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Medical and psychosocial determinants of risk of postpartum depression: a cross-sectional study

  • Karolina Maliszewska (a1), Mariola Bidzan (a2), Małgorzata Świątkowska-Freund (a1) and Krzysztof Preis (a1)

Abstract

Objective

The aim of this study was to investigate the degree of risk of maternal postpartum depression during the second month of puerperium.

Method

In total, 387 postnatal women filled out a questionnaire concerning their health and social status, as well as the following tests: the Edinburgh Postnatal Depression Scale (EPDS), the Patient Health Questionnaire-9 (PHQ-9), the Neo Five-Factor Inventory (NEO-FFI) Personality Inventory and the Berlin Social Support Scales. After 4–8 weeks, patients responded to another questionnaire with the EPDS and the PHQ-9.

Results

In total, 48 patients (12.40%) were found to be at risk of postpartum depression between the fourth and eighth weeks after delivery. Premenstrual syndrome [adjusted odds ratio (ORa)=2.93, confidence interval (CI) 1.30–6.63] and EPDS>12 points during the first week after the delivery (ORa=3.74, CI 1.59–9.04) increased the risk of postnatal depression. A similar role is played by a high result in neuroticism scale of the NEO-FFI (ORa=1.50, CI 1.17–1.92) and a positive family history of any psychiatric disorder (ORa=1.03, CI 1.01–1.06).

Conclusion

A history of premenstrual syndrome and a higher risk of affective disorder soon after a childbirth are associated with greater chances of depressive symptoms in the second month postpartum. This is also the case if a patient is neurotic and has a relative with a history of any psychiatric disorder. Such women should have their mental status carefully evaluated.

Copyright

Corresponding author

*Karolina Maliszewska, Department of Obstetrics, Medical University of Gdańsk, ul. 1a Kliniczna Street, 80-402 Gdańsk, Poland Tel: +48 58 349 34 45; Fax: +48 58 349 34 16; E-mail: lek.kmaliszewska@gmail.com

References

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1. Gavin, NI, Gaynes, BN, Lohr, KN et al. Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol 2005;106:10711083.
2. Myers, ER, Aubuchon-Endsley, N, Bastian, LA et al. Efficacy and safety of screening for postpartum depression. Rockville, MD, 2013.
3. Deave, T. Associations between child development and women’s attitudes to pregnancy and motherhood. J Reprod Infant Psychol 2005;23:6375.
4. World Health Organisation. The ICD-10 classification of mental and behavioural disorders: diagnostic criteria for research. Geneva: World Health Organisation, 1993.
5. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th edn. Washington, DC: American Psychiatric Association, 2013.
6. Clark, LA, Watson, D, Mineka, S. Temperament, personality, and the mood and anxiety disorders. J Abnorm Psychol 1994;103:103116.
7. Enns, MW, Cox, BJ. Personality dimensions and depression: review and commentary. Can J Psychiatry 1997;42:274284.
8. Hakulinen, C, Elovainio, M, Pulkki-Raback, L et al. Personality and depressive symptoms: individual participant meta-analysis of 10 cohort studies. Depress Anxiety 2015;32:461470.
9. Dudek, D, Jaeschke, R, Siwek, M et al. Postpartum depression: identifying associations with bipolarity and personality traits. Preliminary results from a cross-sectional study in Poland. Psychiatry Res 2014;215:6974.
10. Martin-Santos, R, Gelabert, E, Subira, S et al. Research letter: is neuroticism a risk factor for postpartum depression? Psychol Med 2012;42:15591565.
11. Verkerk, GJ, Denollet, J, Van Heck, GL et al. Personality factors as determinants of depression in postpartum women: a prospective 1-year follow-up study. Psychosom Med 2005;67:632637.
12. Podolska, MZ, Bidzan, M, Majkowicz, M et al. Personality traits assessed by the NEO Five-Factor Inventory (NEO-FFI) as part of the perinatal depression screening program. Med Sci Monit 2010;16:7781.
13. Pilkington, PD, Whelan, TA, Milne, LC. Maternal crying and postpartum distress: the moderating role of partner support. J Reprod Infant Psychol 2015;113.
14. Gjerdingen, D, McGovern, P, Attanasio, L et al. Maternal depressive symptoms, employment, and social support. J Am Board Fam Med 2014;27:8796.
15. Cox, JL, Holden, JM, Sagovsky, R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 1987;150:782786.
16. Haran, C, van Driel, M, Mitchell, BL et al. Clinical guidelines for postpartum women and infants in primary care – a systematic review. BMC Pregnancy Childbirth 2014;14:51.
17. v Ballestrem, CL, Strauss, M, Kachele, H. Contribution to the epidemiology of postnatal depression in Germany – implications for the utilization of treatment. Arch Womens Ment Health 2005;8:2935.
18. Conradt, E, Manian, N, Bornstein, MH. Screening for depression in the postpartum using the Beck Depression Inventory II: what logistic regression reveals. J Reprod Infant Psychol 2012;30:427435.
19. Beck, CT, Gable, RK. Postpartum Depression Screening Scale: development and psychometric testing. Nurs Res 2000;49:272282.
20. Kammerer, M, Marks, MN, Pinard, C et al. Symptoms associated with the DSM IV diagnosis of depression in pregnancy and post partum. Arch Womens Ment Health 2009;12:135141.
21. Hanusa, BH, Scholle, SH, Haskett, RF et al. Screening for depression in the postpartum period: a comparison of three instruments. J Womens Health (Larchmt) 2008;17:585596.
22. Chaudron, LH, Szilagyi, PG, Tang, W et al. Accuracy of depression screening tools for identifying postpartum depression among urban mothers. Pediatrics 2010;125:609617.
23. Henshaw, C. Mood disturbance in the early puerperium: a review. Arch Womens Ment Health 2003;6(Suppl. 2):3342.
24. Meltzer-Brody, S. New insights into perinatal depression: pathogenesis and treatment during pregnancy and postpartum. Dialogues Clin Neurosci 2011;13:89100.
25. O’Hara, MW. Postpartum depression: what we know. J Clin Psychol 2009;65:12581269.
26. Talge, NM, Neal, C, Glover, V. Antenatal maternal stress and long-term effects on child neurodevelopment: how and why? J Child Psychol Psychiatry 2007;48:245.
27. Eberhard-Gran, M, Slinning, K, Rognerud, M. Screening for postnatal depression – a summary of current knowledge. Tidsskr Nor Laegeforen 2014;134:297301.
28. Dennis, CL. Can we identify mothers at risk for postpartum depression in the immediate postpartum period using the Edinburgh Postnatal Depression Scale? J Affect Disord 2004;78:163169.
29. Zawadzki, B, Strelau, J, Szczepaniak, P, Śliwińska, M. NEOFFI – Inwentarz Osobowości NEOFFI [NEOFFI – personality inventory NEOFFI]. Warszawa: Pracownia Testów Psychologicznych Polskiego Towarzystwa Psychologicznego, 1998.
30. Łuszczyńska, A, Mazurkiewicz, M, Kowalska, M et al. Berlińskie Skale Wsparcia Społecznego (BSSS): Wyniki wstępnych badań nad adaptacją skal i ich własnościami psychometrycznymi [Berlin Social Support Scales (BSSS): results of preliminary studies on adaptation of scales and their psychometric properties]. Stud Psychol 2006;44:1727.
31. Austin, MP. Marce International Society position statement on psychosocial assessment and depression screening in perinatal women. Best Pract Res Clin Obs Gynaecol 2014;28:179187.
32. Maliszewska, K, Swiatkowska-Freund, M, Bidzan, M et al. Relationship, social support, and personality as psychosocial determinants of the risk for postpartum blues. Ginekol Pol 2016;87:442447.
33. Maliszewska, K, Bidzan, M, Swiatkowska-Freund, M et al. Personality type, social support and other correlates of risk for affective disorders in early puerperium. Ginekol Pol 2016;87:814819.
34. Kudo, N, Shinohara, H, Kodama, H. Heart rate variability biofeedback intervention for reduction of psychological stress during the early postpartum period. Appl Psychophysiol Biofeedback 2014;39:203211.
35. Ahn, S, Corwin, EJ. The association between breastfeeding, the stress response, inflammation, and postpartum depression during the postpartum period: prospective cohort study. Int J Nurs Stud 2015;52:15821590.
36. Klein, DN, Kotov, R, Bufferd, SJ. Personality and depression: explanatory models and review of the evidence. Annu Rev Clin Psychol 2011;7:269295.
37. Buttner, MM, Mott, SL, Pearlstein, T et al. Examination of premenstrual symptoms as a risk factor for depression in postpartum women. Arch Womens Ment Health 2013;16:219225.
38. Lee, Y-J, Yi, S-W, Ju, D-H et al. Correlation between postpartum depression and premenstrual dysphoric disorder: single center study. Obstet Gynecol Sci 2015;58:353.
39. O’Hara, MW, McCabe, JE. Postpartum depression: current status and future directions. Annu Rev Clin Psychol 2013;9:379407.
40. Matthey, S. Are we overpathologising motherhood? J Affect Disord 2010;120:263266.
41. Pilkington, PD, Milne, LC, Cairns, KE et al. Modifiable partner factors associated with perinatal depression and anxiety: a systematic review and meta-analysis. J Affect Disord 2015;165180.
42. Kaźmierczak, M, Kiełbratowska, B, Karasiewicz, K. The other side of the mirror – the role of partner’s empathy in transition to parenthood. Health Psychol Rep 2015;3:150157.
43. Rosand, GM, Slinning, K, Eberhard-Gran, M et al. Partner relationship satisfaction and maternal emotional distress in early pregnancy. BMC Public Health 2011;11:161.
44. Gotlib, IH, Joormann, J.. Cognition and depression: current status and future directions. Annu Rev Clin Psychol 2010;6:285312.
45. Stuart, AL, Pasco, JA, Jacka, FN et al. Comparison of self-report and Structured Clinical Interview in the identification of depression. Compr Psychiatry 2014;55:866869.
46. Myers, JK, Weissman, MM. Use of a self-report symptom scale to detect depression in a community sample. Am J Psychiatry 1980;137:10811084.
47. Bergant, AM, Nguyen, T, Heim, K, Ulmer, H, Dapunt, O. German language version and validation of the Edinburgh Postnatal Depression Scale. Dtsch Med Wochenschr 1998;123:3540.
48. Garcia-Esteve, L, Ascaso, C et al. Validation of the Edinburgh Postnatal Depression Scale (EPDS) in Spanish mothers. J Affect Disord 2003;75:7176.
49. Guedeney, N, Fermanian, J. Validation study of the French version of the Edinburgh Postnatal Depression Scale (EPDS): new results about use and psychometric properties. Eur Psychiatry 1998;13:8389.
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