title: Twin pregnancies: evaluation of major depression, stress, and social support.
abstract: BACKGROUND
  Twin pregnancies are at increased physiological and psychosocial risks.
  
  
  OBJECTIVE
  To investigate the prevalence of major depression in twin pregnancies and correlate with stress and social support.
  
  
  METHODS
  The study included 51 pregnant women under specialized prenatal care who were evaluated by a Portuguese version of the semi-structured questionnaire Primary Care Evaluation of Mental Disorders (PRIME-MD) for Major Depression, and the Prenatal Psychosocial Profile (PPP) for evaluation of stress and social support.
  
  
  RESULTS
  Major depression was found in 33.3% of pregnant women, and prevailing symptoms were fatigue or loss of energy (100%), insomnia or hypersomnia (82.4%), changes in appetite (82.4%), decreased interest in daily activities (82.4%), and psychomotor agitation or retardation (82.4%). Among pregnant women who were diagnosed depressive, 76.5% also had a high level of stress and 47.1% complained about lack of social support. Statistical significance was found when correlating depression with perception of negative aspects of having twins and belief in significant body changes during pregnancy (p = .005 and .03, respectively). Marital status, occupation, and pregnancy planning were not significantly associated with the diagnosis of depression.
  
  
  CONCLUSIONS
  Major depression occurs in one-third of pregnant women expecting twins and is associated with higher levels of stress and lack of social support. A multidisciplinary approach in these cases is fundamental to minimize further risks and complications.
authors: Psychology Division, Hospital das Clínicas, São Paulo, Brazil. grguerra@uol.com.br
authors: Glaucia R G
authors: GR
authors: Benute
authors: Debora C R
authors: DC
authors: Nozzella
authors: Cecilia
authors: C
authors: Prohaska
authors: Adolfo
authors: A
authors: Liao
authors: Mara C S
authors: MC
authors: de Lucia
authors: Marcelo
authors: M
authors: Zugaib
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology*; D059285:Pregnancy, Twin / Q000523:psychology*; D011379:Prognosis; D011446:Prospective Studies; D012944:Social Support; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult