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Vanwetswinkel F, Bruffaerts R, Arif U, Hompes T. The longitudinal course of depressive symptoms during the perinatal period: A systematic review. J Affect Disord 2022; 315:213-223. [PMID: 35803394 DOI: 10.1016/j.jad.2022.06.087] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 06/22/2022] [Accepted: 06/27/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Perinatal Depression (PND) is one of the most common complications (10-20 %) during the perinatal period and its clinical course and phenotypes are still an area of research. It is becoming increasingly clear that pregnant women and mothers with depression are not a homogeneous clinical group. METHODS A systematic literature search in 4 databases revealed 359 studies, 33 relevant studies met the inclusion criteria. We only included studies with at least three assessment points in total. RESULTS Two to six trajectory classes were identified. A three trajectories solution was most observed. All the included studies reported a low symptom trajectory but ranged from 6.5 % to 92 %. The high-symptom group was in most of the studies the smallest subgroup (1.1 % - 14.6 %). Most of the studies described episodic trajectories of depressive symptoms during the peripartum. The most common risk factor associated with a high-symptom trajectory of depressive symptoms in our study was a history of depression. Important socio-demographic predictors were: young age, ethnicity, low maternal education, low income, single relationship status or relationship problems, unplanned or unintended pregnancy and experiencing high stress levels. LIMITATIONS The methodology and the observed PND trajectories of the included studies differed, which makes generalizability difficult in this review. CONCLUSIONS PND is a frequent but heterogeneous disorder. Globally, four major groups could be distinguished: low, medium, high and episodic trajectories. There is a need for consensus regarding which assessment instruments to use, validated cutoff scores and similar time points of assessment.
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Affiliation(s)
- Femke Vanwetswinkel
- Adult Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium; Department of Neurosciences, Faculty of Medicine, Research Group Psychiatry, University of Leuven, Leuven, Belgium.
| | - Ronny Bruffaerts
- Adult Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium; Department of Neurosciences, Faculty of Medicine, Research Group Psychiatry, University of Leuven, Leuven, Belgium
| | - Umesa Arif
- Biomedical Sciences, Faculty of Medicine, University of Leuven, Leuven, Belgium
| | - Titia Hompes
- Adult Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium; Department of Neurosciences, Faculty of Medicine, Research Group Psychiatry, University of Leuven, Leuven, Belgium
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Tharwat D, Trousselard M, Fromage D, Belrose C, Balès M, Sutter-Dallay AL, Ezto ML, Hurstel F, Harvey T, Martin S, Vigier C, Spitz E, Duffaud AM. Acceptance Mindfulness-Trait as a Protective Factor for Post-Natal Depression: A Preliminary Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1545. [PMID: 35162565 PMCID: PMC8834924 DOI: 10.3390/ijerph19031545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 02/06/2023]
Abstract
(1) Background: the prevalence of postnatal depression (PND) reaches up to 20%. PND could be based on the interaction between a psychological vulnerability and chronic stress that pregnancy would activate. Vulnerability factors reflect a psychological profile mirroring mindfulness-trait (MT). A high level of MT is associated with an efficient regulation of both physiological and psychological stress, especially negative moods. Interestingly, mindfulness level can be improved by program based on mindfulness meditation. We hypothesize that MT is a protective factor for PND. We also postulate that negative moods increase during the pregnancy for women who develop a PND after delivery (2) Methods: we conducted a multicentric prospective longitudinal study including 85 women during their first trimester of their pregnancy and 72 from the childbirth to the baby's first birthday". At the inclusion, presence and acceptance of MT and various variables of personality and of psychological functioning were assessed. Mood evolution was monitored each month during the pregnancy and a delivery trauma risk was evaluated after delivery. PND detection was carried out at 48 h, 2, 6 and 12 months after the delivery with the Edinburgh Postnatal Depression Scale with a screening cut-off >11. (3) Results: high-acceptance MT is a protective factor for PND (OR: 0.79). Women without PND displayed less negative mood during pregnancy (p < 0.05 for Anxiety, Confusion and Anger). (4) Conclusions: these results suggest the value of deploying programs to enhance the level of mindfulness, especially in its acceptance dimension, before, during and after pregnancy, to reduce the risk of PND.
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Affiliation(s)
- Dahlia Tharwat
- Groupe Hospitalier Diaconesses Croix Saint Simon, 75012 Paris, France; (D.T.); (T.H.)
- Unit of Stress Neurophysiology, French Armed Forces Biomedical Research Institute, BP73, 91223 Brétigny-sur-Orge, France; (M.T.); (C.B.); (C.V.)
- APEMAC/EPSAM, Université de Lorraine, UR 4360, Ile du Saulcy, BP 30309, CEDEX 1, 57006 Metz, France;
| | - Marion Trousselard
- Unit of Stress Neurophysiology, French Armed Forces Biomedical Research Institute, BP73, 91223 Brétigny-sur-Orge, France; (M.T.); (C.B.); (C.V.)
- Réseau ABC des Psychotraumas, CEDEX 5, 34093 Montpellier, France
- French Military Health Service Academy, 1 Place Alphonse Laveran, CEDEX 05, 75230 Paris, France; (D.F.); (S.M.)
| | - Dominique Fromage
- French Military Health Service Academy, 1 Place Alphonse Laveran, CEDEX 05, 75230 Paris, France; (D.F.); (S.M.)
| | - Célia Belrose
- Unit of Stress Neurophysiology, French Armed Forces Biomedical Research Institute, BP73, 91223 Brétigny-sur-Orge, France; (M.T.); (C.B.); (C.V.)
- Réseau ABC des Psychotraumas, CEDEX 5, 34093 Montpellier, France
| | - Mélanie Balès
- Périnatal Psychiatry Network, University Department of Child Psychaitry, CH Charles Perrens, 33076 Bordeaux, France; (M.B.); (A.-L.S.-D.)
| | - Anne-Laure Sutter-Dallay
- Périnatal Psychiatry Network, University Department of Child Psychaitry, CH Charles Perrens, 33076 Bordeaux, France; (M.B.); (A.-L.S.-D.)
- BPHRC, Inserm 1219, Bordeaux University, 33000 Bordeaux, France
| | | | - Françoise Hurstel
- Protection Maternelle et Infantile du Department de la Moselle, 57000 Metz, France;
| | - Thierry Harvey
- Groupe Hospitalier Diaconesses Croix Saint Simon, 75012 Paris, France; (D.T.); (T.H.)
| | - Solenne Martin
- French Military Health Service Academy, 1 Place Alphonse Laveran, CEDEX 05, 75230 Paris, France; (D.F.); (S.M.)
| | - Cécile Vigier
- Unit of Stress Neurophysiology, French Armed Forces Biomedical Research Institute, BP73, 91223 Brétigny-sur-Orge, France; (M.T.); (C.B.); (C.V.)
| | - Elisabeth Spitz
- APEMAC/EPSAM, Université de Lorraine, UR 4360, Ile du Saulcy, BP 30309, CEDEX 1, 57006 Metz, France;
| | - Anaïs M. Duffaud
- Unit of Stress Neurophysiology, French Armed Forces Biomedical Research Institute, BP73, 91223 Brétigny-sur-Orge, France; (M.T.); (C.B.); (C.V.)
- Réseau ABC des Psychotraumas, CEDEX 5, 34093 Montpellier, France
- French Military Health Service Academy, 1 Place Alphonse Laveran, CEDEX 05, 75230 Paris, France; (D.F.); (S.M.)
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Morreale M, Holingue C, Samuels J, Nestadt G. Long-term physical health outcomes of obsessive-compulsive personality disorder traits. J Clin Psychol 2021; 77:2626-2637. [PMID: 34224579 DOI: 10.1002/jclp.23207] [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: 10/23/2020] [Revised: 04/24/2021] [Accepted: 05/30/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Obsessive-compulsive personality disorder (OCPD) is characterized by pervasive and persistent traits including preoccupation with orderliness, perfectionism, and control. Relatively little is known about the potential relationship between OCPD traits and physical health. METHODS We investigated the association between OCPD traits and several self-reported medical conditions in 249 individuals followed prospectively from 1981 until 2004/2005 as part of the Epidemiological Catchment Area. RESULTS The OCPD trait score was inversely related to hypertension in males, in models unadjusted (OR = 0.66; 95% CI, 0.45-0.90) and adjusted (OR = 0.70; 95% CI, 0.47-0.95) for sociodemographic variables. Perfectionism was inversely related to hypertension in the unadjusted models for men (OR = 0.34; 95% CI, 0.12-0.89). Indecisiveness was positively associated with heart conditions in adjusted models for women (OR = 3.46; 95% CI, 1.11-10.52). CONCLUSION OCPD traits are associated with cardiovascular health in both sexes. Further studies are needed to understand the specificity of these relationships, as well as to determine the underlying mechanism.
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Affiliation(s)
- Michael Morreale
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Calliope Holingue
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jack Samuels
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Gerald Nestadt
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Stephanie K, Brigitte R. Various mentalizing concepts in mothers with postpartum depression, comorbid anxiety, and personality disorders. Infant Ment Health J 2021; 42:488-501. [PMID: 33759190 DOI: 10.1002/imhj.21914] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Mentalization is defined as the human capacity to reflect upon one's own or others' behaviors in terms of underlying mental states and intentions. Several concepts of mentalizing exist, which differ in content, assessment, and clinical prediction. AIMS The present study examines the relationship between the three main concepts of mentalizing, namely, reflective functioning (RF), parental reflective functioning (PRF), and Mind-Mindedness (MM), in mothers with postpartum depression. It was hypothesized that mentalizing concepts differ in their convergent and divergent variance, as well as their clinical validity regarding comorbid anxiety and personality disorders (PDs). METHOD Fifty clinically referred mothers with postpartum depression and infants aged 3-10 months were examined by means of the Reflective Functioning Scale, Parental Reflective Functioning Questionnaire, and Mind-Mindedness Coding-System. RESULTS No significant associations were found between RF and PRF, or between PRF and MM; higher RF was associated with more MM-nonattuned mind-related comments. Increased depression and anxiety were linked to lower PRF in terms of higher PRF-prementalizing. Lower RF, but not PRF, was associated with comorbid PDs. Specifically, obsessive-compulsive PD was associated to considerably fewer MM-nonattuned mind-related comments. CONCLUSION Distinct concepts of mentalizing represent divergent competencies, differentially linked to maternal postpartum psychopathology.
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Affiliation(s)
- Krink Stephanie
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Institute of Psychology, University of Münster, Muenster, Germany
| | - Ramsauer Brigitte
- Faculty of medicine, MSH Medical School Hamburg - University of Applied Sciences and Medical University, Hamburg, Germany
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Meems M, Hulsbosch L, Riem M, Meyers C, Pronk T, Broeren M, Nabbe K, Oei G, Bogaerts S, Pop V. The Brabant study: design of a large prospective perinatal cohort study among pregnant women investigating obstetric outcome from a biopsychosocial perspective. BMJ Open 2020; 10:e038891. [PMID: 33109659 PMCID: PMC7592269 DOI: 10.1136/bmjopen-2020-038891] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Pregnancy is characterised by many biological and psychosocial changes. Adequate maternal thyroid function is important for the developing fetus throughout gestation. Latent class analyses recently showed three different patterns of change in thyroid function throughout pregnancy with different associations with obstetric outcome. Maternal distress during the pregnancy (anxiety and depression) negatively affects obstetric outcome. Pregnancy distress in turn may be affected by personality traits and attachment styles. Moreover, during the pregnancy, substantial social changes occur in the partner relationship and work experience. The aim of the Brabant study is to investigate the association between thyroid function trajectories and obstetric outcomes. Moreover, within the Brabant study, we will investigate how different trajectories of pregnancy distress are related to obstetric outcome, and the role of personality in this association. We will evaluate the possible role of maternal distress and attachment style on maternal-fetal bonding. Finally, we will study social changes in the perinatal period regarding partner relationship and well-being and performance at work. METHODS AND ANALYSIS The Brabant study is a longitudinal, prospective cohort study of an anticipated 4000 pregnant women. Women will be recruited at 8-10 weeks gestation among community midwife practices in South-East Brabant in the Netherlands. Thyroid function parameters (TSH and fT4), thyroid peroxidase antibody and human chorionic gonadotrophin will be assessed at 12, 20 and 28 weeks gestation. Moreover, at these three time points women will fill out questionnaires assessing demographic and obstetric features, life style habits and psychological and social variables, such as depressive symptoms, personality, partner relationship quality and burnout. Data from the obstetric records will also be collected. ETHICS AND DISSEMINATION The study has been approved by the Medical Ethical Committee of the Máxima Medical Center Veldhoven. Results will be submitted to peer-reviewed journals in the relevant fields and presented on national and international conferences.
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Affiliation(s)
- Margreet Meems
- CoRPS - Center of Research on Psychological and Somatic disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Lianne Hulsbosch
- CoRPS - Center of Research on Psychological and Somatic disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Madelon Riem
- CoRPS - Center of Research on Psychological and Somatic disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Christina Meyers
- Department of Human Resource Studies, Tilburg University, Tilburg, The Netherlands
| | - Tila Pronk
- Department of Social Psychology, Tilburg University, Tilburg, The Netherlands
| | - Maarten Broeren
- Laboratory of Clinical Chemistry and Hematology, Maxima Medical Center, Veldhoven, The Netherlands
| | - Karin Nabbe
- Clinical Laboratory, Diagnostiek voor U, Eindhoven, The Netherlands
| | - Guid Oei
- Department of Obstetrics and Gynecology, Maxima Medical Center, Eindhoven, The Netherlands
| | - Stefan Bogaerts
- Department of Developmental Psychology, Tilburg University, Tilburg, The Netherlands
| | - Victor Pop
- CoRPS - Center of Research on Psychological and Somatic disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
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