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Hu Q, Chen J, Ma J, Li Y, Xu Y, Yue C, Cong E. Causal effects of neuroticism on postpartum depression: a bidirectional mendelian randomization study. Arch Womens Ment Health 2024; 27:837-844. [PMID: 38634868 PMCID: PMC11405473 DOI: 10.1007/s00737-024-01466-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/28/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE Postpartum depression (PPD) brings adverse and serious consequences to both new parents and newborns. Neuroticism affects PPD, which remains controversial for confounding factors and reverse causality in cross-sectional research. Therefore, mendelian randomization (MR) study has been adopted to investigate their causal relationship. METHODS This study utilized large-scale genome-wide association study genetic pooled data from three major databases: the United Kingdom Biobank, the European Bioinformatics Institute, and the FinnGen databases. The causal analysis methods used inverse variance weighting (IVW). The weighted median, MR-Egger method, MR-PRESSO test, and the leave-one-out sensitivity test have been used to examine the results' robustness, heterogeneity, and horizontal pleiotropy. The fixed effect model yielded the results of meta-analysis. RESULTS In the IVW model, a meta-analysis of the MR study showed that neuroticism increased the risk of PPD (OR, 1.17; 95% CI, 1.11-1.25, p < 0.01). Reverse analysis showed that PPD could not genetically predict neuroticism. There was no significant heterogeneity or horizontal pleiotropy bias in this result. CONCLUSION Our study suggests neuroticism is the risk factor for PPD from a gene perspective and PPD is not the risk factor for neuroticism. This finding may provide new insights into prevention and intervention strategies for PPD according to early detection of neuroticism.
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Affiliation(s)
- Qianying Hu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, China
- School of Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Jianhua Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, China
| | - Jingjing Ma
- School of Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Yuting Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, China
| | - Yifeng Xu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, China.
| | - Chaoyan Yue
- Obstetrics and Gynecology Hospital of Fudan University, Fang Xie Road, No419, Shanghai, Shanghai, China.
| | - Enzhao Cong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, China.
- School of Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China.
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Neda-Stepan O, Giurgi-Oncu C, Sălcudean A, Bernad E, Bernad BC, Boeriu E, Enătescu VR. Evaluating the Impact of Obsessive-Compulsive Symptoms and Personality Types on Perinatal Depressive Symptoms. Behav Sci (Basel) 2024; 14:589. [PMID: 39062412 PMCID: PMC11273467 DOI: 10.3390/bs14070589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/29/2024] [Accepted: 07/05/2024] [Indexed: 07/28/2024] Open
Abstract
Perinatal depression (PPD) presents a significant public health concern, often influenced by psychological and personality factors. This study investigated the impact of personality traits, particularly neuroticism, and obsessive-compulsive disorder (OCD) symptoms on the severity of PPD. The primary aim was to quantify the contributions of these factors to the risk and severity of PPD to enhance early intervention strategies. A total of 47 pregnant women with depressive symptoms per DSM-5 criteria at "Pius Brinzeu" County Emergency Hospital in Timisoara, Romania, were enrolled in this cross-sectional study, as well as 49 women without depressive symptoms as controls. Personality traits were assessed using the NEO Five-Factor Inventory (NEO-FFI), and OCD symptoms were measured using the Obsessive-Compulsive Inventory (OCI). Depression severity was evaluated using the Edinburgh Postnatal Depression Scale (EPDS). This set of questionnaires were administered antepartum and postpartum. The logistic regression analysis highlighted neuroticism as a significant predictor of PPD severity, with an increase in neuroticism associated with a higher risk of PPD (coefficient = 0.24, p < 0.001). Conversely, openness showed a protective effect (coefficient = -0.13, p = 0.009). Higher OCD symptomatology, particularly ordering and hoarding, were linked with increased depression scores. Specifically, the total OCI score significantly predicted the EPDS score (coefficient = 0.03, p = 0.003). Furthermore, significant increases in EPDS anxiety and depression scores were observed in the perinatal period, indicating worsening of symptoms (anxiety coefficient = 0.51; p < 0.001). The findings suggest that personality traits like neuroticism and OCD symptoms significantly contribute to the severity of PPD. Interventions targeting these specific traits could potentially mitigate the risk and severity of perinatal depression, underscoring the need for personalized treatment plans that consider these psychological dimensions.
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Affiliation(s)
- Oana Neda-Stepan
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (O.N.-S.); (B.-C.B.)
- Department VIII—Neurosciences, Discipline of Psychiatry, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (C.G.-O.); (V.R.E.)
| | - Cătălina Giurgi-Oncu
- Department VIII—Neurosciences, Discipline of Psychiatry, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (C.G.-O.); (V.R.E.)
| | - Andreea Sălcudean
- Discipline of Sociobiology, Department of Ethics and Social Sciences, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540136 Targu Mures, Romania;
| | - Elena Bernad
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Brenda-Cristiana Bernad
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (O.N.-S.); (B.-C.B.)
| | - Estera Boeriu
- Department of Pediatrics, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Virgil Radu Enătescu
- Department VIII—Neurosciences, Discipline of Psychiatry, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (C.G.-O.); (V.R.E.)
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Orkaby N, Kalfon-Hakhmigari M, Levy S, Krissi H, Peled Y, Handelzalts JE. COVID-19-Related worries mediate the association between attachment orientation and elevated depression levels at 21-month postpartum. J Reprod Infant Psychol 2024; 42:550-562. [PMID: 36210511 DOI: 10.1080/02646838.2022.2132382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/28/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND The study's aims were to examine whether the COVID-19 pandemic was associated with increases in depression levels of 21 months postpartum women who were initially sampled before the pandemic and whether COVID-19-related worries mediated the association between women's attachment orientations and this hypothesized increase. METHODS Participants comprised 185 postpartum women sampled in the maternity ward of a tertiary healthcare center in Israel followed from childbirth to 21 months postpartum in four-time points. . We analyzed demographic and obstetric information and the Experiences in Close Relationships (ECR) scale at T1; changes in the Edinburgh Postnatal Depression Scale (EPDS) levels at all timepoints (T1-4); and COVID-19-related worries at T4. RESULTS Results showed a significant increase in depression levels at T4 compared to T2 and T3, and an increase in the prevalence of women at the lower clinical EPDS threshold. COVID-19-related worries mediated the association between anxious attachment and depression (indirect effect: B = .21, p < .05, 95% CI = (.015, .47), R2=0.12). DISCUSSION The evident effect of COVID-19 on postpartum depression is associated with variability between people. Thus, early assessment of women's attachment orientations might provide a strategy for identifying and treating women at risk.
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Affiliation(s)
- Naomi Orkaby
- School of Behavioral Sciences, Academic College of Tel-Aviv-Yafo, Tel-Aviv, Israel
| | | | - Sigal Levy
- School of Behavioral Sciences, Academic College of Tel-Aviv-Yafo, Tel-Aviv, Israel
| | - Haim Krissi
- The Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Yoav Peled
- The Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Jonathan E Handelzalts
- School of Behavioral Sciences, Academic College of Tel-Aviv-Yafo, Tel-Aviv, Israel
- Department of Psychiatry, University of Michigan, Ann Arbor, Michiga, USA
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Neda-Stepan O, Giurgi-Oncu C, Sălcudean A, Bernad E, Bernad BC, Enătescu VR. The Influence of Personality Traits on Postpartum Depression: A Systematic Review Based on the NEO-FFI Scale. Diseases 2024; 12:82. [PMID: 38785737 PMCID: PMC11120481 DOI: 10.3390/diseases12050082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/20/2024] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
Postpartum depression (PPD) is a significant global health concern with profound implications for mothers, families, and societies. This systematic review aims to synthesize current research findings to understand better how personality traits, as assessed by the NEO Five-Factor Inventory (NEO-FFI), contribute to the development and progression of PPD. Conducted in January 2024, this review searched major databases like PubMed, PsycINFO, and Scopus up to December 2023, focusing on the NEO-FFI's role in evaluating PPD. Following PRISMA guidelines, studies were selected based on strict criteria, including the exclusive use of NEO-FFI for personality assessment and a focus on postpartum women. A total of seven studies were included after a rigorous two-step screening process, and their data were qualitatively synthesized. The review covered a total of 4172 participants, with a prevalence of clinically significant postpartum depression symptoms ranging from 10.6% to 51.7%. Notably, Neuroticism emerged as a significant predictor of PPD, with odds ratios ranging from 1.07 (95% CI: 0.96-1.20) in some studies to as high as 1.87 (95% CI: 1.53-2.27) in others. In contrast, traits like Extraversion and Conscientiousness generally showed protective effects, with lower scores associated with reduced PPD risk. For instance, Extraversion scores correlated negatively with PPD risk (Beta = -0.171) in one study. However, the impact of other traits such as Openness and Agreeableness on PPD risk was less clear, with some studies indicating negligible effects. The review highlights Neuroticism as a consistent and significant predictor of PPD risk, with varying impacts from other personality traits. The findings suggest potential pathways for targeted interventions in maternal mental health care, emphasizing the need for comprehensive personality evaluations in prenatal and postnatal settings.
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Affiliation(s)
- Oana Neda-Stepan
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (O.N.-S.); (B.-C.B.)
- Department VIII—Neurosciences, Discipline of Psychiatry, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (C.G.-O.); (V.R.E.)
| | - Cătălina Giurgi-Oncu
- Department VIII—Neurosciences, Discipline of Psychiatry, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (C.G.-O.); (V.R.E.)
| | - Andreea Sălcudean
- Discipline of Sociobiology, Department of Ethics and Social Sciences, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540136 Targu Mures, Romania
| | - Elena Bernad
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Brenda-Cristiana Bernad
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (O.N.-S.); (B.-C.B.)
| | - Virgil Radu Enătescu
- Department VIII—Neurosciences, Discipline of Psychiatry, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (C.G.-O.); (V.R.E.)
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Severo M, Petito A, Ventriglio A, Iuso S, Ianzano G, Marconcini A, Giannaccari E, Palma GL, Altamura M, Sorrentino F, Maruotti G, Nappi L, Caroli A, Bellomo A. Exploring the Relationship between Neuroticism and Perinatal Depressive Symptoms: Findings from a 2-Year, Multicenter Study in Italy. Brain Sci 2024; 14:366. [PMID: 38672016 PMCID: PMC11048708 DOI: 10.3390/brainsci14040366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/05/2024] [Accepted: 04/06/2024] [Indexed: 04/28/2024] Open
Abstract
Neuroticism is a personality trait associated with the risk of affective disorders and perinatal depression. We investigated the relationship between different levels of neuroticism, psychological characteristics, and depressive symptoms in a sample of pregnant women (N = 2631) who accessed the gynecology departments in the Puglia Region (Italy) from July 2020 to November 2022. Women were assessed for depressive symptoms and associated risk factors in their third trimester of pregnancy (T0) and after childbirth (T1), and followed-up at 6 months and 1 year after delivery if presenting signs of depression (T2-T3). The Edinburgh Postnatal Depression Scale (EPDS) was used to screen depressive symptoms, and neuroticism was assessed through the subscales of the NEO Five Factor Inventory. Standardized measures of resilience, coping strategies, partner attachment, and quality of life were also employed. Higher levels of neuroticism were significantly associated with: (a) higher scores on the EPDS; (b) higher anxiety in the experience of close relationships; (c) lower psychological wellbeing; (d) lower levels of resilience; (e) lower levels of active coping; and (f) higher levels of self-blame. Our findings may suggest that neuroticism is a specific associated factor of perinatal depression and should be routinely assessed in the clinical screening of pregnant women in order to promote an early referral to psychological or psychiatric support services.
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Affiliation(s)
- Melania Severo
- Department of Humanistic Studies, University of Foggia, 71122 Foggia, Italy; (M.S.); (S.I.)
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (A.P.); (G.I.); (M.A.); (A.B.)
| | - Annamaria Petito
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (A.P.); (G.I.); (M.A.); (A.B.)
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (A.P.); (G.I.); (M.A.); (A.B.)
| | - Salvatore Iuso
- Department of Humanistic Studies, University of Foggia, 71122 Foggia, Italy; (M.S.); (S.I.)
| | - Giulio Ianzano
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (A.P.); (G.I.); (M.A.); (A.B.)
| | | | | | | | - Mario Altamura
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (A.P.); (G.I.); (M.A.); (A.B.)
| | - Felice Sorrentino
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (F.S.); (G.M.); (L.N.)
| | - Giuseppe Maruotti
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (F.S.); (G.M.); (L.N.)
| | - Luigi Nappi
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (F.S.); (G.M.); (L.N.)
| | - Antonella Caroli
- Department of Health Promotion, Regione Puglia, 70121 Bari, Italy;
| | - Antonello Bellomo
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (A.P.); (G.I.); (M.A.); (A.B.)
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6
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Handelzalts JE, Ohayon S, Levy S, Peled Y. Risk psychosocial factors associated with postpartum depression trajectories from birth to six months. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-023-02604-y. [PMID: 38193942 DOI: 10.1007/s00127-023-02604-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 12/11/2023] [Indexed: 01/10/2024]
Abstract
PURPOSE The purpose of this study was to assess the trajectory of women's depressive symptoms during the first six months postpartum, identify risk factors (sociodemographic, obstetric and personality) associated with classes, and examine associations between classes and postpartum PTSD at two months and bonding at six months. METHODS The final sample included 212 women who gave birth in the maternity wards of a large tertiary health center that were approached at 1-3 days, two months, and six months postpartum and completed a demographic questionnaire and measures of neuroticism (BFI) and postpartum depression (EPDS), postpartum PTSD (City Birth Trauma Scale) and bonding (PBQ). Obstetric data were taken from the medical files. RESULTS Cluster analysis revealed three distinctive clusters: "stable-low" (64.2%), "transient-decreasing" (25.9%), and "stable-high" (9.9%). Neuroticism, general-related PTSD symptoms, and bonding were associated with differences between all trajectories. Birth-related PTSD symptoms were associated with differences between both stable-high and transient-decreasing trajectories and the stable-low trajectory. No obstetric or demographic variables were associated with differences between trajectories. CONCLUSION We suggest that screening women for vulnerabilities such as high levels of neuroticism and offering treatment can alleviate the possible deleterious effects of high-symptom depression trajectories that may be associated with their vulnerability.
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Affiliation(s)
- Jonathan Eliahu Handelzalts
- School of Behavioral Sciences, The Academic College of Tel-Aviv Yafo, 68114, Tel-Aviv, Israel.
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
| | - Shay Ohayon
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
| | - Sigal Levy
- School of Behavioral Sciences, The Academic College of Tel-Aviv Yafo, 68114, Tel-Aviv, Israel
| | - Yoav Peled
- Rabin Medical Center, The Helen Schneider Hospital for Women, Petach-Tikva, Israel
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Míguez MC, Vázquez MB. Prevalence of postpartum major depression and depressive symptoms in Spanish women: A longitudinal study up to 1 year postpartum. Midwifery 2023; 126:103808. [PMID: 37672853 DOI: 10.1016/j.midw.2023.103808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 07/15/2023] [Accepted: 08/28/2023] [Indexed: 09/08/2023]
Abstract
OBJECTIVE Depression is a prevalent mental disorder in the postpartum period, with consequences for both the mother and her offspring. However, longitudinal studies determining the moments of greatest vulnerability and severity of depression during the postpartum period are scarce. The aims of this research were to determine the prevalence and trajectories of probable depression and major depression during the first year postpartum. DESIGN Longitudinal study. SETTING Interviews were conducted personally at three times: 2 months, 6 months and 1 year postpartum. PARTICIPANTS 561 postpartum women. MEASUREMENTS AND FINDINGS Depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS) and the Structured Clinical Interview (SCID) for the Diagnostic and Statistical Manual of Mental Disorders (DSM). Descriptive and comparative analyses have been carried out. The prevalence of probable depression at 2 months, 6 months and 1 year postpartum, using a cut-off point ≥ 10, was 30.3%, 26.0% and 25.3%, respectively; and that of major depression using SCID was 10.3%, 10.9% and 14.8, respectively. The prevalence of probable depression was highest at 2 months postpartum and that of major depression at 1 year postpartum. Probable depression followed a downward trajectory and major depression followed an upward trajectory. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The clinical relevance of this research is that it has made it possible to demonstrate that depression is very prevalent in the first year postpartum and that, far from subsiding, the prevalence remains very high even at 1 year postpartum. Our findings highlight the importance of taking mental health care into account throughout at least the first year postpartum.
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Terrone G, Bianciardi E, Fontana A, Pinci C, Castellani G, Sferra I, Forastiere A, Merlo M, Marinucci E, Rinaldi F, Falanga M, Pucci D, Siracusano A, Niolu C. Psychological Characteristics of Women with Perinatal Depression Who Require Psychiatric Support during Pregnancy or Postpartum: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085508. [PMID: 37107790 PMCID: PMC10138626 DOI: 10.3390/ijerph20085508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/20/2023] [Accepted: 04/11/2023] [Indexed: 05/11/2023]
Abstract
Antenatal depression may be distinct from postpartum depression in terms of prevalence, severity of symptoms, comorbidities, prognosis, and risk factors. Although risk factors for perinatal depression have been identified, it is unclear whether there are differences in the onset of perinatal depression (PND). This study explored the characteristics of women requiring mental health support during pregnancy or postpartum. A sample of 170 women (58% in pregnancy; 42% postpartum) who contacted the SOS-MAMMA outpatient clinic was recruited. Clinical data sheets and self-report questionnaires (EPDS, LTE-Q, BIG FIVE; ECR; BSQ; STICSA) were administered, hypothesizing possible risk factors, such as personality traits, stressful life events, body dissatisfaction, attachment style, and anxiety. Hierarchical regression models were carried out in the pregnancy (F10;36 = 8.075, p < 0.001, adjR2 = 0.877) and postpartum groups (F10;38 = 3.082, p < 0.05, adjR2 = 0.809). Recent stressful life events and conscientiousness were associated with depression in both the pregnant (29.3%, 25.5% of variance) and postpartum groups (23.8%, 20.7% of variance). In pregnant women, "openness" (11.6%), body dissatisfaction (10.2%), and anxiety (7.1%) symptoms were predictive of depression. In the postpartum group, "neuroticism" (13.8%) and insecure romantic attachment dimensions (13.4%; 9.2%) were the strongest predictors. Perinatal psychological interventions should consider the differences between mothers with depression during pregnancy and postpartum.
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Affiliation(s)
- Grazia Terrone
- Department of History, Cultural Heritage, Education and Society, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Emanuela Bianciardi
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
- Correspondence:
| | - Andrea Fontana
- Department of Human Sciences, Lumsa University of Rome, 00193 Rome, Italy
| | - Carolina Pinci
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Giulia Castellani
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Irene Sferra
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Anna Forastiere
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Mattia Merlo
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Elicio Marinucci
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Fiamma Rinaldi
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Marina Falanga
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Daniela Pucci
- Department of Mental Health and Pathological Addictions (DSMDP), ASL ROMA 5, 00019 Tivoli (Rome), Italy
| | - Alberto Siracusano
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Cinzia Niolu
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
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Zhuang J, Chen Q, Liu C, Zuo R, Zhang Y, Dang J, Wang Z. Investigating the association between maternal childbirth intention, labor epidural analgesia, and postpartum depression: A prospective cohort study. J Affect Disord 2023; 324:502-510. [PMID: 36586623 DOI: 10.1016/j.jad.2022.12.108] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 08/26/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Postpartum depression (PPD) is a general depressive episode after childbirth. Studies have shown that unmatched analgesic intention increases the risk of PPD, but the use of labor epidural analgesia (LEA) during childbirth can reduce this risk. We aimed to investigate the association between maternal childbirth intention, LEA, and PPD and risk factors that may be related to PPD. METHODS A total of 590 mothers were included in this prospective cohort study. Demographic, prenatal, intrapartum and postpartum data were recorded. We investigated the association between childbirth intention, LEA and PPD and assessed the interactions between two factors. Logistic regression analysis was used to screen variables that might be associated with the occurrence of PPD. RESULTS Overall, 130 of 451 women completing the study at 3 months had PPD (28.8 %). We did not find an association between unmatched childbirth intention, use of LEA and PPD (adjustOR = 0.684 CI 0.335-1.396, p = 0.296; adjustOR = 0.892, CI 0.508-1.565, p = 0.690). Chronic pain affecting daily life, prenatal EPDS, SAS, SSRS score, family accompaniment during labor, and 1-day numerical rating scale (NRS) score were significantly associated with PPD (p < 0.05). LIMITATIONS In the 3-month follow-up, we only recorded the EPDS score, not the pain score, and did not evaluate the association between postpartum chronic pain and PPD. CONCLUSIONS The association between maternal childbirth intention, LEA and PPD was not significant. Chronic pain affecting daily life, prenatal EPDS, SAS, SSRS score, family accompaniment during labor, and 1-day NRS score were significantly related to the occurrence of PPD (p < 0.05).
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Affiliation(s)
- Jingwen Zhuang
- Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Qianmin Chen
- Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Chao Liu
- Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Ronghua Zuo
- Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Yuhan Zhang
- Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Jingjing Dang
- Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Zhiping Wang
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, 209 Tongshan Road, Xuzhou 221004, Jiangsu, China; Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221004, Jiangsu, China.
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Liu W, Wu X, Gao Y, Xiao C, Xiao J, Fang F, Chen Y. A longitudinal study of perinatal depression and the risk role of cognitive fusion and perceived stress on postpartum depression. J Clin Nurs 2023; 32:799-811. [PMID: 35501970 DOI: 10.1111/jocn.16338] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/17/2022] [Accepted: 04/08/2022] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To explore fluctuations in perinatal depression based on physiological, psychological and interpersonal dimensions to analyse risk factors across three time points: in the third trimester and at weeks 1 and 6 postpartum. BACKGROUND Pregnant women experience depression at multiple time points and require screening. Studies have shown protective and negative factors related to postpartum depression. Cognitive fusion refers to an individual's emotions and behaviours that are regulated and influenced by that individual's own cognitive overregulation, especially when facing stress. This is an important psychological factor related to depression, but little is known about it in pregnant women. DESIGN A longitudinal study was conducted from June 2019-July 2020, and the findings are reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. METHODS Pregnant women (n = 207) were recruited, and a questionnaire survey was performed at 32-34 weeks of pregnancy and at weeks 1 and 6 postpartum. Repeated-measures analysis of variance was performed to analyse the changes in depression over time. Regression analysis and linear mixed modelling were used to identify risk factors. Pearson's correlation analysis was performed to analyse the relationships between variables. RESULTS Of the pregnant women, 36.70% experienced antenatal depression and prolonged depression with the onset of postpartum depression (12.21%). Some depressive moods disappeared spontaneously after delivery (47.37%). Perceived stress was the highest risk predictor of postpartum depression (β = 0.332), followed by cognitive fusion (β = 0.178), which remained stable over time and might have been positively related to having a vulnerable personality (0.2 < r < 0.4). Social support plays a positive role in lowering postpartum depression (β = -0.027). CONCLUSIONS Changes in depression were influenced by multiple factors with stability and predictability across time. Psychological dimensions, such as perceived stress and cognitive fusion, are risk factors for developing postpartum depression and antenatal depression. RELEVANCE TO CLINICAL PRACTICE Pregnant women can be divided into depressive cohorts according to screening at different time points to provide targeted interventions.
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Affiliation(s)
- Wenting Liu
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiaxin Wu
- School of Nursing, Peking University, Beijing, China
| | - Yuanmin Gao
- Nursing Department, Xiangya Third Hospital of Central South University, Changsha, China
| | - Chaoqun Xiao
- Department of Obstetrics and Gynecology, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Julan Xiao
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Fan Fang
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Yu Chen
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
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11
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Gutiérrez Hermoso L, Catalá Mesón P, Écija Gallardo C, Marín Morales D, Peñacoba Puente C. Mother-Child Bond through Feeding: A Prospective Study including Neuroticism, Pregnancy Worries and Post-Traumatic Symptomatology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2115. [PMID: 36767481 PMCID: PMC9915468 DOI: 10.3390/ijerph20032115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/16/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
Post-traumatic stress disorder (PTSD) is a common postpartum problem and influences maternal bonding with the infant. However, the relationship between this disorder, maternal personality, and the infant's emotional state during feeding is not clear. The aim of the present study was to explore the contribution of neuroticism on the infant's emotional state during feeding, by attending to the mediating role of postpartum PTSD (P-PTSD) symptoms and the moderating role of worries during pregnancy. A prospective design study was developed with 120 women with a low pregnancy risk. They responded to a questionnaire assessing maternal personality (first trimester), worries during pregnancy (third trimester), P-PTSD symptoms, and mother-baby bonding (4 months postpartum). The results showed a positive association among neuroticism, infant irritability during feeding, and P-PTSD symptoms, suggesting the latter plays a mediating role in the relationship between neuroticism and infant irritability (B = 0.102, standard error (SE) = 0.03, 95% coefficient interval (CI) [0.038, 0.176]). Excessive worries, related to coping with infant care, played a moderating role between neuroticism and P-PTSD symptoms (B = 0.413, SE = 0.084, p = 0.006, 95% CI [0.245, 0.581]). This relationship was interfered with by depressive symptoms in the first trimester (covariate) (B = 1.820, SE = 0.420, p = 0.016, ci [2.314, 0.251]). This study contributes to a better understanding of the role of neuroticism as an influential factor in the occurrence of P-PTSD symptoms, and in the impairment of infant bonding during feeding. Paying attention to these factors may favor the development of psychological support programs for mothers, with the aim of strengthening the bond with their child.
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Affiliation(s)
- Lorena Gutiérrez Hermoso
- Department of Psychology, Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón, Spain
| | - Patricia Catalá Mesón
- Department of Psychology, Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón, Spain
| | - Carmen Écija Gallardo
- Department of Psychology, Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón, Spain
| | - Dolores Marín Morales
- Obstetric Department, Hospital Universitario de Fuenlabrada, Camino del Molino, 2, 28942 Fuenlabrada, Spain
| | - Cecilia Peñacoba Puente
- Department of Psychology, Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón, Spain
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12
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Forssman L, Gottwald JM. The impact of interactive book sharing on child cognitive and socio-cognitive development (the REaL trial): study protocol for a randomized controlled trial. Trials 2022; 23:802. [PMID: 36153547 PMCID: PMC9509634 DOI: 10.1186/s13063-022-06733-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 09/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The quality of children's early home learning environment has an influence on their cognitive development, preliteracy skills, and subsequent educational outcomes. Early intervention programs that promote positive parenting behaviors and child cognition have great potential to positively influence children's school readiness and thereby support social equality. One often advocated parental practice for promoting child language and cognition is interactive book sharing. METHODS We have conducted a randomized controlled trial to evaluate the effects of a parent-child interactive book sharing intervention on early child language, cognition, and parental behaviors. Participating caregivers and their 10-month-old child were randomized to an interactive book sharing intervention group (n = 59) or to an active control group (n = 56). The intervention was delivered by a facilitator to small groups of parent-child dyads on a weekly basis over 5 weeks. The primary outcomes were child language and socio-cognition; secondary outcomes were child executive function and parental scaffolding, sensitivity and reciprocity during book sharing, and problem-solving tasks. Data were collected at baseline, post-intervention, and at 6 and 12 months post-intervention. DISCUSSION The Roadmap to Executive function and Language (REaL) trial aims to evaluate the impact of a brief early parenting intervention on key factors for child development, including child cognition and parental behaviors. If this intervention is beneficial for child outcomes, that would be of significance for the development of early interventions to promote child development. TRIAL REGISTRATION The REaL trial is registered on the International Standard Randomized Controlled Trial Number database, registration number ISRCTN22319305. Retrospectively registered on 7 February 2020.
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Affiliation(s)
- Linda Forssman
- Department of Psychology, Uppsala University, von Kraemers allé 1, 75142, Uppsala, Sweden.
| | - Janna M Gottwald
- Department of Psychology, Uppsala University, von Kraemers allé 1, 75142, Uppsala, Sweden
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13
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Fagerberg T, Söderman E, Gustavsson JP, Agartz I, Jönsson EG. Thirteen-year follow-up of long-term treated psychotic disorder: personality aspects. Nord J Psychiatry 2022; 76:386-393. [PMID: 34620037 DOI: 10.1080/08039488.2021.1981436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Personality is an aspect that can affect the symptoms and social function in individuals with psychotic disorders. Several studies have investigated personality in schizophrenia and other long-term psychotic disorders. No study has examined the stability of personality traits exceeding five years in patients with schizophrenia and related disorders. The aim of this study was to investigate the stability of personality traits over a 13-year period among patients with schizophrenia and related disorders and healthy individuals and to evaluate case-control differences. METHODS At three occasions during a 13-year period patients with schizophrenia and related disorders (n = 28) and healthy individuals (n = 57) completed Swedish universities Scales of Personality (SSP). Mean-level change and case-control differences were investigated for all the individuals using within- and between-subject analyses, respectively. Analyses were performed on three occasions for all 13 subscales and the three overall factors of SSP. Also, correlations, means, and SDs were calculated. RESULTS Tests of within-subject correlations showed differences in two subscales: Lack of Assertiveness, which were influenced by age, and Physical Trait Aggression, where patients' ratings were stable, whereas controls rated themselves less aggressive at a higher age. Between-subjects correlations showed differences regarding diagnosis, time, age, gender, or age × gender in nine of the 13 subscales as well as in factor Neuroticism. CONCLUSION Long-term follow-up showed generally high stability of personality traits measured with SSP. Between-subject analyses over the 13 years showed that patients differed compared to controls for the SSP factor Neuroticism as well as the subscale Detachment, which is in accordance with previous studies within this population.
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Affiliation(s)
- Tomas Fagerberg
- Human Brain Informatics (HUBIN), Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Erik Söderman
- Human Brain Informatics (HUBIN), Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - J Petter Gustavsson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ingrid Agartz
- Human Brain Informatics (HUBIN), Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden.,NORMENT - TOP study, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Erik G Jönsson
- Human Brain Informatics (HUBIN), Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden.,NORMENT - TOP study, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Pathways from Neuroticism, Social Support, and Sleep Quality to Antenatal Depression during the Third Trimester of Pregnancy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095602. [PMID: 35565028 PMCID: PMC9100278 DOI: 10.3390/ijerph19095602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 02/04/2023]
Abstract
Background: Antenatal depression is a severe public health problem. Many studies support the concept that neuroticism, social support, and sleep quality are closely related to antenatal depression. However, there is little evidence concerning the influencing pathways of these variables on antenatal depression. The aim of this study is to investigate the pathways from neuroticism, social support, and sleep quality to antenatal depression during the third trimester of pregnancy. Methods: A cross-sectional study design was used. A total of 773 eligible women in the third trimester of pregnancy submitted valid questionnaires from June 2016 to April 2017. Instruments with good reliability and validity were used to measure neuroticism, social support, sleep quality, and antenatal depression. Structural equation modeling was used to explore the pathways from neuroticism, social support, and sleep quality to antenatal depression during the third trimester of pregnancy. Results: Antenatal depression is shown to be positively correlated with neuroticism and negatively correlated with social support and sleep quality. Neuroticism is shown to have a direct effect and indirect effects through social support and sleep quality on antenatal depression. Conclusions: Neuroticism influences antenatal depression directly and indirectly. Social support and sleep quality are the mediators of the indirect relationship between neuroticism and antenatal depression. Our results suggest that a personality test offered to all pregnant women could help detect a vulnerability to depression, whereupon intervention in the domains of sleep and social support could prove preventive.
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Murakami K, Ishikuro M, Obara T, Ueno F, Noda A, Onuma T, Matsuzaki F, Kikuchi S, Kobayashi N, Hamada H, Iwama N, Metoki H, Saito M, Sugawara J, Tomita H, Yaegashi N, Kuriyama S. Maternal personality and postpartum mental disorders in Japan: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Sci Rep 2022; 12:6400. [PMID: 35430603 PMCID: PMC9013371 DOI: 10.1038/s41598-022-09944-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/21/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractPersonality has been shown to predict postpartum depressive symptoms (PDS) assessed by the Edinburgh Postnatal Depression Scale (EPDS). However, existing studies have not considered the underlying symptom dimensions in the EPDS. We analyzed data from 15,012 women who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Personality was assessed in middle pregnancy using the short-form Eysenck Personality Questionnaire-Revised. PDS were defined as EPDS score ≥ 9 at 1 month after delivery. The EPDS items were further divided into three dimensions: depressed mood, anxiety, and anhedonia. Multiple analyses were conducted to examine the associations of each personality scale with PDS and three dimensions in the EPDS, adjusting for age, parity, mode of delivery, education, income, and social isolation. The prevalence of PDS assessed by the EPDS at 1 month after delivery was 13.1%. Higher neuroticism scores were associated with PDS (odds ratio [OR], 2.63; 95% confidence interval [CI], 2.48 to 2.79) and all three dimensions (all p < 0.001). Lower extraversion scores were associated with PDS (OR, 0.74; 95% CI, 0.70 to 0.78) and all three dimensions (all p < 0.001). Lower psychoticism scores were associated with PDS (OR, 0.89; 95% CI, 0.85 to 0.94) and anxiety (p < 0.001), but not with depressed mood (p = 0.20) or anhedonia (p = 0.92). In conclusion, higher neuroticism and lower extraversion were associated with PDS and the three underlying dimensions in the EPDS, while lower psychoticism was associated with anxiety, but not with depressed mood or anhedonia.
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16
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Liakea I, K. C. A, Bränn E, Fransson E, Sundström Poromaa I, Papadopoulos FC, Skalkidou A. Working Memory During Late Pregnancy: Associations With Antepartum and Postpartum Depression Symptoms. Front Glob Womens Health 2022; 3:820353. [PMID: 35284907 PMCID: PMC8904422 DOI: 10.3389/fgwh.2022.820353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 01/27/2022] [Indexed: 11/13/2022] Open
Abstract
Background Few studies, with conflicting results, report on the association between memory performance and depressive symptoms during the perinatal period. In this study, we aimed to evaluate whether memory performance during late pregnancy is associated with antepartum (APD) and postpartum depression (PPD) symptoms. Method We conducted a prospective follow-up of 283 pregnant women, nested within a large cohort of women enrolled in the BASIC study in Uppsala University hospital between 2009 and 2019. The Wechsler Digit Span Task (forward-DSF, backward-DSB and total score-DST) was performed to evaluate short-term memory/attention (DSF) and working memory (DSB) around the 38th gestational week; the Edinburgh Postnatal Depression Scale (EPDS), evaluating depressive symptoms, was filled out at 17, 32, 38 gestational weeks, as well as at 6 weeks postpartum. Unadjusted and multivariate logistic regression was used to assess the association between performance on the Digit Span Task and outcome, namely depressive symptoms (using a cut-off of 12 points on the EPDS) at 38 gestational weeks, as well as at 6 weeks postpartum. Results APD symptoms were not significantly associated with DSF (p = 0.769) or DSB (p = 0.360). APD symptoms were significantly associated with PPD symptoms (p < 0.001). Unadjusted regression modeling showed that DSF in pregnancy was a significant predictor of PPD symptoms (OR 1.15; 95% CI, 1.00, 1.33, p = 0.049), and remained a significant predictor when adjusted for confounders (education and feeling rested at assessment; OR 1.21, 95% CI 1.03, 1.42, p = 0.022). DSF was a predictor of PPD symptoms only for women without a pre-pregnancy history of depression (OR 1.32; 95% CI 1.04, 1.67, p = 0.024) and also those without APD (OR 1.20, 95% CI 1.01, 1.43, p = 0.040). Conclusion There was no significant association between working and short-term memory performance and APD symptoms. Among all women, but especially non-depressed earlier in life and/or at antepartum, those scoring high on the forward memory test, i.e., short-term memory, had a higher risk for PPD. Future studies are required to further explore the pathophysiology behind and the predictive value of these associations.
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Affiliation(s)
- Iliana Liakea
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- *Correspondence: Iliana Liakea
| | - Ashish K. C.
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Emma Bränn
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Emma Fransson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | | | - Alkistis Skalkidou
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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17
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The Mediation Effect of Coping Strategies between Personality and Blood Pressure in Pregnancy Complicated by Hypertension. Healthcare (Basel) 2022; 10:healthcare10020341. [PMID: 35206955 PMCID: PMC8871720 DOI: 10.3390/healthcare10020341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/26/2022] [Accepted: 02/07/2022] [Indexed: 11/28/2022] Open
Abstract
Background: Hypertension is the most common medical condition during pregnancy. Hypertensive disorders are associated with an increased risk of adverse outcomes for both mother and fetus. This study examined the role played by personality and coping strategies in relation to blood pressure levels during pregnancy. The specific goal was to study whether coping strategies can mediate the effect of personality in pregnant women with hypertension. Methods: A sample of 351 pregnant women was enlisted, encompassing 192 pregnancies complicated by hypertension. This is a cross-sectional study where personality traits were measured by the five-factor model and coping was evaluated by Jalowiec’s coping inventory scale. Results: Personality can partially predict systolic and diastolic blood pressure. Openness to experience trait is inversely correlated with systolic and diastolic blood pressure. Conversely, emotion-focused coping directly correlated with blood pressure levels. Systolic (β = −0.14; p < 0.05) and diastolic (β = −0.15; p < 0.05) blood pressure were also predicted by openness to experience. Conclusions: It is recommended to reinforce the development of coping strategies which focus more on the problem than on the emotion, avoiding detrimental effects of emotional coping in blood pressure levels during pregnancy.
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Personality traits as a risk factor for postpartum depression: A systematic review and meta-analysis. J Affect Disord 2022; 298:577-589. [PMID: 34763034 DOI: 10.1016/j.jad.2021.11.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 10/30/2021] [Accepted: 11/03/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Certain personality traits increase vulnerability to depression, but the evidence linking personality and postpartum depression (PPD) is less robust. This systematic review aimed to identify personality traits that increase the risk of PPD. METHODS We systematically reviewed studies retrieved from PubMed/Medline, PsycINFO, Scopus, CINAHL, and Cochrane, following the PRISMA guidelines for reporting. We carried out a meta-analysis on the association between neuroticism and PPD. RESULTS A total of 34 studies were analyzed. Of these, 31 considered at least one trait associated with PPD; 10 studies considered at least one trait not associated with PPD. The meta-analysis included 13 studies, concluding that neuroticism was associated with PPD (OR: 1.37; 95%CI: 1.22-1.53; p<0.001). LIMITATIONS Study design and approach to personality assessment influence results. Prospective longitudinal studies of persons with no prior history of mood disorder would provide stronger evidence about whether particular personality traits predict PPD. Most studies reviewed used self-report measures to assess personality. Study design and approach to personality assessment influence results, and indications of publication bias were found. CONCLUSIONS Neuroticism is the personality trait most widely studied in relation to PPD. Our meta-analysis found this trait is strongly related with PPD. Moreover, vulnerable personality style and trait anxiety are also associated with PPD. Screening for these traits might help identify women at risk, improving prevention, early detection, and possibly treatment.
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Enătescu I, Craina M, Gluhovschi A, Giurgi-Oncu C, Hogea L, Nussbaum LA, Bernad E, Simu M, Cosman D, Iacob D, Marinescu I, Enătescu VR. The role of personality dimensions and trait anxiety in increasing the likelihood of suicide ideation in women during the perinatal period. J Psychosom Obstet Gynaecol 2021; 42:242-252. [PMID: 32116087 DOI: 10.1080/0167482x.2020.1734790] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
INTRODUCTION Increasing amount of data reveal that suicide risk is a real phenomenon among perinatal women, determined by several other psychopathological conditions with depression being just one of them. This study aimed to investigate the role of personality dimensions on the occurrence of suicide ideation during the perinatal period. METHODS A longitudinal prospective study was performed in pregnant women who were monitored at university-based obstetrical care units in our county. Recruited women were reassessed between 6 and 8 weeks into their postnatal period. Trait and state anxiety, five-factor based dimensions of personality, and depressive symptoms were assessed using established psychometric measures. Appropriate statistical analyses were conducted, depending on the distribution of variables. RESULTS Significant levels of state anxiety (33.7% vs. 15.5%), depressive symptoms (19.8% vs. 8.5%), and suicide risk (13.9% vs. 6.3%) have halved in the postnatal period compared to the antenatal assessment. A lower level of education was associated with the presence of postnatal suicide ideation (p = .041), while an unemployed professional status was more frequent in pregnant women presenting antenatal suicide ideation (p = .021). Trait anxiety was predictive for the appearance of suicide ideation within the entire perinatal period assessed (p < .001 and p = .007, respectively). Agreeableness and conscientiousness predicted antenatal suicide ideation (p = .033 and p = .032, respectively). DISCUSSIONS Different dimensions of personality may play a contributing role in the development of suicide ideation in perinatal women. Consequently, personality dimensions and trait anxiety, not only depressive symptoms, should be investigated when attempting to identify perinatal women at risk of suicide.
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Affiliation(s)
- Ileana Enătescu
- Discipline of Child Care and Neonatology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Marius Craina
- Department of Obstetrics and Gynecology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Adrian Gluhovschi
- Department of Obstetrics and Gynecology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Cătălina Giurgi-Oncu
- Discipline of Psychiatry, "Victor Babes" University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Lavinia Hogea
- Discipline of Psychology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Laura Alexandra Nussbaum
- Discipline of Child and Adolescent Psychiatry, "Victor Babes" University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Elena Bernad
- Department of Obstetrics and Gynecology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Mihaela Simu
- Discipline of Neurology, "Victor Babes, " University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Doina Cosman
- Discipline of Medical Psychology, Iuliu Hațieganu" University of Medicine and Pharmacy Cluj Napoca, Cluj-Napoca, Romania
| | - Daniela Iacob
- Discipline of Child Care and Neonatology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Ileana Marinescu
- Discipline of Psychiatry, University of Medicine and Pharmacy Craiova, Craiova, Romania
| | - Virgil Radu Enătescu
- Discipline of Psychiatry, "Victor Babes" University of Medicine and Pharmacy Timisoara, Timisoara, Romania
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Abstract
ABSTRACT Despite extensive research, the etiology behind postpartum depression (PPD) remains a mystery. Experts have theorized about various potential risk factors, including hormonal fluctuations, genetics, prior history of depression, low socioeconomic status, adolescent pregnancy, and certain personality traits. This article provides foundational information about PPD, reviewing the risk factors for and the consequences of this mood disorder. Postpartum blues and postpartum psychosis are briefly discussed for context, although they differ from PPD. Screening and treatment options are explained, and nursing implications for practice are presented.
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Affiliation(s)
- Barbara Marie Alba
- Barbara Marie Alba is the director of nursing for maternal-child health services at New York-Presbyterian Hospital, New York City. Contact author: . The author and planners have disclosed no potential conflicts of interest, financial or otherwise. A podcast with the author is available at www.ajnonline.com
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21
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Gauffin E, Willebrand M, Ekselius L, Öster C. Stability in Personality After Physical Trauma. J Burn Care Res 2021; 42:415-419. [PMID: 33027526 DOI: 10.1093/jbcr/iraa170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Personality trait stability may be influenced by several factors, there among different life events such as psychological trauma. However, little is known regarding trait stability after physical trauma. Therefore, our primary aim was to assess the extent of stability in personality in burn patients during the first year after injury. Eighty-four burn patients, admitted to a national burn center, were assessed with the Swedish universities Scales of Personality during acute care and 12 months postburn. Personality domain scores remained stable between acute care and 12 months postburn. On the trait level, the only change was seen in personality trait Stress Susceptibility, where burn patients' scores were lower compared with norm scores during acute care but then increased, and normalized, at 12 months postburn. To conclude, personality scores remained relatively stable during the first year after burn trauma.
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Affiliation(s)
- Emelie Gauffin
- Department of Neuroscience Psychiatry, Uppsala University, Uppsala University Hospital, Sweden
| | - Mimmie Willebrand
- Department of Neuroscience Psychiatry, Uppsala University, Uppsala University Hospital, Sweden
| | - Lisa Ekselius
- Department of Neuroscience Psychiatry, Uppsala University, Uppsala University Hospital, Sweden
| | - Caisa Öster
- Department of Neuroscience Psychiatry, Uppsala University, Uppsala University Hospital, Sweden
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22
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Predicting women with depressive symptoms postpartum with machine learning methods. Sci Rep 2021; 11:7877. [PMID: 33846362 PMCID: PMC8041863 DOI: 10.1038/s41598-021-86368-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 03/15/2021] [Indexed: 11/09/2022] Open
Abstract
Postpartum depression (PPD) is a detrimental health condition that affects 12% of new mothers. Despite negative effects on mothers’ and children’s health, many women do not receive adequate care. Preventive interventions are cost-efficient among high-risk women, but our ability to identify these is poor. We leveraged the power of clinical, demographic, and psychometric data to assess if machine learning methods can make accurate predictions of postpartum depression. Data were obtained from a population-based prospective cohort study in Uppsala, Sweden, collected between 2009 and 2018 (BASIC study, n = 4313). Sub-analyses among women without previous depression were performed. The extremely randomized trees method provided robust performance with highest accuracy and well-balanced sensitivity and specificity (accuracy 73%, sensitivity 72%, specificity 75%, positive predictive value 33%, negative predictive value 94%, area under the curve 81%). Among women without earlier mental health issues, the accuracy was 64%. The variables setting women at most risk for PPD were depression and anxiety during pregnancy, as well as variables related to resilience and personality. Future clinical models that could be implemented directly after delivery might consider including these variables in order to identify women at high risk for postpartum depression to facilitate individualized follow-up and cost-effectiveness.
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Maternal personality and postnatal bonding disorder in Japan: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. J Affect Disord 2021; 282:580-586. [PMID: 33445079 DOI: 10.1016/j.jad.2020.12.187] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/21/2020] [Accepted: 12/26/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Despite much knowledge of the effects of maternal psychopathology on bonding, the effects of personality have received less attention. We aimed to examine the association between maternal personality and postnatal bonding disorder. METHODS We analyzed data from 15,654 women who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Personality was assessed in middle pregnancy using the short-form Eysenck Personality Questionnaire-Revised, with the score for each subscale categorized into four levels. Bonding disorder was defined as the Mother-to-Infant Bonding Scale score of ≥5 one month after delivery. Multiple logistic regression analyses were conducted to examine the association between personality and bonding disorder after adjusting for age, education, parity, feelings towards pregnancy, social isolation, as well as the Edinburgh Postpartum Depression Scale (EPDS) score. RESULTS Higher extraversion was associated with a decreased risk of bonding disorder (p for trend <0.001). Higher neuroticism was associated with an increased risk of bonding disorder (p for trend <0.001), and this association disappeared after further adjustment for EPDS score (p for trend 0.39). No association between psychoticism and bonding disorder was observed (p for trend 0.83), and the association appeared after further adjustment for EPDS score (p for trend 0.0017). Higher lie was associated with a decreased risk of bonding disorder (p for trend <0.001). LIMITATIONS Maternal personality and bonding were self-reported. CONCLUSIONS Lower extraversion, higher psychoticism, and lower lie were associated with bonding disorder. The association between higher neuroticism and bonding disorder was explained by postnatal depressive symptoms.
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Mavrandrea P, Giovazolias T. The effect of personality on depressive symptoms: The mediating effect of adult attachment. CURRENT PSYCHOLOGY 2020. [DOI: 10.1007/s12144-020-01207-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Bittner A, Junge-Hoffmeister J, Treichel T, Coenen A, Weidner K. Maladaptive personality styles in a clinical sample of women with postpartum depression. J Affect Disord 2020; 263:318-325. [PMID: 31969261 DOI: 10.1016/j.jad.2019.11.151] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 11/04/2019] [Accepted: 11/30/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Personality traits are associated with the onset and course of postpartum depression. The impact of maladaptive personality traits on mother-child bonding and parenting is less studied. Therefore, the aims of this study are to investigate: a) the frequency of maladaptive personality styles in women with postpartum depression; b) the association between personality styles and the course of maternal psychopathology; and c) the association between personality styles and mother-child bonding and parenting competence. METHODS We examined n = 123 patients of a mother-baby unit with the Personality Style and Disorder Inventory (PSSI) at admission and instruments assessed maternal psychopathological symptoms (BSI), mother-child bonding (PBQ), and parenting sense of competence (PSOC) at admission and discharge. RESULTS Maladaptive personality styles were frequent. Women with postpartum depression had higher scores on the schizoid, avoidant, obsessive-compulsive, negativistic, dependent, borderline, depressive, and self-forgetting PSSI scales than women of the general population. The presence of maladaptive personality styles was associated with higher psychopathology, impaired mother-child bonding, and lower parenting sense of competence at admission. From admission to discharge, women showed significant improvements on psychopathology, bonding and parenting irrespective of the presence of maladaptive personality styles. However, mothers with maladaptive personality styles still had higher psychopathology and impaired mother-child bonding at discharge compared to mothers with normal PSSI scores. LIMITATIONS Data is based upon a clinical sample of women hospitalized in a mother-child unit. Results are not representative for all women with postpartum depression. CONCLUSIONS Our results underline the need for early identification of maladaptive personality styles and for the adequate treatment and monitoring of women with postpartum depression. It can be anticipated that women suffering from maladaptive personality styles will need ongoing care to prevent long-term negative outcomes.
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Affiliation(s)
- Antje Bittner
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Fetscherstr. 74, D-01307, Dresden, Germany.
| | - Juliane Junge-Hoffmeister
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
| | - Tina Treichel
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
| | - Anne Coenen
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
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Evcili F, Daglar G. How do personality characteristics of risky pregnant women affect their prenatal distress levels? JOURNAL OF HEALTH RESEARCH 2019. [DOI: 10.1108/jhr-07-2019-0143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose
The prenatal distress level of the pregnant woman is influenced by many variables. Personality characteristics are one of the most important of these variables. Knowing personality characteristics of pregnant women contributes to the personalization of care. The purpose of this paper is to identify the effect of personality characteristics of pregnant women at risk on the prenatal distress level.
Design/methodology/approach
A total of 438 women who were hospitalized based on a medical diagnosis associated with pregnancy were included in the study. The participants were administered the Personal Information Form, Cervantes Personality Scale and Revised Prenatal Distress Questionnaire. Data were evaluated using the SPSS 22.0 software program.
Findings
Of the pregnant women, 27.4 percent found their ability to cope with stress insufficient, and one-fifth of them found their social support insufficient. The pregnant women at risk with introverted, neurotic and inconsistent personality were found to have high levels of prenatal distress.
Research limitations/implications
This study was conducted on a group of Turkish pregnant women and cannot be generalized to other cultures. The data obtained from the research cannot be used to evaluate the psychological and physical disorders of the pregnant woman.
Practical implications
All health care professionals should evaluate women not only physically but also mentally and emotionally, beginning with the preconceptional period. They should determine the conditions that create distress and identify the personality characteristics that prevent from coping with stress. By using cognitive and behavioral techniques, pregnant women should be trained to gain skills on subjects such as risk perception and stress management, personality characteristics and coping, problem solving, psychological endurance and optimism. Caring initiatives should be personalized in line with personality characteristics of pregnant women. The care offered within this framework will contribute to the strengthening and development of the health of not only the women but also the family and society, and to the reduction of health care costs.
Social implications
Researchers have determined that pregnant women at risk with introverted, neurotic and inconsistent personality characteristics have higher distress levels. They have determined that these pregnant women find their ability to cope with stress more inadequate. It is vital to cope with stress during pregnancy due to its adverse effects on maternal/fetal/neonatal health.
Originality/value
The prenatal distress level of the pregnant woman is influenced by many demographic (age, marital status and socioeconomic level), social (marital dissatisfaction, and lack of social support), personal (self-esteem, neuroticism and negative life experiences) and pregnancy-related (experiencing risky pregnancy, and previous pregnancy experiences) variables. Personality characteristics are one of the most important of these variables. This research is original because there are limited number of studies examining the effect of personality characteristics on prenatal distress level in the literature. And knowing the relationship between personality characteristics and distress by health professionals enables individualization of care. The care offered within this framework will contribute to the strengthening and development of the health of not only the women, but also the family and society, and to the decrease of health care costs.
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Linking personality types to depressive symptoms: A prospective typology based on neuroticism, extraversion and conscientiousness. Neuropsychologia 2019; 136:107289. [PMID: 31794711 DOI: 10.1016/j.neuropsychologia.2019.107289] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 10/28/2019] [Accepted: 11/29/2019] [Indexed: 12/22/2022]
Abstract
From a traditional variable-centered perspective, the personality traits specifically linked to depressive symptoms are neuroticism, extraversion, and conscientiousness (NEC). Few studies have considered the interactive effects of personality traits within individuals from the taxonomic perspective. We explored novel NEC personality subtypes in general and subthreshold depressive subjects by using graph-based classification algorithms and multiple external validators. Personality and depressive symptoms were assessed in 1055 healthy subjects (150 with subthreshold depression) using the NEO-PI-R and BDI at baseline. NEC personality data were used to identify subtypes in healthy and subthreshold depressive samples, and external validators, including current and longitudinal depressive symptoms and seven subcortical gray matter volumes, were examined. Four novel NEC personality types in the general sample showed superior current and longitudinal behavioral validation of depressive symptoms as well as some discrimination in biological indicators (putamen, nucleus accumbens, and amygdala). Four profiles defined in subthreshold depression selectively exhibited meaningful differences in longitudinal depressive symptoms. In both samples, some types adhere to the principles previously described NEC three-way interaction. The resulting typology, especially the four types in the general population, linked depressive symptoms provided a superior description of within-person organization of neuroticism, extraversion, and conscientiousness.
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Axfors C, Eckerdal P, Volgsten H, Wikström AK, Ekselius L, Ramklint M, Sundström Poromaa I, Skalkidou A. Investigating the association between neuroticism and adverse obstetric and neonatal outcomes. Sci Rep 2019; 9:15470. [PMID: 31664086 PMCID: PMC6820798 DOI: 10.1038/s41598-019-51861-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 10/04/2019] [Indexed: 11/13/2022] Open
Abstract
Neuroticism is not only associated with affective disorders but also with certain somatic health problems. However, studies assessing whether neuroticism is associated with adverse obstetric or neonatal outcomes are scarce. This observational study comprises first-time mothers (n = 1969) with singleton pregnancies from several cohorts based in Uppsala, Sweden. To assess neuroticism-related personality, the Swedish universities Scales of Personality was used. Swedish national health registers were used to extract outcomes and confounders. In logistic regression models, odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for the outcomes by an increase of 63 units of neuroticism (equalling the interquartile range). Analyses were adjusted for maternal age, educational level, height, body mass index, year of delivery, smoking during pregnancy, involuntary childlessness, and psychiatric morbidity. Main outcomes were mode of delivery, gestational diabetes mellitus, gestational hypertension, preeclampsia, induction of delivery, prolonged delivery, severe lacerations, placental retention, postpartum haemorrhage, premature birth, infant born small or large for gestational age, and Apgar score. Neuroticism was not independently associated with adverse obstetric or neonatal outcomes besides gestational diabetes. For future studies, models examining sub-components of neuroticism or pregnancy-specific anxiety are encouraged.
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Affiliation(s)
- Cathrine Axfors
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Patricia Eckerdal
- Department for Women's and Children's Health, Uppsala University, Uppsala, Sweden.
| | - Helena Volgsten
- Department for Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Anna-Karin Wikström
- Department for Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Lisa Ekselius
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Mia Ramklint
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | | | - Alkistis Skalkidou
- Department for Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Axfors C, Bränn E, Henriksson HE, Hellgren C, Kunovac Kallak T, Fransson E, Lager S, Iliadis SI, Sylvén S, Papadopoulos FC, Ekselius L, Sundström-Poromaa I, Skalkidou A. Cohort profile: the Biology, Affect, Stress, Imaging and Cognition (BASIC) study on perinatal depression in a population-based Swedish cohort. BMJ Open 2019; 9:e031514. [PMID: 31641004 PMCID: PMC6830667 DOI: 10.1136/bmjopen-2019-031514] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
PURPOSE With the population-based, prospective Biology, Affect, Stress, Imaging and Cognition (BASIC) cohort, we aim to investigate the biopsychosocial aetiological processes involved in perinatal depression (PND) and to pinpoint its predictors in order to improve early detection. PARTICIPANTS From September 2009 to November 2018, the BASIC study at Uppsala University Hospital, Sweden, has enrolled 5492 women, in 6478 pregnancies, of which 46.3% first-time pregnancies and with an average age of 31.5 years. After inclusion around gestational week 16-18, participants are followed-up with data collection points around gestational week 32, at childbirth, as well as three times postpartum: after 6 weeks, 6 months and 1 year. At the last follow-up, 70.8% still remain in the cohort. FINDINGS TO DATE In addition to internet-based surveys with self-report instruments, participants contribute with biological samples, for example, blood samples (maternal and from umbilical cord), biopsies (umbilical cord and placenta) and microbiota samples. A nested case-control subsample also takes part in cognitive and emotional tests, heart rate variability tests and bioimpedance tests. Subprojects have identified various correlates of PND of psychological and obstetric origin in addition to factors of the hypothalamic-pituitary-adrenal axis and immune system. FUTURE PLANS In parallel with the completion of data collection (final follow-up November 2019), BASIC study data are currently analysed in multiple subprojects. Since 2012, we are conducting an ongoing follow-up study on the participants and their children up to 6 years of age (U-BIRTH). Researchers interested in collaboration may contact Professor Alkistis Skalkidou (corresponding author) with their request to be considered by the BASIC study steering committee.
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Affiliation(s)
- Cathrine Axfors
- Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Emma Bränn
- Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | | | - Theodora Kunovac Kallak
- Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Centre for Reproductive Biology in Uppsala (CRU), Uppsala University, Uppsala, Sweden
| | - Emma Fransson
- Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institute, Stockholm, Sweden
| | - Susanne Lager
- Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Centre for Reproductive Biology in Uppsala (CRU), Uppsala University, Uppsala, Sweden
| | | | - Sara Sylvén
- Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | | | - Lisa Ekselius
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
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Personality Traits Predict Meeting the WHO Recommendation of 6 Months' Breastfeeding: A Prospective General Population Cohort Study. Adv Neonatal Care 2019; 19:118-126. [PMID: 30325749 DOI: 10.1097/anc.0000000000000547] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although personality as well as anxiety and depression are recognized as predictors for breastfeeding initiation, evidence of an association of these factors with 6 months' exclusive breastfeeding as recommended by the World Health Organization (WHO) is sparse. PURPOSE The purpose of this study was to investigate the associations of personality and symptoms of anxiety and depression during and after pregnancy with meeting the WHO recommendation of 6 months' exclusive breastfeeding. METHODS In their first trimester of pregnancy, 5784 pregnant women were enrolled in Dutch primary obstetric care centers and hospitals, of which 2927 completed the breastfeeding assessments 6 months postpartum. We performed logistic regression analyses to test the associations of "big five" personality traits (NEO Five Factor Inventory), anxiety (State-Trait Anxiety Inventory), and depression (Edinburgh Postnatal Depression Scale) symptom levels during pregnancy and postpartum with meeting the WHO recommendation of 6 months' exclusive breastfeeding. RESULTS Agreeableness (odds ratio [OR] = 1.18, P = .006) and openness (OR = 1.31, P < .001) were positively associated with meeting the WHO recommendation, whereas extraversion (OR = 0.83, P = .005) and neuroticism (OR = 1.18, P = .006) were negatively associated. After adjustment for both antenatal and postpartum symptom levels of anxiety and depression, the associations of the agreeableness, extraversion, and openness personality traits remained strong and statistically significant (P < .05). IMPLICATIONS FOR PRACTICE Patient-centered care should take personality into account in an effort to tailor interventions to optimize breastfeeding behavior. IMPLICATIONS FOR RESEARCH In contrast to earlier findings, personality traits may be of greater importance than symptoms of anxiety and depression for meeting the WHO recommendation of 6 months' exclusive breastfeeding.
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Smorti M, Ponti L, Tani F. Maternal depressive symptomatology during pregnancy is a risk factor affecting newborn's health: a longitudinal study. J Reprod Infant Psychol 2019; 37:444-452. [PMID: 30880451 DOI: 10.1080/02646838.2019.1581919] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Depression symptomatology in pregnant women is a condition that represents an important risk factor for the health of both women and children. Objectives: The aim of this study was to investigate the influence of women's depression symptomatology on the clinical aspects of their delivery, both directly and indirectly, through mothers' prenatal attachment to their unborn children. Moreover, we analysed whether these aspects affect the well-being of the newborn, assessed through the Apgar score. Methods: A longitudinal design was carried out on a total of 203 pregnant women. At weeks 31-32 of gestation, women filled out the Beck Depression Inventory and the Prenatal Attachment Inventory. The day of childbirth, hospital healthcare staff registered the clinical data of childbirth. Results: A woman's depressive symptomatology negatively affects prenatal attachment to her unborn child and positively affects the clinical aspects of the delivery, both directly and mediated by the quality of prenatal attachment. Moreover, the Apgar score was negatively influenced by the clinical aspects of the delivery and, indirectly, by the depressive symptomatology. Conclusion: Depressive symptomatology during pregnancy has negative outcomes, affecting the delivery experience of women, the first emotional bond with the child, and the well-being of the newborn.
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Affiliation(s)
- Martina Smorti
- a Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa , Pisa , Italy
| | - Lucia Ponti
- b Department of Health Sciences, University of Florence , Florence , Italy
| | - Franca Tani
- b Department of Health Sciences, University of Florence , Florence , Italy
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Wikman A, Axfors C, Iliadis SI, Cox J, Fransson E, Skalkidou A. Characteristics of women with different perinatal depression trajectories. J Neurosci Res 2019; 98:1268-1282. [DOI: 10.1002/jnr.24390] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 12/07/2018] [Accepted: 01/09/2019] [Indexed: 01/27/2023]
Affiliation(s)
- Anna Wikman
- Department of Women’s and Children’s Health Uppsala University Uppsala Sweden
| | - Cathrine Axfors
- Department of Women’s and Children’s Health Uppsala University Uppsala Sweden
- Department of Neuroscience, Psychiatry Uppsala University Uppsala Sweden
| | - Stavros I Iliadis
- Department of Women’s and Children’s Health Uppsala University Uppsala Sweden
| | - John Cox
- Keele University Keele United Kingdom
| | - Emma Fransson
- Department of Women’s and Children’s Health Uppsala University Uppsala Sweden
- Department of Microbiology, Tumour and Cell biology Karolinska Institute Stockholm Sweden
| | - Alkistis Skalkidou
- Department of Women’s and Children’s Health Uppsala University Uppsala Sweden
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Cato K, Sylvén SM, Georgakis MK, Kollia N, Rubertsson C, Skalkidou A. Antenatal depressive symptoms and early initiation of breastfeeding in association with exclusive breastfeeding six weeks postpartum: a longitudinal population-based study. BMC Pregnancy Childbirth 2019; 19:49. [PMID: 30696409 PMCID: PMC6352434 DOI: 10.1186/s12884-019-2195-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 01/17/2019] [Indexed: 12/17/2022] Open
Abstract
Background Depressive symptoms negatively impact on breastfeeding duration, whereas early breastfeeding initiation after birth enhances the chances for a longer breastfeeding period. Our aim was to investigate the interplay between depressive symptoms during pregnancy and late initiation of the first breastfeeding session and their effect on exclusive breastfeeding at six weeks postpartum. Methods In a longitudinal study design, web-questionnaires including demographic data, breastfeeding information and the Edinburgh Postnatal Depression Scale (EPDS) were completed by 1217 women at pregnancy weeks 17–20, 32 and/or at six weeks postpartum. A multivariable logistic regression model was fitted to estimate the effect of depressive symptoms during pregnancy and the timing of the first breastfeeding session on exclusive breastfeeding at six weeks postpartum. Results Exclusive breastfeeding at six weeks postpartum was reported by 77% of the women. Depressive symptoms during pregnancy (EPDS> 13); (OR:1.93 [1.28–2.91]) and not accomplishing the first breastfeeding session within two hours after birth (OR: 2.61 [1.80–3.78]), were both associated with not exclusively breastfeeding at six weeks postpartum after adjusting for identified confounders. Τhe combined exposure to depressive symptoms in pregnancy and late breastfeeding initiation was associated with an almost 4-fold increased odds of not exclusive breastfeeding at six weeks postpartum. Conclusions Women reporting depressive symptoms during pregnancy seem to be more vulnerable to the consequences of a postponed first breastfeeding session on exclusive breastfeeding duration. Consequently, women experiencing depressive symptoms may benefit from targeted breastfeeding support during the first hours after birth. Electronic supplementary material The online version of this article (10.1186/s12884-019-2195-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Karin Cato
- Department of Women's and Children's Health, Uppsala University Hospital, 751 85, Uppsala, SE, Sweden.
| | - Sara M Sylvén
- Department of Women's and Children's Health, Uppsala University Hospital, 751 85, Uppsala, SE, Sweden.,Department of Neuroscience, Psychiatry, Uppsala University Hospital, Uppsala, Sweden
| | - Marios K Georgakis
- Department of Women's and Children's Health, Uppsala University Hospital, 751 85, Uppsala, SE, Sweden.,Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - Natasa Kollia
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Christine Rubertsson
- Department of Women's and Children's Health, Uppsala University Hospital, 751 85, Uppsala, SE, Sweden
| | - Alkistis Skalkidou
- Department of Women's and Children's Health, Uppsala University Hospital, 751 85, Uppsala, SE, Sweden
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Kofman YB, Eng ZE, Busse D, Godkin S, Campos B, Sandman CA, Wing D, Yim IS. Cortisol reactivity and depressive symptoms in pregnancy: The moderating role of perceived social support and neuroticism. Biol Psychol 2019; 147:107656. [PMID: 30703466 DOI: 10.1016/j.biopsycho.2019.01.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 01/09/2019] [Accepted: 01/26/2019] [Indexed: 01/17/2023]
Abstract
Perinatal depression negatively impacts mother-infant health and well-being. Previous work has linked cortisol reactivity to perinatal depressive symptoms, but moderating effects including social support and neuroticism, have not been studied. Forty-nine pregnant women (9-30 weeks' gestational age; GA) provided saliva samples in response to the Trier Social Stress Test (TSST) and to awakening (cortisol awakening response, CAR), and completed questionnaires on perceived social support, personality, and depressive symptoms. Two hierarchical logistic regressions, one including the TSST response and one including the CAR as predictor variables, suggest that cortisol reactivity, social support from the baby's father, and neuroticism contribute to depressive symptoms, controlling for GA (both p < .01). Significant statistical interactions among predictors of pregnancy depressive symptoms were, however, only found in the model using the CAR. Findings highlight the importance of considering biopsychosocial interactions in studies predicting perinatal depressive symptoms.
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Affiliation(s)
- Yasmin B Kofman
- Department of Psychological Science, University of California, Irvine, 4562 Social and Behavioral Sciences Gateway, Irvine, CA 92697-7085, USA
| | - Zoe E Eng
- Department of Psychological Science, University of California, Irvine, 4562 Social and Behavioral Sciences Gateway, Irvine, CA 92697-7085, USA
| | - David Busse
- Department of Psychological Science, University of California, Irvine, 4562 Social and Behavioral Sciences Gateway, Irvine, CA 92697-7085, USA
| | - Sophia Godkin
- Department of Psychological Science, University of California, Irvine, 4562 Social and Behavioral Sciences Gateway, Irvine, CA 92697-7085, USA
| | - Belinda Campos
- Department of Chicano and Latino Studies, University of California, Irvine, 3151 Social Science Plaza, Irvine, CA 92697-5100, USA
| | - Curt A Sandman
- Department of Psychiatry and Human Behavior, University of California, Early Human and Lifespan Development Program, 1 University Drive, Orange, CA 92866, USA
| | - Deborah Wing
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of California, Irvine, 333 City Blvd. West, Suite 1400, Orange CA 92868, USA
| | - Ilona S Yim
- Department of Psychological Science, University of California, Irvine, 4562 Social and Behavioral Sciences Gateway, Irvine, CA 92697-7085, USA.
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Neuroticism modulates mood responses to pharmacological sex hormone manipulation in healthy women. Psychoneuroendocrinology 2019; 99:251-256. [PMID: 30390443 DOI: 10.1016/j.psyneuen.2018.10.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/13/2018] [Accepted: 10/18/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Women show increased risk of depressive symptoms during hormonal transition phases. The risk mechanisms may include changes in mood in response to fluctuating ovarian hormones moderated by predisposing risk factors for mood disorders, such as personality trait Neuroticism. METHODS A pooled sample of 92 mentally healthy women (28.3 ± 7.1, mean age ± SD) from two independent cohorts run in our lab, using gonadotropin-releasing hormone agonist (GnRHa) experimentally (n = 28) compared to placebo (n = 27) and as part in vitro fertilization (n = 37), were extracted from the Center for Integrated Molecular Brain Imaging database. All women filled in questionnaires of trait Neuroticism from the NEO personality Inventory-Revised (NEO PI-R) at baseline and self-reported levels of mood disturbances with the Profile of Mood States (POMS) daily during 14 days of GnRHa intervention or placebo. Effects of intervention by trait Neuroticism on serial daily reports of mood disturbances were examined using mixed model analyses. RESULTS Personality trait Neuroticism significantly modulated daily mood responses to GnRHa, but not placebo. Women with high and low scores on trait Neuroticism at baseline experienced more pronounced changes in mood when exposed to GnRHa, whereas women with medium trait Neuroticism scores remained relatively stable. CONCLUSIONS The susceptibility to hormone-triggered mood changes appears to depend upon women's general tendency to experience distress and destabilization of mood, as captured by personality trait Neuroticism. This could aid clinicians evaluate hormone-related vulnerability for mood disorders in women and may guide targeted prevention in reproductive care.
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Axfors C, Hellgren C, Volgsten H, Skoog Svanberg A, Ekselius L, Wikström AK, Ramklint M, Skalkidou A, Sundström-Poromaa I. Neuroticism is associated with higher antenatal care utilization in obstetric low-risk women. Acta Obstet Gynecol Scand 2018; 98:470-478. [PMID: 30457176 DOI: 10.1111/aogs.13506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 11/13/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Elevated neuroticism is associated with higher health care utilization in the general population. This study aimed to investigate the association between neuroticism and the use of publicly financed antenatal care in obstetric low-risk women, taking predisposing and need factors for health care utilization into consideration. MATERIAL AND METHODS Participants comprised 1052 obstetric low-risk women (no chronic diseases or adverse pregnancy conditions) included in several obstetrics/gynecology studies in Uppsala, Sweden. Neuroticism was self-rated on the Swedish universities Scales of Personality. Medical records of their first subsequent pregnancy were scanned for antenatal care use. Associations between antenatal care use and neuroticism were analyzed with logistic regression (binary outcomes) or negative binomial regression (count outcomes) comparing the 75th and 25th neuroticism percentiles. Depending on the Akaike information criterion the exposure was modeled as either linear or with restricted cubic splines. Analyses were adjusted for predisposing (sociodemographic and parity) and need factors (body mass index and psychiatric morbidity). RESULTS After adjustment, women with higher neuroticism had more fetal ultrasounds (incidence rate ratio = 1.09, 95% confidence interval (CI) 1.02-1.16), more emergency visits to an obstetrician/gynecologist (incidence rate ratio = 1.22, 95% CI 1.03-1.45) and were more likely to visit a fear-of-childbirth clinic (odds ratio = 2.71, 95% CI 1.71-4.29). Moreover, they more often consulted midwives in specialized antenatal care facilities (significant J-shaped association). CONCLUSIONS Neuroticism was associated with higher utilization of publicly financed antenatal care in obstetric low-risk women, even after adjusting for predisposing and need factors. Future studies should address the benefits of interventions as a complement to routine antenatal care programs to reduce subclinical anxiety.
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Affiliation(s)
- Cathrine Axfors
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Charlotte Hellgren
- Department for Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Helena Volgsten
- Department for Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - Lisa Ekselius
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Anna-Karin Wikström
- Department for Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Mia Ramklint
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Alkistis Skalkidou
- Department for Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Maleki A, Faghihzadeh S, Niroomand S. The relationship between paternal prenatal depressive symptoms with postnatal depression: The PATH model. Psychiatry Res 2018; 269:102-107. [PMID: 30145288 DOI: 10.1016/j.psychres.2018.08.044] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 06/23/2018] [Accepted: 08/13/2018] [Indexed: 01/28/2023]
Abstract
The purpose of the study was to determine the relationship between men's prenatal and postnatal depressive symptom (PDS). In a descriptive study, 403 fathers meeting the inclusion criteria were enrolled using Poisson random sampling method from public health clinics in Zanjan, Iran. All participants were selected in the third trimester of pregnancy and were followed up eight weeks after childbirth. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen the participants for depressive symptoms. Data was analyzed using descriptive test, Path analysis at a confidence level of 95%. Results showed that the effect of the prenatal depressive symptoms on PDS had perfect good fitness indices. A high level of prenatal depressive symptoms predicted a high level of PDS. We found significant total mediating effects of state, trait, and total anxiety on PDS. The total moderating effect of income on PDS was not statistically significant. These results suggest that a high level of prenatal depressive symptoms is a risk factor for a high level of PDS. Therefore, health providers should pay more attention to the psychological health of fathers during the pre and postpartum period. The predictor factors should be considered in both intervention and clinical assessment of paternal PDS.
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Affiliation(s)
- Azam Maleki
- Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Iran
| | - Soghrat Faghihzadeh
- Biostatistics Department, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Soudabeh Niroomand
- Midwifery Department, School of Nursing & Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran.
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Women with prolonged nausea in pregnancy have increased risk for depressive symptoms postpartum. Sci Rep 2018; 8:15796. [PMID: 30361517 PMCID: PMC6202412 DOI: 10.1038/s41598-018-33197-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 09/19/2018] [Indexed: 01/07/2023] Open
Abstract
The aim of this population-based, longitudinal study was to assess the association between nausea and vomiting in pregnancy (NVP) and perinatal depressive symptoms. Pregnant women (N = 4239) undergoing routine ultrasound at gestational week (GW) 17 self-reported on NVP and were divided into those without nausea (G0), early (≤17 GW) nausea without medication (G1), early nausea with medication (G2), and prolonged (>17 GW) nausea (G3). The Edinburgh Postnatal Depression Scale at GW 17 and 32 (cut-off ≥13) and at six weeks postpartum (cut-off ≥12) was used to assess depressive symptoms. Main outcome measures were depressive symptoms at GW 32 and at six weeks postpartum. NVP was experienced by 80.7%. The unadjusted logistic regression showed a positive association between all three nausea groups and depressive symptoms at all time-points. After adjustment, significant associations with postpartum depressive symptoms remained for G3, compared to G0 (aOR = 1.66; 95% CI 1.1–2.52). After excluding women with history of depression, only the G3 group was at higher odds for postpartum depressive symptoms (aOR = 2.26; 95% CI 1.04–4.92). In conclusion, women with prolonged nausea have increased risk of depressive symptoms at six weeks postpartum, regardless of history of depression.
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Bränn E, Fransson E, White RA, Papadopoulos FC, Edvinsson Å, Kamali-Moghaddam M, Cunningham JL, Sundström-Poromaa I, Skalkidou A. Inflammatory markers in women with postpartum depressive symptoms. J Neurosci Res 2018; 98:1309-1321. [PMID: 30252150 DOI: 10.1002/jnr.24312] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/18/2018] [Accepted: 07/19/2018] [Indexed: 12/30/2022]
Abstract
Postpartum depression (PPD) is a devastating disorder affecting not only more than 10% of all women giving birth, but also the baby, the family, and the society. Compiling evidence suggests the involvement of the immune system in the pathophysiology of major depression; yet, the immune response in perinatal depression is not as well studied. The aim of this study was to investigate the alterations in peripheral levels of inflammatory biomarkers in 169 Swedish women with and without depressive symptoms according to the Edinburgh postnatal depression scale or the M.I.N.I neuropsychiatric interview at eight weeks postpartum. Among the 70 markers analyzed with multiplex proximity extension assay, five were significantly elevated in women with postpartum depressive symptoms in the adjusted LASSO logistic regression analysis: Tumor necrosis factor ligand superfamily member (TRANCE) (OR-per 1 SD increase = 1.20), Hepatocyte growth factor (HGF) (OR = 1.17) Interleukin (IL)-18 (OR = 1.06), Fibroblast growth factor 23 (FGF-23) (OR = 1.25), and C-X-C motif chemokine 1 (CXCL1) (OR 1.11). These results indicate that women with PPD have elevated levels of some inflammatory biomarkers. It is, therefore, plausible that PPD is associated with a compromised adaptability of the immune system.
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Affiliation(s)
- Emma Bränn
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Emma Fransson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Åsa Edvinsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Masood Kamali-Moghaddam
- Department of Immunology, Genetics & Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Janet L Cunningham
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | | | - Alkistis Skalkidou
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Skjothaug T, Smith L, Wentzel-Larsen T, Moe V. DOES FATHERS' PRENATAL MENTAL HEALTH BEAR A RELATIONSHIP TO PARENTING STRESS AT 6 MONTHS? Infant Ment Health J 2018; 39:537-551. [PMID: 30091797 DOI: 10.1002/imhj.21739] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This study aimed to explore fathers' mental health and retrospectively reported adverse childhood experiences during pregnancy, as well as various pathways predicting self-reported stress at 6 months' postpartum as assessed by the Parenting Stress Index (PSI; R.R. Abidin, ). A total of 835 fathers contributed data to the study. Data collection comprised five time points during pregnancy and one at 6 months' postpartum. The main analyses were performed using linear regression and path analyses. First, linear regression analyses showed that paternal anxiety symptoms during pregnancy predicted stress scores in the PSI child domain at 6 months (coefficient = 0.36). Second, path analyses showed that depressive symptoms during pregnancy predicted parenting stress in the child domain, mediated by spousal disharmony at 6 months' postpartum (coefficient = 0.77). Third, adverse childhood experiences scores predicted parenting stress in the child domain by two different pathways: one mediated by anxiety symptoms in pregnancy (coefficient = 0.29) and the other by depressive symptoms in pregnancy and experienced spousal disharmony at 6 months' postpartum (coefficient = 0.77). The findings suggest that fathers' symptoms of anxiety and depression during pregnancy as well as adverse childhood experiences predict paternal stress and a negative perception of their children's behavior at 6 months' postpartum.
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Orbach-Zinger S, Landau R, Harousch AB, Ovad O, Caspi L, Kornilov E, Ioscovich A, Bracco D, Davis A, Fireman S, Hoshen M, Eidelman LA. The Relationship Between Women’s Intention to Request a Labor Epidural Analgesia, Actually Delivering With Labor Epidural Analgesia, and Postpartum Depression at 6 Weeks. Anesth Analg 2018; 126:1590-1597. [DOI: 10.1213/ane.0000000000002501] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Fagerberg T, Söderman E, Petter Gustavsson J, Agartz I, Jönsson EG. Stability of personality traits over a five-year period in Swedish patients with schizophrenia spectrum disorder and non-psychotic individuals: a study using the Swedish universities scales of personality. BMC Psychiatry 2018; 18:54. [PMID: 29486736 PMCID: PMC6389041 DOI: 10.1186/s12888-018-1617-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 01/24/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Personality is considered as an important aspect in persons with psychotic disorders. Several studies have investigated personality in schizophrenia. However, no study has investigated stability of personality traits exceeding three years in patients with schizophrenia. This study aims to investigate the stability of personality traits over a five-year period among patients with schizophrenia and non-psychotic individuals and to evaluate case-control differences. METHODS Patients with psychotic disorders (n = 36) and non-psychotic individuals (n = 76) completed Swedish universities Scales of Personality (SSP) at two occasions five years apart. SSP scores were analysed for effect of time and case-control differences by multiple analysis of covariance (MANCOVA) and within-subjects correlation. RESULTS MANCOVA within-subjects analysis did not show any effect of time. Thus, SSP mean scale scores did not significantly vary during the five-year interval. Within subject correlations (Spearman) ranged 0.30-0.68 and 0.54-0.75 for the different SSP scales in patients and controls, respectively. Patients scored higher than controls in SSP scales Somatic Trait Anxiety, Psychic Trait Anxiety, Stress Susceptibility, Lack of Assertiveness, Detachment, Embitterment, and Mistrust. CONCLUSION The stability of the SSP personality trait was reasonably high among patients with psychotic disorder, although lower than among non-psychotic individuals, which is in accordance with previous research.
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Affiliation(s)
- Tomas Fagerberg
- Human Brain Informatics (HUBIN), Department of Clinical Neuroscience, Centre for Psychiatric Research, Psychiatry Section, Karolinska Institutet and Hospital, Stockholm, Sweden
| | - Erik Söderman
- Human Brain Informatics (HUBIN), Department of Clinical Neuroscience, Centre for Psychiatric Research, Psychiatry Section, Karolinska Institutet and Hospital, Stockholm, Sweden
| | - J. Petter Gustavsson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ingrid Agartz
- Human Brain Informatics (HUBIN), Department of Clinical Neuroscience, Centre for Psychiatric Research, Psychiatry Section, Karolinska Institutet and Hospital, Stockholm, Sweden
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine. Psychiatry section, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Erik G. Jönsson
- Human Brain Informatics (HUBIN), Department of Clinical Neuroscience, Centre for Psychiatric Research, Psychiatry Section, Karolinska Institutet and Hospital, Stockholm, Sweden
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine. Psychiatry section, University of Oslo, Oslo, Norway
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Eckerdal P, Georgakis MK, Kollia N, Wikström AK, Högberg U, Skalkidou A. Delineating the association between mode of delivery and postpartum depression symptoms: a longitudinal study. Acta Obstet Gynecol Scand 2018; 97:301-311. [DOI: 10.1111/aogs.13275] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 11/22/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Patricia Eckerdal
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | - Marios K. Georgakis
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
- Department of Hygiene, Epidemiology and Medical Statistics; School of Medicine; National and Kapodistrian University of Athens; Athens Greece
| | - Natasa Kollia
- Department of Nutrition and Dietetics; School of Health Science and Education; Harokopio University; Athens Greece
| | - Anna-Karin Wikström
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | - Ulf Högberg
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | - Alkistis Skalkidou
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
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Denis A, Luminet O. Cognitive factors and post-partum depression: What is the influence of general personality traits, rumination, maternal self-esteem, and alexithymia? Clin Psychol Psychother 2017; 25:359-367. [PMID: 29282785 DOI: 10.1002/cpp.2168] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 11/22/2017] [Accepted: 11/24/2017] [Indexed: 11/10/2022]
Abstract
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 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). RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- Anne Denis
- Université Grenoble Alpes, University Savoie Mont Blanc, LIP/PC2S, 38000, Grenoble, France
| | - Olivier Luminet
- Psychological Sciences Research Institute and Belgian Fund for Scientific Research (FRS-FNRS), Catholic University of Louvain, Louvain-la-Neuve, Belgium
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Axfors C, Sylvén S, Ramklint M, Skalkidou A. Adult attachment's unique contribution in the prediction of postpartum depressive symptoms, beyond personality traits. J Affect Disord 2017; 222:177-184. [PMID: 28709025 DOI: 10.1016/j.jad.2017.07.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Revised: 06/22/2017] [Accepted: 07/05/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Personality traits such as neuroticism can help identify pregnant women at risk of postpartum depressive symptoms (PPDS). However, it is unclear whether attachment style could have an additional contribution to this risk elevation. This study aimed to examine the overlap of adult attachment insecurity and neuroticism/trait anxiety as PPDS predictors, taking into account baseline depressive symptoms. METHODS A Swedish population-based sample of pregnant women reported on adult attachment and either neuroticism (n = 1063) or trait anxiety (n = 555). Depressive symptoms were assessed at baseline, and at six weeks and six months postpartum. Correlations between attachment and neuroticism/trait anxiety were calculated. Generalized linear models of PPDS tested the effect of attachment anxiety and avoidance, adjusting for neuroticism/trait anxiety and baseline depression. Logistic regression models with combined high attachment anxiety and neuroticism/trait anxiety visualized their value as risk factors beyond antenatal depression. RESULTS Attachment and neuroticism/trait anxiety were highly correlated (r = .55-.77). Attachment anxiety exerted a partially independent effect on PPDS at six weeks (p < .05) and at six months (p < .05) adjusting for neuroticism. Among antenatally non-depressed, combined high attachment anxiety and high neuroticism or trait anxiety was predictive of PPDS at both assessment points. LIMITATIONS Low acceptance rate, exclusive use of self-reports. CONCLUSIONS Beyond personality, attachment anxiety had a small independent effect on the risk of PPDS. Combining items of adult attachment and neuroticism/trait anxiety could prove useful in antenatal screening for high risk of PPDS.
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Affiliation(s)
- Cathrine Axfors
- Uppsala University, Department of Neuroscience, Psychiatry, Sweden.
| | - Sara Sylvén
- Uppsala University, Department of Neuroscience, Psychiatry, Sweden
| | - Mia Ramklint
- Uppsala University, Department of Neuroscience, Psychiatry, Sweden
| | - Alkistis Skalkidou
- Uppsala University, Department for Women's and Children's Health, Sweden
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Abstract
The study of perinatal mental health (mental health during pregnancy and postpartum) is a complex field of study that is of major importance both for the mental and physical health of new mothers and for the neurobehavioral development and long-term functioning of the children they bear. In this review, we cover the most recent additions to this rapidly evolving field. Notable advances include further illumination of the epidemiological patterns and clinical manifestations of perinatal mood disruption; new efficacy data on treatment and prevention; clarifications of the respective contributions of maternal mental illness and psychotropic medication to outcomes of pregnancy, birth, and child development; and updated expert guidelines for screening.
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Affiliation(s)
- Thalia Robakis
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Eugenia Jernick
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Katherine Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
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Axfors C, Sylvén S, Skalkidou A, Ramklint M. Psychometric properties of the attachment style questionnaire in Swedish pregnant women: short and full versions. J Reprod Infant Psychol 2017. [PMID: 29517387 DOI: 10.1080/02646838.2017.1342786] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES (i) To evaluate the reliability and factor structure of the Attachment Style Questionnaire - Short Form (ASQ-SF) for use in pregnant women and (ii) to compare the reliability and factor structure of the short- and full version-ASQ among pregnant women. BACKGROUND Adult attachment insecurity is currently included as a major risk factor in studies of perinatal health. None of the self-report measures with a Swedish translation have been psychometrically evaluated in a pregnant cohort. METHODS A population-based cohort of 1631 pregnant women answered the ASQ in late pregnancy. Internal consistency (item-subscale correlations, Cronbach's α, and α if item deleted) was evaluated for the seven available subscales. Confirmatory factor analysis (CFA) was run to examine the factor structure of the short form compared with the full-version. Test-retest correlations were assessed in a subgroup (n = 48). RESULTS All mean item-subscale correlations for the ASQ-SF were > 0.30. Cronbach's α's for ASQ-SF dimensions were as follows: Avoidance (0.87); Anxiety (0.89); Discomfort with Closeness (0.85); Relationships as Secondary (0.54); Confidence (0.83); Need for Approval (0.76); and Preoccupation with Relationships (0.77). No item removal substantively increased subscale α's. The CFA demonstrated better model fit for the ASQ-SF than for the full-version ASQ, while other reliability measures were similar. Test-retest correlations ranged from 0.65 to 0.84. CONCLUSION The ASQ-SF showed similar psychometric properties in pregnant women as in the general population and had good reliability, but the optimal factor structure needs to be studied further. Results support the usage of the ASQ-SF in pregnant cohorts.
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Affiliation(s)
- Cathrine Axfors
- a Department of Neuroscience, Psychiatry , Uppsala University , Uppsala , Sweden
| | - Sara Sylvén
- a Department of Neuroscience, Psychiatry , Uppsala University , Uppsala , Sweden
| | - Alkistis Skalkidou
- b Department for Women's and Children's Health , Uppsala University , Uppsala , Sweden
| | - Mia Ramklint
- a Department of Neuroscience, Psychiatry , Uppsala University , Uppsala , Sweden
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Bränn E, Papadopoulos F, Fransson E, White R, Edvinsson Å, Hellgren C, Kamali-Moghaddam M, Boström A, Schiöth HB, Sundström-Poromaa I, Skalkidou A. Inflammatory markers in late pregnancy in association with postpartum depression-A nested case-control study. Psychoneuroendocrinology 2017; 79:146-159. [PMID: 28285186 DOI: 10.1016/j.psyneuen.2017.02.029] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 02/22/2017] [Accepted: 02/27/2017] [Indexed: 01/21/2023]
Abstract
Recent studies indicate that the immune system adaptation during pregnancy could play a significant role in the pathophysiology of perinatal depression. The aim of this study was to investigate if inflammation markers in a late pregnancy plasma sample can predict the presence of depressive symptoms at eight weeks postpartum. Blood samples from 291 pregnant women (median and IQR for days to delivery, 13 and 7-23days respectively) comprising 63 individuals with postpartum depressive symptoms, as assessed by the Edinburgh postnatal depression scale (EPDS≥12) and/or the Mini International Neuropsychiatric Interview (M.I.N.I.) and 228 controls were analyzed with an inflammation protein panel using multiplex proximity extension assay technology, comprising of 92 inflammation-associated markers. A summary inflammation variable was also calculated. Logistic regression, LASSO and Elastic net analyses were implemented. Forty markers were lower in late pregnancy among women with depressive symptoms postpartum. The difference remained statistically significant for STAM-BP (or otherwise AMSH), AXIN-1, ADA, ST1A1 and IL-10, after Bonferroni correction. The summary inflammation variable was ranked as the second best variable, following personal history of depression, in predicting depressive symptoms postpartum. The protein-level findings for STAM-BP and ST1A1 were validated in relation to methylation status of loci in the respective genes in a different population, using openly available data. This explorative approach revealed differences in late pregnancy levels of inflammation markers between women presenting with depressive symptoms postpartum and controls, previously not described in the literature. Despite the fact that the results do not support the use of a single inflammation marker in late pregnancy for assessing risk of postpartum depression, the use of STAM-BP or the novel notion of a summary inflammation variable developed in this work might be used in combination with other biological markers in the future.
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Affiliation(s)
- Emma Bränn
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - Emma Fransson
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | | | - Åsa Edvinsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Charlotte Hellgren
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Masood Kamali-Moghaddam
- Department of Immunology, Genetics & Pathology, Science for Life Laboratory, Uppsala University, Sweden
| | - Adrian Boström
- Department of Neuroscience, Functional Pharmacology, Uppsala University, Sweden
| | - Helgi B Schiöth
- Department of Neuroscience, Functional Pharmacology, Uppsala University, Sweden
| | | | - Alkistis Skalkidou
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
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Chang CC, Chang HA, Fang WH, Chang TC, Huang SY. Gender-specific association between serotonin transporter polymorphisms (5-HTTLPR and rs25531) and neuroticism, anxiety and depression in well-defined healthy Han Chinese. J Affect Disord 2017; 207:422-428. [PMID: 27788383 DOI: 10.1016/j.jad.2016.08.055] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 07/17/2016] [Accepted: 08/23/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND A tri-allelic serotonin transporter promoter polymorphism (5-HTTLPR/rs25531) more effectively determines the levels of transcriptional efficacy than that with the bi-allelic 5-HTTLPR polymorphism in vitro. Both are reportedly associated with personality traits of negative emotionality, but with conflicting findings. One explanation for this is that a gender difference may play a role in genetic contribution. Here, we hypothesized that the tri-allelic genotype of the serotonin transporter is more closely linked to neuroticism, an anxiety- and depression-related trait, than the bi-allelic variation, particularly in a gender-dependent way. METHODS The genotypes of the 5-HTTLPR and rs25531 loci were determined in 1139 well-defined physically and mentally healthy Han Chinese (550 men, 589 women; mean age 38.3±10.3 years). All participants completed the neuroticism measure of the short-form Maudsley Personality Inventory (MPI). The levels of anxiety and depression were assessed by the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI), respectively. RESULTS A significant tri-allelic genotype-by-gender interaction effect was found in the MPI-neuroticism measure. S'S' homozygotes were associated with higher neuroticism than L' allele carriers in men. Also, both the BAI and BDI scores were higher in the S'S' homozygotic men. In the bi-allelic analyses, however, there was only an association between SS genotype and MPI-neuroticism in men. LIMITATIONS Sub-analyses by gender-stratification may reduce the statistical power. CONCLUSIONS Our findings confirm that gender differences exist in the genetic contributions of the serotonin transporter in human neuroticism, and anxiety/depression. Our data provide further support for rs25531, strengthening the effects of 5-HTTLPR.
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Affiliation(s)
- Chuan-Chia Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Wen-Hui Fang
- Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Tieh-Ching Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - San-Yuan Huang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan.
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Associations between a polymorphism in the hydroxysteroid (11-beta) dehydrogenase 1 gene, neuroticism and postpartum depression. J Affect Disord 2017; 207:141-147. [PMID: 27721188 DOI: 10.1016/j.jad.2016.09.030] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 09/15/2016] [Accepted: 09/24/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND 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. METHODS 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. RESULTS 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. LIMITATIONS The use of the EPDS, which is a self-reporting instrument. CONCLUSIONS 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.
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