title: Preconception personality disorder and antenatal maternal mental health: A population-based cohort study.
abstract: Prior anxiety and depression have been identified as risk factors for maternal perinatal mental health problems, but other preconception mental disorders have not been prospectively examined. This study investigated prospectively whether women with preconception personality disorder have increased rates of antenatal anxiety and/or depressive symptoms.
  
  
  
  244 women in a population cohort were assessed for personality disorder at age 24 using the Standardised Assessment of Personality. Five to twelve years later, women were screened with the Clinical Interview Schedule, Revised Anxiety Subscale and the Edinburgh Postnatal Depression Scale during the third trimester of 328 pregnancies.
  
  
  
  Preconception personality disorder was associated with a three-fold increase in the odds of antenatal anxiety symptoms, which remained with adjustment for preconception background factors and preconception common mental disorder (adjusted OR 2.84, 95% CI 1.31-6.15). Preconception personality disorder was associated with doubled odds of antenatal depressive symptoms, however this was attenuated with adjustment for preconception background factors and preconception common mental disorder (adjusted OR 1.98, 95% CI 0.81-4.81).
  
  
  
  Our findings are restricted to pregnant women aged 29-35 years. Anxiety and depression may have been under-identified because they were assessed at a single antenatal time point. Residual confounding of the associations by preconception common mental disorder at other time points may have occurred.
  
  
  
  Women with personality disorder are at heightened risk of anxiety symptoms in pregnancy, over and above risks associated with prior common mental disorder. This raises a possibility that pregnancy brings particular emotional challenges for women with personality disorders.
authors.affiliation: Population Health, Murdoch Childrens Research Institute, Parkville, VIC, Australia; Centre for Adolescent Health, Royal Children's Hospital, Parkville, VIC, Australia; School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Hudson
authors.affiliation: Population Health, Murdoch Childrens Research Institute, Parkville, VIC, Australia; Centre for Adolescent Health, Royal Children's Hospital, Parkville, VIC, Australia; Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Spry
authors.affiliation: Population Health, Murdoch Childrens Research Institute, Parkville, VIC, Australia; Centre for Adolescent Health, Royal Children's Hospital, Parkville, VIC, Australia; Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
authors.forename: Rohan
authors.initials: R
authors.lastname: Borschmann
authors.affiliation: Population Health, Murdoch Childrens Research Institute, Parkville, VIC, Australia; Centre for Adolescent Health, Royal Children's Hospital, Parkville, VIC, Australia.
authors.forename: Denise
authors.initials: D
authors.lastname: Becker
authors.affiliation: Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Moran
authors.affiliation: Population Health, Murdoch Childrens Research Institute, Parkville, VIC, Australia; Centre for Adolescent Health, Royal Children's Hospital, Parkville, VIC, Australia; Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia; Department of Pediatrics, The University of Melbourne, Melbourne, Australia.
authors.forename: Craig
authors.initials: C
authors.lastname: Olsson
authors.affiliation: Population Health, Murdoch Childrens Research Institute, Parkville, VIC, Australia; Centre for Adolescent Health, Royal Children's Hospital, Parkville, VIC, Australia.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Coffey
authors.affiliation: Population Health, Murdoch Childrens Research Institute, Parkville, VIC, Australia; Centre for Adolescent Health, Royal Children's Hospital, Parkville, VIC, Australia; Clinical Epidemiology & Biostatistics Unit, Royal Children's Hospital, Parkville, VIC, Australia.
authors.forename: Helena
authors.initials: H
authors.lastname: Romaniuk
authors.affiliation: Population Health, Murdoch Childrens Research Institute, Parkville, VIC, Australia; Centre for Adolescent Health, Royal Children's Hospital, Parkville, VIC, Australia; School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia; Department of Pediatrics, The University of Melbourne, Melbourne, Australia.
authors.forename: Jordana K
authors.initials: JK
authors.lastname: Bayer
authors.affiliation: Population Health, Murdoch Childrens Research Institute, Parkville, VIC, Australia; Centre for Adolescent Health, Royal Children's Hospital, Parkville, VIC, Australia. Electronic address: George.patton@rch.org.au.
authors.forename: George C
authors.initials: GC
authors.lastname: Patton
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000523:psychology; D015331:Cohort Studies; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D019052:Depression, Postpartum / Q000175:diagnosis* / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008603:Mental Health; D010554:Personality Disorders / Q000175:diagnosis / Q000523:psychology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology*; D011263:Pregnancy Trimester, Third; D012307:Risk Factors; D055815:Young Adult
keywords: Epidemiology; Maternal health; Mental disorders; Personality disorders