The Predictive Role of Anxiety Disorders on Depressive Phenomenology During Post-partum Period

Aims:

To investigate the predictive role of any specific (DSM-IV) Anxiety Disorders (AD) on depressive symptoms and Major or Minor Depressive Disorder (MDD, mDD) during early postpartum period.

Method:

Women (at the 12th-15th gestational week, N=1066) were recruited in the framework of the Program ‘Perinatal Depression - Research & Screening Unit (PND-ReScU)". Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale (EPDS), and Axis-I disorders (AD, MDD, mDD) were diagnosed with the Structured Clinical Interview for Axis-I Disorders (SCID-I).

Results:

Any current AD at baseline (3rd month of pregnancy) was detected in 231 (21.7%). Having at least one current AD, was associated with a greater likelihood of having MDD or mDD during the early postpartum period, even after the adjustment for the confounding factor of having a lifetime history of MDD (RR=3.86 95%CI 1.58-9.42).

In particular, women affected by Obsessive Compulsive Disorder (N=17; 1.6%) or Panic Disorder (N=43; 4%) had at higher risk to develop depressive symptoms (EPDS≥13) during the postpartum period than women without these AD (RR=6.9 and 6.7 respectively). As for the risk of developing PPD, the strongest association was found for women with Panic Disorder (RR=7.6 95% CI 2.62-22.0).

Conclusions:

AD are associated with a greater likelihood to develop depressive symptoms and MDD or mDD during the early postpartum period. Women with current PD have the strongest risk to develop both MDD or mDD and depressive symptoms during early postpartum period compared to other anxiety disorders.

The predictive Role of Anxiety Disorders on Depressive Phenomenology During Post-partum Period

Aims:

To investigate the predictive role of any specific (DSM-IV) Anxiety Disorders (AD) on depressive symptoms and Major or Minor Depressive Disorder (MDD, mDD) during early postpartum period.

Method:

Women (at the 12th-15th gestational week, N=1066) were recruited in the framework of the Program ‘Perinatal Depression - Research & Screening Unit (PND-ReScU)’. Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale (EPDS), and Axis-I disorders (AD, MDD, mDD) were diagnosed with the Structured Clinical Interview for Axis-I Disorders (SCID-I).

Results:

Any current AD at baseline (3rd month of pregnancy) was detected in 231 (21.7%). Having at least one current AD, was associated with a greater likelihood of having MDD or mDD during the early postpartum period, even after the adjustment for the confounding factor of having a lifetime history of MDD (RR=3.86 95%CI 1.58-9.42).

In particular, women affected by Obsessive Compulsive Disorder (N=17; 1.6%) or Panic Disorder (N=43; 4%) had at higher risk to develop depressive symptoms (EPDS≥13) during the postpartum period than women without these AD (RR=6.9 and 6.7 respectively). As for the risk of developing PPD, the strongest association was found for women with Panic Disorder (RR=7.6 95% CI 2.62-22.0).

Conclusions:

AD are associated with a greater likelihood to develop depressive symptoms and MDD or mDD during the early postpartum period. Women with current PD have the strongest risk to develop both MDD or mDD and depressive symptoms during early postpartum period compared to other anxiety disorders.

Pelvic floor dyssynergia and psychiatric disorders. Does the snake bite its tail?

AIM

Psychological and/or psychiatric disorders (PSY) and functional gastrointestinal disorders (FGID) are often linked. Pelvic floor dyssynergia (PFD) is one of the most frequent FGID, but few studies have investigated its possible relationship with PSY. The aim of the present study was to evaluate whether an increased prevalence of PSY, and of what types, exist in patients affected with PFD.

METHODS

Thirty-four female patients PFD and 34 age- and gender-matched control subjects were evaluated. The prevalence rates of axis I psychiatric disorders (DSM IV) and of pathological temperaments (Schneider-Akiskal criteria) were determined.

RESULTS

PSY were detected in 29 patients (85.3%) and in 11 controls (32.3%), (p=0.000). A family load was present in 7 patients (20.6%) and in 2 controls (5.9%), (NS). Sixteen patients (47.0%) and no control subjects were diagnosed as having axis I psychiatric disorders (p=0.000); anxiety disorders were the most frequently represented condition. A pathological temperament was found in 28 patients (82.3%) (primarily the phobic-anxious temperament) and in 11 control subjects (32.3%),(p=0.000).

CONCLUSIONS

This study shows that there is a higher prevalence of PSY in PFD patients than in controls in particular, anxiety disorders and the phobic-anxious temperament. We would recommend that a psychiatric evaluation be carried out in patients with PFD, especially before starting rehabilitation therapy for obstructed defecation, as the presence of psychiatric disorders could alter the course and decrease the efficacy of such a rehabilitation program.