Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-10T07:12:16.207Z Has data issue: false hasContentIssue false
  • English
  • Français

Clinical presentation of postnatal and non-postnatal depressive episodes

Published online by Cambridge University Press:  12 March 2007

CARLY COOPER ,
LISA JONES ,
EMMA DUNN ,
LIZ FORTY ,
SAYEED HAQUE ,
FEMI OYEBODE ,
NICK CRADDOCK  and
IAN JONES
CARLY COOPER
Affiliation:
Department of Psychiatry, University of Birmingham, Queen Elizabeth Psychiatric Hospital, Birmingham, UK
LISA JONES
Affiliation:
Department of Psychiatry, University of Birmingham, Queen Elizabeth Psychiatric Hospital, Birmingham, UK
EMMA DUNN
Affiliation:
Department of Psychological Medicine, School of Medicine, Henry Welcome Building for Biomedical Research, Cardiff University, Cardiff, UK
LIZ FORTY
Affiliation:
Department of Psychological Medicine, School of Medicine, Henry Welcome Building for Biomedical Research, Cardiff University, Cardiff, UK
SAYEED HAQUE
Affiliation:
Department of Psychiatry, University of Birmingham, Queen Elizabeth Psychiatric Hospital, Birmingham, UK
FEMI OYEBODE
Affiliation:
Department of Psychiatry, University of Birmingham, Queen Elizabeth Psychiatric Hospital, Birmingham, UK
NICK CRADDOCK
Affiliation:
Department of Psychological Medicine, School of Medicine, Henry Welcome Building for Biomedical Research, Cardiff University, Cardiff, UK
IAN JONES*
Affiliation:
Department of Psychological Medicine, School of Medicine, Henry Welcome Building for Biomedical Research, Cardiff University, Cardiff, UK
*
*Address for correspondence: Dr Ian Jones, Department of Psychological Medicine, The Henry Wellcome Building for Biomedical Research in Wales, Academic Avenue, Cardiff University, Heath Park, Cardiff CF14 4XN, UK. (Email: JonesIR1@cf.ac.uk)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The relationship of postnatal (postpartum) depression (PND) to episodes of depression occurring at other times is not well understood. Despite a number of studies of clinical presentation, there is little consistency in the literature. We have undertaken within- and between-individual comparisons of the clinical presentation of postnatal (PN) and non-postnatal (NPN) depressive episodes in women with recurrent depression.

Method

In a sample of well-characterized, parous women meeting DSM-IV and ICD-10 criteria for recurrent major depressive disorder, the clinical presentation of episodes of major depression with onset within 4 weeks of giving birth (PND group, n=50) were compared with (i) the non-postnatal episodes of women with PND, and (ii) episodes of major depression in parous women who had not experienced episodes of mood disorder in relation to childbirth (NPND group, n=132). In addition, the non-postnatal episodes of the PND group of women were compared with the depressive episodes of the NPND group.

Results

The small number of differences found between PN and NPN depressive episodes, such as reduced early morning wakening in postnatal episodes, are likely to be explicable by the context of having a new baby rather than by any difference in the nature of the underlying depression.

Conclusions

The results do not point to substantial differences in clinical presentation between episodes of major depression occurring in relation to childbirth and at other times. Other avenues of research are therefore required to demonstrate a specific relationship between childbirth and depression.

Type
Original Article
Information
Psychological Medicine , Volume 37 , Issue 9 , September 2007 , pp. 1273 - 1280
Copyright
Copyright © Cambridge University Press 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

APA (2000). Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM-IV). American Psychiatric Association: Washington, DC.Google Scholar
Bloch, M., Schmidt, P. J., Danaceau, M., Murphy, J., Nieman, L. & Rubinow, D. R. (2000). Effects of gonadal steroids in women with a history of postpartum depression. American Journal of Psychiatry 157, 924–930.CrossRefGoogle ScholarPubMed
Brockington, I. F. (1996). Puerperal psychosis. In Motherhood and Mental Health, pp. 200–284. Oxford University Press: Oxford.CrossRefGoogle Scholar
CEMD (2001). Why mothers die, 1997–1999. In The Fifth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom (ed. Lewis, G. and Drife, J.). RCOG Press: London. Available online at: www.cemach.org.uk?publications.htm.Google Scholar
CEMD (2004). Why mothers die, 2000–2002. In The Sixth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom (ed. Lewis, G. and Drife, J.). RCOG Press: London. Available online at: www.cemach.org.uk?publications.htm.Google Scholar
Cooper, P. J., Campbell, E. A., Day Kennerley, H. & Bond, A. (1988). Non-psychotic disorder after childbirth: a prospective study of prevalence, incidence, course and nature. British Journal of Psychiatry 152, 799–806.CrossRefGoogle ScholarPubMed
Cox, J. L., Holden, J. M. & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry 150, 782–786.CrossRefGoogle ScholarPubMed
Cox, J. L., Murray, D. & Chapman, G. (1993). A controlled study of the onset, duration and prevalence of postnatal depression. British Journal of Psychiatry 163, 27–31.CrossRefGoogle ScholarPubMed
Eberhard-Gran, M., Eskild, A., Tambs, K., Samuelsen, S. O. & Opjordsmoen, S. (2002). Depression in postpartum and non-postpartum women: prevalence and risk factors. Acta Psychiatrica Scandinavica 106, 426–433.CrossRefGoogle ScholarPubMed
Eberhard-Gran, M., Tombs, K., Opjordsmoen, S., Skrondal, A. & Eskild, A. (2003). A comparison of anxiety and depressive symptomatology in postpartum and non-postpartum mothers. Social Psychiatry and Psychiatric Epidemiology 38, 551–556.CrossRefGoogle ScholarPubMed
Endicott, J., Spitzer, R. L., Fleiss, J. L. & Cohen, J. (1976). The Global Assessment Scale: a procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry 33, 766–772.CrossRefGoogle Scholar
Evans, J., Heron, J., Francomb, H., Oke, S. & Golding, J. (2001). Cohort study of depressed mood during pregnancy and after childbirth. British Medical Journal 323, 257–260.CrossRefGoogle ScholarPubMed
Forty, L., Jones, L., Macgregor, S., Caesar, S., Cooper, C., Hough, A., Dean, L., Dave, S., Farmer, A., McGuffin, P., Brewster, S., Craddock, N. & Jones, I. (2006). Familiality of postpartum depression in unipolar disorder: results of a family study. American Journal of Psychiatry 163, 1549–1553.CrossRefGoogle ScholarPubMed
Hendrick, V., Altshuler, L., Strouse, T. & Grosser, S. (2000). Postpartum and Nonpostpartum depression: differences in presentation and response to pharmacologic treatment. Depression and Anxiety 11, 66–72.3.0.CO;2-D>CrossRefGoogle ScholarPubMed
Hendrick, V., Altshuler, L. L. & Suri, R. (1998). Hormonal changes in the postpartum and implications for postpartum depression. Psychosomatics 39, 93–101.CrossRefGoogle ScholarPubMed
Jones, I. & Craddock, N. (2001). Familiality of the puerperal trigger in bipolar disorder: results of a family study. American Journal of Psychiatry 158, 913–917.CrossRefGoogle ScholarPubMed
Jones, I. & Craddock, N. (2002). Do puerperal psychotic episodes identify a more familial subtype of bipolar disorder? Results of a family history study. Psychiatric Genetics 12, 177–180.CrossRefGoogle ScholarPubMed
Jones, I. & Craddock, N. (2005). Bipolar disorder and childbirth – the importance of recognising risk. British Journal of Psychiatry 186, 453–454.CrossRefGoogle ScholarPubMed
McGuffin, P., Katz, R., Watkins, S. & Rutherford, J. (1996). A hospital-based twin register of the heritability of DSM-IV unipolar depression. Archives of General Psychiatry 53, 129–136.CrossRefGoogle ScholarPubMed
Murray, L. (1989). Childbirth as a life event: the Cambridge study of postnatal depression and infant development. In Current Approaches: Childbirth as a Life Event (ed. Cox, J. L., Paykel, E. S. and Page, M. L.), pp. 23–36. Duphar Laboratories: Southampton.Google Scholar
O'Hara, M. W., Zekowski, E. M., Phillips, L. H. & Wright, E. J. (1990). Controlled prospective study of postpartum mood disorders: comparison of childbearing and nonchildbearing women. Journal of Affective Disorders 5, 97–101.Google Scholar
Pitt, B. (1968). Atypical depression following childbirth. British Journal of Psychiatry 114, 1325–1335.CrossRefGoogle ScholarPubMed
Troutman, B. R. & Cutrona, C. E. (1990). Nonpsychotic postpartum depression among adolescent mothers. Journal of Abnormal Psychology 99, 69–78.CrossRefGoogle ScholarPubMed
Whiffen, V. E. (1992). Is postpartum depression a distinct diagnosis? Clinical Psychology Review 12, 485–508.CrossRefGoogle Scholar
Whiffen, V. E. & Gotlib, I. H. (1993). Comparison of postpartum and non-postpartum depression: clinical presentation, psychiatric history and psychosocial functioning. Journal of Consulting and Clinical Psychology 6, 485–494.CrossRefGoogle Scholar
Wing, J. K., Babor, T., Brugha, T., Burke, J., Cooper, J., Giel, R., Jablensky, A., Regier, D. & Sartorius, N. (1990). SCAN: Schedules for Clinical Assessment in Neuropsychiatry. Archives of General Psychiatry 47, 589–593.CrossRefGoogle ScholarPubMed
WHO (1993). The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research. World Health Organization: Geneva.Google Scholar
Wisner, K L., Peindl, K. & Hanusa, B. H. (1994). Symptomatology of affective and psychotic illnesses related to childbearing. Journal of Affective Disorders 30, 77–87.CrossRefGoogle ScholarPubMed