The comorbidity of Axis I disorders in depressed pregnant women

Abstract

Purpose Depression during pregnancy is highly prevalent and is associated with increased risk of a variety of negative psychological and medical outcomes in both mothers and offspring. Antenatal depression often co-occurs with significant anxiety, potentially exacerbating morbidities for women and their children. However, screening during the antenatal period is frequently limited to assessment of depression, so that other significant co-morbid disorders may be missed. Follow-up assessment by clinicians has similarly focused primarily on detection of depressive symptoms. Anxiety, obsessive compulsive disorder, and post-traumatic stress disorder, among others, often go undetected in perinatal care settings, even when depression is identified. Failing to recognize these comorbid diagnoses may lead to inadequate treatment or only partial alleviation of distress. Consequently, screening for and assessment of comorbid disorders is warranted. Method In this study, 382 pregnant women (M age = 25.8 [SD = 5.3] years, 85.0% Caucasian) receiving care at a university hospital clinic and Maternal Mental Health Care centers in eastern Iowa and who screened positive for depression on the Beck Depression Inventory completed the Structured Clinical Interview for DSM-IV to assess comorbid mental health symptoms and diagnoses. Results Overall, findings demonstrate high rates of anxiety disorders among women both with and without current major depression, although depressed women reported higher rates of generalized anxiety disorder and post-traumatic stress disorder. Notably, however, incidence specific symptoms were comparable across groups. Conclusions Routine screening of both anxiety and depression during pregnancy should be conducted.

Perinatal Anxiety Screening Scale validiy and reliability study in Turkish (PASS-TR validity and reliability)

“…PASS-TR scores were correlated with Beck depression, Beck anxiety and Hamilton anxiety scores. It is not surprising that it correlates with depression scores, since the co-existence of anxiety and depressive disorders can exceed 60% [31,32]. In the original version of PASS, this ratio was in the range of 0.77-0.83 [10].…”

Preventing post‐traumatic stress disorder following childbirth and traumatic birth experiences: a systematic review

“…PTSD symptoms (following childbirth or any traumatic event) can develop directly after the traumatic event, but can also occur much later in life . The diagnosis is made by a qualified professional, preferably using a validated clinical interview such as Clinician‐Administered PTSD Scale (considered the gold standard) or Structured Clinical Interview for DSM disorders . Screening questionnaires such as the Impact of Event Scale (IES) and Mini International Neuropsychiatric Interview for PTSD (MINI‐PTSD) , are useful to assess the presence of PTSD symptoms but are not suitable for diagnosing PTSD.…”

Examining the relationship between perinatal depression and neurodevelopment in infants and children through structural and functional neuroimaging research

“…However, the World Health Organization defines the puerperal period as up to one year after delivery (Robertson et al, 2003). There is some evidence to suggest that PND is a distinct entity from nonpuerperal MDE, given its clinical presentation, course, and treatment response (Fox et al, 2018;Hendrick et al, 2000) and the rates of comorbid mental health disorders, particularly anxiety (Dindo et al, 2017;Hendrick et al, 2000;Putnam et al, 2017). Anxiety disorders have a prevalence rate of 21.7% during the third trimester of pregnancy, and 11.1% during the first three postpartum months (Borri et al, 2008;Reck et al, 2008).…”