Generalized anxiety disorder: course and risk factors in pregnancy.
BACKGROUND
There are limited studies of generalized anxiety disorder (GAD) across pregnancy.


METHODS
Women (n = 2793) were enrolled in the Yale Pink and Blue study, a cohort enriched with subjects who suffered from major depressive disorder (MDD) within the past five years or used antidepressants in the past year. Subjects were evaluated with the Composite International Diagnostic Interview at three time points: twice in pregnancy and once after delivery. We defined a generalized anxiety disorder (GAD) episode as per DSM IV but with required duration reduced to one month or longer. Course and correlates of GAD were examined in women who had: 1) no GAD during the 6 months prior or in pregnancy (Group A), 2) GAD in the 6 months prior to but not in pregnancy (Group B), 3) GAD in pregnancy only (Group C) and 4) GAD both in the 6 months prior to and during pregnancy (Group D).


RESULTS
9.5% of the cohort suffered from GAD at some point in pregnancy. Anxiety symptoms were highest in the first trimester and decreased across pregnancy. Regression analysis revealed that previous GAD episodes, education, social support and a history of child abuse distinguished between membership in the four groups.


CONCLUSIONS
The sample may not be representational, as it was enhanced with those at risk, and had relatively low representation of socio-economically disadvantaged women.


CONCLUSIONS
Identification of anxious patients during pregnancy may provide an opportunity to engage those in need of psychiatric treatment.
Dept Psychiatry, University of Melbourne, Austin Health, Heidelberg 3081, Victoria, Australia.
Anne
A
Buist
Nathan
N
Gotman
Kimberly Ann
KA
Yonkers
D000328:Adult; D001008:Anxiety Disorders / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology / Q000523:psychology*; D011264:Pregnancy Trimesters / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012307:Risk Factors; D012944:Social Support; D055815:Young Adult
Psychiatr Serv. 2009 Mar;60(3):322-8
19252044
Obstet Gynecol. 2007 Nov;110(5):1102-12
17978126
Birth. 2006 Dec;33(4):297-302
17150068
Br J Psychiatry Suppl. 2004 Feb;46:s31-7
14754816
J Affect Disord. 2008 May;108(1-2):101-11
18001841
Acta Obstet Gynecol Scand. 2006;85(8):937-44
16862471
Arch Womens Ment Health. 2003 Feb;6(1):51-7
12715264
Early Hum Dev. 2010 May;86(5):305-10
20547016
Can J Psychiatry. 1995 Mar;40(2):87-92
7788623
Can J Psychiatry. 2008 Jul;53(7):435-40
18674401
J Abnorm Psychol. 2004 Aug;113(3):471-6
15311992
J Affect Disord. 2010 Jan;120(1-3):258-62
19428119
Harv Rev Psychiatry. 2000 Sep;8(3):148-53
10973939
Dev Neuropsychol. 2009;34(4):476-93
20183712
J Affect Disord. 2003 Apr;74(2):139-47
12706515
J Affect Disord. 2009 Apr;114(1-3):216-23
18765164
J Trauma Stress. 2008 Apr;21(2):218-22
18404649
Soc Psychiatry Psychiatr Epidemiol. 2005 Dec;40(12):972-9
16249971
Child Abuse Negl. 2001 Jul;25(7):909-21
11523868
Br J Psychiatry. 2001 Aug;179:151-6
11483477
Br J Psychiatry Suppl. 1996 Jun;(30):68-75
8864151
Gen Hosp Psychiatry. 2010 Mar-Apr;32(2):213-5
20302997
Aust N Z J Psychiatry. 1998 Jun;32(3):370-8
9672726
Arch Womens Ment Health. 2009 Oct;12(5):345-9
19565328
Br J Psychiatry. 1987 Jun;150:782-6
3651732
J Womens Health (Larchmt). 2010 Mar;19(3):477-90
20156110
Infant Behav Dev. 2010 Feb;33(1):23-9
19945170
J Affect Disord. 2009 Dec;119(1-3):142-8
19346001
Am J Psychiatry. 2006 May;163(5):881-4
16648330
Stress. 2011 Jan;14(1):53-65
20666659