical evaluation and treatment of patients visiting their physician due to restless legs or depressive symptoms.
Hartley, C; Pretorius, K; Mohamed, A; Laughton, B; Madhi, S; Cotton, M F; Steyn, B; Seedat, S
Maternal postpartum depression poses significant risks for mother-child interaction and long-term infant outcomes. Human immunodeficiency virus (HIV) status has also been implicated in the development of postpartum depression, but the association between maternal depression and infant social behavior in the context of HIV infection has not been fully investigated. First, we examined the relationship between maternal postpartum depression and infant social withdrawal at 10-12 months of age in HIV-infected mothers and infants. Second, we ascertained whether infant social withdrawal could be significantly predicted by maternal postpartum depression. The sample consisted of 83 HIV-infected mother-infant dyads. Mothers were assessed for postpartum depression with the Edinburgh Postnatal Depression Scale (EPDS), and infant social withdrawal behavior was rated using the Modified Alarm Distress Baby Scale (m-ADBB). 42.2% of the mothers scored above the cut-off point for depression on the EPDS, and a third of infants (31%) were socially withdrawn. Notably, maternal depression did not predict infant social withdrawal as measured by the m-ADBB. Infant social withdrawal was also not significantly associated with failure to thrive or gender. These preliminary findings need further investigation with respect to the impact on long-term neurodevelopmental and behavioral outcomes.
Nahas, V; Amasheh, N
This study discovers, describes, and explains the personal experiences, perceptions, and care meanings of Jordanian women who have suffered postpartum depression. Most postpartum cases often are misdiagnosed as exclusively psychological and untreated by health care professionals without consideration to the cultural meanings of this problem. Understanding the experiences of these women is important, as their expressions often are contextually and culturally influenced. Using Leininger's Theory of Culture Care Diversity and Universality, a purposive sample of 22 Jordanian women diagnosed with postpartum depression, living in Sydney, were interviewed. The ethnonursing research method and data analysis procedures were used. Results revealed that Jordanian mothers experienced severe loss of control over emotions of loneliness, hopelessness, and feelings of being a bad mother. Three major themes focusing on the care meanings and experiences of Jordanian women are discussed: (a) Care means strong family support and kinship during the postpartum period, (b) care is carrying out and fulfilling traditional gender roles as mother and wife, and (c) care is preservation of Jordanian childbearing customs as expressed in the celebration of the birth of the baby.
Conclusion: Dentists may face burnout and depressive symptoms during their professional life. Increased burnout level can give an idea on depressive symptoms, and may provide an opportunity to identify depression earlier. Creating and raising awareness about burnout are important to avoid and prevent depression among dentists. Further longitudinal studies analyzing the effects of interdisciplinary client-centered self-management programs for dentists on depressive symptoms and burnout must be planned.
Sedigheh Abdollahpour; Afsaneh Keramat; Seyyed Abbas Mousavi; Ahmad Khosravi; zahra motaghi
Background & aim: Childbirth is a stressful event in women’s lives, and if a mother perceives it as an unpleasant event, it can influence her postpartum mental health. Depression is a common mental disorder, which can has serious consequences depending on its severity. Therefore, this study aimed to investigate the effect of debriefing and brief cognitive-behavioral therapy on postpartum depression in traumatic childbirth. Methods: This clinical trial was performed on 179 mothers who experien...
Smith, Patrick J; Attix, Deborah K; Weldon, B Craig; Monk, Terri G
Previous studies have shown that elevated depressive symptoms are associated with increased risk of postoperative delirium. However, to our knowledge no previous studies have examined whether different components of depression are differentially predictive of postoperative delirium. One thousand twenty patients were screened for postoperative delirium using the Confusion Assessment Method and through retrospective chart review. Patients underwent cognitive, psychosocial, and medical assessments preoperatively. Depression was assessed using the Geriatric Depression Scale-Short Form. Thirty-eight patients developed delirium (3.7%). Using a factor structure previously validated among geriatric medical patients, the authors examined three components of depression as predictors of postoperative delirium: negative affect, cognitive distress, and behavioral inactivity. In multivariate analyses controlling for age, education, comorbidities, and cognitive function, the authors found that greater behavioral inactivity was associated with increased risk of delirium (OR: 1.95 [1.11, 3.42]), whereas negative affect (OR: 0.65 [0.31, 1.36]) and cognitive distress (OR: 0.95 [0.63, 1.43]) were not. Different components of depression are differentially predictive of postoperative delirium among adults undergoing noncardiac surgery. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
Full Text Available Background: Stress, anxiety, and postpartum depression are the most common problems among women in their childbearing age. Research has shown that aromatherapy administered during labor reduces anxiety in mothers. With regard to the specific biological conditions in postpartum period and the subsequent drop in hormone levels, this study investigated the effect of lavender on prevention of stress, anxiety, and postpartum depression in women. Materials and Methods: In a clinical trial, 140 women admitted to the obstetric and gynecological unit were randomly divided into aromatherapy and non-aromatherapy groups immediately after delivery. Intervention with aromatherapy consisted of inhaling three drops of lavender essential oil every 8 h with for 4 weeks. The control group received routine care after discharge and was followed up by telephone only. After 2 weeks, 1 and 3 months of delivery, women were assessed by the 21-item Depression, Anxiety, and Stress Scale and the Edinburgh stress, anxiety, and depression scale in the two groups. Data analysis was performed by Mann-Whitney, analysis of variance (ANOVA, and post hoc tests. Level of significance was set as 0.05 for all tests. Results: The results showed that the mean stress, anxiety, and depression at time point of 2 weeks (P = 0.012, P < 0.0001, and P = 0.003, respectively and stress, anxiety, and depression scores at time points of 1 month (P < 0.0001 and 3 months after delivery (P < 0.0001 were significantly lower in the study group compared with the control group. Conclusions: Inhaling the scent of lavender for 4 weeks can prevent stress, anxiety, and depression after childbirth.
Beeber, Linda S; Schwartz, Todd A; Martinez, Maria I; Holditch-Davis, Diane; Bledsoe, Sarah E; Canuso, Regina; Lewis, Virginia S
Low-income mothers develop depressive symptoms at higher rates than the general population, adding to the existing risk that economic hardship places on their infants and toddlers. Emphasizing a few key intervention targets, an approach that is especially relevant to mothers when depressive symptoms compromise their energy and concentration, can improve interventions with populations facing adversity. The goal of this study was to identify contextual risk factors that significantly contributed to depressive symptoms and that, in combination with depressive symptoms, were associated with compromised parenting. Using baseline data from 251 ethnically diverse mothers from six Early Head Start programs in the Northeastern and Southeastern US, who were recruited for a clinical trial of an in-home intervention, Belsky's ecological framework of distal to proximal levels of influence was used to organize risk factors for depressive symptoms in hierarchical regression models. Under stress, mothers of toddlers reported more severe depressive symptoms than mothers of infants, supporting the need for depressive symptom screening and monitoring past the immediate postpartum period. Multivariate models revealed intervention targets that can focus depression prevention and intervention efforts, including helping mothers reduce chronic day-to-day stressors and conflicts with significant others, and to effectively handle challenging toddler behaviors, especially in the face of regional disciplinary norms. Presence of a live-in partner was linked to more effective parenting, regardless of participants' depressive symptom severity. © 2014 Wiley Periodicals, Inc.
Dekker, Rebecca L; Lennie, Terry A; Doering, Lynn V; Chung, Misook L; Wu, Jia-Rong; Moser, Debra K
Among patients with heart failure (HF), anxiety symptoms may co-exist with depressive symptoms. However, the extent of overlap and risk factors for anxiety symptoms have not been thoroughly described. The aim of this study was to describe the coexistence of anxiety and depressive symptoms, and to determine the predictors of anxiety symptoms in patients with HF. The sample consisted of 556 outpatients with HF (34% female, 62±12 years, 54% New York Heart Association (NYHA) class III/IV) enrolled in a multicenter HF quality of life registry. Anxiety symptoms were assessed with the Brief Symptom Inventory-anxiety subscale. Depressive symptoms were measured with the Beck Depression Inventory-II (BDI). We used a cut-point of 0.35 to categorize patients as having anxiety symptoms or no anxiety symptoms. Logistic regression was used to determine whether age, gender, minority status, educational level, functional status, comorbidities, depressive symptoms, and antidepressant use were predictors of anxiety symptoms. One-third of patients had both depressive and anxiety symptoms. There was a dose-response relationship between depressive symptoms and anxiety symptoms; higher levels of depressive symptoms were associated with a higher level of anxiety symptoms. Younger age (odds ratio (OR)= 0.97, p=0.004, 95% confidence interval (CI) 0.95-0.99) and depressive symptoms (OR =1.25, panxiety symptoms. Patients with HF and depressive symptoms are at high risk for experiencing anxiety symptoms. Clinicians should assess these patients for comorbid anxiety symptoms. Research is needed to test interventions for both depressive and anxiety symptoms.
Bass, Judith K; Ryder, Robert W; Lammers, Marie-Christine; Mukaba, Thibaut N; Bolton, Paul A
To determine if a post-partum depression syndrome exists among mothers in Kinshasa, Democratic Republic of Congo, by adapting and validating standard screening instruments. Using qualitative interviewing techniques, we interviewed a convenience sample of 80 women living in a large peri-urban community to better understand local conceptions of mental illness. We used this information to adapt two standard depression screeners, the Edinburgh Post-partum Depression Scale and the Hopkins Symptom Checklist. In a subsequent quantitative study, we identified another 133 women with and without the local depression syndrome and used this information to validate the adapted screening instruments. Based on the qualitative data, we found a local syndrome that closely approximates the Western model of major depressive disorder. The women we interviewed, representative of the local populace, considered this an important syndrome among new mothers because it negatively affects women and their young children. Women (n = 41) identified as suffering from this syndrome had statistically significantly higher depression severity scores on both adapted screeners than women identified as not having this syndrome (n = 20; P depression and validated instruments to screen for this disorder. As the importance of compromised mental health in developing world populations becomes recognized, the methods described in this report will be useful more widely.
Drozd, Filip; Haga, Silje Marie; Brendryen, Håvar; Slinning, Kari
As much as 10-15% of new mothers experience depression postpartum. An Internet-based intervention (Mamma Mia) was developed with the primary aims of preventing depressive symptoms and enhancing subjective well-being among pregnant and postpartum women. A secondary aim of Mamma Mia was to ease the transition of becoming a mother by providing knowledge, techniques, and support during pregnancy and after birth. The aim of the paper is to provide a systematic and comprehensive description of the intervention rationale and the development of Mamma Mia. For this purpose, we used the intervention mapping (IM) protocol as descriptive tool, which consists of the following 6 steps: (1) a needs assessment, (2) definition of change objectives, (3) selection of theoretical methods and practical strategies, (4) development of program components, (5) planning adoption and implementation, and (6) planning evaluation. Mamma Mia is a fully automated Internet intervention available for computers, tablets, and smartphones, intended for individual use by the mother. It starts in gestational week 18-24 and lasts up to when the baby becomes 6 months old. This intervention applies a tunneled design to guide the woman through the program in a step-by-step fashion in accordance with the psychological preparations of becoming a mother. The intervention is delivered by email and interactive websites, combining text, pictures, prerecorded audio files, and user input. It targets risk and protective factors for postpartum depression such as prepartum and postpartum attachment, couple satisfaction, social support, and subjective well-being, as identified in the needs assessment. The plan is to implement Mamma Mia directly to users and as part of ordinary services at well-baby clinics, and to evaluate the effectiveness of Mamma Mia in a randomized controlled trial and assess users' experiences with the program. The IM of Mamma Mia has made clear the rationale for the intervention, and linked
Jakobsen, Louise M.; Jorgensen, Anette F. B.; Thomsen, Birthe L.
Background: Danish professional caregivers have high rates of depressive symptoms. One proposed cause is exposure to emotion work. However, emotion work is usually measured by self-report which may bias results. Objectives: The objective of this study was to examine the association of emotion work......, externally observed at the workplace, with self-reported depressive symptoms of professional caregivers. Design and data sources: The study was a cross-sectional observational study. Data was collected by 9 observers who assessed emotion work stressors and emotion work resources in 124 individual...... professional caregivers working in 56 work units across 10 eldercare homes. Emotion work stressors were defined as i) barriers for empathetic care, ii) taxing aggressive events, and iii) taxing non-aggressive events. Emotion work resources were defined as i) meaningful events, and ii) social interactions...
Smith-Nielsen, Johanne; Væver, Mette Skovgaard; Tharner, Anne
were 4 and 13 months of age. Results: MANCOVA revealed a significant adverse effect of maternal depression on infant cognitive development at four months of age, the effect size being large, and with similar effects for boys and girls. At 13 months of age infants of mothers who had been suffering from...... on infant cognitive development as early as at four months postpartum; at the same time, in the lack of other risk factors, this effect may not be enduring. From a developmental psychopathology perspective this study stresses the importance of understanding the complex nature of how risk factors may impact......Background: It is well documented that maternal postpartum depression (PPD) has the potential to disrupt aspects of caregiving known to be critical for healthy child development. However, with regard to long term effects of PPD on global indices of infant development measured by standardized...
Nielsen, Nina O; Strøm, Marin; Boyd, Heather A
of postpartum depression (PPD). The objective of the study was thus to determine whether low vitamin D status during pregnancy was associated with postpartum depression. In a case-control study nested in the Danish National Birth Cohort, we measured late pregnancy serum concentrations of 25[OH]D3 in 605 women...... with PPD and 875 controls. Odds ratios [OR) for PPD were calculated for six levels of 25[OH]D3. Overall, we found no association between vitamin D concentrations and risk of PPD (p = 0.08). Compared with women with vitamin D concentrations between 50 and 79 nmol/L, the adjusted odds ratios for PPD were 1...
Dévieux, Jessy G; Jean-Gilles, Michèle; Rosenberg, Rhonda; Beck-Sagué, Consuelo; Attonito, Jennifer M; Saxena, Anshul; Stein, Judith A
Substance-abusing pregnant and postpartum women are less likely to maintain consistent condom use and drug and alcohol abstinence, which is particularly concerning in high HIV-prevalence areas. Data from 224 pregnant and postpartum women in substance abuse treatment were analyzed to examine effects of history of substance use, child abuse, and mental health problems on current substance use and condom-use barriers. Mediators were depression, relationship power and social support. Most participants (72.9 %) evidenced current depression. Less social support (-0.17, p power (-0.48, p power (0.15, p power limit highest-risk women's ability to negotiate condom use and abstain from substance use, increasing their risk of acute HIV infection and vertical transmission.
Atkeson, Beverly M.; And Others
Investigated depressive symptoms in rape victims (N=115) for one year following their assaults. Depressive symptoms were higher in victims than in controls. By four months postrape, depressive symptoms in the victim group had diminished, and the victims were no longer significantly different from the nonvictim control group. (Author)
Din, Meriam Omar; Noor, Noraini M
Due to a dearth of research on depressive symptoms in Malaysia, particularly in Malay women, a community study was conducted to examine the prevalence and factors associated with current depressive symptoms in rural and urban Malay women with low socioeconomic status. Four hundred eighty-seven women (N rural = 242, N urban = 245) were interviewed. Information on socio-demographic variables, potential risk factors (family history of mental health problems, lifetime major depressive symptoms, and current life stressors), and current depressive symptoms (measured by the Centre for Epidemiologic Studies Depression Scale, CES-D) was collected. The prevalence of current depressive symptoms (CES-D scores > or = 16) reported was 34.5%, while the prevalence of lifetime major depressive symptoms was 27.5%. A significantly higher rate of current depressive symptoms was observed in urban women compared to rural women, chi(2) (1, N = 487) = 3.99, p depressive symptoms. The results of the multiple hierarchical regression analysis indicated that three potential factors (family history of mental health problems, lifetime major depressive symptoms, and current life stressors) were positively associated with current depressive symptoms, accounting for 17.8% of the variance, over and above the socio-demographic variables. The prevalence of depressive symptoms reported in the study was comparable to past studies. Among the factors associated with current depressive symptoms, the single most important was lifetime major depressive symptoms, followed by current life stressors, and family history of mental health problems. Among the socio-demographic variables used, perceived health status was the most important. The factors associated with depressive symptoms found in this study are consistent with past findings in the West, implying the universality of the phenomenon and common factors related to depressive symptoms in women.
Lopez, Alexa A; Skelly, Joan M; Higgins, Stephen T
We examined whether pregnant and newly postpartum smokers at risk for postpartum depression respond to an incentive-based smoking-cessation treatment and how the intervention impacts depression ratings. This study is a secondary data analysis. Participants (N = 289; data collected 2001-2013) were smokers at the start of prenatal care who participated in 4 controlled clinical trials on the efficacy of financial incentives for smoking cessation. Women were assigned either to an intervention wherein they earned vouchers exchangeable for retail items contingent on abstaining from smoking or to a control condition wherein they received vouchers of comparable value independent of smoking status. Treatments were provided antepartum through 12-weeks postpartum. Depression ratings (Beck Depression Inventory [BDI]-1A) were examined across 7 antepartum/postpartum assessments. Women who reported a history of prior depression or who had BDI scores ≥ 17 at the start of prenatal care were categorized as depression-prone (Dep+), while those meeting neither criterion were categorized as depression-negative (Dep-). The intervention increased smoking abstinence independent of depression status (p postpartum BDI ratings as well as the proportion of women scoring in the clinical range (≥17 and >21) compared with the control treatment (ps ≤ .05). Treatment effects on depression ratings were attributable to changes in Dep+ women. These results demonstrate that depression-prone pregnant and newly postpartum women respond well to this incentive-based smoking-cessation intervention in terms of achieving abstinence, and the intervention also reduces the severity of postpartum depression ratings in this at-risk population. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Alessandra Ambrosini; Giovanni Stanghellini
OBJECTIVES: This paper intends to offer a theoretical insight into the myths of motherhood and how these myths can bear on the pathogenesis of postpartum depression. METHODS: From a man's view motherhood is conceptualized as a necessary stage in the progress towards the attainment of femininity. This view is impersonal and external to the experience of motherhood. From a female perspective, motherhood presents itself as a conflicting situation. We will then focus on the necessity to construct...
Virtanen, Marianna; Jokela, Markus; Madsen, Ida Eh
Objectives This systematic review and meta-analysis combined published study-level data and unpublished individual-participant data with the aim of quantifying the relation between long working hours and the onset of depressive symptoms. Methods We searched PubMed and Embase for published....... In the majority of cohorts, long working hours was defined as working ≥55 hours per week. In multivariable-adjusted meta-analyses of 189 729 participants from 35 countries [96 275 men, 93 454 women, follow-up ranging from 1-5 years, 21 747 new-onset cases), there was an overall association of 1.14 (95% confidence...... interval (CI) 1.03-1.25] between long working hours and the onset of depressive symptoms, with significant evidence of heterogeneity (I 2=45.1%, P=0.004). A moderate association between working hours and depressive symptoms was found in Asian countries (1.50, 95% CI 1.13-2.01), a weaker association...
Virtanen, Marianna; Jokela, Markus; Madsen, Ida Eh
. In the majority of cohorts, long working hours was defined as working ≥55 hours per week. In multivariable-adjusted meta-analyses of 189 729 participants from 35 countries [96 275 men, 93 454 women, follow-up ranging from 1-5 years, 21 747 new-onset cases), there was an overall association of 1.14 (95% confidence......Objectives This systematic review and meta-analysis combined published study-level data and unpublished individual-participant data with the aim of quantifying the relation between long working hours and the onset of depressive symptoms. Methods We searched PubMed and Embase for published...... interval (CI) 1.03-1.25] between long working hours and the onset of depressive symptoms, with significant evidence of heterogeneity (I 2=45.1%, P=0.004). A moderate association between working hours and depressive symptoms was found in Asian countries (1.50, 95% CI 1.13-2.01), a weaker association...
Mohamed Saleem Abdul Shukkoor
Full Text Available Postpartum depression affects 15% of women. Channa striatus, a freshwater fish, is consumed in local Malay population as a rejuvenating diet during postpartum period. This study evaluated the antidepressant-like effect of lipid extract of C. striatus fillet and its mechanism of action in female Sprague-Dawley rats in postpartum model of depression. The rats were ovariectomized and treated with high dose of progesterone and estradiol benzoate for 23 days to have hormone-simulated pregnancy. The day 24 and afterwards were considered as the postpartum period. During the postpartum period, lipid extract was administered at 125, 250, and 500 mg/kg through intraperitoneal route for 15 days. Fluoxetine (10 mg/kg was used as the positive control. On postpartum day 15, the animals were tested in forced swimming test (FST and open field test (OFT followed by biochemical analysis. Withdrawal of hormone administration during the postpartum period induced depressive-like behavior in FST. Administration of lipid extract reversed that depressive-like behavior at 125, 250, and 500 mg/kg in FST. In OFT, it decreased the exploratory activity. The mechanism of the antidepressant-like effect may be mediated through the decrease in plasma corticosterone, increase in plasma oxytocin, and decrease in nuclear factor-kappa B in prefrontal cortex of rats.
Sundström Poromaa, Inger; Comasco, Erika; Georgakis, Marios K; Skalkidou, Alkistis
Women have a lifetime risk of major depression double that of men but only during their reproductive years. This sex difference has been attributed partially to activational effects of female sex steroids and also to the burdens of pregnancy, childbirth, and parenting. Men, in contrast, have a reproductive period difficult to delineate, and research on the mental health of men has rarely considered the effects of fatherhood. However, the couple goes through a number of potentially stressing events during the reproductive period, and both mothers and fathers are at risk of developing peripartum depression. This Review discusses the literature on maternal and paternal depression and the endocrine changes that may predispose a person to depression at this stage of life, with specific focus on the hypothalamus-pituitary axis, oxytocin, and testosterone levels in men. Important findings on sex differences in the neural correlates of maternal and paternal behavior have emerged, highlighting the relevance of the emotional brain in mothers and the sociocognitive brain in fathers and pointing toward the presence of a common parents' brain. Additionally, sex differences in neurogenesis and brain plasticity are described in relation to peripartum depression. © 2016 The Authors. Journal of Neuroscience Research Published by Wiley Periodicals, Inc. © 2016 The Authors. Journal of Neuroscience Research Published by Wiley Periodicals, Inc.
Full Text Available Background and Objectives: Postpartum depression is one of most important health problems in women. This study was performed with the purpose of comparing the frequency of postpartum depression in pregnant women with emotion and problem-focused coping strategies. Methods: This study was conducted as a prospective cohort study on 200 pregnant women with stress (low and high levels. The samples were pregnant women referred to all health-treatment, centers of Ardabil, which were selected using a multi-stage sampling method; and according to coping strategy, they were divided into two groups: emotion-focused and problem-focused. Low-risk pregnant women completed questionnaires about demographic characteristics, perceived stress, and Billings and Moos coping strategies in the 38th to 42th week of their pregnancy, and completed the Edinburgh depression scale in the 3th to 4th weeks after childbirth. Data were analyzed using chi 2 and t tests. p<0.05 considered significant.Results: In this study, 170 participant women (85% used emotion-focused strategy and 30 women (15% used problem-focused strategy. Frequency of postpartum depression was 6.7% in the problem-focused group and 8.2% in the emotion-focused group. There was no significant difference in the frequency of postpartum depression between women with the problem- and emotion-focused strategies. Relative risk for postpartum depression was 1.2 times more among the women used emotion-focused strategy than women used problem-focused strategy (p<0.05.Conclusion: According to the results of this study, there was no significant relationship between postpartum depression and the two emotion-focused and problem-focused coping strategies. This can be due to high influence of postpartum specific endocrine factors in the etiology of this type of depression compared to other depressions.
Drury, Stacy S; Scaramella, Laura; Zeanah, Charles H
The lasting negative impact of postpartum depression (PPD) on offspring is well established. PPD seems to have an impact on neurobiological pathways linked to socioemotional regulation, cognitive and executive function, and physiologic stress response systems. This review focus on examining the current state of research defining the effect of universal, selected, and indicated interventions f