Beyond "postpartum depressions": specific anxiety diagnoses during pregnancy predict different outcomes: results from PND-ReScU.
OBJECTIVE
Literature underlines that the Edinburgh Postnatal Depression Scale (EPDS) is the most common measure to assess postpartum depression (PPD) worldwide and suggests that the rate of false positives is high. Furthermore, the EPDS does not distinguish between depression and anxiety. This study describes different definitions of PPD and whether pregnancy anxiety disorders are risk factors for different PPDs at both 1month and 1year postpartum.


METHODS
1066 women were recruited during pregnancy and followed until the 12th month postpartum (N=500). Women were administered the SCID and completed the PDPI-R during pregnancy. During the postpartum women who had an EPDS score of 13 or more were administered the SCID to distinguish minor or major depressive episodes (mMD) from false positives.


RESULTS
41.5% and 44.9% of the PPD assessed with the EPDS were false positives at the 1st month and during the 1st year postpartum respectively. The difference observed in prevalence rates estimated with EPDS and SCID was statistically significant both at the 1st month and during the 1st year postpartum. Overall the effect of anxiety diagnoses in predicting PPD was stronger at the 1st month than during the 1st year postpartum. The role of panic disorder is associated both with probable depression (ES=0.82) and with mMD (ES=0.87) at the 1st month postpartum, and predicted mMD during the 1st year postpartum (ES=0.71). OCD predicted false positives at the 1st month postpartum (ES=0.89).


CONCLUSIONS
An antenatal screening of specific anxiety diagnoses could be extremely useful for the prevention of possible postpartum distress outcomes.
Mauri
Mauro
M
Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, School of Medicine, University of Pisa, Pisa, Italy. mmauri@psico.med.unipi.it
Oppo
Annalisa
A
Montagnani
Maria Sole
MS
Borri
Chiara
C
Banti
Susanna
S
Camilleri
Valeria
V
Cortopassi
Sonia
S
Ramacciotti
Daniele
D
Rambelli
Cristina
C
Cassano
Giovanni B
GB
D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D019052:Depression, Postpartum / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy; D016584:Panic Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D010555:Personality Inventory / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D011379:Prognosis; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012307:Risk Factors; D055815:Young Adult