Is postpartum depression a homogenous disorder: time of onset, severity, symptoms and hopelessness in relation to the course of depression

Abstract

Background: Postpartum depression (PPD) is a common illness, but due to the underlying processes and the diversity of symptoms, some variability is exhibited. The risk of postpartum depression is great if the mother has previously suffered from depression, but there is some evidence that a certain subgroup of women only experience depression during the postpartum period. Methods: The study group consisted of 104 mothers with postpartum major depression and a control group of 104 postpartum mothers without depression. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) was used for data collection. The severity of depression and other mental symptoms were assessed using several validated rating scales. Results: A history of past depression (82%), including depression during pregnancy (42%) and during the postpartum period (53%), was very common in those with current PPD. Eighteen per cent of mothers with current PPD had previously not had any depressive episodes and four per cent had experienced depression only during the postpartum period. Therefore, pure PPD was rare. The onset of PPD was usually (84%) within six weeks of childbirth. Obsessive-compulsive symptoms, phobic anxiety, paranoid ideation, depressed mood, diminished pleasure/ interest, decreased energy, and psychomotor agitation/retardation were common with all kinds of depression histories. Pure PPD was the most similar to the first depressive episode. Nevertheless, the severity of depression, the level of hopelessness, somatisation, interpersonal sensitivity, anxiety, hostility, psychoticism, sleep disturbance, and suicidal ideation were lower, appetite changed less, and concentration was better than in other recurrent depressions. Conclusions: According to this study, PPD is not a homogenous disorder. The time of onset, severity, symptoms, level of hopelessness, and the course of depression vary. Recurrent depression is common. All mothers must be screened during the sixth week postpartum at the latest. Screening alone is not effective; it is also important to give mothers information about PPD and to discuss the symptoms with them in order for them to recognise this disorder and possible new episodes in the future.

Prevalence and Determinants of Postpartum Depression in Sukoharjo District, Central Java

“…Depresi postpartum dapat terjadi mulai dari setelah melahirkan sampai satu bulan sesudahnya, bahkan sampai satu tahun (Muchanga et al, 2017). Insiden depresi meningkat secara signifikan selama tiga bulan pertama setelah ibu melahirkan, dan kejadian depresi akan meningkat tiga kali lipat lebih tinggi pada lima minggu setelah melahirkan (Kettunen, Koistinen and Hintikka, 2014).…”

Pogimdyminių Depresinių Sutrikimų Ankstyvoji Diagnostika - Efektyvios Prevencijos Pagrindas

“…Sutrikimo pradžia, sunkumas, simptomai ir eiga yra labai įvairūs [3]. Depresijos sutrikimai yra biopsichosocialinės prigimties ir turi būti vertinami kompleksiškai.…”

“…Medicininiu požiūriu nėštumo ir pogimdyminis laikotarpis yra fiziologinė būklė, tačiau kartu tai unikalus psichoorganinis persitvarkymo periodas, kurio metu vyksta audringi neuroendogeniniai pokyčiai, moters socialinio vaidmens kaita bei psichologinis prisitaikymas. Hormonų pokyčiai nulemia neįprastus nuotaikos svyravimus bei tam tikrą fizinį diskomfortą visoms pagimdžiusioms moterims [2,3]. Hormonų pusiausvyra paprastai atsistato tik praėjus 6 mėnesiams po gimdymo [3].…”

“…Hormonų pokyčiai nulemia neįprastus nuotaikos svyravimus bei tam tikrą fizinį diskomfortą visoms pagimdžiusioms moterims [2,3]. Hormonų pusiausvyra paprastai atsistato tik praėjus 6 mėnesiams po gimdymo [3]. Kai kurie tyrėjai spėja, kad hormonų pokyčiai nėštumo metu didina moters pažeidžiamumą pasireikšti pirmam depresijos epizodui ar pasikartojančios depresijos atkryčiui [17,18].…”

“…Taip pat būtina įvertinti galimo piktnaudžiavimo svaigalais pasekmes bei kitų somatinių ligų (pvz. skydliaukės pažeidimų) galimai sukeltus nuotaikos sutrikimus [3]. Somatogeninių pokyčių fone sąlygiškai pakeliami psichogeniniai veiksniai gali išprovokuoti pirmą nuotaikos sutrikimų epizodą, sukelti persirgtos depresijos atkrytį ar išryškinti kitus latentinius psichikos sutrikimus.…”