Clinical features of and risk factors for major depression with history of postpartum episodes in Han Chinese women: A retrospective study.
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Yang Fuzhong, Gardner Charles O, Bigdeli Tim, Gao Jingfang, Zhang Zhen, Tao Ming, Liu Ying, Li Youhui, Wang Gang, Shi Jianguo, Gao Chengge, Zhang Kerang, Li Kan, Wang Xumei, Liu Lanfen, Sun Jing, Du Bo, Shi Shenxun, Zhang Jingbei, Wu Wenyuan, Wang Xueyi, Shen Jianhua, Liu Tiebang, Gu Danhua, Liang Wei, Deng Hong, Pan Jiyang, Yang Lijun, Jian Hu, Jiang Guoqin, Meng Huaqing, Miao Guodong, Li Yi, Hu Chunmei, Huang Guoping, Zhang Yutang, Chen Yunchun, Ha Baowei, Gao Shu, Fang Xiang, Mei Qiyi, Hong Xiaohong, Yang Donglin, Liu Tieqiao, Fengyu Yu, Zhong Hui, Sang Hong, Chen Guibing, Cai Min, Song Yan, Dong Jicheng, Shen Zhenmin, Zhang Wei, Wang Xiaoping, Pan Runde, Liu Xiaojuan, Li Yi, Liu Zhengrong, Zhang Qiwen, Li Gongying, Flint Jonathan, Kendler Kenneth S
Аннотация
METHODS: Data were derived from the China, Oxford and Virginia Commonwealth University Experimental Research on Genetic Epidemiology (CONVERGE) study (N=6017 cases) and analyzed in two steps. We first examined the clinical features of and risk factors for MD patients with (N=981) or without (N=4410) a history of PPD. We then compared the differences between first-onset postpartum MD (N=583) and first-onset non-postpartum MD (N=398) in those with a history of PPD. Linear, logistic and multinomial logistic models were employed to measure the associations.
RESULTS: A history of PPD was associated with more guilt feelings, greater psychiatric comorbidity, higher neuroticism, earlier onset and more chronicity (OR 0.2-2.8). Severe premenstrual symptoms (PMS) and more childbirths increased the risk of PPD, as did a family history of MD, childhood sexual abuse, stressful life events and lack of social support (OR 1.1-1.3). In the MD with history of PPD subsample, first-onset postpartum MD was associated with fewer recurrent major depressive episodes, less psychiatric comorbidity, lower neuroticism, less severe PMS and fewer disagreements with their husbands (OR 0.5-0.8), but more childbirths (OR 1.2).
LIMITATIONS: Data were obtained retrospectively through interview and recall bias may have affected the results.
CONCLUSIONS: MD with history of PPD in Han Chinese women is typically chronic and severe, with particular risk factors including severe PMS and more childbirths. First-onset postpartum MD and first-onset non-postpartum MD can be partly differentiated by their clinical features and risk factors, but are not clearly distinctive.