Skip to main content
×
×
Home

Mood changes after delivery: role of the serotonin transporter gene

  • J. Sanjuan (a1), R. Martin-Santos (a2), L. Garcia-Esteve (a2), J. M. Carot (a3), R. Guillamat (a4), A. Gutierrez-Zotes (a5), I. Gornemann (a6), F. Canellas (a7), E. Baca-Garcia (a8), M. Jover (a9), R. Navines (a2), V. Valles (a4), E. Vilella (a5), Y. de Diego (a6), J. A. Castro (a7), J. L. Ivorra (a9), E. Gelabert (a2), M. Guitart (a4), A. Labad (a5), F. Mayoral (a7), M. Roca (a7), M. Gratacos (a10), J. Costas (a11), J. van Os (a12) and R. de Frutos (a9)...
Abstract
Background

Polymorphic variations in the serotonin transporter gene (5-HTT) moderate the depressogenic effects of tryptophan depletion. After childbirth there is a sharp reduction in brain tryptophan availability, thus polymorphic variations in 5-HTT may play a similar role in the post-partum period.

Aims

To study the role of 5-HTT polymorphic variations in mood changes after delivery.

Method

One thousand, eight hundred and four depression-free Spanish women were studied post-partum. We evaluated depressive symptoms at 2–3 days, 8 weeks and 32 weeks post-partum. We used diagnostic interview to confirm major depression for all probable cases. Based on two polymorphisms of 5-HTT (5-HTTLPR and STin2 VNTR), three genotype combinations were created to reflect different levels of 5-HTT expression.

Results

One hundred and seventy-three women (12.7%) experienced major depression during the 32-week post-partum period. Depressive symptoms were associated with the high-expression 5-HTT genotypes in a dose–response fashion at 8 weeks post-partum, but not at 32 weeks.

Conclusions

High-expression 5-HTT genotypes may render women more vulnerable to depressive symptoms after childbirth.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Mood changes after delivery: role of the serotonin transporter gene
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Mood changes after delivery: role of the serotonin transporter gene
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Mood changes after delivery: role of the serotonin transporter gene
      Available formats
      ×
Copyright
Corresponding author
Julio Sanjuán, Unidad de Psiquiatría, Facultad de Medicina Valencia, Universidad de Valencia, Blasco Ibáñez 15, 46010 Valencia, Spain. Email: julio.sanjuan@uv.es
Footnotes
Hide All

Declaration of Interest

None. Funding detailed in Acknowledgements.

Footnotes
References
Hide All
1 Kendler, KS, Neale, MC, Kessler, RC, Heath, AC, Eaves, LJ. A population-based study of major depression in women. The impact of varying definitions of illness. Arch Gen Psychiatry 1992; 49: 257–66.
2 O'Hara, MW, Swain, AM. Rates and risk of postnatal depression – a meta analysis. Int Rev Psychiatry 1996; 8: 3754.
3 García-Esteve, L, Ascaso, C, Ojuel, J, Navarro, P. Validation of the Edinburgh Postnatal Depression Scale (EPDS) in Spanish mothers. J Affect Disord 2003; 75: 71–6.
4 Petrou, S, Cooper, P, Murray, L, Davidson, LL. Economic costs of post-natal depression in a high-risk British cohort. Br J Psychiatry 2002; 181: 505–12.
5 Wisner, KL, Chambers, C, Sit, DK. Postpartum depression: a major public health problem. JAMA 2006; 296: 2616–8.
6 Bloch, M, Daly, RC, Rubinow, DR. Endocrine factors in the etiology of postpartum depression. Compr Psychiatry 2003; 44: 234–46.
7 Serreti, A, Olgiati, P, Colombo, C. Influence of postpartum onset on the course of mood disorders. BMC Psychiatry 2006; 6: 17.
8 Maes, M, Ombelet, W, Verkerk, R, Bosmans, E, Scharpé, S. Effects of pregnancy and delivery on the availability of plasma tryptophan to the brain: relationships to delivery-induced immune activation and early post-partum anxiety and depression. Psychol Med 2001; 31: 847–58.
9 Payne, JL. The role of estrogen in mood disorders in women. Int Rev Psychiatry 2003; 15: 280–90.
10 Baïlara, KM, Henry, C, Lestage, J, Launay, JM, Parrot, F, Swendsen, J, Sutter, AL, Roux, D, Dallay, D, Demotes-Mainard, J. Decreased brain tryptophan availability as a partial determinant of post-partum blues. Psychoneuroendocrinology 2006; 31: 407–13.
11 Van der Does, AJ. The mood-lowering effect of tryptophan depletion: possible explanation for discrepant findings. Arch Gen Psychiatry 2001; 58: 200–2.
12 Moreno, FA, Rowe, DC, Kaiser, B, Chase, D, Michaels, T, Gelernter, J, Delgado, PL Association between a serotonin transporter promoter region polymorphism and mood response during tryptophan depletion. Mol Psychiatry 2002; 7: 213–6.
13 Neumeister, A, Hu, XZ, Luckenbaugh, DA, Sachwrz, M, Nugent, AC, Bonne, O, Herscovitch, P, Goldman, D, Drevets, WC, Charney, DS. Differential effects of 5-HTTLPR genotypes on the behavioral and neural responses to tryptophan depletion in patients with major depression and controls. Arch Gen Psychiatry 2006; 63: 978–86.
14 Jans, LA, Riedel, WJ, Markus, CR, Blokland, A. Serotonergic vulnerability and depression: assumptions, experimental evidence and implications. Mol Psychiatry 2007; 12: 522–43.
15 Murphy, DL, Li, Q, Engel, S, Wichems, C, Andrews, A, Lesch, KP, Uhl, G. Genetic perspectives on the serotonin transporter. Brain Res Bull 2001; 56: 487–94.
16 Lesch, KP, Gutknecht, L. Pharmacogenetics of the serotonin transporter. Biol Psychiatry 2005; 29: 1062–73.
17 Hranilovic, D, Stefulj, J, Schwab, S, Borrmann-Hassenbach, M, Albus, M, Jernej, B, Wildenauer, D. Serotonin transporter promoter and intron 2 polymorphisms: relationship between allelic variants and gene expression. Biol Psychiatry 2004; 55: 1090–4.
18 Cox, JL, Holden, JM, Sagovsky, R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 1987; 150: 782–6.
19 Navarro, P, Ascaso, C, García-Esteve, L, Aguado, J, Torres, A, Martín-Santos, R. Postnatal psychiatric morbidity: a validation study of the GHQ-12 and the EPDS as screening tools. Gen Hosp Psychiatry 2007; 29: 17.
20 Nurnberger, JI, Blehar, MC, Kaufmann, J. Diagnostic interview for genetic studies. Rationale, unique features, and training. NIMH Genetic Initiative. Arch Gen Psychiatry 1994; 51: 849–59.
21 Roca, M, Martín-Santos, R, Sainz, J, Obiols, J, Serrano, MJ, Torrens, M, Subirà, S, Gili, M, Navinés, R, Ibañez, A, Nadal, M, Barrantes, N, Cañellas, F. Diagnostic Interview for Genetics Studies (DIGS): inter-rater and test–retest reliability and validity in a Spanish population. Eur Psychiatry 2007; 22: 44–8.
22 Heils, A, Teufel, A, Petri, S, Stöber, G, Riederer, P, Bengel, D, Lesch, KP. Allelic variation of human serotonin transporter gene expression. J Neurochem 1996; 66: 2621–4.
23 Fiskerstrand, CE, Lovejoy, EA, Quinn, JP. An intronic polymorphic domain often associated with susceptibility to affective disorders has allele dependent differential enhancer activity in embryonic stem cells. FEBS Letters 1999; 458: 171–4.
24 Mackenzie, A, Quinn, J. A serotonin transporter gene intron 2 polymorphic region, correlated with affective disorders, has allele-dependent differential enhancer like properties in the mouse embryo. Proc Natl Acad Sci USA 1999; 96: 15251–5.
25 Nakamura, M, Ueno, S, Sano, A, Tanabe, H. The human serotonin transporter gene linked polymorphism (5-HTTLPR) shows ten novel allelic variants. Mol Psychiatry 2000; 5: 32–8.
26 Fan, JB, Sklar, P. Meta-analysis reveals association between serotonin transporter gene STin2 VNTR polymorphism and schizophrenia. Mol Psychiatry 2005; 10: 928–38.
27 Seyfried, LS, Marcus, SM. Postpartum mood disorders. Int Rev Psychiatry 2003; 15: 231–42.
28 Miller, LJ, Rukstalis, M. Beyond the ‘blues’. Hypotheses about postpartum reactivity. In Postpartum Mood Disorder (ed Miller, LJ): 319. American Psychiatric Press, 1999.
29 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorder (4th edn) (DSM–IV). APA, 1994.
30 World Health Organization. The ICD–10 Classification of Mental and Behavioural Disorders. Diagnostic Criteria for Research. WHO, 1992.
31 Goldberg, DP. A dimensional model for common mental disorders. Br J Psychiatry 1996; 168: 44–9.
32 Kendler, KS, Gardner, CO Jr. Boundaries of major depression: an evaluation of DSM–IV criteria. Am J Psychiatry 1998; 155: 172–7.
33 Aggen, SH, Neale, MC, Kendler, KS. DSM criteria for major depression: evaluating symptom patterns using latent-trait item response models. Psychol Med 2005; 35: 475–87.
34 Roiser, JP, Müller, U, Clark, L, Sahakian, BJ. The effects of acute tryptophan depletion and serotonin transporter polymorphism on emotional processing in memory and attention. Int J Neuropsychopharmacol 2007; 10: 449–61.
35 Evans, J, Heron, J, Francomb, H, Oke, S, Golding, J. Cohort study of depressed mood during pregnancy and after childbirth. BMJ 2001; 323: 257–60.
36 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: 163–9.
37 Forty, L, Jones, L, Macgregor, S, Caesar, S, Cooper, C, Hough, A, Dean, L, Dave, S, Farmer, A, McGuffin, P, Brewster, S, Craddock, N, Jones, I. Familiality of postpartum depression in unipolar disorder: results of a family study. Am J Psychiatry 2006; 163: 1549–53.
38 Caspi, A, Sugden, K, Moffitt, TE, Taylor, A, Craig, IW, Harrington, H, McClay, J, Mill, J, Martin, J, Braithwaite, A, Poulton, R. Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene. Science 2003; 301: 386–9.
39 Kendler, KS, Kuhn, JW, Vittum, J, Prescott, CA, Riley, B. The interaction of stressful life events and a serotonin transporter polymorphism in the Sanjuan et al prediction of episodes of major depression: a replication. Arch Gen Psychiatry 2005; 62: 529–35.
40 Kaufman, J, Yang, BZ, Douglas-Palumberi, H. Social supports and serotonin transporter gene moderate depression in maltreated children. Proc Natl Acad Sci USA 2004; 101: 17316–21.
41 Jacobs, N, Kenis, G, Peeters, , Derom, C, Vlietinck, R, van Os, J. Stress-related negative affectivity and genetically altered serotonin transporter function: evidence of synergism in shaping risk of depression. Arch Gen Psychiatry 2006; 63: 989–96.
42 Zalsman, G, Huang, Y, Oquendo, MA, Burke, AK, Hu, XZ, Brent, DA, Ellis, SP, Goldman, D, Mann, JJ. Association of a triallelic serotonin transporter gene promoter region (5-HTTLPR) polymorphism with stressful life events and severity of depression. Am J Psychiatry 2006; 163: 1588–93.
43 Wilhelm, K, Mitchell, PB, Niven, H, Finch, A, Wedgwood, L, Scimone, A, Blair, IP, Parker, G, Schofield, PR. Life events, first depression onset and the serotonin transporter gene. Br J Psychiatry 2006; 188: 210–5.
44 Cervilla, J, Molina, E, Rivera, M, Torres-González, F, Bellón, JA, Moreno, B, Luna, JD, Lorente, JA, Mayoral, F, King, M, Nazareth, I. The risk for depression conferred by stressful life events is modified by variations at the serotonin transporter 5HTTLPR genotype: evidence from the Spanish PREDICT Gene cohort. Mol Psychiatry 2007; 12: 748–55.
45 Sun, HS, Tsai, HW, Ko, HC, Chang, FM, Yeh, TL. Association of tryptophan hydroxylase gene polymorphism with depression, anxiety and comorbid depression and anxiety in a population-based sample of postpartum Taiwanese women. Genes Brain Behav 2004; 3: 328–36.
46 Coyle, N, Jones, I, Robertson, E, Lendon, C, Craddock, N. Variation at the serotonin transporter gene influences susceptibility to bipolar affective puerperal psychosis. Lancet 2000; 356: 1490–1.
47 Scheid, JM, Holzman, CB, Jones, N, Friderici, KH, Nummy, KA, Symonds, LL, Sikorskii, A, Regier, MK, Fisher, R. Depressive symptoms in mid-pregnancy, lifetime stressors and the 5-HTTLPR genotype. Genes Brain Behav 2007; 6: 453–64.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score

Mood changes after delivery: role of the serotonin transporter gene

  • J. Sanjuan (a1), R. Martin-Santos (a2), L. Garcia-Esteve (a2), J. M. Carot (a3), R. Guillamat (a4), A. Gutierrez-Zotes (a5), I. Gornemann (a6), F. Canellas (a7), E. Baca-Garcia (a8), M. Jover (a9), R. Navines (a2), V. Valles (a4), E. Vilella (a5), Y. de Diego (a6), J. A. Castro (a7), J. L. Ivorra (a9), E. Gelabert (a2), M. Guitart (a4), A. Labad (a5), F. Mayoral (a7), M. Roca (a7), M. Gratacos (a10), J. Costas (a11), J. van Os (a12) and R. de Frutos (a9)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *