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Mayerhofer L, Nes RB, Yu B, Ayorech Z, Lan X, Ystrom E, Røysamb E. Stability and change in maternal wellbeing and illbeing from pregnancy to three years postpartum. Qual Life Res 2024:10.1007/s11136-024-03730-z. [PMID: 38992240 DOI: 10.1007/s11136-024-03730-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2024] [Indexed: 07/13/2024]
Abstract
PURPOSE Motherhood affects women's mental health, encompassing aspects of both wellbeing and illbeing. This study investigated stability and change in wellbeing (i.e., relationship satisfaction and positive affect) and illbeing (i.e., depressive and anxiety symptoms) from pregnancy to three years postpartum. We further investigated the mutual and dynamic relations between these constructs over time and the role of genetic propensities in their time-invariant stability. DATA AND METHODS This four-wave longitudinal study included 83,124 women from the Norwegian Mother, Father, and Child Cohort Study (MoBa) linked to the Medical Birth Registry of Norway. Data were collected during pregnancy (30 weeks) and at 6, 18 and 36 months postpartum. Wellbeing and illbeing were based on the Relationship Satisfaction Scale, the Differential Emotions Scale and Hopkins Symptoms Checklist-8. Genetics were measured by the wellbeing spectrum polygenic index. Analyses were based on random intercept cross-lagged panel models using R. RESULTS All four outcomes showed high stability and were mutually interconnected over time, with abundant cross-lagged predictions. The period of greatest instability was from pregnancy to 6 months postpartum, followed by increasing stability. Prenatal relationship satisfaction played a crucial role in maternal mental health postpartum. Women's genetic propensity to wellbeing contributed to time-invariant stability of all four constructs. CONCLUSION Understanding the mutual relationship between different aspects of wellbeing and illbeing allows for identifying potential targets for health promotion interventions. Time-invariant stability was partially explained by genetics. Maternal wellbeing and illbeing develop in an interdependent way from pregnancy to 36 months postpartum.
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Affiliation(s)
| | - Ragnhild Bang Nes
- PROMENTA Research Center, Oslo University, Oslo, Norway
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Philosophy, Classics, and History of Arts and Ideas, University of Oslo, Oslo, Norway
| | - Baeksan Yu
- Gwangju National University of Education, Gwangju, South Korea
| | - Ziada Ayorech
- PROMENTA Research Center, Oslo University, Oslo, Norway
| | - Xiaoyu Lan
- PROMENTA Research Center, Oslo University, Oslo, Norway
| | - Eivind Ystrom
- PROMENTA Research Center, Oslo University, Oslo, Norway
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- PsychGen Centre for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Espen Røysamb
- PROMENTA Research Center, Oslo University, Oslo, Norway
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
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Korja R, Nolvi S, Scheinin NM, Tervahartiala K, Carter A, Karlsson H, Kataja EL, Karlsson L. Trajectories of maternal depressive and anxiety symptoms and child's socio-emotional outcome during early childhood. J Affect Disord 2024; 349:625-634. [PMID: 38184113 DOI: 10.1016/j.jad.2023.12.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 12/08/2023] [Accepted: 12/27/2023] [Indexed: 01/08/2024]
Abstract
Maternal symptoms of depression and anxiety during pregnancy and early postnatal years are suggested to impose differential negative effects on child's socio-emotional development depending on the characteristics of the symptoms, such as timing, intensity, and persistence. The aim of this study was to identify trajectories of maternal depressive and anxiety symptoms from pregnancy until 2 years postpartum and to examine their relationship with child socio-emotional problems and competence at 2 and 5 years of age. The sample included 1208 mother-infant dyads from FinnBrain Birth Cohort study. Latent growth mixture modelling (LGMM) was utilized to model the trajectories of maternal depressive symptoms, measured using the Edinburgh Postnatal Depression Scale (EPDS), and general anxiety, measured with Symptom Checklist-90 (SCL-90) at 14, 24, and 34 weeks' gestation (gw) and at 3, 6 and 24 months postpartum. Maternal depression was also assessed at 12 months. Child socio-emotional problems and competence were evaluated using the Brief Infant Toddler Social Emotional Assessment (BITSEA) at 2 years and Strengths and Difficulties Questionnaire (SDQ) at 5 years. Relevant background factors and maternal concurrent symptomatology were controlled for. The trajectories of maternal depressive and anxiety symptoms were associated negatively with differential aspects of child long term socio-emotional outcomes from early toddlerhood to preschool years. The trajectories of depressive symptoms and high-level persistent symptoms that continued from pregnancy to two years of child age had the strongest negative association with child outcomes. This highlights the importance of identifying and treating maternal symptomatology, especially that of depression, as early as possible.
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Affiliation(s)
- Riikka Korja
- University of Turku, Department of Psychology and Speech-Language Pathology, Turku, Finland; University of Turku, Department of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland; The Centre of Excellence for Learning Dynamics and Intervention Research (InterLearn), University of Turku, Turku, Finland.
| | - Saara Nolvi
- University of Turku, Department of Psychology and Speech-Language Pathology, Turku, Finland; University of Turku, Department of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland; The Centre of Excellence for Learning Dynamics and Intervention Research (InterLearn), University of Turku, Turku, Finland
| | - Noora M Scheinin
- University of Turku, Department of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland; University of Turku and Turku University Hospital, Department of Clinical Medicine, Psychiatry, Turku, Finland
| | - Katja Tervahartiala
- University of Turku, Department of Psychology and Speech-Language Pathology, Turku, Finland; University of Turku, Department of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland; University of Turku and Turku University Hospital, Centre for Population Health Research, Turku, Finland; The Centre of Excellence for Learning Dynamics and Intervention Research (InterLearn), University of Turku, Turku, Finland
| | - Alice Carter
- Psychology Department, University of Massachusetts at Boston, Boston, USA
| | - Hasse Karlsson
- University of Turku, Department of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland; University of Turku and Turku University Hospital, Department of Clinical Medicine, Psychiatry, Turku, Finland; University of Turku and Turku University Hospital, Centre for Population Health Research, Turku, Finland
| | - Eeva-Leena Kataja
- University of Turku, Department of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland; University of Turku and Turku University Hospital, Centre for Population Health Research, Turku, Finland
| | - Linnea Karlsson
- University of Turku, Department of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland; University of Turku and Turku University Hospital, Centre for Population Health Research, Turku, Finland; University of Turku and Turku University Hospital, Department of Clinical Medicine, Paediatrics and adolescent medicine, Turku, Finland
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Kim J, Hurh K, Kim H, Park EC, Ha MJ. Effect of the peripartum depressive symptoms on the Internet use disorder of their offspring in late childhood: retrospective longitudinal study. Sci Rep 2024; 14:417. [PMID: 38172226 PMCID: PMC10764353 DOI: 10.1038/s41598-023-50603-5] [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: 09/26/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
Internet use disorder (IUD) is an emerging social and mental health concern. This study aimed to analyze the relative risk of IUD in late childhood among children whose mothers experienced peripartum depressive symptoms. This study included 762 participants (397 boys and 365 girls) and was conducted in 2017 (aged 9) and 2019 (aged 11). We analyzed the adjusted relative risk of being at high risk for IUD based on whether the mother experienced depressive symptoms during pregnancy or one month after delivery. We also considered the persistence of depressed mood for 4 months after delivery and the severity of peripartum depressive symptoms. From 2017, 20.7% of boys and 14.0% of girls were at high risk of developing IUD. Compared to the non-peripartum depressive group, girls whose mothers experienced peripartum depressive symptoms and those that persisted for 4 months were 1.084 and 1.124 times more likely to be at high risk of IUD (95% confidence interval = 1.005-1.170 and 1.013-1.248), respectively. There were no statistically significant differences among boys. Peripartum depressed mood could be one of risk factors of IUD. IUD needs to be monitored in children whose mothers experienced peripartum depressive symptoms.
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Affiliation(s)
- Jinhyun Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyungduk Hurh
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Hyunkyu Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Min Jin Ha
- Department of Health Informatics and Biostatistics, Graduate School of Public Health, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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Trajectories of maternal depressive symptoms from pregnancy to 11 years postpartum: Findings from Avon Longitudinal Study of Parents and Children (ALSPAC) cohort. J Affect Disord 2023; 328:191-199. [PMID: 36773763 DOI: 10.1016/j.jad.2023.02.023] [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: 03/18/2022] [Revised: 01/26/2023] [Accepted: 02/04/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND Maternal depressive symptoms are common in pregnancy and may extend to the perinatal period and beyond for some women. To date, few longitudinal studies have investigated maternal depressive symptoms from pregnancy to eleven years postpartum. Drawing data from a large population-based study cohort the aims of this study were to 1) identify distinct groups of mothers defined by their trajectories of depressive symptoms spanning from pregnancy to eleven years following the birth of the child, and 2) to identify psychosocial risk factors during pregnancy and in the first few postnatal years that are associated with these trajectories. METHODS Data were analyzed from 14,170 mothers who participated in Avon Longitudinal Study of Parents and Children (ALSPAC). The Edinburgh Postnatal Depression Scale (EPDS) was used to capture maternal depressive symptoms across 10 time points including two prenatal (18 and 32 weeks), and eight postnatal (2, 8, 21, 33, 61, 73, 97 and 134 months) time points. The latent growth model was created to describe the course of maternal depressive symptoms across the preceding time points followed by a latent growth mixture modelling (LGMM) to identify distinct trajectories of depressive symptoms over time within the overall sample. The predictors of maternal depressive symptoms trajectories were categorized into sociodemographic, child, and psychosocial factors. The multinomial regression analyses were conducted to explore associations between the risk factors and depressive symptoms trajectories. RESULTS LGMM identified four distinct trajectories of maternal depressive symptoms over time: minimal symptoms, increasing symptoms, persistent symptoms, and decreasing symptoms. Predictors of all patterns of depression - persistent, increasing and decreasing symptoms include smoking during pregnancy, and partner conflict. The strongest predictors of the persistent symptom trajectory included maternal history of depression and inadequate social support. LIMITATIONS The use of self-reported maternal mental health symptoms and under representation of ethnic minorities are our study's limitations. CONCLUSIONS The study findings highlight the importance of early identification and treatment for mothers experiencing depressive symptoms from pregnancy to the perinatal period and beyond.
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Johann A, Dukic J, Rothacher Y, Ehlert U. Trajectories of reproductive transition phase mood disorder from pregnancy to postpartum: A Swiss longitudinal study. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057221147391. [PMID: 36748405 PMCID: PMC9909046 DOI: 10.1177/17455057221147391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Depressive symptoms are common in the peripartum period and pose a great risk to the well-being of the mother, the infant, and the entire family. Evidence from longitudinal studies suggests that affected women do not constitute one homogeneous group in terms of severity, chronicity, and onset of symptoms. To account for individual differences regarding the longitudinal course of depressive symptoms from pregnancy to the postpartum period, growth mixture models have proven to be useful. METHODS We conducted a group-based trajectory modeling analysis to identify perinatal depressive symptom trajectories in a Swiss sample (n = 151). Depressive symptoms were assessed six times, covering nearly 6 months from the third trimester of pregnancy to 3 months postpartum. In addition to determining perinatal depressive symptom trajectories, we aimed to examine whether these trajectories are linked to psychopathological risk factors such as a history of premenstrual syndrome (PMS), anxiety, prenatal stress, and somatic symptoms after delivery that are associated with hormonal fluctuations. RESULTS The findings revealed three trajectories of perinatal depressive symptoms that were relatively stable over time and differed in symptom load (low, medium, high), as well as one trajectory of decreasing symptoms, with a significant symptom reduction after giving birth. Women with a higher depressive symptom load experienced a greater degree of prior premenstrual symptoms, prenatal anxiety, and birth anxiety, as well as somatic symptoms after delivery. CONCLUSION Further research is needed to account for the distinct trajectories of perinatal depressive symptoms in order to provide appropriate care for affected women. A focus on somatic symptoms after delivery and their association with depressive mood is essential to better understand the potential shared etiopathology of reproductive transition phase mood disorders.
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Affiliation(s)
- Alexandra Johann
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Jelena Dukic
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Yannick Rothacher
- Psychological Methods, Evaluation and Statistics, University of Zurich, Zurich, Switzerland
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland,Ulrike Ehlert, Clinical Psychology and Psychotherapy, University of Zurich, Binzmühlestrasse 14, 8050 Zurich, Switzerland.
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Ilomäki M, Lindblom J, Salmela V, Flykt M, Vänskä M, Salmi J, Tolonen T, Alho K, Punamäki RL, Wikman P. Early life stress is associated with the default mode and fronto-limbic network connectivity among young adults. Front Behav Neurosci 2022; 16:958580. [PMID: 36212193 PMCID: PMC9537946 DOI: 10.3389/fnbeh.2022.958580] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
Exposure to early life stress (ELS) is associated with a variety of detrimental psychological and neurodevelopmental effects. Importantly, ELS has been associated with regional alterations and aberrant connectivity in the structure and functioning of brain regions involved in emotion processing and self-regulation, creating vulnerability to mental health problems. However, longitudinal research regarding the impact of ELS on functional connectivity between brain regions in the default mode network (DMN) and fronto-limbic network (FLN), both implicated in emotion-related processes, is relatively scarce. Neuroimaging research on ELS has mostly focused on single nodes or bi-nodal connectivity instead of functional networks. We examined how ELS is associated with connectivity patterns within the DMN and FLN during rest in early adulthood. The participants (n = 86; 47 females) in the current functional magnetic resonance imaging (fMRI) study were young adults (18–21 years old) whose families had participated in a longitudinal study since pregnancy. ELS was assessed both prospectively (parental reports of family relationship problems and mental health problems during pregnancy and infancy) and retrospectively (self-reported adverse childhood experiences). Inter-subject representational similarity analysis (IS-RSA) and multivariate distance matrix regression (MDMR) were used to analyze the association between ELS and the chosen networks. The IS-RSA results suggested that prospective ELS was associated with complex alterations within the DMN, and that retrospective ELS was associated with alterations in the FLN. MDMR results, in turn, suggested that that retrospective ELS was associated with DMN connectivity. Mean connectivity of the DMN was also associated with retrospective ELS. Analyses further showed that ELS-related alterations in the FLN were associated with increased connectivity between the prefrontal and limbic regions, and between different prefrontal regions. These results suggest that exposure to ELS in infancy might have long-lasting influences on functional brain connectivity that persist until early adulthood. Our results also speak for the importance of differentiating prospective and retrospective assessment methods to understand the specific neurodevelopmental effects of ELS.
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Affiliation(s)
- Miro Ilomäki
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- *Correspondence: Miro Ilomäki,
| | - Jallu Lindblom
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
- Department of Clinical Medicine, Faculty of Medicine, University of Turku, Turku, Finland
| | - Viljami Salmela
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Marjo Flykt
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
| | - Mervi Vänskä
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
| | - Juha Salmi
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Neuroscience and Biomedical Engineering, Aalto University, Helsinki, Finland
| | - Tuija Tolonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Kimmo Alho
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Advanced Magnetic Imaging Centre, Aalto NeuroImaging, Aalto University, Espoo, Finland
| | | | - Patrik Wikman
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Kiewa J, Meltzer-Brody S, Milgrom J, Bennett E, Mackle T, Guintivano J, Hickie IB, Colodro-Conde L, Medland SE, Martin N, Wray N, Byrne E. Lifetime prevalence and correlates of perinatal depression in a case-cohort study of depression. BMJ Open 2022; 12:e059300. [PMID: 35973706 PMCID: PMC9621163 DOI: 10.1136/bmjopen-2021-059300] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES This study sought to evaluate the prevalence, timing of onset and duration of symptoms of depression in the perinatal period (PND) in women with depression, according to whether they had a history of depression prior to their first perinatal period. We further sought to identify biopsychosocial correlates of perinatal symptoms in women with depression. DESIGN AND SETTING The Australian Genetics of Depression Study is an online case cohort study of the aetiology of depression. For a range of variables, women with depression who report significant perinatal depressive symptoms were compared with women with lifetime depression who did not experience perinatal symptoms. PARTICIPANTS In a large sample of parous women with major depressive disorder (n=7182), we identified two subgroups of PND cases with and without prior depression history (n=2261; n=878, respectively). PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome measure was a positive screen for PND on the lifetime version of the Edinburgh Postnatal Depression Scale. Descriptive measures reported lifetime prevalence, timing of onset and duration of PND symptoms. There were no secondary outcome measures. RESULTS The prevalence of PND among parous women was 70%. The majority of women reported at least one perinatal episode with symptoms both antenatally and postnatally. Of women who experienced depression prior to first pregnancy, PND cases were significantly more likely to report more episodes of depression (OR=1.15 per additional depression episode, 95% CI 1.13 to 1.17, p<0.001), non-European ancestry (OR 1.5, 95% CI 1.0 to 2.1, p=0.03), severe nausea during pregnancy (OR 1.3, 95% CI 1.1 to 1.6, p=0.006) and emotional abuse (OR 1.4, 95% CI 1.1 to 1.7, p=0.005). CONCLUSIONS The majority of parous women with lifetime depression in this study experienced PND, associated with more complex, severe depression. Results highlight the importance of perinatal assessments of depressive symptoms, particularly for women with a history of depression or childhood adverse experiences.
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Affiliation(s)
- Jacqueline Kiewa
- Child Health Research Centre, The University of Queensland Faculty of Medicine and Biomedical Sciences, Brisbane, Queensland, Australia
| | | | - Jeannette Milgrom
- Parent-Infant Research Institute, Heidelberg Heights, Victoria, Australia
- University of Melbourne, Melbourne, Victoria, Australia
| | | | | | - Jerry Guintivano
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Sarah E Medland
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Nick Martin
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Naomi Wray
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Enda Byrne
- Child Health Research Centre, The University of Queensland Faculty of Medicine and Biomedical Sciences, Brisbane, Queensland, Australia
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Zietlow AL, Woll CFJ, Nonnenmacher N, Müller M, Labonte V, Ditzen B, Paulus M, Sodian B, Nater UM, Herpertz SC, Reck C. Study protocol of the COMPARE-Interaction study: the impact of maternal comorbid depression and anxiety disorders in the peripartum period on child development. BMJ Open 2022; 12:e050437. [PMID: 35058257 PMCID: PMC8783832 DOI: 10.1136/bmjopen-2021-050437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION To date, there are only few studies that compare the consequences of peripartum maternal depressive disorders (PD) versus depressive with comorbid anxiety disorders (PDCA) for infant and child development. As comorbidity is associated with greater impairment and symptom severity related to the primary diagnosis, comorbidity in mothers might raise their offspring's risk of developing internalising or externalising disorders even more than has been noted in conjunction with PD alone. METHODS AND ANALYSIS This study aims to analyse the impact of parental psychopathology, particularly peripartum depression in mothers with and without comorbid anxiety disorders according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) on child cognitive and socioemotional development. Maternal/paternal psychopathology, mother-infant/father-infant interaction and child development are assessed at four measurement points over the first 2 years (T1: 3-4 months postpartum, T2: 12 months postpartum, T3: 18 months postpartum and T4: 24 months postpartum). The mediating role of mother-infant/father-infant interaction and infant stress reactivity in the relationship between PD/PDCA and infant cognitive and socioemotional development will be analysed. In the ongoing study, 174 families (n=58 mothers with PD, n=58 mothers with PDCA and n=58 healthy controls) will be recruited in inpatient and outpatient centres as well as maternity hospitals in Munich and Heidelberg. ETHICS AND DISSEMINATION This study is implemented in accordance with the current guidelines of the World Medical Association (revised Declaration of Helsinki) and the General Data Protection Regulation of the European Union. The study procedures were approved by the independent ethics committees of the Department of Psychology, Ludwig-Maximilians-University Munich (74_Reck_b) and of the Medical Faculty, University Heidelberg (S-446/2017). Participation is voluntary. A signed written informed consent form must be obtained from each study subject prior to any study-specific procedure. Participants can withdraw from the study at any point in time without giving a reason or being subjected to any future disadvantages. In case of withdrawal from the study, the subject's data and material will be kept unless the participant asks for data removal. Results will be published and disseminated to further the discussion on the effects of maternal PD and PDCA on parent-infant interaction, infant stress reactivity and child development. Furthermore, study results will be presented at international congresses and expert conferences.
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Affiliation(s)
- Anna-Lena Zietlow
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Christian Franz Josef Woll
- Department of Psychology, Clinical Psychology of Children and Adolescents, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Nora Nonnenmacher
- Institute of Medical Psychology, Centre of Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Mitho Müller
- Department of Psychology, Clinical Psychology of Children and Adolescents, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Verena Labonte
- Department of Psychology, Clinical Psychology of Children and Adolescents, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Beate Ditzen
- Institute of Medical Psychology, Centre of Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Markus Paulus
- Department of Psychology, Developmental and Educational Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Beate Sodian
- Department of Psychology, Developmental and Educational Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Urs M Nater
- Department of Psychology, University of Vienna, Vienna, Austria
| | - Sabine C Herpertz
- Department of General Psychiatry, Centre of Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Corinna Reck
- Department of Psychology, Clinical Psychology of Children and Adolescents, Ludwig-Maximilians-University Munich, Munich, Germany
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Klimes-Dougan B, Papke V, Carosella KA, Wiglesworth A, Mirza SA, Espensen-Sturges TD, Meester C. Basal and reactive cortisol: A systematic literature review of offspring of parents with depressive and bipolar disorders. Neurosci Biobehav Rev 2022; 135:104528. [PMID: 35031342 DOI: 10.1016/j.neubiorev.2022.104528] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 01/06/2022] [Accepted: 01/07/2022] [Indexed: 11/19/2022]
Abstract
One of the most consistent biological findings in the study of affective disorders is that those with depression commonly show abnormal cortisol response, which suggests dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. Children of parents with mood disorders offer the opportunity to explore the biological pathways that may confer risk for psychopathology. This review explores basal and reactive cortisol in the offspring of parents who are currently depressed or have had a history of a depressive or bipolar disorder. Using PRISMA guidelines, search terms yielded 2002 manuscripts. After screening, 87 of these manuscripts were included. Results from the literature suggest that while the degree and direction of dysregulation varies, offspring of a parent with depression tend to show elevations in both basal (particularly morning and evening) and reactive (tentatively for social stressors) cortisol levels. There were few studies focused on offspring of parents with bipolar disorder. This review also discusses implications and recommendations for future research regarding the HPA axis in the intergenerational transmission of depressive disorders.
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Affiliation(s)
- Bonnie Klimes-Dougan
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA.
| | - Victoria Papke
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA
| | - Katherine A Carosella
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA
| | - Andrea Wiglesworth
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA
| | - Salahudeen A Mirza
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA
| | - Tori D Espensen-Sturges
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA
| | - Christina Meester
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA
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Association between Second-Time Mother's Prenatal Depression and Firstborn's Behaviour Problems: The Mediation Role of Parenting Daily Hassles. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312794. [PMID: 34886521 PMCID: PMC8657250 DOI: 10.3390/ijerph182312794] [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: 11/12/2021] [Revised: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 11/17/2022]
Abstract
Background: With the relaxation of birth control policy in China in recent years, second-time mothers’ mental health has raised concerns. However, the impact of firstborn children’s behaviour problems on second-time mothers’ prenatal depression in families transitioning to siblinghood has received little attention from family psychologists. Aims: This research aims to investigate whether firstborn children’s behaviour problems affect second-time mothers’ prenatal depression and the mediation role of daily parenting hassles, i.e., minor stressors associated with parenting, on this relationship. Methods: Data about second-time mothers’ prenatal depression, parenting daily hassles, and firstborn children’s behaviour problems were collected from 105 families transitioning to two children families using mother-reported questionnaires. Regressions were used to analyze the data. Results: About half of the mothers in the sample have depressive symptoms. Firstborns’ behaviour problems did not have a direct effect on the mother’s prenatal depression, but the problems did have an indirect effect via parenting daily hassles. The mothers’ age was significantly associated with prenatal depression. Conclusions: The mediation role of parenting daily hassles in the association with firstborn’s behaviour problems and mother’s prenatal depression suggests the need for support that reduce the levels of daily parenting hassles from firstborn children.
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Korja R, McMahon C. Maternal prenatal mood problems and lower maternal emotional availability associated with lower quality of child's emotional availability and higher negative affect during still-face procedure. INFANCY 2021; 26:901-919. [PMID: 34370394 DOI: 10.1111/infa.12428] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 07/09/2021] [Accepted: 07/15/2021] [Indexed: 01/20/2023]
Abstract
Our aim was to study the effects of maternal perinatal mood and maternal emotional availability on child emotional availability and negative affect during the still-face procedure (SFP). The sample included 214 women who participated in a prospective study. We assessed maternal mood problems using the Mini International Neuropsychiatric Interview and PRAQ questionnaire during pregnancy and using STAI and EPDS questionnaires during pregnancy and at 6 months after delivery. Maternal and child emotional availability were studied using the Emotional Availability Scales during the SFP at 6 months. We observed and quantified child's negative affect during SFP episodes. We found that mothers with maternal mood problems (anxiety and/or depression) during pregnancy, but not postnatally, showed less optimal maternal structuring during the SFP, and the children showed lower involvement and responsiveness during interactions with their mothers. Furthermore, lower maternal emotional availability was related to the child's higher negative affect during the SFP. Our findings underline the independent roles of both prenatal stress exposure and maternal caregiving behavior in a child's socioemotional development.
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Affiliation(s)
- Riikka Korja
- Department of Psychology, University of Turku, Turku, Finland.,The Centre for Emotional Health, Macquarie University, Sydney, NSW, Australia
| | - Catherine McMahon
- The Centre for Emotional Health, Macquarie University, Sydney, NSW, Australia
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12
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Hulkkonen P, Kataja EL, Vahlberg T, Koivuniemi E, Houttu N, Pellonperä O, Mokkala K, Karlsson H, Laitinen K. The efficacy of probiotics and/or n-3 long-chain polyunsaturated fatty acids intervention on maternal prenatal and postnatal depressive and anxiety symptoms among overweight and obese women. J Affect Disord 2021; 289:21-30. [PMID: 33930612 DOI: 10.1016/j.jad.2021.04.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/01/2021] [Accepted: 04/06/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Maternal depression and anxiety may endanger well-being of both mother and child. We investigated the efficacy of probiotics and/or fish oil (FO) in modifying pre- and postnatal depressive and anxiety symptoms. Symptom trajectories were identified and the influence of lifestyle factors on symptoms was evaluated. METHODS Overweight women (n = 439) were randomized to intervention groups (probiotics+FO, probiotics+placebo, FO+placebo, placebo+placebo) from early pregnancy until six months postpartum, and assessed for depressive and anxiety symptoms with Edinburgh Postnatal Depression Scale (EPDS) and Anxiety subscale of Symptoms Checklist (SCL-90) at early and late pregnancy and three, six and 12 months postpartum. Latent growth mixture modeling was used to model the symptom courses. Dietary quality and physical activity were assessed with validated indices. RESULTS Symptom scores were generally low. Statistically significant intervention effect was seen during pregnancy (p = 0.017): EPDS scores increased (by 1.11 points) in the FO+probiotics group and decreased (by 0.85 points) in the FO+placebo group. At 12 months postpartum, FO+placebo group had lower EPDS scores compared to probiotics+placebo group (p = 0.039). No differences in SCL scores were seen in response to the intervention. Irrespective of the intervention, three depressive and two anxiety symptoms trajectories were identified. Dietary quality correlated negatively with depressive symptoms in early pregnancy and six months postpartum and with anxiety symptoms in early pregnancy. Perinatal events including mother-reported colic were related to symptoms. LIMITATIONS Secondary outcomes of the primary trial. CONCLUSIONS Intervention had a modest impact on depressive symptoms. Diet and obstetric events were associated with depressive and anxiety symptoms.
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Affiliation(s)
- P Hulkkonen
- Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, University of Turku, Turku, Finland; Department of Psychology and Logopedics, University of Turku, Finland
| | - E-L Kataja
- Department of Psychology and Logopedics, University of Turku, Finland; The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Finland
| | - T Vahlberg
- Department of Clinical Medicine, Biostatistics, University of Turku, Turku, Finland
| | - E Koivuniemi
- Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, University of Turku, Turku, Finland
| | - N Houttu
- Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, University of Turku, Turku, Finland
| | - O Pellonperä
- Department of Obstetrics and Gynecology, University of Turku and Turku University Hospital, Turku, Finland
| | - K Mokkala
- Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, University of Turku, Turku, Finland
| | - H Karlsson
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Finland; Turku University Hospital and University of Turku, Department of Psychiatry, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - K Laitinen
- Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, University of Turku, Turku, Finland.
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Ross KM, Letourneau N, Climie E, Giesbrecht G, Dewey D. Perinatal Maternal Anxiety and Depressive Symptoms and Child Executive Function and Attention at Two-years of Age. Dev Neuropsychol 2020; 45:380-395. [PMID: 33081504 DOI: 10.1080/87565641.2020.1838525] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The objective was to investigate whether perinatal maternal anxiety and depressive symptoms predicted child attention and executive function (EF). Mothers (N = 614) reported pregnancy and three-months postnatal anxiety and depressive symptoms. Attention and EF were measured at two-years-of-age. Covariates were demographics, alcohol use, mood disorder history, and pregnancy factors. Higher prenatal anxiety, b(SE) =.020(.005), p<.001, and postnatal depressive symptoms, b(SE) =.009(.004), p=.04, predicted poorer child attention. A prenatal-by-postnatal depressive symptom interaction emerged, b(SE) = -.005(.003), p=.04: When pregnancy depressive symptoms were low, higher postnatal symptoms predicted poorer attention. No distress variables predicted EF, p's>.22. Perinatal distress timing, kind, and change were important for child attention.
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Affiliation(s)
- Kharah M Ross
- Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, Department of Paediatrics, and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute and Werklund School of Education, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics, Department of Community Health Sciences, And Hotchkiss Brain Institute, University of Calgary , Calgary, Canada
| | - Nicole Letourneau
- Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, Department of Paediatrics, and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute and Werklund School of Education, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics, Department of Community Health Sciences, And Hotchkiss Brain Institute, University of Calgary , Calgary, Canada
| | - Emma Climie
- Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, Department of Paediatrics, and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute and Werklund School of Education, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics, Department of Community Health Sciences, And Hotchkiss Brain Institute, University of Calgary , Calgary, Canada
| | - Gerald Giesbrecht
- Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, Department of Paediatrics, and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute and Werklund School of Education, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics, Department of Community Health Sciences, And Hotchkiss Brain Institute, University of Calgary , Calgary, Canada
| | - Deborah Dewey
- Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, Department of Paediatrics, and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute and Werklund School of Education, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics, Department of Community Health Sciences, And Hotchkiss Brain Institute, University of Calgary , Calgary, Canada
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14
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Pellowski JA, Bengtson AM, Barnett W, DiClemente K, Koen N, Zar HJ, Stein DJ. Perinatal depression among mothers in a South African birth cohort study: Trajectories from pregnancy to 18 months postpartum. J Affect Disord 2019; 259:279-287. [PMID: 31454590 PMCID: PMC6851529 DOI: 10.1016/j.jad.2019.08.052] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 06/24/2019] [Accepted: 08/17/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Perinatal depression affects 21-50% of women in South Africa and poses significant health risks to mothers and children. Trajectories of depressive symptoms change over time and have not been well characterized during the perinatal period in low and middle-income countries. METHODS Data from women enrolled in a population-based birth cohort study in Paarl, South Africa with at least 3 depression measures from pregnancy through 18 months postpartum (N = 831) were analyzed. Depressive symptoms were measured continuously using the Edinburgh Postnatal Depression Scale (EPDS). Group-based trajectory models were used to estimate trajectories of depressive symptoms during the perinatal period and multinomial multivariable models to identify predictors of trajectory group membership. RESULTS Five distinct trajectory patterns of depressive symptoms were identified: moderate levels of depressive symptoms during pregnancy but minimal postpartum (3.5%), minimal levels during pregnancy and increasing postpartum (3.7%), unstable levels peaking at 12 months postpartum (6.6%), mild levels with slight decrease postpartum (82.9%), and severe levels during pregnancy and postpartum (3.1%). Membership in the chronic severe symptom group was associated with stressful life events, sexual intimate partner violence and tobacco use. LIMITATIONS Modeling limitations prevented determining how changes in psychosocial predictors over time may influence depressive symptom trajectories. CONCLUSIONS Mild to severe depressive symptoms during pregnancy/postpartum were common among this South African cohort. Interventions to treat women with severe chronic depressive symptoms with co-occurring psychosocial issues are urgently needed.
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Affiliation(s)
- Jennifer A. Pellowski
- Department of Behavioral and Social Sciences, International Health Institute, Brown University School of Public Health, Providence, RI, USA,Corresponding author.
| | - Angela M. Bengtson
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Whitney Barnett
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and South African Medical Research Council (SAMRC) Unit on Child & Adolescent Health, University of Cape Town, South Africa
| | - Kira DiClemente
- Department of Behavioral and Social Sciences, International Health Institute, Brown University School of Public Health, Providence, RI, USA
| | - Nastassja Koen
- Department of Psychiatry and Mental Health and South African Medical Research Council (SAMRC) Unit on Risk & Resilience in Mental Disorders, Neuroscience Institute, University of Cape Town, South Africa
| | - Heather J. Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and South African Medical Research Council (SAMRC) Unit on Child & Adolescent Health, University of Cape Town, South Africa
| | - Dan J. Stein
- Department of Psychiatry and Mental Health and South African Medical Research Council (SAMRC) Unit on Risk & Resilience in Mental Disorders, Neuroscience Institute, University of Cape Town, South Africa
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Punamäki RL, Qouta SR, Diab SY. The role of maternal attachment in mental health and dyadic relationships in war trauma. Heliyon 2019; 5:e02867. [PMID: 31890934 PMCID: PMC6926227 DOI: 10.1016/j.heliyon.2019.e02867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/01/2019] [Accepted: 11/12/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Infant care is a demanding task in dangerous war conditions, but research on the wellbeing of mother-infant dyads is mainly available in peaceful conditions. Knowledge on protective versus risking processes is especially vital for tailoring effective help, and the present study proposes the maternal attachment style to play an important role in dangerous war conditions. OBJECTIVE The study analyses, first, how various traumatic war events, such as losses, horrors and life-threat, are associated with maternal mental health and dyadic mother-infant interaction quality, indicated by maternal emotional availability (EA). Second, it tests a hypothesis that maternal insecure attachment risks and secure attachment protects good mental health and optimal EA from negative impacts of traumatic war events. METHOD The prospective three-wave study involved 502 Palestinian mothers, who were pregnant during the 2014 War on Gaza, and participated at delivery (T1), and when the infant was seven (T2; N = 392) and eighteen (T3; N = 386) months. Mothers reported about war events at T1 and T2 (death and losses, witnessing horrors and life-threat), and posttraumatic stress disorder (PTSD) and depression symptoms at T2 and T3. Dyadic interaction quality was assessed by mother-perceived emotional availability (EA) scale at T2 and T3, and attachment styles by mothers' self-reports at T3. RESULTS Death and losses, witnessing horrors, and life-threat were all associated with a high level of maternal PTSD, but only at T2, whereas death and losses were associated with her depressive symptoms both at T2 and T3. Witnessing horrors was associated with a low close and positive and a high distant and negative emotional availability at T2 and T3. As hypothesized, maternal avoidant attachment was associated with a low level of close and positive EA in general, and especially when the dyads were exposed to a high level of traumatic war events, thus indicating a risking function. Against the hypothesis, secure attachment did not show any protective function on emotional availability, while, unexpectedly, maternal preoccupied attachment was associated with close and positive emotional availability, when dyads were exposed to a high level of traumatic war events. CONCLUSION Mothering in conditions of war and military violence is an overwhelmingly demanding task, and mother-infant dyads need legal, social, and psychological assistance. Knowledge and reflection of unique responses and meanings of different attachment styles would be fruitful in tailoring effective help.
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Affiliation(s)
- Raija-Leena Punamäki
- Tampere University, Faculty of Social Sciences, Department of Psychology, Finland
| | - Samir R. Qouta
- Doha Institute For Graduate Studies, Qatar
- Islamic University Gaza, Department of Education and Psychology, Gaza, Palestine
| | - Safwat Y. Diab
- Tampere University, Faculty of Social Sciences, Department of Psychology, Finland
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16
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Garman EC, Cois A, Tomlinson M, Rotheram-Borus MJ, Lund C. Course of perinatal depressive symptoms among South African women: associations with child outcomes at 18 and 36 months. Soc Psychiatry Psychiatr Epidemiol 2019; 54:1111-1123. [PMID: 30805694 DOI: 10.1007/s00127-019-01665-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 01/21/2019] [Indexed: 01/05/2023]
Abstract
PURPOSE Latent modelling was used to identify trajectories of depressive symptoms among low-income perinatal women in South Africa. Predictors of trajectories and the association of trajectories with child outcomes were assessed. METHODS This is a secondary analysis of data collected among women living in Cape Town settlements (N = 446). Participants were eligible if pregnant and 18 years or older, and included in the analysis if allocated to the control arm (routine perinatal care). Participants were excluded in case of non-singleton birth and baby death. Follow-up assessments were at 2 weeks, 6-, 18-, and 36-month postpartum. Trajectories of depressive symptoms were based on the Edinburgh Postnatal Depression Scale scores until 18-month postpartum, using latent class growth analysis. Child physical, cognitive, socio-emotional, and behavioural outcomes were assessed at 18 and/or 36 months. Univariate and multivariate regressions were used to identify predictors of trajectories and differences in child outcomes. RESULTS Four trajectories were identified: chronic low (71.1%), late postpartum (10.1%), early postpartum (14.4%), and chronic high (4.5%). Low social support, unwanted pregnancy, and risky drinking were associated with the chronic high trajectory; unemployment and HIV-positive status with the early postpartum trajectory; and intimate partner violence with the late postpartum trajectory. Weight-to-length and weight-for-age z-scores at 18 months, and weight-for-age z-scores, length-for-age z-scores, emotional symptom, and peer problem scores at 36 months differed across trajectories. CONCLUSIONS Severe depressive symptoms in postpartum period have a lasting effect on child physical and socio-emotional outcomes. Multiple screening throughout pregnancy and 1-year postpartum is essential.
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Affiliation(s)
- Emily Claire Garman
- Department of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town, Building B, 46 Sawkins Road, Rondebosch, Cape Town, Western Cape, 7700, South Africa.
| | - Annibale Cois
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, Western Cape, South Africa
- Burden of Disease Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, PO Box 19070, Tygerberg, 7505, South Africa
| | - Mark Tomlinson
- Department of Psychology, Institute for Child and Adolescent Health Research, Stellenbosch University, Maitland, Private Bag X1, Stellenbosch, Western Cape, 7602, South Africa
| | - Mary Jane Rotheram-Borus
- University of California, UCLA Psychiatry and Behavioral Sciences, 10920 Wilshire Blvd, Suite 350, Box 957051, Los Angeles, CA, 90024, USA
| | - Crick Lund
- Department of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town, Building B, 46 Sawkins Road, Rondebosch, Cape Town, Western Cape, 7700, South Africa
- Population Research Department, Centre for Global Mental Health, Health Service, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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17
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Garman EC, Schneider M, Lund C. Perinatal depressive symptoms among low-income South African women at risk of depression: trajectories and predictors. BMC Pregnancy Childbirth 2019; 19:202. [PMID: 31200665 PMCID: PMC6570971 DOI: 10.1186/s12884-019-2355-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 06/09/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The aim of the study was to identify trajectories of perinatal depressive symptoms and their predictors among women living in a low-resource setting in South Africa, and who present with a risk of depression during pregnancy. METHODS This is a secondary analysis of a randomised controlled trial among 384 women living in Khayelitsha, a low income setting in South Africa, recruited at their first antenatal visit if they scored 13 or above on the Edinburgh Postnatal Depression Scale, were at least 18 years of age, less than 29 weeks pregnant and spoke isiXhosa. Participants were followed up at 8 months gestation, 3 and 12 months postpartum. Latent trajectories of depressive symptoms were identified using growth mixture modelling, based on the Hamilton Depression Rating Scale (HDRS). There were no differences in HDRS scores between the control and intervention arms, so all participants were assessed together. Health, social and economic predictors of trajectories were investigated to identify high-risk groups with greater or more chronic depressive symptoms, using univariate logistic regression. RESULTS Two trajectories were identified: antenatal only (91.4%), with moderate to severe symptoms at baseline which later subside; and antenatal and postnatal (8.6%), with severe depressive symptoms during pregnancy and later in the postpartum period, which subside temporarily to moderate levels at 3 months postpartum. Predictors for the antenatal and postnatal trajectory include severe food insecurity, intimate partner violence, lower social support, greater functional impairment, problematic drinking and suicide risk. CONCLUSIONS A small proportion of women who are at risk for depression antenatally remain at risk throughout the perinatal period, and can be differentiated from those who show a natural remission. Identification and referral strategies should be developed with these findings in mind, especially given the limited mental health resources in low-income settings.
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Affiliation(s)
- Emily C. Garman
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Marguerite Schneider
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Crick Lund
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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18
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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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19
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Korja R, Nolvi S, Kataja EL, Scheinin N, Junttila N, Lahtinen H, Saarni S, Karlsson L, Karlsson H. The courses of maternal and paternal depressive and anxiety symptoms during the prenatal period in the FinnBrain Birth Cohort study. PLoS One 2018; 13:e0207856. [PMID: 30557345 PMCID: PMC6296666 DOI: 10.1371/journal.pone.0207856] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 11/07/2018] [Indexed: 01/09/2023] Open
Abstract
Maternal prenatal symptoms of depression and anxiety have been suggested to impose differential effects on later offspring development, depending on their characteristics, such as timing, intensity and persistence. Paternal symptoms have been less investigated. While knowledge on these trajectory characteristics is essential for improved comprehension of prenatal stress, prospective studies including both expecting parents have been scarce. We aim at identifying and comparing the trajectories of prenatal depressive and anxiety symptoms in both parents in a pregnancy cohort design. The sample included 3202 mothers and 2076 fathers who were recruited to the FinnBrain Birth Cohort study (www.finnbrain.fi). Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) and general anxiety by the anxiety scale of the Symptom Checklist -90 (SCL-90) repeatedly at 14, 24, and 34 gestational weeks. Five differential depressive and four anxiety symptom trajectories were identified across pregnancy both in mothers and in fathers. The trajectories of consistently low depressive or anxiety symptoms were associated with higher educational level in both parents, and with nulliparity and non-smoking during pregnancy in mothers. Parents with consistently high or increasing levels of symptoms had more often prenatal SSRI medication. The congruences between elevated depressive and anxiety symptoms at any point in pregnancy, as well as parental trajectories within families were low. However, in this population-based sample, the self-reported symptom levels of both parents were generally very low. Variance in timing and persistence of parent-reported prenatal depressive and anxiety symptoms is potentially important, while symptom trajectories are very similar in mothers and fathers. These differential symptom trajectories and the significance of their correlates should be acknowledged when studying prenatal stress exposures and the related outcomes in children.
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Affiliation(s)
- Riikka Korja
- University of Turku, Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland
- University of Turku, Department of Psychology, Turku, Finland
| | - Saara Nolvi
- University of Turku, Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland
| | - Eeva-Leena Kataja
- University of Turku, Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland
- University of Turku, Department of Psychology, Turku, Finland
| | - Noora Scheinin
- University of Turku, Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland
- University of Turku and Turku University Hospital, Department of Psychiatry, Turku, Finland
| | - Niina Junttila
- University of Turku, Department of Teacher Education, Turku, Finland
| | - Henna Lahtinen
- University of Turku, Department of Psychology, Turku, Finland
| | - Suoma Saarni
- University of Turku, Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland
- University of Turku and Turku University Hospital, Department of Psychiatry, Turku, Finland
- Helsinki University Hospital, Department of Psychiatry, Helsinki, Finland
| | - Linnea Karlsson
- University of Turku, Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland
- University of Turku and Turku University Hospital, Institute of Clinical Medicine, Department of Child Psychiatry, Turku, Finland
| | - Hasse Karlsson
- University of Turku, Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland
- University of Turku and Turku University Hospital, Department of Psychiatry, Turku, Finland
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20
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Latent trajectory groups of perinatal depressive and anxiety symptoms from pregnancy to early postpartum and their antenatal risk factors. Arch Womens Ment Health 2018; 21:689-698. [PMID: 29654413 DOI: 10.1007/s00737-018-0845-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 04/02/2018] [Indexed: 02/01/2023]
Abstract
The aim of this study is to identify subgroups of women who exhibit distinct trajectory patterns of depressive and anxiety disorders from pregnancy to early postpartum and the risk factors associated with the latent trajectory group memberships. Women (n = 615) from the Feelings in Pregnancy and Motherhood (FIP) longitudinal study were followed from early pregnancy to early postpartum for a 7-month period in 2006-2007. The semi-parametric group-based trajectory modeling approach was used to identify the latent trajectory groups. Multinomial logit models were then used to explore the association between latent trajectory group membership and antenatal characteristics. We identified four latent trajectory groups of perinatal depressive symptoms: "low-stable" (49.6%), "moderate-stable" (42.3%), "postpartum" (3.6%), and "antepartum" (4.6%). Significant risk factors associated with these trajectory group memberships were past depression, stress level, ethnicity, the mother's age, and relationship satisfaction. Three latent trajectory groups of perinatal anxiety symptoms were identified: "very low-stable" (8.9%); "low-stable" (60.7%); and "moderate-stable" (30.4%). Significant risk factor associated with these trajectories were past depression, stress level, and income level. Latent trajectory groups of perinatal depressive and anxiety symptoms were identified to uncover potential heterogeneity in populations. Our findings support the need for multiple assessments starting from early pregnancy to the postpartum, which can give some important insights on the characteristics of the women at high symptom burden trajectories for early interventions that may alter the progress of their mental symptoms.
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Baron E, Bass J, Murray SM, Schneider M, Lund C. A systematic review of growth curve mixture modelling literature investigating trajectories of perinatal depressive symptoms and associated risk factors. J Affect Disord 2017; 223:194-208. [PMID: 28763638 PMCID: PMC5592733 DOI: 10.1016/j.jad.2017.07.046] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 07/20/2017] [Accepted: 07/24/2017] [Indexed: 01/23/2023]
Abstract
BACKGROUND The aim of this study was to review the growth curve mixture modelling (GCMM) literature investigating trajectories of perinatal maternal depressive symptoms and associated risk factors. METHODS A systematic search of peer-reviewed articles published until November 2015 was conducted in seven databases. Articles using GCMM to identify trajectories of perinatal depressive symptoms were considered. Symptoms had to be assessed at least three times, anytime from pregnancy to two years postpartum (PROSPERO; 2016:CRD42016032600). RESULTS Eleven studies met inclusion criteria. All reported a low risk trajectory, characterised by stable low depressive symptoms throughout the perinatal period. A stable moderate-high or high symptom trajectory was reported in eight of 11 studies, suggesting a high-risk group with persistent depressive symptoms. Six studies also reported transient trajectories, with either increasing, decreasing or episodic depressive symptoms. None of the demographic, personality or clinical characteristics investigated systematically differentiated groups of women with different symptom trajectories, within or across studies. Thus, it is difficult to differentiate women at high or low risk of specific perinatal depression trajectories. LIMITATIONS A meta-analysis was not possible. The studies' settings and inclusion criteria limit the generalisability of the findings to low-risk, middle- to high-income women. CONCLUSIONS Relatively similar trajectories of perinatal depressive symptoms were identified across studies. Evidence on factors differentiating women assigned to different trajectories was inconsistent. Research with larger samples and in more diverse settings is needed to inform services and policies on how and when to effectively identify subgroups of women at high risk of perinatal depression.
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Affiliation(s)
- Emily Baron
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa.
| | - Judith Bass
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
| | - Sarah M Murray
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
| | - Marguerite Schneider
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Crick Lund
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Center for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Porat-Zyman G, Taubman-Ben-Ari O, Morag I, Kuint J. Maternal mental health over the course of 4 years following childbirth: The contribution of birth circumstances and psycho-social factors. Women Health 2016; 58:72-91. [DOI: 10.1080/03630242.2016.1267687] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | | | - Iris Morag
- Department of Neonatology, The Edmond and Lily Safra Children’s Hospital, Chaim Sheba Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jacob Kuint
- Department of Neonatology, The Edmond and Lily Safra Children’s Hospital, Chaim Sheba Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Trajectories of maternal depressive symptoms across the birth of a child: associations with toddler emotional development. Arch Womens Ment Health 2016; 19:153-65. [PMID: 26184834 DOI: 10.1007/s00737-015-0546-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Accepted: 07/05/2015] [Indexed: 01/18/2023]
Abstract
Depression during the perinatal period is common and impacts the physical and psychological well-being of those who experience it. One area of particular significance is the course of maternal depression across time, including the differential effects of depression trajectories during the perinatal period on early child development. The current study explored trajectories of maternal depressive symptoms from pregnancy through 2 years postpartum and their relation to toddler emotional development. Participants included 120 primarily low-income, ethnically diverse women and their toddlers. Depression was assessed during pregnancy, at 3 months postpartum, and at 1 and 2 years postpartum. Toddler emotional development was assessed at age 2 via video observations and mother report. Results indicated a four-class model that best fits the data: low-decreasing (47.5 %), stable-low (22.5 %), stable-moderate (21.7 %), and increasing (8.3 %) trajectories of maternal depressive symptoms. Women in the increasing group reported significantly more toddler social and emotional problems at age 2 than women in all other groups, and women in the stable-moderate group reported significantly more toddler social and emotional problems at age 2 than women in the stable-low group. No associations between trajectories and observed toddler affect expression were found. Results highlight variable courses of depressive symptoms for women across the birth of a child as well as the importance of reducing depression for the benefit of both mother and child. It is important for clinicians working with pregnant and postpartum mothers to assess for depressive symptoms over time and not just at a single time point.
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Vänskä M, Punamäki RL, Lindblom J, Tolvanen A, Flykt M, Unkila-Kallio L, Tulppala M, Tiitinen A. Timing of Early Maternal Mental Health and Child Cortisol Regulation. INFANT AND CHILD DEVELOPMENT 2015. [DOI: 10.1002/icd.1948] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Mervi Vänskä
- Psychology/School of Social Sciences and Humanities; University of Tampere; Tampere Finland
| | - Raija-Leena Punamäki
- Psychology/School of Social Sciences and Humanities; University of Tampere; Tampere Finland
| | - Jallu Lindblom
- Psychology/School of Social Sciences and Humanities; University of Tampere; Tampere Finland
| | - Asko Tolvanen
- Department of Psychology; University of Jyvaskyla; Jyvaskyla Finland
| | - Marjo Flykt
- Psychology/School of Social Sciences and Humanities; University of Tampere; Tampere Finland
| | - Leila Unkila-Kallio
- Department of Obstetrics and Gynaecology; Helsinki University Central Hospital; Helsinki Finland
- Department of Obstetrics and Gynaecology; University of Helsinki; Helsinki Finland
| | - Maija Tulppala
- Department of Obstetrics and Gynaecology; University of Helsinki; Helsinki Finland
| | - Aila Tiitinen
- Department of Obstetrics and Gynaecology; Helsinki University Central Hospital; Helsinki Finland
- Department of Obstetrics and Gynaecology; University of Helsinki; Helsinki Finland
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van der Waerden J, Galéra C, Saurel-Cubizolles MJ, Sutter-Dallay AL, Melchior M. Predictors of persistent maternal depression trajectories in early childhood: results from the EDEN mother-child cohort study in France. Psychol Med 2015; 45:1999-2012. [PMID: 25678201 DOI: 10.1017/s003329171500015x] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Maternal depression in the pre- and postpartum period may set women on a course of chronic depressive symptoms. Little is known about predictors of persistently elevated depressive symptoms in mothers from pregnancy onwards. The aims of this study are to determine maternal depression trajectories from pregnancy to the child's fifth birthday and identify associated risk factors. METHOD Mothers (N = 1807) from the EDEN mother-child birth cohort study based in France (2003-2011) were followed from 24-28 weeks of pregnancy to their child's fifth birthday. Maternal depression trajectories were determined with a semi-parametric group-based modelling strategy. Sociodemographic, psychosocial and psychiatric predictors were explored for their association with trajectory class membership. RESULTS Five trajectories of maternal symptoms of depression from pregnancy onwards were identified: no symptoms (60.2%); persistent intermediate-level depressive symptoms (25.2%); persistent high depressive symptoms (5.0%); high symptoms in pregnancy only (4.7%); high symptoms in the child's preschool period only (4.9%). Socio-demographic predictors associated with persistent depression were non-French origin; psychosocial predictors were childhood adversities, life events during pregnancy and work overinvestment; psychiatric predictors were previous mental health problems, psychological help, and high anxiety during pregnancy. CONCLUSIONS Persistent depression in mothers of young children is associated to several risk factors present prior to or during pregnancy, notably anxiety. These characteristics precede depression trajectories and offer a possible entry point to enhance mother's mental health and reduce its burden on children.
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Affiliation(s)
- J van der Waerden
- Department of Social Epidemiology,INSERM UMR-S 1136,Pierre Louis Institute of Epidemiology and Public Health,F-75013 Paris,France
| | - C Galéra
- Department of Child and Adolescent Psychiatry,Charles Perrens Hospital,F-33000 Bordeaux,France
| | | | | | - M Melchior
- Department of Social Epidemiology,INSERM UMR-S 1136,Pierre Louis Institute of Epidemiology and Public Health,F-75013 Paris,France
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McMahon CA, Boivin J, Gibson FL, Hammarberg K, Wynter K, Fisher JRW. Older maternal age and major depressive episodes in the first two years after birth: findings from the Parental Age and Transition to Parenthood Australia (PATPA) study. J Affect Disord 2015; 175:454-62. [PMID: 25679200 DOI: 10.1016/j.jad.2015.01.025] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 12/10/2014] [Accepted: 01/14/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND This study examines whether (1) older maternal age is associated with increased risk of depressive episodes between four months and two years after first birth and (2) the role of subsequent reproductive, social and child factors in vulnerability to later onset depression. METHOD 592 women were recruited in the third trimester of pregnancy in three age-groups (≤ 30 years; 31-36 years,≥37 years); 434 (73%) completed all assessments at four months and two years after birth. Major Depression episodes (MDE) were assessed at four months and two years using the Mini International Neuropsychiatric Interview (MINI). Maternal (age, mode of conception, prior mood symptoms, health), child (temperament, health), reproductive (subsequent fertility treatment, pregnancy, birth, pregnancy loss) and social contextual variables (language background, paid work, practical support, life stresses) were assessed in pregnancy and postnatally using validated questionnaires and structured interview questions. RESULTS Maternal age was not related to prevalence or timing of MDE. Depression symptoms, poor child health, low practical support at four months and a non-English language background predicted episodes of depression between four months and two years, ps <0.05. LIMITATIONS Life history risks for depression were not considered, nor symptom profiles over time. CONCLUSIONS Findings indicate that despite a more complex reproductive context, older first time mothers are not more likely to report major depressive episodes in the first two years after birth. Prevalence for the whole sample was at the lower end of reported community ranges and was comparable early and later in the postpartum period. Screening for depression after childbirth should not be restricted to the early months.
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Affiliation(s)
- Catherine A McMahon
- Centre for Emotional Health, Department of Psychology, Macquarie University North Ryde, NSW, 2109, Australia.
| | - Jacky Boivin
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, UK
| | | | - Karin Hammarberg
- Jean Hailes Research Unit, School of Public Health & Preventive Medicine, Monash University, Australia
| | - Karen Wynter
- Jean Hailes Research Unit, School of Public Health & Preventive Medicine, Monash University, Australia
| | - Jane R W Fisher
- Jean Hailes Research Unit, School of Public Health & Preventive Medicine, Monash University, Australia
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Peñacoba Puente C, Carmona Monge FJ, Marín Morales D. Psychopathological Symptoms and Locus of Control in Women with Low-Risk Pregnancies. Women Health 2013; 53:808-23. [DOI: 10.1080/03630242.2013.840878] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | | | - Dolores Marín Morales
- c Department of Nursing, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain, and Obstetrics Department , Hospital Universitario de Fuenlabrada , Fuenlabrada , Madrid , Spain
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