title: Heterogeneity in perinatal depression: how far have we come? A systematic review.
abstract: Despite perinatal depression (PND) being a common mental disorder affecting pregnant women and new mothers, limited attention has been paid to the heterogeneous nature of this disorder. We examined heterogeneity in PND symptom profiles and symptom trajectories. Literature searches revealed 247 studies, 23 of which were included in the final review. The most common statistical approaches used to explore symptom and trajectory heterogeneity were latent class model and growth mixture model. All but one study examined PND symptom trajectories and provided collective evidence of at least three heterogeneous patterns: low, medium, or chronic-high symptom levels. Social and psychological risk factors were the most common group of predictors related to a higher burden (high sum of score) of depressive symptoms. These studies were consistent in reporting poorer health outcomes for children of mothers assigned to high burden symptom trajectories. Only one study explored heterogeneity in symptom profile and was the only one to describe the specific constellations of depressive symptoms related to the PND heterogeneous patterns identified. Therefore, there is limited evidence on the specific symptoms and symptom configurations that make up PND heterogeneity. We suggest directions for future research to further clarify the PND heterogeneity and its related mechanisms.
authors: School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, CB# 7460, Chapel Hill, NC, 27599, USA. hsantos@unc.edu.
authors: Hudson
authors: 0000-0002-4040-366X
authors: H
authors: Santos
authors: Department of Biostatistics, Lineberger Comprehensive Cancer Center, and Gillings School of Global Public Health, University of North Carolina at Chapel Hill, CB# 7295, Chapel Hill, NC, 27599, USA.
authors: Xianming
authors: X
authors: Tan
authors: School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, CB# 7460, Chapel Hill, NC, 27599, USA.
authors: Rebecca
authors: R
authors: Salomon
mesh_terms: D000328:Adult; D003863:Depression / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D006801:Humans; D009035:Mothers / Q000523:psychology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000523:psychology*; D011644:Puerperal Disorders / Q000175:diagnosis* / Q000523:psychology*
keywords: Heterogeneity; Latent class; Perinatal depression; Profile; Trajectory