==================================CMR17================================== 17. Causes, treatment, signs and symptoms of depression specifically in the post partum period (i.e. first year after childbirth or traceable to the event of childbirth). To include mild depression (also known as 'baby blues') to post partum psychosis. 1 UI - 87094325 AU - Watson E ; Evans SJ TI - An example of cross-cultural measurement of psychological symptoms in post-partum mothers. AB - As one of the components of a longitudinal study of the use made of child health services by mothers resident in Tower Hamlets an attempt was made to assess psychiatric morbidity across cultures using three measures, Goldberg's General Health Questionnaire, the interviewer's assessment of distress and the mothers' own opinion; and secondly to see whether mothers from varying cultures differ from the indigenous population in the psychological symptoms they experienced in the year following their infants' birth. There was a reasonable agreement between the three measures suggesting that it is possible to compare psychiatric morbidity across cultures; in addition there seemed to be little difference in the psychological symptoms experienced in the year following their infant's birth by mothers in the varying cultures. MH - Bangladesh/ETHNOLOGY ; *Cross-Cultural Comparison ; Depressive Disorder/DIAGNOSIS/*ETHNOLOGY ; Emigration and Immigration ; England ; Female ; Human ; Pregnancy ; Puerperal Disorders/ DIAGNOSIS/*ETHNOLOGY ; Support, Non-U.S. Gov't SO - Soc Sci Med 1986;23(9):869-74 2 UI - 87050357 AU - Gard PR ; Handley SL ; Parsons AD ; Waldron G TI - A multivariate investigation of postpartum mood disturbance. AB - The interrelationships of 'blues' and later postpartum depression with a number of biochemical, medical, and psychosocial variables have been examined in 52 subjects. The two syndromes shared only an impressive association with a prior history of gynaecological problems. Puerperal 'blues' was characterised in addition by associations with primiparity, tearfulness during pregnancy, and reduced plasma total tryptophan in the early puerperium. Depressive symptomatology up to nine months postpartum was related to an excess of male births and to an altered pattern of decline of non-esterified fatty acids immediately postpartum. In each case, the 'risk' variables were statistically independent and combined linearly. Stepwise discriminant analysis successfully discriminated 'blues' and depression from their respective non-cases. 'Blues and postpartum depression were only weakly related and, apart from gynaecological history, each was associated with separate and independent causative factors. MH - Adolescence ; Adult ; Affective Symptoms/BLOOD/*ETIOLOGY ; Crying ; Depression/ETIOLOGY ; Fatty Acids, Nonesterified/BLOOD ; Female ; Human ; Parity ; Pregnancy ; Puerperal Disorders/BLOOD/ *ETIOLOGY ; Support, Non-U.S. Gov't ; Tryptophan/BLOOD SO - Br J Psychiatry 1986 May;148:567-75 3 UI - 87045323 AU - McNeil TF TI - A prospective study of postpartum psychoses in a high-risk group. 1. Clinical characteristics of the current postpartum episodes. AB - Postpartum psychotic episodes (PPPs) occurring during the first 6 months after delivery were prospectively studied in 88 pregnant index women with a history of nonorganic psychosis and 104 pregnant controls with no such history. While no control developed a PPP, PPPs were found following 28% of the index deliveries, almost all of these 25 cases being psychiatrically hospitalized. PPPs were especially frequent among cases with total illness diagnoses of Cycloid Psychosis and Affective Illness. More than half of the 25 cases had symptom onset within 3 weeks of delivery, and these early onset cases represented predominantly affective disorders, many of whom were manic in this episode. Cases with onset after 3 weeks were predominantly schizophrenic. Confusion was part of the current episode symptomatology in about one third of the cases and was well distributed across the different diagnostic groups. MH - Bipolar Disorder/DIAGNOSIS ; Depressive Disorder/DIAGNOSIS ; Female ; Human ; Pregnancy ; Prognosis ; Prospective Studies ; Psychotic Disorders/*DIAGNOSIS/THERAPY ; Puerperal Disorders/ *DIAGNOSIS/THERAPY ; Risk ; Schizophrenia/DIAGNOSIS ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. SO - Acta Psychiatr Scand 1986 Aug;74(2):205-16 4 UI - 86189399 AU - LaRoche C TI - Prevention in high risk children of depressed parents. AB - Opportunities for prevention of psychopathology in children and families are often overlooked in the treatment of the depressed adult patient. Research and clinical findings are reviewed which highlight the impact on children and the family of depressed parents. They range from illness serious enough to require hospitalization to cases in which depression has not yet been diagnosed. These findings are used as guidelines for the development of preventive and therapeutic interventions for all family members. MH - Adjustment Disorders/THERAPY ; Adult ; Ambulatory Care ; Bipolar Disorder/FAMILIAL & GENETIC ; Child ; Comparative Study ; Crisis Intervention ; Death ; Depressive Disorder/OCCURRENCE/*THERAPY ; Female ; Fetal Death ; Grief ; Hospitalization ; Human ; Male ; Marriage ; Maternal Behavior ; Mental Disorders/*PREVENTION & CONTROL ; Parent-Child Relations ; Pregnancy ; Puerperal Disorders/THERAPY ; Risk SO - Can J Psychiatry 1986 Mar;31(2):161-5 5 UI - 86318055 AU - Buesching DP ; Glasser ML ; Frate DA TI - Progression of depression in the prenatal and postpartum periods. AB - Studies of birth related emotional disorders, which track a cohort of women prospectively throughout the prenatal and postpartum periods, have rarely been undertaken. We measured depression at six separate intervals in the prenatal and postpartum periods among an experimental cohort (n = 57) and at two separate intervals in a nonpregnant control cohort matched on age. Subjects with high levels of prenatal depression were three times more likely to report a past history of depression and two and one-half times more likely to have high depression levels at six weeks postpartum (indicating risk for a puerperal depression). However, they were only one-third more likely to experience transient postpartum depression. Prenatal depression may be another facet of a more encompassing maladjustment which includes past depressive episodes and increased risk for puerperal depression. MH - Depressive Disorder/*DIAGNOSIS/PSYCHOLOGY ; Female ; Human ; Pregnancy ; Pregnancy Complications/*DIAGNOSIS/PSYCHOLOGY ; Prospective Studies ; Psychological Tests ; Puerperal Disorders/ *DIAGNOSIS/PSYCHOLOGY ; Risk SO - Women Health 1986 Summer;11(2):61-78 6 UI - 86272988 AU - Oates MR TI - The treatment of psychiatric disorders in pregnancy and the puerperium. AB - Although few psychotropic drugs are known to be teratogenic or to have adverse effects on the developing fetus or neonate, no psychotropic drug is of proven safety. It is therefore very important that psychotropic medication should not be prescribed lightly during pregnancy or lactation and that such drugs should be prescribed only where there are positive indications for their use. Close collaboration between obstetrician and psychiatrist is recommended before treatment of a mental illness with psychotropic medication. Breast feeding should not routinely be suspended in mothers who require psychotropic medication. There is an adequate range of psychotropic drugs available to safely treat the pregnant or lactating woman who is mentally ill. MH - Antiparkinson Agents/THERAPEUTIC USE ; Breast Feeding ; Electroconvulsive Therapy ; Female ; Human ; Lithium/ADVERSE EFFECTS/THERAPEUTIC USE ; Pregnancy ; Pregnancy Complications/ DRUG THERAPY/*THERAPY ; Psychotic Disorders/DRUG THERAPY/*THERAPY ; Psychotropic Drugs/ADVERSE EFFECTS/THERAPEUTIC USE ; Puerperal Disorders/DRUG THERAPY/*THERAPY SO - Clin Obstet Gynaecol 1986 Jun;13(2):385-95 7 UI - 86268876 AU - Sharp PT ; Dennerstein L ; Hrasky M ; Lynch C ; Burrows GD TI - A mother and baby unit in a psychiatric hospital. AB - Two rooms where women with puerperal psychiatric illness could be admitted together with their babies were provided in a general psychiatric unit. Over a 21-month-period demand for joint admission far exceeded capacity and most referrals could not be accepted. Women with various psychiatric disorders were referred to and managed in the unit. Greatest demand was for young women suffering from psychosis following childbirth. MH - Breast Feeding ; Female ; *Hospital Units ; *Hospitals, Psychiatric ; Human ; Infant, Newborn ; Mothers/PSYCHOLOGY ; Pregnancy ; Psychotic Disorders/THERAPY ; Puerperal Disorders/ *THERAPY ; Socioeconomic Factors SO - Aust NZ J Obstet Gynaecol 1986 Feb;26(1):44-8 8 UI - 86251332 AU - Gottlieb SE ; Barrett DE TI - Effects of unanticipated cesarean section on mothers, infants, and their interaction in the first month of life. AB - The impact of an unanticipated primary cesarean section on the mother, on the infant, and on their interaction was studied during the perinatal period and at 1 month following delivery. Thirty-four mother-infant pairs participated in the study. Fourteen subjects delivered by nonelective, nonemergency cesarean section. Twenty mothers, who delivered vaginally, served as the controls. All subjects had attended a series of prepared childbirth classes. Maternal questionnaire and infant observational data were collected on day 2 and on day 30. Mother-infant interactions in teaching and play sessions were assessed on day 30. The cesarean group was found to have a higher number of obstetrical complications, an increased incidence of maternal depression, and a more difficult convalescence. Previous experience with children emerged as an important mediating variable in the analysis of maternal affective status. No infant behavioral differences were detected as a function of mode of delivery. The discussion highlights the interventions that can be utilized to minimize the negative emotional consequences for women who deliver by cesarean section. MH - Adult ; Cesarean Section/*PSYCHOLOGY ; Child Development ; Depression/OCCURRENCE ; Female ; Follow-Up Studies ; Human ; Infant, Newborn/*PSYCHOLOGY ; *Mother-Child Relations ; Mothers/ *PSYCHOLOGY ; Play and Playthings ; Pregnancy ; Puerperal Disorders/OCCURRENCE ; Pursuit, Smooth SO - J Dev Behav Pediatr 1986 Jun;7(3):180-5 9 UI - 86216984 AU - Cogill SR ; Caplan HL ; Alexandra H ; Robson KM ; Kumar R TI - Impact of maternal postnatal depression on cognitive development of young children. AB - Ninety four women and their first born children took part in a longitudinal study of maternal mental health during pregnancy and after delivery. The children's cognitive functioning was assessed at age 4 using the McCarthy scales, without knowledge of the mothers' psychiatric history or current health. As expected girls performed slightly better than boys and children from middle class and professional families did better than children from working class homes, as did children whose mothers had achieved at least one A level at school. Significant intellectual deficits were found in the children whose mothers had suffered with depression, but only when this depression occurred in the first year of the child's life. Marital conflict and a history of paternal psychiatric problems were independently linked with lower cognitive test scores; together with a working class home background these were the only factors that contributed to the deleterious effect of maternal postnatal depression. MH - *Child Development ; Child, Preschool ; Cognition ; Depression/ *PSYCHOLOGY ; Female ; Human ; Male ; *Maternal Behavior ; Parent-Child Relations ; Pregnancy ; Puerperal Disorders/ *PSYCHOLOGY ; Sex Factors ; Social Class ; Support, Non-U.S. Gov't SO - Br Med J [Clin Res] 1986 May 3;292(6529):1165-7 10 UI - 86214402 AU - O'Hara MW TI - Social support, life events, and depression during pregnancy and the puerperium. AB - A sample of 99 women was studied prospectively from the second trimester of pregnancy until nine weeks post partum. Depressed and nondepressed women identified at the second-trimester assessment and the postpartum assessment were compared on measures of stressful life events and social support provided by their spouses and close confidants. Nine percent of women during pregnancy and 12% of women after delivery were depressed. Women experiencing postpartum depression reported more stressful life events and less support from their spouses after delivery than the women not experiencing postpartum depression. Women experiencing depression during pregnancy reported somewhat less support from their spouses and more support from their confidants than nondepressed women. The results of the study suggest that different causes may be responsible for prepartum and postpartum depression. MH - Adult ; Depressive Disorder/*DIAGNOSIS ; Female ; Human ; *Life Change Events ; Marriage ; Personality Inventory ; Pregnancy ; Pregnancy Complications/*DIAGNOSIS ; Prospective Studies ; Puerperal Disorders/*DIAGNOSIS ; *Social Environment ; *Social Support ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. SO - Arch Gen Psychiatry 1986 Jun;43(6):569-73 11 UI - 86213846 AU - Reus VI TI - Behavioral disturbances associated with endocrine disorders. AB - Patients with major endocrine disorders frequently experience significant changes in mood and mentation. Similarly, many individuals presenting as psychiatric patients have pathologic alterations in neuroendocrine function. Although pathognomic behavioral changes are rare, increased recognition of characteristic symptom complexes may lead to earlier diagnosis and improved treatment planning. MH - Addison's Disease/COMPLICATIONS ; Adenoma/COMPLICATIONS ; Adult ; Affective Symptoms/ETIOLOGY ; Child ; Cushing's Syndrome/ COMPLICATIONS ; Depression/ETIOLOGY ; Endocrine Diseases/ *COMPLICATIONS ; Female ; Human ; Hyperparathyroidism/ COMPLICATIONS ; Hyperprolactinemia/COMPLICATIONS ; Hyperthyroidism/COMPLICATIONS ; Hypopituitarism/COMPLICATIONS ; Hypothyroidism/COMPLICATIONS ; Mental Disorders/*ETIOLOGY ; Parathyroid Neoplasms/COMPLICATIONS ; Personality Disorders/ ETIOLOGY ; Pregnancy ; Psychotic Disorders/ETIOLOGY ; Puerperal Disorders/ETIOLOGY ; Review SO - Annu Rev Med 1986;37:205-14 12 UI - 86212428 AU - Quadagno DM ; Dixon LA ; Denney NW ; Buck HW TI - Postpartum moods in men and women. AB - Twenty-one married couples, recruited from childbirth classes (mean age 29.6 years), were administered questionnaires measuring 20 different moods during the third trimester of pregnancy (prepartum period), during the postpartum period, and at 6 months after birth (follow-up period). In each questionnaire period individual questionnaires were filled out daily by both the mother and father for 10 consecutive days. The results indicated that the postpartum period, compared with the prepartum and follow-up periods, is an emotionally unique time but not a period marked by depression. The moods that were rated as being experienced more strongly by men and women during the postpartum period were associated with anxiety and concern for one's ability to cope such as "nervousness,: "worried,: "helpless,: and "anxious: or positive emotions such as "enthusiastic: and "happy.: It is concluded that men and women in this sample tend to experience the postpartum period in an emotionally similar way. MH - Adult ; Affect ; Anxiety ; Attitude ; Comparative Study ; Depression/OCCURRENCE ; *Emotions ; Female ; Human ; Male ; Middle Age ; Parents/*PSYCHOLOGY ; Pregnancy ; Puerperal Disorders/OCCURRENCE ; *Puerperium ; Questionnaires ; Support, Non-U.S. Gov't ; Time Factors SO - Am J Obstet Gynecol 1986 May;154(5):1018-23 13 UI - 86211320 AU - Persson-Blennow I ; N:aslund B ; McNeil TF ; Kaij L TI - Offspring of women with nonorganic psychosis: mother-infant interaction at one year of age. AB - Mother-infant interaction during feeding and in an unstructured play situation was studied in the home at 1 year of age in 46 index mother-infant pairs in which the mother had a history of nonorganic psychosis and in 80 demographically similar control pairs. As was true at the five previous observation ages, some aspects of the interaction were significantly more negative in index than control pairs. Index mothers showed increased tension and uncertainty regarding the infant's needs, increased physical contact during feeding and a discrepancy between the intonation and content of the mother's verbal contact with the infant. Index infants did not differ from controls in behavior in interaction. Across the entire first year, the Cycloid and Schizophrenic mothers deviated most frequently from controls, while the Affectives' interaction was more negative than controls' for the first time at the 1-year observation. MH - Adult ; Affective Disorders, Psychotic/PSYCHOLOGY ; Cyclothymic Disorder/PSYCHOLOGY ; Female ; Follow-Up Studies ; Human ; Infant ; Infant Care ; Infant, Newborn ; Maternal Behavior ; *Mother-Child Relations ; Play and Playthings ; Pregnancy ; Psychotic Disorders/*PSYCHOLOGY ; Puerperal Disorders/*PSYCHOLOGY ; Schizophrenic Psychology ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. SO - Acta Psychiatr Scand 1986 Feb;73(2):207-13 14 UI - 86205830 AU - Kennerley H ; Gath D TI - Maternity blues reassessed. AB - Maternity Blues, although seldom a serious problem in clinical practice, is potentially important to research on affective disorders in general. Childbirth is a major life event known to be associated with large changes in maternal hormones. The determinants of the Blues may therefore be psychological and social, or biological, or both. This paper reviews the relevant literature. Reported associations between Maternity Blues and psychiatric disorder are examined. Possible psychological, social and biochemical determinants are reviewed, but no firm inferences on causation can yet be drawn. Conflicting results in the literature may have been due to variations in definition and measurement of the syndrome. The authors have recently used psychometric methods to develop a questionnaire for detecting and measuring Maternity Blues. By cluster analysis of responses to the questionnaire, a 'Primary Blues' cluster was defined, consisting of 7 items: tearful, tired, anxious, over-emotional, up and down in mood, low spirited, muddled in thinking. The item 'depression' appeared in another less frequent cluster. MH - Affective Disorders, Psychotic/DIAGNOSIS ; Depressive Disorder/ *DIAGNOSIS/PSYCHOLOGY ; Estrogens/BLOOD ; Female ; Human ; Organic Mental Disorders/DIAGNOSIS ; Pregnancy ; Progesterone/ BLOOD ; Psychological Tests ; Puerperal Disorders/*DIAGNOSIS/ PSYCHOLOGY ; Research ; Schizophrenia/DIAGNOSIS ; Stress, Psychological/COMPLICATIONS SO - Psychiatr Dev 1986 Spring;4(1):1-17 15 UI - 86205284 AU - Fawcett J ; York R TI - Spouses' physical and psychological symptoms during pregnancy and the postpartum. AB - This cross-sectional descriptive study investigated the type and frequency of physical and psychological symptoms experienced by pregnant and postpartal women and their spouses. The sample of 70 married couples included 23 pairs in an early pregnancy group, 24 in a late pregnancy group, and 23 in a postpartum group. Both spouses completed a symptoms checklist of 20 physical and 3 psychological symptoms and the Beck Depression Inventory. Findings indicate that both spouses experienced some physical and psychological symptoms during pregnancy and the postpartum, although the women reported many more symptoms than did the men. Women in the late pregnancy group reported the highest number of physical symptoms; those in the postpartum group, the lowest number. No differences, however, in reports of psychological symptoms were found among the three groups of women. No significant differences in reports of either physical or psychological symptoms were found among the three groups of men. MH - Adult ; Anxiety ; Appetite ; Cross Sectional Studies ; Depression ; Fatigue ; Female ; Human ; Male ; *Marriage ; Nausea ; Personality Inventory ; *Pregnancy ; *Puerperium ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. ; Vomiting SO - Nurs Res 1986 May-Jun;35(3):144-8 16 UI - 86079013 AU - Robinson GE ; Stewart DE TI - Postpartum psychiatric disorders. AB - Postpartum blues, postpartum neurotic depression and puerperal psychoses have distinct clinical features; they affect women in all social classes and in all cultures, and despite numerous studies they have not been linked definitively with any biologic or psychosocial variables. The only possible exception is puerperal psychosis, which emerges much more often in women with a personal or family history of a bipolar affective disorder than in women without, a finding that probably explains the reluctance of some researchers to recognize puerperal psychotic episodes as distinct from psychotic episodes at other times. If postpartum blues last longer than 2 weeks and are disabling they are classified as neurotic depression and warrant treatment, often requiring both psychosocial approaches and psychotropic drug therapy. Antidepressants, major tranquillizers, electroconvulsive therapy and lithium have proved effective in the treatment of postpartum psychoses, depending on the symptoms. Both lithium and diazepam have been reported to cause deleterious side effects on breast-fed infants, and as the side effects of other psychotropic drugs given to a nursing mother are imperfectly understood, bottle feeding seems prudent. MH - Adult ; Antidepressive Agents, Tricyclic/THERAPEUTIC USE ; Case Report ; Family ; Female ; Human ; Infant, Newborn ; Lithium/ THERAPEUTIC USE ; Milk, Human ; Pregnancy ; Psychotherapy, Brief ; Psychotic Disorders/DRUG THERAPY/OCCURRENCE/*PHYSIOPATHOLOGY ; Puerperal Disorders/DRUG THERAPY/OCCURRENCE/*PHYSIOPATHOLOGY ; Recurrence ; Review ; Time Factors SO - Can Med Assoc J 1986 Jan 1;134(1):31-7