Symptom features of postpartum depression: are they distinct?

Bernstein, Ira H.; Rush, A. John; Yonkers, Kimberly A.; Carmody, Thomas; Woo, Ada; McConnell, Beth A.; Trivedi, Madhukar H.

doi:10.1002/da.20276

Cited by 104 publications

(96 citation statements)

References 38 publications

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“…An additional new finding is that MDE symptoms vary according to previous episodes of depression. According to previous studies, psychomotor symptoms, decreased energy, changes in appetite, sleep disturbances, poor concentration, and mild suicidal ideation are typical of PPD [6,30,31,36]. In this study, symptoms such as depressed mood, loss of interest/pleasure, psychomotor agitation/retardation, and decreased energy were common with all kinds of histories of depression.…”

Section: Discussionsupporting

confidence: 61%

“…All nine SCID symptoms and all SCL-90 symptoms were different between the mothers suffering from major depression and the non-depressed postpartum mothers. The symptom profile was wide, as shown by numerous studies [6,[30][31][32][33][34][35][36][37][38]. Increased or decreased appetite, sleep disturbances, and decreased energy, each of which may be difficult to differentiate from healthy women because of postpartum status, other medical reasons and child care stress were also different [6][7][8].…”

Section: Discussionmentioning

confidence: 99%

“…50% of mothers exhibit these symptoms [34,35]. According to Bernstein et al [36], psychomotor symptoms and impaired concentration/decision-making were prominent in PPD, while women who had depression outside the postpartum period more often reported a sad mood, suicidal ideation, and reduced interest. Prevalence of thoughts of self-harm and suicidal ideation during the postpartum period was between 5% and 14% [37,38].…”

Section: Introductionmentioning

confidence: 99%

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

Kettunen

Koistinen

Hintikka

2014

BMC Pregnancy Childbirth

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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.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Kettunen

Koistinen

Hintikka

2014

BMC Pregnancy Childbirth

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“…Poor sleep quality among women with PPD may compromise performance of critical maternal activities to insure infant safety such as concentration, reaction time, and decision-making (Bernstein et al, 2006). Because infants generally entrain to maternal circadian rhythms, infants of depressed mothers may also experience poor sleep quality, which may further exacerbate maternal depressive symptoms (Hiscock & Wake, 2001).…”

mentioning

confidence: 99%

Sleep Quality in Women With and Without Postpartum Depression

Posmontier

2008

Journal of Obstetric, Gynecologic & Neonatal Nursing

117

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Objective-To compare and measure the effects of sleep quality on women with and without postpartum depression (PPD).Design-A case-control repeated measures matched pairs design. Setting-Home and obstetric office.Participants-Forty-six women who were 6 to 26 weeks postpartum. Two participants were dropped from the final analysis because they were outliers.Methods-Participants underwent wrist actigraphy at home for 7 consecutive days to measure sleep quality (sleep latency, wake after sleep onset, sleep efficiency, wake episodes). The Postpartum Depression Screening Scale measured depression severity. Psychosocial variables were collected during a screening interview. A structured clinical interview was used to diagnose PPD. Correlations, t-tests, and hierarchical multiple regressions were run to analyze data.Results-With the exception of wake episodes, sleep latency (B = 1.80, S.E. = 0.73, P<0.05), wake after sleep onset (B = 6.85, S.E. = 2.85, P<0.05), and thus sleep efficiency (B = −6.31, S.E. = 3.13, P<0.05) predicted PPD symptom severity.Conclusions-Women with PPD experienced poorer sleep quality than women without PPD, and sleep quality worsened with increasing PPD symptom severity. Clinicians need to address measures to improve sleep quality in depressed mothers to decrease symptom severity, and researchers need to develop interventions to facilitate better sleep quality in women with PPD. KeywordsSleep quality; postpartum depression; wrist actigraphy Callouts:1. In women with postpartum depression, nighttime breastfeeding demands, high-needs infants, and little nighttime support may negatively impact on sleep quality and further exacerbate depressive symptoms. 2.Women with PPD experienced poorer sleep quality than women without PPD, and sleep quality worsened with increasing PPD symptom severity. 3.Because poor sleep quality may negatively impact on PPD symptom severity, clinicians need to address measures to improve sleep quality and minimize nighttime sleep interruptions.Women are vulnerable to poor sleep quality in part because of dramatic hormonal fluctuations occurring during the reproductive cycle (Soares & Murray, 2006 NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript especially estrogen and progesterone mediate neurotransmitter levels in the brain responsible for maintaining the quality of sleep. Immediately after childbirth, precipitous decreases in estrogen and progesterone precipitate sleep disturbances in most women including difficulty initiating and maintaining sleep even in the absence of infant care (Lee, McEnany, & Zaffke, 2000). Postpartum women experience less total sleep time, less sleep efficiency (time asleep vs. time in bed), and decreased time to rapid eye movement (REM) compared to nonpostpartum women. In spite of being biologically programmed to be awake during the day and sleepy at night, new mothers normally experience less sleep and a 20% increase in wake time during the first 6 weeks postpartum (Goyal, Gay, & Lee, 2007). Because the same neurot...

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“…The most important limitation of the EPDS is the fact that although it was specifically designed to screen for PPD, all items are similar to those from general depression scales, meaning that it does not include items about the context of a woman's experience as a new mother. Although perinatal depression symptomatology is not specific, it is influenced by the particular situation of being a mother of a newborn [56] and some authors have reported differences between perinatal depressive episodes and those that occur in other periods, such as, more anxious features, guilty, emotional lability, irritability, and concentration/decision-making difficulties [54,57]; irrational worries about the well-being of the infant; and obsessional thoughts of harming themselves or their infants are not uncommon [58]. Gibson et al [59] systematically reviewed the published evidence on EPDS validity for detecting PPD and AD.…”

Section: Sixthmentioning

confidence: 99%

Why should we screen for perinatal depression? Ten reasons to do it

Pereira¹,

Soares²,

Bos³

et al. 2014

IJCNMH

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In this paper we review some of the best available evidence to argue that screening for perinatal depression should be systematically conducted since pregnancy. Our view is organized in ten topics: (1) perinatal depression high prevalence; (2) its potential negative consequences, including maternal, conjugal, foetal, infantile, and child effects; (3) its under-detection and treatment; (4) its stigma; (5) the professionals and women misconceptions related to perinatal depression; (6) the availability of valid and short self-report screening instruments for perinatal depression and (7) their acceptability; (8) the increase in recognition, diagnosis, and treatment rates in comparison with routine practice; (9) the opportunity, given the large number of contacts that women have with health professionals in the perinatal period; and (10) perinatal depression screening potential cost-effectiveness.

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Symptom features of postpartum depression: are they distinct?

Cited by 104 publications

References 38 publications

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

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

Sleep Quality in Women With and Without Postpartum Depression

Why should we screen for perinatal depression? Ten reasons to do it

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