title: The impact of perinatal depression on the evolution of anxiety and obsessive-compulsive symptoms.
abstract: We sought to examine the evolution of postpartum anxiety, obsessions and compulsions over time, and the influence of depression on their clinical course. This was a prospective cohort of obstetric patients enrolled at a tertiary care women's hospital. Women were recruited immediately postpartum and followed for 6 months. Women were screened for depression, state-trait anxiety, and obsessive-compulsive symptoms and dichotomized by the presence of depression. Four hundred sixty-one women agreed to participate in the study and completed the 2 weeks postpartum assessment; 331 (72 %) women completed the assessment at 6 months postpartum. At 2 weeks postpartum, 28 (19.9 %) women with depression had anxiety symptoms, compared to 4 (1.3 %) women who screened negative for depression (p < 0.001). Similarly, 36 (25.7 %) women with depression endorsed obsessions and compulsions compared to 19 (8.4 %) women without depression (p < 0.001). A significant interaction effect was present with anxiety over time such that by 6 months postpartum, there were no differences in symptoms in women with and without depression (p = 0.860). Conversely, the differences in obsessions and compulsions between depressed and non-depressed women persisted (p = 0.017). Women with postpartum depression are more likely to experience comorbid state-trait anxiety and obsessive-compulsive symptoms in the immediate postpartum period. While state-trait anxiety symptoms tend to resolve with time, obsessive-compulsive symptoms persist. Understanding these temporal trends is critical to tailor appropriate monitoring and treatment.
authors.affiliation: Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, 250 E Superior St, Suite 05-2185, Chicago, IL, 60611, USA, emily-miller-1@northwestern.edu.
authors.forename: Emily S
authors.initials: ES
authors.lastname: Miller
authors.forename: Denada
authors.initials: D
authors.lastname: Hoxha
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Wisner
authors.forename: Dana R
authors.initials: DR
authors.lastname: Gossett
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000453:epidemiology* / Q000523:psychology; D003863:Depression / Q000175:diagnosis* / Q000523:psychology; D019052:Depression, Postpartum / Q000175:diagnosis* / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D009771:Obsessive-Compulsive Disorder / Q000453:epidemiology* / Q000523:psychology; D010552:Personality Assessment / Q000706:statistics & numerical data*; D010555:Personality Inventory; D049590:Postpartum Period; D011247:Pregnancy; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires; D055815:Young Adult