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

Published online by Cambridge University Press:  31 May 2017

Karolina Maliszewska*
Affiliation:
Department of Obstetrics, Medical University of Gdańsk, Gdańsk, Poland
Mariola Bidzan
Affiliation:
Institute of Psychology, University of Gdansk, Gdańsk, Poland
Małgorzata Świątkowska-Freund
Affiliation:
Department of Obstetrics, Medical University of Gdańsk, Gdańsk, Poland
Krzysztof Preis
Affiliation:
Department of Obstetrics, Medical University of Gdańsk, Gdańsk, Poland
*
*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: [email protected]

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.

Type
Original Articles
Copyright
© Scandinavian College of Neuropsychopharmacology 2017 

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References

1. Gavin, NI, Gaynes, BN, Lohr, KN et al. Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol 2005;106:10711083.CrossRefGoogle ScholarPubMed
2. Myers, ER, Aubuchon-Endsley, N, Bastian, LA et al. Efficacy and safety of screening for postpartum depression. Rockville, MD, 2013.Google Scholar
3. Deave, T. Associations between child development and women’s attitudes to pregnancy and motherhood. J Reprod Infant Psychol 2005;23:6375.CrossRefGoogle Scholar
4. World Health Organisation. The ICD-10 classification of mental and behavioural disorders: diagnostic criteria for research. Geneva: World Health Organisation, 1993.Google Scholar
5. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th edn. Washington, DC: American Psychiatric Association, 2013.CrossRefGoogle Scholar
6. Clark, LA, Watson, D, Mineka, S. Temperament, personality, and the mood and anxiety disorders. J Abnorm Psychol 1994;103:103116.CrossRefGoogle ScholarPubMed
7. Enns, MW, Cox, BJ. Personality dimensions and depression: review and commentary. Can J Psychiatry 1997;42:274284.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.Google ScholarPubMed
13. Pilkington, PD, Whelan, TA, Milne, LC. Maternal crying and postpartum distress: the moderating role of partner support. J Reprod Infant Psychol 2015;113.Google Scholar
14. Gjerdingen, D, McGovern, P, Attanasio, L et al. Maternal depressive symptoms, employment, and social support. J Am Board Fam Med 2014;27:8796.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
19. Beck, CT, Gable, RK. Postpartum Depression Screening Scale: development and psychometric testing. Nurs Res 2000;49:272282.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
23. Henshaw, C. Mood disturbance in the early puerperium: a review. Arch Womens Ment Health 2003;6(Suppl. 2):3342.CrossRefGoogle ScholarPubMed
24. Meltzer-Brody, S. New insights into perinatal depression: pathogenesis and treatment during pregnancy and postpartum. Dialogues Clin Neurosci 2011;13:89100.CrossRefGoogle ScholarPubMed
25. O’Hara, MW. Postpartum depression: what we know. J Clin Psychol 2009;65:12581269.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
27. Eberhard-Gran, M, Slinning, K, Rognerud, M. Screening for postnatal depression – a summary of current knowledge. Tidsskr Nor Laegeforen 2014;134:297301.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.Google Scholar
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.Google Scholar
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
36. Klein, DN, Kotov, R, Bufferd, SJ. Personality and depression: explanatory models and review of the evidence. Annu Rev Clin Psychol 2011;7:269295.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
39. O’Hara, MW, McCabe, JE. Postpartum depression: current status and future directions. Annu Rev Clin Psychol 2013;9:379407.CrossRefGoogle ScholarPubMed
40. Matthey, S. Are we overpathologising motherhood? J Affect Disord 2010;120:263266.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
44. Gotlib, IH, Joormann, J.. Cognition and depression: current status and future directions. Annu Rev Clin Psychol 2010;6:285312.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.Google Scholar
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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