The incidence of depressive episodes is different before, during, and after pregnancy: A population-based study.
DSM-V
Depression
Incidence
Postpartum
Pregnancy
Recurrence
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 02 2023
01 02 2023
Historique:
received:
18
01
2022
revised:
08
11
2022
accepted:
11
11
2022
pmc-release:
01
02
2024
pubmed:
18
11
2022
medline:
7
12
2022
entrez:
17
11
2022
Statut:
ppublish
Résumé
Depressive episodes during pregnancy are widely investigated but it is still unknown whether pregnancy is a high-risk period compared to the pre-pregnancy period. Therefore, we aimed to investigate the incidence and recurrence of depressive episodes before, during, and after pregnancy. In the current population-based registry study, we calculated monthly incidence and recurrence of psychiatric inpatient admissions and outpatient psychiatric contact for depressive episodes. We identified a population consisting of all first childbirths in Denmark from 1999 through 2015 (N = 392,287). Incidence of inpatient admission during pregnancy was lower than before pregnancy. After childbirth, a significant increase in first-time and recurrent psychiatric inpatient admissions was observed, especially in the first months. In contrast, outpatient psychiatric treatment incidence and recurrence were increased both during pregnancy as well as in the postpartum period, as compared to pre-pregnancy. Analyses were performed on depressive episodes representing the severe end of the spectrum, questioning generalizability to milder forms of depression treated outside psychiatric specialist treatment facilities. We found a different pattern of severe episodes of depression compared to moderate episodes before, during, and after pregnancy. In light of our findings and those of others, we suggest distinguishing between timing of onset in the classification of depression in the perinatal period: Depression with pregnancy onset OR with postpartum onset (instead of the current DSM classifier "with perinatal onset"), as well as severity of depression, which is important for both clinical and future research endeavors.
Sections du résumé
BACKGROUND
Depressive episodes during pregnancy are widely investigated but it is still unknown whether pregnancy is a high-risk period compared to the pre-pregnancy period. Therefore, we aimed to investigate the incidence and recurrence of depressive episodes before, during, and after pregnancy.
METHODS
In the current population-based registry study, we calculated monthly incidence and recurrence of psychiatric inpatient admissions and outpatient psychiatric contact for depressive episodes. We identified a population consisting of all first childbirths in Denmark from 1999 through 2015 (N = 392,287).
RESULTS
Incidence of inpatient admission during pregnancy was lower than before pregnancy. After childbirth, a significant increase in first-time and recurrent psychiatric inpatient admissions was observed, especially in the first months. In contrast, outpatient psychiatric treatment incidence and recurrence were increased both during pregnancy as well as in the postpartum period, as compared to pre-pregnancy.
LIMITATIONS
Analyses were performed on depressive episodes representing the severe end of the spectrum, questioning generalizability to milder forms of depression treated outside psychiatric specialist treatment facilities.
CONCLUSION
We found a different pattern of severe episodes of depression compared to moderate episodes before, during, and after pregnancy. In light of our findings and those of others, we suggest distinguishing between timing of onset in the classification of depression in the perinatal period: Depression with pregnancy onset OR with postpartum onset (instead of the current DSM classifier "with perinatal onset"), as well as severity of depression, which is important for both clinical and future research endeavors.
Identifiants
pubmed: 36395991
pii: S0165-0327(22)01289-7
doi: 10.1016/j.jad.2022.11.031
pmc: PMC9768818
mid: NIHMS1852201
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
273-276Subventions
Organisme : NIMH NIH HHS
ID : R01 MH122869
Pays : United States
Informations de copyright
Copyright © 2022 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Conflict of Interest The authors state there is no conflict of interest.
Références
Obstet Gynecol. 2018 Apr;131(4):671-679
pubmed: 29528926
Best Pract Res Clin Obstet Gynaecol. 2020 Apr;64:52-58
pubmed: 31672290
Brain Behav. 2019 Nov;9(11):e01441
pubmed: 31613060
Am J Obstet Gynecol. 2005 Feb;192(2):522-6
pubmed: 15695997
Midwifery. 2022 Aug;111:103365
pubmed: 35640360
BMJ Open. 2016 Jan 05;6(1):e008758
pubmed: 26733566
Issues Ment Health Nurs. 2007 Jul;28(7):765-80
pubmed: 17654110
JAMA. 2006 Dec 6;296(21):2582-9
pubmed: 17148723
PLoS Med. 2009 Feb 10;6(2):e13
pubmed: 19209952
J Clin Psychiatry. 2012 Dec;73(12):e1485-91
pubmed: 23290332
Curr Psychiatry Rep. 2015 Oct;17(10):76
pubmed: 26267038
Lancet Psychiatry. 2017 Jun;4(6):477-485
pubmed: 28476427
Epidemiology. 2015 Jan;26(1):79-84
pubmed: 25322321
Focus (Am Psychiatr Publ). 2020 Apr;18(2):106-119
pubmed: 33162848
Open Access Rheumatol. 2016 Mar 23;8:23-36
pubmed: 27843367
Br J Gen Pract. 2017 Oct;67(663):e692-e699
pubmed: 28847773
Obstet Med. 2012 Sep;5(3):94-7
pubmed: 27582863
J Affect Disord. 2019 Apr 1;248:139-146
pubmed: 30731281
Acta Psychiatr Scand. 2019 Jun;139(6):548-557
pubmed: 30908590
Scand J Public Health. 2011 Jul;39(7 Suppl):54-7
pubmed: 21775352
J Affect Disord. 2017 Sep;219:86-92
pubmed: 28531848
Hum Reprod. 2020 Apr 28;35(4):958-967
pubmed: 32227097
Scand J Public Health. 2011 Jul;39(7 Suppl):22-5
pubmed: 21775345
Depress Anxiety. 2014 Jun;31(6):459-71
pubmed: 24272961
Arch Womens Ment Health. 2020 Feb;23(1):71-79
pubmed: 30762147
Arch Womens Ment Health. 2017 Feb;20(1):11-23
pubmed: 27796597
Psychiatr Serv. 2004 Apr;55(4):407-14
pubmed: 15067153
Obstet Gynecol. 2005 Nov;106(5 Pt 1):1071-83
pubmed: 16260528
Thyroid. 1999 Jul;9(7):705-13
pubmed: 10447018
Arch Womens Ment Health. 2012 Oct;15(5):333-41
pubmed: 22643848