==================================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