Postpartum Anxiety and Comorbid Depression in a Population-Based Sample of Women.
ABSTRACT Abstract Background: Population-based estimates of prevalence of anxiety and comorbid depression are lacking. Therefore, we estimated the prevalence and risk factors for postpartum anxiety and comorbid depressive symptoms in a population-based sample of women. Methods: Using multinomial logistic regression, we examined the prevalence and risk factors for postpartum anxiety and depressive symptoms using 2009-2010 data from the Illinois and Maryland Pregnancy Risk Assessment Monitoring System, a population-based survey of mothers who gave birth to live infants. Survey participants are asked validated screening questions on anxiety and depressive symptoms. Results: Among 4451 postpartum women, 18.0% reported postpartum anxiety symptoms, of whom 35% reported postpartum depressive symptoms (6.3% overall). In the multivariable model, higher numbers of stressors during pregnancy (adjusted odds ratio [aOR] range: 1.3-9.7) and delivering an infant at ≤27 weeks gestation (aOR range: 2.0-5.7) were associated with postpartum anxiety and postpartum depressive symptoms, experienced individually or together. Smoking throughout pregnancy was associated with postpartum anxiety symptoms only (aOR=2.3) and comorbid anxiety and depressive symptoms (aOR=2.9). Conclusions: Given the possible adverse effects of postpartum anxiety and comorbid depression on maternal health and infant development, clinicians should be aware of the substantial prevalence, comorbidity, and risk factors for both conditions and facilitate identification, referral, and/or treatment.
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ABSTRACT: Background 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.Methods 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.ResultsA 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.Conclusions 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 effective; it is also important to give mothers information about PPD and to discuss the symptoms with them in order for them to recognise this disorder and possible new episodes in the future.BMC Pregnancy and Childbirth 12/2014; 14(1):402. DOI:10.1186/PREACCEPT-1301881224127235 · 2.15 Impact Factor
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ABSTRACT: Objective To investigate the prevalence and analyze the risk factors of postpartum depression (PPD) in Tangxia Community, Guangzhou, a community representative of the process of urbanization in China. Methods A total of 1 823 delivery women in Tangxia Community, Guangzhou were screened with the Chinese Version of Edinburgh Postnatal Depression Scale, Hamilton Depression Scale and Social Support Rating Scale. The risk factors were evaluated by self-made questionnaire based on literature interview combined with expert consultation. The data collected were analyzed using Student's t test and logistic regression in SPSS16.0. Results The prevalence of PPD in Tangxia Community, Guangzhou was 27.37%. Mutivariant logistic regression analysis identified mode of delivery, puerperant from one-child family, relationship between mother-in-law and daughter-in-law and fetus gender as the risk factors of PPD while housing condition was negatively correlated with the incidence of PPD with OR value of 0.82.The the total score of social support rating scale, the score of objective support, subjective support and social utilization degree were significantly reduced in women with PPD in contrast with women without PPD. Conclusions The incidence of PPD was slightly higher than other regions of China. It's of great importance to distinguish risk factors in regional culture context and develop health promotion program in order to enhance the well-being of delivery women.Asian Pacific Journal of Tropical Medicine 03/2014; 7(3):244–249. DOI:10.1016/S1995-7645(14)60030-4 · 0.93 Impact Factor
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ABSTRACT: Introduction: Postpartum depression (PPD) is a common and serious illness that affects up to 14% of women in the first month after childbirth. We present an update on the pharmacologic treatment of PPD, although there continues to be a lack of large, randomized controlled trials (RCTs). Areas covered: A review of the literature on the use of antidepressants, hormonal supplements and omega-3 fatty acids for the prevention and the treatment of PPD published since the original review in 2009 and the authors' opinion on the current status of the pharmacological treatment of PPD are covered. An electronic search was performed by using PubMed, Medline and PsychINFO. Inclusion criteria were: i) empirical articles in peer-reviewed English-language journals; ii) well-validated measures of depression; and iii) a uniform scoring system for depression among the sample. Expert opinion: Since the last Expert Opinion review, four antidepressant treatment studies and one prevention study of PPD have been published. Six RCTs evaluating the use of omega-3 fatty acids (four for prevention and two for treatment) have been published. There continues to be lack of data regarding the pharmacotherapy of PPD. However, serotonin reuptake inhibitors should be considered first-line for women with PPD after it has been determined that the proper diagnosis is not bipolar disorder. It is important to individualize treatment for women with PPD and consider the risks and benefits of treatment while breastfeeding.Expert Opinion on Pharmacotherapy 04/2014; DOI:10.1517/14656566.2014.911842 · 3.09 Impact Factor