Journal of affective disorders · 2019
Changes in psychopathological symptoms during pregnancy and after delivery: A prospective-longitudinal study in women with and without anxiety and depressive disorders prior to pregnancy.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Asselmann E, Kunas S L, Wittchen H-U, Martini J
Аннотация
BACKGROUND: The role of anxiety and depressive disorders prior to pregnancy for changes in peripartum psychopathological symptoms has not been resolved yet.
METHODS: A regional-epidemiological sample of 306 women was prospectively followed in seven waves from early pregnancy until 16 months postpartum. Lifetime DSM-IV anxiety and depressive disorders were assessed at baseline with the CIDI-V. Psychopathological symptoms (somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism) were measured with the BSI three times during pregnancy and three times after delivery.
RESULTS: Multilevel analyses revealed that women with versus without lifetime anxiety (β=0.22 to β=0.32) and depressive (β=0.24 to β=0.34) disorders prior to pregnancy experienced higher peripartum psychopathological symptoms. All symptoms linearly decreased during pregnancy (β=-0.02 to β=-0.07 per month). Somatization (β=-0.46) was lower, whereas paranoid ideation (β=0.26) and obsession-compulsion (β=0.21) were higher after delivery than during pregnancy. Though, obsession-compulsion linearly decreased after delivery (β=-0.02). Lifetime anxiety disorders prior to pregnancy interacted with linear changes in anxiety (β=-0.04) and phobic anxiety (β=-0.05) during pregnancy. That is, only women with, but not without anxiety disorders prior to pregnancy experienced a linear decline in anxiety and phobic anxiety during pregnancy.
LIMITATIONS: Lifetime anxiety and depressive disorders were assessed in early pregnancy and might be biased.
CONCLUSIONS: Peripartum psychopathological symptoms are higher in women with versus without lifetime anxiety and depressive disorders prior to pregnancy, but symptom changes only slightly vary by lifetime diagnostic status.
METHODS: A regional-epidemiological sample of 306 women was prospectively followed in seven waves from early pregnancy until 16 months postpartum. Lifetime DSM-IV anxiety and depressive disorders were assessed at baseline with the CIDI-V. Psychopathological symptoms (somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism) were measured with the BSI three times during pregnancy and three times after delivery.
RESULTS: Multilevel analyses revealed that women with versus without lifetime anxiety (β=0.22 to β=0.32) and depressive (β=0.24 to β=0.34) disorders prior to pregnancy experienced higher peripartum psychopathological symptoms. All symptoms linearly decreased during pregnancy (β=-0.02 to β=-0.07 per month). Somatization (β=-0.46) was lower, whereas paranoid ideation (β=0.26) and obsession-compulsion (β=0.21) were higher after delivery than during pregnancy. Though, obsession-compulsion linearly decreased after delivery (β=-0.02). Lifetime anxiety disorders prior to pregnancy interacted with linear changes in anxiety (β=-0.04) and phobic anxiety (β=-0.05) during pregnancy. That is, only women with, but not without anxiety disorders prior to pregnancy experienced a linear decline in anxiety and phobic anxiety during pregnancy.
LIMITATIONS: Lifetime anxiety and depressive disorders were assessed in early pregnancy and might be biased.
CONCLUSIONS: Peripartum psychopathological symptoms are higher in women with versus without lifetime anxiety and depressive disorders prior to pregnancy, but symptom changes only slightly vary by lifetime diagnostic status.