The course of panic disorder during the peripartum period and the risk for adverse child development: A prospective-longitudinal 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:
01 04 2020
Historique:
received: 12 10 2018
revised: 20 12 2019
accepted: 03 01 2020
entrez: 29 3 2020
pubmed: 29 3 2020
medline: 16 2 2021
Statut: ppublish

Résumé

Panic disorders during pregnancy and after delivery may have detrimental effects for mother and child, but no firm conclusions regarding the course and outcomes of peripartum panic disorders can be drawn from previous studies. N = 306 women were repeatedly interviewed with the Composite International Diagnostic Interview for Women. Social support and partnership quality, gestational outcomes, duration of breastfeeding, regulatory disorders, maternal bonding and parenting style were assessed via medical and maternal reports. Standardized observations of neuropsychological development, infant temperament and attachment were conducted 4 and 16 months after delivery. Women reported heterogenous courses of panic disorders, and panic disorders/panic attacks were commonly observed during the early stages of pregnancy. Women with peripartum panic disorders presented with a worse psychosocial situation (e.g., lower social support). Clear behavioral differences (temperament, attachment) in infants of women with panic disorders as compared to women with no anxiety and depressive disorder could not be detected in this study, but differences concerning gestational outcomes, duration of breastfeeding, maternal parenting, and bonding as well as regulatory problems in infants were identified. This prospective-longitudinal multi-wave study is restricted by the relative small sizes of the particular groups that limit the power to detect group differences. Heterogenous courses and outcomes of perinatal panic disorders require intensive monitoring of affected mother-infant-dyads who may benefit from early targeted interventions to prevent an escalation of dyadic problems.

Sections du résumé

BACKGROUND
Panic disorders during pregnancy and after delivery may have detrimental effects for mother and child, but no firm conclusions regarding the course and outcomes of peripartum panic disorders can be drawn from previous studies.
METHODS
N = 306 women were repeatedly interviewed with the Composite International Diagnostic Interview for Women. Social support and partnership quality, gestational outcomes, duration of breastfeeding, regulatory disorders, maternal bonding and parenting style were assessed via medical and maternal reports. Standardized observations of neuropsychological development, infant temperament and attachment were conducted 4 and 16 months after delivery.
RESULTS
Women reported heterogenous courses of panic disorders, and panic disorders/panic attacks were commonly observed during the early stages of pregnancy. Women with peripartum panic disorders presented with a worse psychosocial situation (e.g., lower social support). Clear behavioral differences (temperament, attachment) in infants of women with panic disorders as compared to women with no anxiety and depressive disorder could not be detected in this study, but differences concerning gestational outcomes, duration of breastfeeding, maternal parenting, and bonding as well as regulatory problems in infants were identified.
LIMITATIONS
This prospective-longitudinal multi-wave study is restricted by the relative small sizes of the particular groups that limit the power to detect group differences.
CONCLUSIONS
Heterogenous courses and outcomes of perinatal panic disorders require intensive monitoring of affected mother-infant-dyads who may benefit from early targeted interventions to prevent an escalation of dyadic problems.

Identifiants

pubmed: 32217255
pii: S0165-0327(18)32404-2
doi: 10.1016/j.jad.2020.01.018
pii:
doi:

Types de publication

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

Langues

eng

Sous-ensembles de citation

IM

Pagination

722-730

Informations de copyright

Copyright © 2020. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of Competing Interest Prof. Dr. Hans-Ulrich Wittchen reports the following, which might be perceived as a potential conflict of interest: Prof. Dr. Hans-Ulrich Wittchen is on the advisory board of the Lundbeck Institute Skodsborg, Denmark and has also received grant support from there. All other authors declare that they have no financial relationships that might be perceived as a potential conflict of interest. All authors had complete freedom to direct the analysis and its reporting within the current manuscript without influence from the sponsors. There was no editorial direction or censorship from the sponsors.

Auteurs

Julia Martini (J)

Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Department of Psychiatry & Psychotherapy, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany. Electronic address: julia.martini@tu-dresden.de.

Katja Beesdo-Baum (K)

Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Department of Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany.

Susan Garthus-Niegel (S)

Institute and Outpatient Clinics of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany; Department of Child Health, Norwegian Institute of Public Health, Oslo, Norway.

Hans-Ulrich Wittchen (HU)

Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Department of Psychiatry & Psychotherapy, Ludwig Maximilans Universitaet Munich, Munich, Germany.

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Classifications MeSH