Treatment of post-partum depression: a review of clinical, psychological and pharmacological options

Fitelson, Elizabeth; Kim, Sarah; Baker, Allison S.; Leight, Kristin

doi:10.2147/ijwh.s6938

Cited by 94 publications

(73 citation statements)

References 144 publications

(162 reference statements)

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“…Notably, decreases in women’s depression scores were inversely correlated with increases in their serum estrogen levels, and available data suggest that estradiol therapy was well tolerated with low dropout rates. However, estradiol therapy may interfere with breastfeeding, a consideration important in the treatment of PPD (Fitelson et al, 2010; Moses-Kolko et al, 2009). Although early data suggested that synthetic progesterones may be therapeutic for PPD, this view has since been challenged and the use of progesterones is not recommended (Dennis et al, 2008).…”

Section: Current Treatment Of Postpartum Depressionmentioning

confidence: 99%

“…Several meta-analyses exist to date and suggest that psychological interventions are efficacious in reducing depressive symptoms (Cuijpers et al, 2008; Dennis and Hodnett, 2007; Lumley et al, 2004; Sockol et al, 2011) at rates similar to those of antidepressant medications (De Crescenzo et al, 2013; Sockol et al, 2011). No conclusive data exist to suggest the superiority of one psychotherapy modality to another in the treatment of PPD (Fitelson et al, 2010), although there is some evidence that IPT, which directly addresses interpersonal problems (e.g., role transitions, relational conflicts), may be more efficacious than CBT, which targets maladaptive depressogenic cognitions (Bledsoe and Grote, 2006; Sockol et al, 2011). …”

Section: Current Treatment Of Postpartum Depressionmentioning

confidence: 99%

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Oxytocin and postpartum depression: Delivering on what's known and what's not

et al. 2014

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The role of oxytocin in the treatment of postpartum depression has been a topic of growing interest. This subject carries important implications, given that postpartum depression can have detrimental effects on both the mother and her infant, with lifelong consequences for infant socioemotional and cognitive development. In recent years, oxytocin has received attention for its potential role in many neuropsychiatric conditions beyond its well-described functions in childbirth and lactation. In the present review, we present available data on the clinical characteristics and neuroendocrine foundations of postpartum depression. We outline current treatment modalities and their limitations, and proceed to evaluate the potential role of oxytocin in the treatment of postpartum depression. The aim of the present review is twofold: a) to bring together evidence from animal and human research concerning the role of oxytocin in postpartum depression, and b) to highlight areas that deserve further research in order to bring a fuller understanding of oxytocin’s therapeutic potential.

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Section: Current Treatment Of Postpartum Depressionmentioning

confidence: 99%

Section: Current Treatment Of Postpartum Depressionmentioning

confidence: 99%

Oxytocin and postpartum depression: Delivering on what's known and what's not

et al. 2014

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“…Sleep disturbances can also lead to negative consequences, such as dysphoric mood and impaired cognitive function, while persistent difficulty with concentration or cognitive tasks is indicative of a mood disorder [ 7 ]. Substance abuse and medical causes of psychiatric symptoms, such as thyroid disorders, should also be considered [ 8 ]. The “baby blues” is a transient mood disturbance that can affect as many as 70% of new mothers within ten days of delivery.…”

Section: Introductionmentioning

confidence: 99%

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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BackgroundPostpartum 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.MethodsThe 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.ResultsA 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.ConclusionsAccording 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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“…Postpartum depression is an increasingly recognized public health problem with far-reaching consequences for both infants and mothers (Fitelson et al 2010). Changes in sleep have been hypothesized as a modifiable risk factor for the development of postpartum depression.…”

Section: Introductionmentioning

confidence: 99%

Poor sleep maintenance and subjective sleep quality are associated with postpartum maternal depression symptom severity

Park

Meltzer‐Brody

Stickgold

2013

Arch Womens Ment Health

152

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Women are at increased risk of developing mood disorders during the postpartum period, and poor postpartum sleep may be a modifiable risk factor for the development of depression. This longitudinal study investigated the relationship between sleep variables and postpartum depression symptoms using wrist actigraphy and self-report surveys. Twenty-five healthy primiparous women were recruited from their outpatient obstetricians’ offices from July 2009 through March 2010. Subjects wore wrist actigraphs for 1 week during the third trimester of pregnancy and again during the 2nd, 6th, 10th, and 14th weeks postpartum while completing sleep logs and sleep surveys. Subjective assessments of mood were collected at the end of each actigraph week. Subjective sleep assessments were strongly predictive of depression severity scores as measured by the Edinburgh Postnatal Depression Scale (EPDS) across all weeks (p<0.001). Actigraphic measures of sleep maintenance, such as sleep fragmentation, sleep efficiency, and wake time after sleep onset, were also significantly correlated with EPDS scores postpartum. However, there was no relationship between nocturnal sleep duration and EPDS scores. This study provides additional evidence that poor sleep maintenance as measured by wrist actigraphy, rather than lesser amounts of sleep, is associated with EPDS scores during the postpartum period and that subjective assessments of sleep may be more accurate predictors of postpartum depression symptoms than wrist actigraphy. It also supports the hypothesis that disrupted sleep may contribute to the development and extent of postpartum depression symptoms.

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Treatment of post-partum depression: a review of clinical, psychological and pharmacological options

Cited by 94 publications

References 144 publications

Oxytocin and postpartum depression: Delivering on what's known and what's not

Oxytocin and postpartum depression: Delivering on what's known and what's not

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

Poor sleep maintenance and subjective sleep quality are associated with postpartum maternal depression symptom severity

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