Psychological and social correlates of the onset of affective disorders among pregnant women

Abstract

SynopsisOne hundred and twenty women recruited from attenders at the antenatal clinic of the Obstetrics Department of a general hospital were asked to complete ad hoc questionnaires during pregnancy; they were then interviewed by psychiatrists using a structured diagnostic interview, the Schedule for Affective Disorders and Schizophrenia (SADS). Nineteen (16%) women were identified as having an onset of an affective disorder during the period of pregnancy, mainly (68%) during the first trimester. As compared with the women without any such onset (controls), the women with pregnancy-related affective disorder (PRAD) were characterized by (1) it being their first pregnancy or first delivery with past termination of pregnancy, (2) early loss of either parent by death, (3) high Eysenck Personality Questionnaire (EPQ) Neuroticism (N) and Psychoticism (P) scores, (4) living in a flat with either a plan to stay there after the forthcoming childbirth or an expectation that their accommodation would be crowded, and (5) negative response to the news of the pregnancy by the husband with low intimacy. The effects of these factors were additive since the probability of developing a PRAD episode was highly correlated with the number of factors reported.

Antenatal Depression and Maternal-Fetal Attachment

“…The only studies on depression in the early to middle stage of pregnancy in Japan are those by Kitamura et al [5,10] and Sugawara et al [6], and our findings this time basically support their results.…”

“…Furthermore, they [5,10] cite 'first pregnancy or the first delivery with a history of previous termination of pregnancy' as risk factors for depression. We included the number of children and history of miscarriage in our current study, but found no association between these factors and depression.…”

“…However, there is growing interest in this issue, and a much higher incidence of antenatal depression has been revealed [2,3] than was previously acknowledged. Kumar [4] reported an incidence of de-pression or anxiety among pregnant women of 15% in the UK, while, according to Kitamura et al [5], in a Japanese population, more than 15% of pregnant women experienced onset of a depressive illness during pregnancy. More recently, the incidence of antenatal depression has been reported to be 4-29% [6] or 3-31% [7], while some even suggest a possibly higher prevalence of depression during pregnancy than during the postpartum period [8,9].…”

“…More recently, the incidence of antenatal depression has been reported to be 4-29% [6] or 3-31% [7], while some even suggest a possibly higher prevalence of depression during pregnancy than during the postpartum period [8,9]. However, even with this shift of attention to depression during pregnancy, studies in Japan are limited to those by Kitamura et al [5,10], and Sugawara et al [6], calling for further clarification of its prevalence in this country today.…”

“…In particular, much attention has been paid to the psychosocial factors [1,5,7,10,11]. In a review, Kitamura et al [12] cited obstetric factors, psychiatric past history, psychiatric family history, personality, attitude towards the pregnancy, accommodation, and social support as factors associated with antenatal depression.…”