title: Do changes in subjective sleep and biological rhythms predict worsening in postpartum depressive symptoms? A prospective study across the perinatal period.
abstract: Abnormalities of sleep and biological rhythms have been widely implicated in the pathophysiology of major depressive disorder (MDD) and bipolar disorder (BD). However, less is known about the influence of biological rhythm disruptions across the perinatal period on postpartum depression (PPD). The objective of this study was to prospectively evaluate the relationship between subjective changes in both sleep and biological rhythms and worsening of depressive symptoms from pregnancy to the postpartum period in women with and without mood disorders. Eighty-three participants (38 euthymic women with a history of a mood disorder and 45 healthy controls) were studied. Participants completed subjective assessments of sleep (Pittsburgh Sleep Quality Index), biological rhythm disturbances (Biological Rhythms Interview of Assessment in Neuropsychiatry), and depressive symptoms (Edinburgh Postnatal Depression Scale) prospectively at two time points: third trimester of pregnancy and at 6-12 weeks postpartum. Multivariate regression analyses showed that changes in biological rhythms across the perinatal period predicted worsening of depressive symptoms in both groups. Moreover, women with a history of a mood disorder showed higher levels of sleep and biological rhythm disruption during both pregnancy and the postpartum period. These findings suggest that disruptions in biological rhythms during the perinatal period increase the risk for postpartum mood worsening in healthy pregnant as well as in pregnant women with a history of mood disorders.
authors.affiliation: MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, Canada.|Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Canada.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Krawczak
authors.affiliation: MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, Canada.|Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Canada.|Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.|Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th Street, Suite C124, Hamilton, ON, L8N 3K7, Canada.
authors.forename: Luciano
authors.initials: L
authors.lastname: Minuzzi
authors.affiliation: Department of Psychiatry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.|Laboratorio de Cronobiologia HCPA/UFRGS, Porto Alegre, RS, Brazil.
authors.forename: Maria Paz
authors.initials: MP
authors.lastname: Hidalgo
authors.affiliation: MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, Canada. freybn@mcmaster.ca.|Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Canada. freybn@mcmaster.ca.|Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada. freybn@mcmaster.ca.|Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th Street, Suite C124, Hamilton, ON, L8N 3K7, Canada. freybn@mcmaster.ca.
authors.forename: Benicio N
authors.initials: BN
authors.lastname: Frey
mesh_terms: D000328:Adult; D001714:Bipolar Disorder; D002940:Circadian Rhythm; D019052:Depression, Postpartum / Q000503:physiopathology*; D005260:Female; D006801:Humans; D018743:Perinatal Care; D011247:Pregnancy; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012720:Severity of Illness Index; D012890:Sleep; D011795:Surveys and Questionnaires
keywords: Biological rhythms; Mood; Postpartum; Pregnancy; Sleep