What Lies Behind Postnatal Depression: Is It Only a Mood Disorder?

Abstract

Postnatal depression (PND) is a common condition that has been extensively researched specifically because of its negative impact on the mother-infant relationship. Psychiatric research has looked at comorbidity of major depressive disorder and found it to be strongly associated with Axis II disorders. This study's principal aim was to investigate whether there is a greater incidence of personality disorder (PD) among a PND population than among a non-PND population at 3 months postpartum. A secondary aim was to define the different types of PD. Depression was assessed with the Montgomery and Asberg Depression Rating Scale (MADRS), and PD was assessed with the Structured Interview for DSM-IV Personality Disorders (SIDP-IV) in 109 women with their 12-week-old infants. Twice as many depressed mothers had PD. The PND group presented a greater number of severe clinical symptoms than the nondepressed group (p < .002). Further research is necessary to reexamine the heterogeneity of PND and reassess its impact on infant development.

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

“…Increased or decreased appetite, sleep disturbances, and decreased energy, each of which may be difficult to differentiate from healthy women because of postpartum status, other medical reasons and child care stress were also different [6][7][8]. Many of the symptoms are similar to those of generalised anxiety disorders, panic disorders, post-traumatic stress disorders, obsessive-compulsive disorders, and personality disorders, and co-morbidity may be high between these disorders and PPD [10,[13][14][15][16][17].…”

“…Co-morbidity studies suggest that PPD is associated with generalised anxiety disorders, panic disorders, posttraumatic stress disorders, and obsessive-compulsive disorders [13][14][15][16]. The incidence of personality disorders among PPD patients is greater than among non-PPD patients, and many symptoms are coloured by these disorders [17].…”

Stolen motherhood-case study of postpartum depression

“…The above mentioned traits are characteristic of a dependent personality. The results of the available studies point to considerably more frequent personality disorders in women with PPD in comparison to the reference group [38,39]. In the study on the overall population the criteria for at least one personality disorder were met by 50% (control group 0%) of women with postpartum depression and these were most frequently cluster C disorders (dependent, avoidant and anankastic personality) [38].…”

NICE guideline for antenatal and postnatal mental health: The health visitor role

“…Health visitors are therefore often involved in organising emergency care or additional support from other agencies and may act as the intermediary between those agencies and the family. In some cases, as a result of delays in accessing treatment, lack of services for certain categories of illness or disability, restrictive referral thresholds or long waiting lists, health visitors may be required to temporarily monitor, manage and advocate for mothers exhibiting acute symptoms of severe mental illness, comorbid presentations including perhaps anxiety, depression and PTSD or mothers with mental illnesses superimposed on learning disabilities, personality disorders, domestic violence or substance misuse (Apter et al 2012, Austin et al 2015, Cummings and Whittaker 2016.…”