Course of a major postpartum depressive episode: A prospective 2 years naturalistic follow-up study.


Journal

Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073

Informations de publication

Date de publication:
15 02 2019
Historique:
received: 22 01 2018
revised: 30 09 2018
accepted: 03 11 2018
entrez: 1 2 2019
pubmed: 1 2 2019
medline: 4 4 2019
Statut: ppublish

Résumé

Survival methodology has not already been used in studies about postpartum depression (PPD) course. The aims of the present study were to estimate the duration of a Major Postpartum Depressive Episode (MPDE) during 2 years, as well as to explore factors associated with the course. This was a prospective, naturalistic, longitudinal study with a cohort of 165 women with a MPDE (DSM-IV criteria). Potential predictors of prognosis were recorded at baseline. Follow-up was conducted using the Longitudinal Interval Follow-up Evaluation (LIFE). Of the total sample, 110 (66.7%) completed the 2 years follow-up. The mean time to full remission was 49.4 weeks (95% CI: 44.0-59.8). The probability of recovering was 30.2% (95% CI: 22.1%-37.4%) at 6 months of follow-up, 66.3% (95% CI: 57.4%-73.4%) at 12 months of follow-up, and 90.3% (95% CI: 79.8%-95.4%) at 24 months of follow-up. Mothers with financial difficulties, onset of depressive episode previous to birth, and those with prior treated depressive episodes took longer in achieving full remission. Results are only generalizable to mothers with PPD treated in a psychiatric outpatient setting. Psychopharmacological treatment was uncontrolled and personality was not assessed. Our findings suggest that PPD could become a chronic disorder, particularly in mothers with an onset of the episode previous to birth, with a history of depression or with financial problems. Knowledge of these factors may help to improve the guidelines of depression management and treatment during the perinatal period.

Sections du résumé

BACKGROUND
Survival methodology has not already been used in studies about postpartum depression (PPD) course. The aims of the present study were to estimate the duration of a Major Postpartum Depressive Episode (MPDE) during 2 years, as well as to explore factors associated with the course.
METHOD
This was a prospective, naturalistic, longitudinal study with a cohort of 165 women with a MPDE (DSM-IV criteria). Potential predictors of prognosis were recorded at baseline. Follow-up was conducted using the Longitudinal Interval Follow-up Evaluation (LIFE).
RESULTS
Of the total sample, 110 (66.7%) completed the 2 years follow-up. The mean time to full remission was 49.4 weeks (95% CI: 44.0-59.8). The probability of recovering was 30.2% (95% CI: 22.1%-37.4%) at 6 months of follow-up, 66.3% (95% CI: 57.4%-73.4%) at 12 months of follow-up, and 90.3% (95% CI: 79.8%-95.4%) at 24 months of follow-up. Mothers with financial difficulties, onset of depressive episode previous to birth, and those with prior treated depressive episodes took longer in achieving full remission.
LIMITATIONS
Results are only generalizable to mothers with PPD treated in a psychiatric outpatient setting. Psychopharmacological treatment was uncontrolled and personality was not assessed.
CONCLUSIONS
Our findings suggest that PPD could become a chronic disorder, particularly in mothers with an onset of the episode previous to birth, with a history of depression or with financial problems. Knowledge of these factors may help to improve the guidelines of depression management and treatment during the perinatal period.

Identifiants

pubmed: 30699882
pii: S0165-0327(18)30152-6
doi: 10.1016/j.jad.2018.11.062
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

965-970

Informations de copyright

Copyright © 2018. Published by Elsevier B.V.

Auteurs

Anna Torres (A)

Unitat de Salut Mental Perinatal CLINIC-BCN, Hospital Clínic, Barcelona, Spain; Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Psychiatry and Clinical Psychology, Universitat de Barcelona, Barcelona, Spain.

Estel Gelabert (E)

Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Bellaterra, Spain.

Alba Roca (A)

Unitat de Salut Mental Perinatal CLINIC-BCN, Hospital Clínic, Barcelona, Spain.

Purificación Navarro (P)

Servei de Psicologia, Regidoria de Polítiques de Gènere Ajuntament de Terrassa, Terrassa, Spain.

Anna Plaza (A)

Unitat de Crisi i Prevenció del Suicidi, CPB-Dreta Eixample, Barcelona, Spain.

Susana Subirà (S)

Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Bellaterra, Spain.

Rocío Martin-Santos (R)

Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Psychiatry and Clinical Psychology, Hospital Clinic, Barcelona, Spain; Department of Medicine, Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), Spain.

Carlos Ascaso (C)

Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Biostatistics Unit, Public Health Department, Universitat de Barcelona, Barcelona, Spain.

Lluïsa Garcia-Esteve (L)

Unitat de Salut Mental Perinatal CLINIC-BCN, Hospital Clínic, Barcelona, Spain; Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. Electronic address: LESTEVE@clinic.cat.

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