Antenatal and Postnatal Maternal Mental Health as Determinants of Infant Neurodevelopment at 18 Months of Age in a Mother-Child Cohort (Rhea Study) in Crete, Greece.

Antenatal and postnatal maternal mental health as determinants of infant neurodevelopment at 18 months of age in a mother-child cohort (Rhea Study) in Crete, Greece.

Filed under: Depression Treatment

Soc Psychiatry Psychiatr Epidemiol. 2012 Dec 18;
Koutra K, Chatzi L, Bagkeris M, Vassilaki M, Bitsios P, Kogevinas M

PURPOSE: A growing body of evidence links poor maternal mental health with negative outcomes on early child development. We examined the effect of antenatal and postnatal maternal mental health on infant neurodevelopment at age 18 months in a population-based mother-child cohort (Rhea Study) in Crete, Greece. METHODS: Self-reported measures of maternal depression (EPDS), trait anxiety (STAI-Trait) and personality traits (EPQ-R) were assessed in a sample of women during pregnancy and at 8 weeks postpartum (n = 223). An additional sample of 247 mothers also completed the EPDS scale at 8 weeks postpartum (n = 470). Neurodevelopment at 18 months was assessed with the use of Bayley Scales of Infant and Toddler Development (3rd edition). RESULTS: Multivariable linear regression models adjusted for confounders revealed that antenatal depressive symptoms (EPDS ? 13) were associated with decrease in cognitive development independently of postnatal depression. High trait anxiety and extraversion were associated with decrease and increase, respectively, in social-emotional development. Also, high trait anxiety and neuroticism had a positive effect on infants’ expressive communication. Finally, postpartum depressive symptoms (EPDS ? 13) were associated with decrease in cognitive and fine motor development independently of antenatal depression. CONCLUSIONS: These findings suggest that antenatal and postnatal maternal psychological well-being has important consequences on early child neurodevelopment.
HubMed – depression


Errors in scoring the Edinburgh Postnatal Depression scale.

Filed under: Depression Treatment

Arch Womens Ment Health. 2012 Dec 18;
Matthey S, Lee C, Crn?ec R, Trapolini T

This study examined the errors made by clinicians when scoring the Edinburgh Postnatal Depression Scale (EPDS). This measure has items with reverse scoring that may increase the likelihood of errors being made. Four hundred ninety-six EPDS forms from client files in four clinical services were examined for item scoring errors and addition errors. Clinicians (N?=?22) from the four services were also surveyed as to what rate of errors they expected the study would find and what rate would be unacceptable. Errors of either type were present in between 13.4 and 28.9 % of forms across the four sites. These error rates were greater than most of the surveyed clinicians expected and were at a level that was considered by most to be problematic. However, the error rates did not have a meaningful impact on the rates of women scoring above various cutoff scores often used with the EPDS. The EPDS is often incorrectly scored by practitioners at a level that is of concern to clinicians of these services. Clinical teams should adopt the use of scoring templates and a double adding-up procedure when using measures such as the EPDS as a way that may reduce such scoring errors.
HubMed – depression


Perinatal Episodes Across the Mood Disorder Spectrum.

Filed under: Depression Treatment

Arch Gen Psychiatry. 2012 Dec 17; 1-8
Di Florio A, Forty L, Gordon-Smith K, Heron J, Jones L, Craddock N, Jones I

CONTEXT Affective disorders are common in women, with many episodes having an onset in pregnancy or during the postpartum period. OBJECTIVE To investigate the occurrence and timing of perinatal mood episodes in women with bipolar I disorder, bipolar II disorder, and recurrent major depression (RMD). SETTING AND PATIENTS Women were recruited in our ongoing research on the genetic and nongenetic determinants of major affective disorders. Participants were interviewed and case notes were reviewed. Best-estimate diagnoses were made according to DSM-IV criteria. The 1785 parous women identified included 1212 women with bipolar disorder (980 with type I and 232 with type II) and 573 with RMD. Data were available on 3017 live births. MAIN OUTCOME MEASURES We report the lifetime occurrence of perinatal mood episodes, the rates of perinatal episodes per pregnancy/postpartum period, and the timing of the onset of episodes in relation to delivery. RESULTS More than two-thirds of all diagnostic groups reported at least 1 lifetime episode of illness during pregnancy or the postpartum period. Women with bipolar I disorder reported an approximately 50% risk of a perinatal major affective episode per pregnancy/postpartum period. Risks were lower in women with RMD or bipolar II disorder, at approximately 40% per pregnancy/postpartum period. Mood episodes were significantly more common in the postpartum period in bipolar I disorder and RMD. Most perinatal episodes occurred within the first postpartum month, with mania or psychosis having an earlier onset than depression. CONCLUSIONS Although episodes of postpartum mood disorder are more common in bipolar I disorder and manic and psychotic presentations occur earlier in the postpartum period, perinatal episodes are highly prevalent across the mood disorder spectrum.
HubMed – depression


Treatment Of Depression In Managed Care (Mental Health Practice Under...

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