Postpartum depression is one of the most prevalent psychopathologies. Its prevalence is estimated to be between 10% and 15%. Despite its multifactorial etiology, it is known that genetics play an important role in the genesis of this disorder. This paper reviews epidemiological evidence supporting the role of genetics in postpartum depression (PPD). The main objectives of this review are to determine which genes and polymorphisms are associated with PPD and discuss how this association may occur. In addition, this paper explores whether these genes are somehow related to or even the same as those linked to Major Depression (MD). To identify gaps in the current knowledge that require investigation, a systematic review was conducted in the electronic databases PubMed, LILACS and SciELO using the index terms "postpartum depression" and "genetics". Literature searches for articles in peer-reviewed journals were made until April 2014. PPD was indexed 56 times with genetics. The inclusion criteria were articles in Portuguese, Spanish or English that were available by institutional means or sent by authors upon request; this search resulted in 20 papers. Genes and polymorphisms traditionally related to MD, which are those involved in the serotonin, catecholamine, brain-derived neurotrophic factor and tryptophan metabolism, have been the most studied, and some have been related to PPD. The results are conflicting and some depend on epigenetics, which makes the data incipient. Further studies are required to determine the genes that are involved in PPD and establish the nature of the relationship between these genes and PPD.

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Suicide is one of the major causes of preventable death. We evaluated suicidality among pregnant women who participated in prenatal care in Brazil. A total of 255 patients were assessed using semi-structured interviews as well as the Edinburgh Postnatal Depression Scale (EPDS), Beck Depression Inventory (BDI), and Mini-International Neuropsychiatric Interview (MINI) Plus. Thereafter, Stata 12 was used to identify the significant predictors of current suicide risk (CSR) among participants using univariate and multivariate analyses (p < 0.05). According to MINI Plus module C, the lifetime suicide attempt rate was 12.55%. The overall CSR was 23.53%, distributed across risk levels of low (12.55%), moderate (1.18%), and high (9.80%). Our rates approximate those found in another Brazilian study (18.4%). Antenatal depression (AD), lifetime bipolar disorder, and any current anxiety disorder (as measured using the MINI) as well as BDI scores ≥15 and EPDS scores ≥11 were identified as positive risk factors in a univariate analysis (p < 0.001). These factors changed after a multivariate analysis was employed, and only years of education [odds ratio (OR) = 0.45; 95% confidence intervals (CIs) = 0.21-0.99], AD (OR = 3.42; 95% CIs = 1.37-8.53), and EPDS scores ≥11 (OR = 4.44; 95% CIs = 1.97-9.97) remained independent risk factors. AD and other psychiatric disorders were the primary risk factors for suicidality, although only the former remained an independent factor after a multivariate analysis. More than 10 years of education and EPDS scores ≥11 were also independent factors; the latter can be used as a screening tool for suicide risk.

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Some studies have investigated the possible relationship between suicide attempts and impulsivity in patients with bipolar disorder. The objective of this study was to assess the relationship between neuropsychological and clinical aspects and suicide behavior in euthymic bipolar patients. The Iowa Gambling Task and the Conner's Continuous Performance Test evaluated impulsivity in 95 euthymic bipolar patients -42 suicide attempters and 115 normal control participants. A factorial analysis evaluated the adequacy of the instruments. Furthermore, a multiple regression analysis was done in order to develop a model to predict suicide attempts. Our results point to a specific type of impulsivity related to making decisions, lack of planning and borderline personality disorder comorbidity. This type of impulsivity is a risk factor for suicide attempts in patients with bipolar disorder. Keywords: Impulsivity, suicidal behavior, bipolar disorder, decision making. ResumoAlguns estudos investigaram a possível relação entre tentativas de suicídio e impulsividade em pacientes com transtorno bipolar. O objetivo do estudo foi avaliar a relação entre características neuropsicológicas e clínicas e o comportamento suicida em pacientes bipolares eutímicos. Utilizamos o Iowa Gambling Task e o Conner's Continuous Performance Test para avaliar a impulsividade em 95 pacientes eutímicos com transtorno bipolar (42 com tentativas de suicídio) e 155 controles normais. Uma análise fatorial avaliou a adequação dos instrumentos e foi criado um modelo para previsão do número de tentativas de suicídio usando regressão linear múltipla. Nossos resultados apontam para um tipo específico de impulsividade relacionada à tomada de decisões, falta de planejamento e para a comorbidade Transtorno de Personalidade Borderline. A impulsividade por não planejamento é um fator de risco para tentativas de suicídio em pacientes com Transtorno Bipolar. Palavras-chaves: Impulsividade, suicídio, transtorno bipolar, tomada de decisão.

IntroductionThe prevalence of gestational depression (GD) is high, and it is estimated that, in developed countries, it affects between 7% and 15% of pregnant women, while in low-economic income countries, the rate reaches 15% to 25% [1,2]. Maybe even more important than the prevalence of GD are the evidences showing how GD impacts on mother, her baby and the whole family.Gestational depression can generate cognitive distortions that affect the decision-making capacity of the mother [3]. Depressed pregnant women are also more prone to use alcohol, tobacco and other licit and illicit drugs. Furthermore, they attend fewer to prenatal care follow up and will show more frequently unhealthy eating habits, sleep disturbances and less physical activities [4]. These behaviors associated to the biological mechanisms of the depression can expose the offspring to deleterious consequences as pre-eclampsia, pre-term birth, restricted fetal growth and/or low birth weight [5]. Additionally, the physiology of the offspring of depressed mothers can be influenced by maternal hypothalamic-pituitary-adrenal (HPA) axis dysfunction, that is, increased levels of cortisol and catecholamines. These can stress the developing brain of the fetus and expose them to behavioral disturbances and psychiatric disorders later in life [6].Besides these impacts, we know that GD can also strongly affect the quality of life of women. Health-related quality of life (HRQL) is a useful concept to measure experienced health state and the alterations, which are consequences of illnesses. It has been recognized and established as an outcome variable and health status indicator in medical and public health research [7,8]. Although some studies have shown that symptoms of depression during pregnancy significantly affect the quality of life of pregnant women [9][10][11] and particularly their social relations and living conditions [12,13], it remains a neglected matter of study.This study aimed to assess the impact of gestational depression on quality of life in a sample of pregnant women in Brazil.

Sintomas de ansiedade durante o período gestacional é muito comum, no entanto, a alta ansiedade pode desencadear desfechos negativos para a saúde materna infantil. No Brasil, há escassez de instrumentos para medir ansiedade especificamente em gestantes. O objetivo deste estudo foi o de construir e validar um Instrumento de Rastreio para Sintomas de Ansiedade Gestacional. Participaram deste estudo 791 gestantes Brasileiras de todos os trimestres gestacional. Todas responderam a um questionário sociodemografico e o IRSAG. A coleta de dados aconteceu via online por meio de convite nas redes sociais. Todas que concordaram em participar da pesquisa receberam o termo de consentimento livre e esclarecido. Este estudo foi aprovado pelo Comitê de Ética em Pesquisa CAAE 22701219.8.0000.5512. Para análise de confiabilidade foi usado o teste estatístico Alfa de Cronbach. Os resultados indicaram que O teste Alfa de Cronbach demonstrou consistência interna de 0,93 indicando uma confiabilidade quase perfeita. Conclusão: O Instrumento de Rastreio para Sintomas de Ansiedade Gestacional, tem uma excelente confiabilidade para aplicação em gestantes Brasileiras.