Elevated Midpregnancy Corticotropin-Releasing Hormone Is Associated with Prenatal, But Not Postpartum, Maternal Depression

Abstract Context: Elevated hypothalamic CRH has been implicated in melancholic major depression in nonpregnant individuals, but the role of placental CRH in maternal prenatal and postpartum depression is largely unexplored. Objective: The objective of the study was to examine the association of maternal midpregnancy plasma CRH levels with prenatal and postpartum depression. Participants: The study included 800 participants in Project Viva, a pregnancy and childhood cohort. Methods: CRH levels were analyzed from blood samples obtained at mean 27.9 wk gestation (± 1.3 sd; range 24.6–37.4 wk) and were normalized on the logarithmic scale. Depression was assessed with the Edinburgh Postpartum Depression Scale (range 0–30 points) in midpregnancy and at 6 months postpartum. We used logistic regression to estimate the odds of scoring 13 or more points on the Edinburgh Postpartum Depression Scale as indicative of major or minor depression. Results: Seventy (8.8%) and 46 (7.5%) women had prenatal and postpartum depression symptoms, respectively. Mean log CRH was 4.93 (± 0.62 sd). After adjusting for confounders, an sd increase in log CRH was associated with nearly 50% higher odds of prenatal depression symptoms (odds ratio 1.48, 95% confidence interval 1.14–1.93). Higher CRH levels during pregnancy were unassociated with greater risk of postpartum depressive symptoms. In fact, there was a suggestion that prenatal CRH levels might be inversely associated with risk of postpartum depressive symptoms (odds ratio 0.82, 95% confidence interval 0.58–1.15). Conclusions: Elevated placental CRH levels in midpregnancy are positively associated with risk of prenatal depression symptoms but not postpartum depression symptoms.

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Factors Associated with Postpartum Depressive Symptoms in Community of Central Nepal

Psychiatry Journal ◽

10.1155/2020/8305304 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Pratima Dawadi ◽

Aarati Sharma Bhatta ◽

Jayalaxmi Shakya

Keyword(s):

Depressive Symptoms ◽

Chronic Disease ◽

Confidence Interval ◽

Odds Ratio ◽

Depression Scale ◽

Semistructured Interview ◽

Female Population ◽

Factors Associated ◽

Postpartum Depressive Symptoms ◽

Pregnancy And Postpartum

Background. Pregnancy and postpartum are considered as high risk periods for the emergence of psychiatric disorder. Although postpartum depressive symptoms have been associated with tragic outcome, such as maternal suicide and infanticide, it is a neglected area of mental health care in developing countries. This study was conducted to find the prevalence and factors associated with postpartum depressive symptoms. Method. A community-based cross-sectional research design was carried out after selecting the three wards of Bharatpur submetropolitan by nonprobability purposive sampling method. A total of 160 mothers in their 1 month to 12 months of postpartum period were interviewed through semistructured interview schedule and Edinburgh Postnatal Depression Scale (EPDS). Collected data were entered in Epi, data 3.1, and was exported into IBM SPSS 20 version. Results. The prevalence of depressive symptoms among postpartum mothers was 27.5%. The multivariate analysis identified two factors significantly associated with postpartum depression including respondents who had education level of ≤10 class (odds ratio AOR=3.25, P=0.03, confidence interval CI=1.10−9.58), chronic disease in their family (odds ratio AOR=3.25, P=0.01, confidence interval CI=1.19−8.16). Conclusion. More than one out of four mothers is suffering from depressive symptoms. The major factors associated with postpartum depressive symptoms are education of respondents and chronic disease in the family. Screening and timely management of depressive symptoms should be incorporated in routine maternal care so as to enhance maternal and child health. Likewise, concerned authority should plan and organize awareness-raising programs and provide attractive package to attract the female population for higher education.

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Back pain and depressive symptoms: A systematic review and meta-analysis

The International Journal of Psychiatry in Medicine ◽

10.1177/0091217420913001 ◽

2020 ◽

pp. 009121742091300 ◽

Cited By ~ 1

Author(s):

Sohrab Amiri ◽

Sepideh Behnezhad ◽

Esfandiar Azad

Keyword(s):

Back Pain ◽

Depressive Symptoms ◽

Confidence Interval ◽

Publication Bias ◽

Odds Ratio ◽

Meta Analysis ◽

Depression Symptoms ◽

Psychological Consequences ◽

Cross Sectional ◽

Effective Prevention

Background Low back pain is a common disorder that has many consequences. This study is an attempt to meta-analyze the risk of depression symptoms in back pain. Method Four databases were selected for review, and this search was conducted using key words. Eleven eligible articles were selected for review and meta-analysis was conducted. Subgroup analyses were continued with study design and the method of measuring depression. Also, the heterogeneity and publication bias were examined. Results Eleven cohort and cross-sectional articles are used in the meta-analysis between back pain and depressive symptoms. The odds ratio 2.07 was calculated for this relationship. In prospective-cohort studies, 1.71 (95% confidence interval = 1.24–2.36) results indicated that back pain is a risk factor for depression symptoms and in cross-sectional studies, pooled odds ratio (2.33; 95% confidence interval = 1.29–4.21) showed that back pain is associated with depression symptoms. Some degree of publication bias was not found in the study. Conclusions Back pain is an effective factor in increasing the likelihood of depression. Adoption of effective prevention and treatment approaches can play an important role in reducing the psychological consequences in these individuals.

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Predictive statistical model for the factors associated with prenatal depression among pregnant adolescents in Maha Sarakham province, Thailand

F1000Research ◽

10.12688/f1000research.21007.2 ◽

2020 ◽

Vol 8 ◽

pp. 1921

Author(s):

Bhanwasa Jantasin ◽

Witaya Yoosook ◽

Supawadee Thaewpia

Keyword(s):

Depressive Symptoms ◽

Statistical Model ◽

Community Health Centers ◽

Goodness Of Fit ◽

Depression Scale ◽

Prenatal Depression ◽

Depression Symptoms ◽

Goodness Of Fit Test ◽

Pregnant Adolescents ◽

Cross Sectional

Background: The rate of adolescent pregnancy has steadily increased in Thailand over the years and depression is considered an important psychological problem in many pregnant adolescents. The aims of this study were to determine the proportion of pregnant adolescents with depressive symptoms and to identify a predictive statistical model for the factors related to prenatal depression among adolescents at antenatal care clinics in 10 community health centers in Maha Sarakham Province. Methods: A cross-sectional study was conducted in 230 randomly selected participants who were pregnant adolescents who volunteered to participate in the research, those aged ≤19 years, and had an estimated gestational age of ≤18 weeks. Those with severe obstetrics complications or a psychiatric disorder were excluded. The subjects were asked to complete a demographic questionnaire and the Thai version of the Edinburgh Postnatal Depression Scale. The mean age of participants was 17.0 (±1.4) years. Results: Overall, 43.9% of the adolescents had a cut off score of ≥11, suggestive of prenatal depressive symptoms. Multivariate analysis identified that pregnant adolescents at a primary school education level were 6.5 times more likely to experience depression symptoms than those with a diploma. Those who were emotionally supported by their husband or partner compared to relatives had a five times higher chance of presenting depressive symptoms, and those with a perceived bad relationship with their husband or partner had seven times higher. The model was well-calibrated (goodness-of-fit test, p = 0.675) and had high discriminative power (ROC curve = 0.73 (95%CI = 0.67 to 0.79). Conclusions: More attention is needed to reduce the known problems with pregnant adolescents and to ensure they continue with their education. Lastly, public education to support mental health initiatives for individuals and families should be encouraged.

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GEJALA DEPRESI POSTPARTUM MEMPENGARUHI KEBERHASILAN ASI EKSKLUSIF : Sistematik Literatur Riview

Jurnal Kesehatan Kusuma Husada ◽

10.34035/jk.v12i1.530 ◽

2020 ◽

pp. 27-34

Author(s):

Nova Arami ◽

Surahma Asti Mulasari ◽

Ummu Hani EN

Keyword(s):

Depressive Symptoms ◽

Breast Milk ◽

Postpartum Depression ◽

Low Income ◽

Critical Appraisal ◽

Previous History ◽

Synthesis Method ◽

Depression Scale ◽

Postpartum Depressive Symptoms ◽

Postpartum Mothers

Air Susu Ibu (ASI) merupakan satu-satunya makanan yang sempurna dan terbaik bagi bayi karena mengandung unsur-unsur gizi yang dibutuhkan untuk pertumbuhan dan perkembangan bayi yang optimal. Namun ada beberapa penyebab ibu tidak memberikan ASI secara eksklusif seperti tidak mendapatkan dukungan dari suami/keluarga, penghasilan, usia, pendidikan yang menyebabkan terjadinya depresi postpartum sehingga menghambat proses laktasi. Tujuan penelitian untuk menyimpulkan dan memeriksa literature (examine literature) apakah gejala depresi pada ibu postpartum berhubungan dengan keberhasilan pemberian ASI. Metode penelitian menggunakan studi appraisal dengan Critical Appraisal Joana Brigs Institute, dan metode sintesis menggunakan PEOS. Pencarian dibatasi pada studi yang diterbitkan dalam bahasa Inggris dan menyajikan data periode 2012-2019. Studi yang terindentifikasi ditinjau menggunakan PRISMA Flowchart. Studi dengan desain kuantitatif terkait gejala depresi postpartum mempengaruhi keberhasilan ASI eksklusif. Hasil penelitian adalah depresi postpartum diukur menggunakan EPDS (Edinburgh Postpartum Depression Scale) yang dilakukan pada ibu postpartum usia 2-6 minggu pascapersalinan. Gejala depresi dapat mempengaruhi keberhasilan pemberian ASI dan beberapa faktornya karena kurangnya dukungan emosional, pendidikan, pengetahuan, pendapatan yang rendah, dan terdapat riwayat depresi sebelumnya. Namun hal yang paling dominan terjadinya depresi postpartum yaitu kurangnya dukungan suami/keluarga. Kesimpulan penelitian ini adalah gejala depresi postpartum dapat mempengaruhi keberhasilan ASI eksklusif dikarenakan ada perubahan hormon dan mood yang terjadi pada ibu seperti tidak nafsu makan, gangguan tidur, cemas, sensitif sehingga dapat menggaggu kelancaran ASI. Breastmilk (ASI) is the only perfect and best food for babies because it contains nutritional elements for optimal baby growth and development. However, there are several reasons why mothers do not exclusively breastfeed, such as not getting support from their husbands/families, stage, education which causes postpartum depression which hinders the lactation process. This study aims to conclude and examine the literature (examining the literature) whether the symptoms of depression in postpartum mothers are associated with breastfeeding. The method of the study using appraisal study using Joana Brigs Institute Critical Appraisal, and synthesis method using PEOS. Base search on studies published in English and present data for the period 2012-2019. Identified studies were reviewed using PRISMA Flowchart. A quantitative design study of postpartum depressive symptoms affects exclusive breastfeeding. The results showed postpartum depression was measured using the EPDS (Edinburgh Postpartum Depression Scale) which was performed on postpartum mothers aged 2-6 weeks postpartum. Depressive symptoms can affect the situation of offering breast milk and several factors due to emotional support, education, low income, a previous history of depression. But the worst thing that happens in postpartum depression is support from family. The conclusion was postpartum depressive symptoms can affect exclusive breast milk because there are hormonal and mood changes that occur in the mother such as lack of appetite, sleep disturbances, anxiety, sensitivity so that they can interfere with the smoothness of breast milk.

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Social support and depressive symptoms among 'money' boys and general men who have sex with men in Shanghai, China

Sexual Health ◽

10.1071/sh14017 ◽

2014 ◽

Vol 11 (3) ◽

pp. 285 ◽

Cited By ~ 14

Author(s):

Huamei Yan ◽

Frank Y. Wong ◽

Tony Zheng ◽

Zhen Ning ◽

Yingying Ding ◽

...

Keyword(s):

Social Support ◽

Depressive Symptoms ◽

Confidence Interval ◽

Odds Ratio ◽

Protective Factor ◽

Depression Scale ◽

Cutoff Score ◽

Social Provision ◽

Sex With Men ◽

Money Boys

The primary objective was to examine prevalence and correlates of social support and depressive symptoms among male sex workers (known as ‘money boys’ (MBs)) and general men who have sex with men (MSM) in Shanghai. The Social Provision Scale (SPS), which consists of 24 items, scored out of 4 for social provision, was used to evaluate the functions of social relationships. The score for each item ranges from 1 to 4, with a higher score indicating more social provision. The overall mean SPS score was 68.1 (s.d. = 6.53) for MBs and 69.3 (s.d. = 6.99) for general MSM. Depression was measured with a 12-item version of the Center for Epidemiological Studies Depression Scale (CES-D), where a score of 9 has been recommended as the cutoff score to indicate possible depressive symptoms. The prevalence of depressive symptoms was 57.9%, with MBs having a higher level of depressive symptoms than general MSM (70.0% v. 46.1%) (odds ratio = 1.86, 95% confidence interval = 1.07–3.24). Social support was a protective factor for depressive symptoms (odds ratio = 0.92, 95% confidence interval = 0.89–0.96). MSM in China, particularly MBs, are vulnerable to low social support and high depressive symptoms, highlighting the need for tailored psychological programs targeting this population.

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Stressful life events and postpartum depressive symptoms among women with disabilities

Women s Health ◽

10.1177/17455065211066186 ◽

2021 ◽

Vol 17 ◽

pp. 174550652110661

Author(s):

Edward J Booth ◽

Panagiota Kitsantas ◽

Hua Min ◽

Anna Z Pollack

Keyword(s):

Depressive Symptoms ◽

Confidence Interval ◽

Life Events ◽

Odds Ratio ◽

Stressful Life Events ◽

Stressful Life ◽

Life Stressors ◽

Pregnancy Risk ◽

Women With Disabilities ◽

Postpartum Depressive Symptoms

Purpose: Although research evidence indicates positive associations between stressful life events and postpartum depression, limited research assessed these associations in women with disabilities. This study examined the effects of stressful life events on postpartum depressive symptoms in women with disabilities. Methods: Data from the 2012–2017 Massachusetts Pregnancy Risk Assessment Monitoring System ( n = 8453) were used in this study. Women were asked if they experienced any life stressors (e.g. financial, traumatic, relational, and emotional) during the 12 months prior to giving birth. Disability was measured based on reports of emotional and physical functioning. Descriptive statistics, bivariate, and binary logistic regression analyses were conducted to estimate the effect of stressful life events on postpartum depressive symptoms among women with and without disabilities. Results: Findings show that 37.4% of women with disabilities had postpartum depressive symptoms, which was significantly higher than 8.79% of women without disabilities. Stressful life events were reported in 86.6% of women with disabilities, compared to 66.6% for women without disabilities. Prevalence of three or more stressful life events and postpartum depressive symptoms was greater among women with disabilities (50.8% and 62.9%, respectively) than women without disabilities (22.6% and 37.0%, respectively). Women with disabilities experiencing six or more stressful life events were more likely (odds ratio = 3.78, 95% confidence interval = [1.57–9.10]) to report postpartum depressive symptoms, compared to those with no stressful life events. Women with disabilities who experienced relational (odds ratio = 2.36, 95% confidence interval = [1.44–3.87]) and traumatic (odds ratio = 1.75, 95% confidence interval = [1.02–3.00]) life stressors had higher odds for postpartum depressive symptoms relative to those reporting no such life stressors. Conclusion: Women with disabilities are at an amplified risk for stressful life events and postpartum depressive symptoms. Relational and traumatic stressful life events particularly increase the odds for postpartum depressive symptoms among this group of mothers. Early prenatal and postnatal screening for life stressors and depressive symptoms, coupled with timely referral for appropriate prenatal and postnatal care, are vital to mitigate the harmful effects of depression among mothers with disabilities and the health of their children.

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Association of Depressive Symptoms with Rapid Kidney Function Decline in Adults with Normal Kidney Function

Clinical Journal of the American Society of Nephrology ◽

10.2215/cjn.18441120 ◽

2021 ◽

pp. CJN.18441120

Author(s):

Zhuxian Zhang ◽

Panpan He ◽

Mengyi Liu ◽

Chun Zhou ◽

Chengzhang Liu ◽

...

Keyword(s):

Depressive Symptoms ◽

Confidence Interval ◽

Kidney Function ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Depression Scale ◽

Epidemiologic Studies ◽

Rapid Decline ◽

Normal Kidney ◽

Normal Kidney Function

Background and objectivesThe relationship of depressive symptoms with kidney function remains poorly investigated. We aimed to evaluate the prospective association between depressive symptoms and rapid decline in kidney function in Chinese adults with normal kidney function.Design, setting, participants, & measurementsA total of 4763 participants with eGFR≥60 ml/min per 1.73 m2 at baseline were enrolled from the China Health and Retirement Longitudinal Study. Baseline depressive symptoms were determined using a ten-item Center for Epidemiologic Studies Depression scale with a cutoff score of greater than or equal to ten to define high depressive symptoms. The GFR was estimated by a combination of serum creatinine and cystatin C. The primary outcome was rapid decline in kidney function, defined as an annualized decline in eGFR of ≥5 ml/min per 1.73 m2. Secondary outcome was defined as an annualized decline in eGFR of ≥5 ml/min per 1.73 m2 and to a level of <60 ml/min per 1.73 m2 at the exit visit.ResultsDuring a median follow-up of 4 years (interquartile range, 3.92–4.00), 260 (6%) participants developed rapid decline in kidney function. Overall, there was a significant positive association between baseline depressive symptoms and rapid decline in kidney function (per five-scores increment; adjusted odds ratio, 1.15; 95% confidence interval, 1.03 to 1.28) after adjustments for major demographic, clinical, or psychosocial covariates. Consistently, compared with participants with low depressive symptoms (total Center for Epidemiologic Studies Depression scale score less than ten), a significantly higher risk of rapid decline in kidney function was found among those with high depressive symptoms (total Center for Epidemiologic Studies Depression scale score greater than or equal to ten; adjusted odds ratio, 1.39; 95% confidence interval, 1.03 to 1.88). Similar results were found for the secondary outcome (per five-scores increment; adjusted odds ratio, 1.26; 95% confidence interval, 1.06 to 1.51).ConclusionsHigh depressive symptoms were significantly associated with a higher risk of rapid kidney function decline among Chinese adults with normal kidney function.

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Inflammation and Risk of Depression in HIV: Prospective Findings From the Multicenter AIDS Cohort Study

American Journal of Epidemiology ◽

10.1093/aje/kwz190 ◽

2019 ◽

Vol 188 (11) ◽

pp. 1994-2003 ◽

Cited By ~ 1

Author(s):

Haidong Lu ◽

Pamela J Surkan ◽

Michael R Irwin ◽

Glenn J Treisman ◽

Elizabeth C Breen ◽

...

Keyword(s):

Cohort Study ◽

Depressive Symptoms ◽

Confidence Interval ◽

Odds Ratio ◽

Interleukin 2 ◽

Depression Symptoms ◽

High Risk Population ◽

Multicenter Aids Cohort Study ◽

Inflammatory Processes ◽

Sex With Men

Abstract Studies suggest that inflammation might be involved in the pathogenesis of depression. Individuals with human immunodeficiency virus (HIV) have a higher risk of depression and elevated inflammatory profiles. Despite this, research on the link between inflammation and depression among this high-risk population is limited. We examined a sample of men who have sex with men from the Multicenter AIDS Cohort Study in prospective analyses of the association between inflammation and clinically relevant depression symptoms, defined as scores >20 on Center for Epidemiological Studies Depression Scale. We included 1,727 participants who contributed 9,287 person-visits from 1984 to 2010 (8,218 with HIV (HIV+) and 1,069 without (HIV−)). Exploratory factor analysis (EFA) was used to characterize underlying inflammatory processes from 19 immune markers. Logistic regression with generalized estimating equations was used to evaluate associations between inflammatory processes and depressive symptoms stratified by HIV serostatus. Three EFA-identified inflammatory processes (EIPs) were identified. EIP-1 scores—described by soluble tumor necrosis factor receptor 2 (sTNF-R2), soluble interleukin-2 receptor α (sIL-2Rα), sCD27, B-cell activating factor, interferon γ-induced protein 10 (IP-10), soluble interleukin-6 receptor (sIL-6R), sCD14, and sGP130—were significantly associated with 9% higher odds of depressive symptoms in HIV+ participants (odds ratio = 1.09; 95% confidence interval: 1.03, 1.16) and 33% higher odds in HIV− participants (odds ratio = 1.33; 95% confidence interval: 1.09, 1.61). Findings suggest that immune activation might be involved in depression risk among both HIV+ and HIV− men who have sex with men.

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Predictive statistical model for the factors associated with prenatal depression among pregnant adolescents in Maha Sarakham province, Thailand

F1000Research ◽

10.12688/f1000research.21007.1 ◽

2019 ◽

Vol 8 ◽

pp. 1921

Author(s):

Bhanwasa Jantasin ◽

Witaya Yoosook ◽

Supawadee Thaewpia

Keyword(s):

Depressive Symptoms ◽

Statistical Model ◽

Community Health Centers ◽

Goodness Of Fit ◽

Depression Scale ◽

Prenatal Depression ◽

Depression Symptoms ◽

Goodness Of Fit Test ◽

Pregnant Adolescents ◽

Cross Sectional

Background: The rate of adolescent pregnancy has steadily increased in Thailand over the years and depression is considered an important psychological problem in many pregnant adolescents. The aims of this study were to determine the proportion of pregnant adolescents with depressive symptoms and to identify a predictive statistical model for the factors related to prenatal depression among adolescents at antenatal care clinics in 10 community health centers in Maha Sarakham Province. Methods: A cross-sectional study was conducted in 230 randomly selected participants who were pregnant adolescents who volunteered to participate in the research, those aged ≤19 years, and had an estimated gestational age of ≤18 weeks. Those with severe obstetrics complications or a psychiatric disorder were excluded. The subjects were asked to complete a demographic questionnaire and the Thai version of the Edinburgh Postnatal Depression Scale. The mean age of participants was 17.0 (±1.4) years. Results: Overall, 43.9% of the adolescents had a cut off score of ≥11, suggestive of prenatal depressive symptoms. Multivariate analysis identified that pregnant adolescents at a primary school education level were 6.5 times more likely to experience depression symptoms than those with a diploma. Those who were emotionally supported by their husband or partner compared to relatives had a five times higher chance of presenting depressive symptoms, and those with a perceived bad relationship with their husband or partner seven times higher. The model was well-calibrated (goodness-of-fit test, p = 0.675) and had high discriminative power (ROC curve = 0.73 (95%CI = 0.67 to 0.79). Conclusions: More attention is needed to reduce the known problems with pregnant adolescents and to ensure they continue with their education. Lastly, public education to support mental health initiatives for individuals and families should be encouraged.

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Is there a relationship between gestational diabetes and postpartum depression?

Current Women s Health Reviews ◽

10.2174/1573404816999200918115133 ◽

2020 ◽

Vol 16 ◽

Author(s):

Salman Khazaei ◽

Erfan Ayubi ◽

Saeid Bashirian ◽

Ronak Hamzehei ◽

Ensiyeh Jenabi

Keyword(s):

Gestational Diabetes ◽

Postpartum Depression ◽

Odds Ratio ◽

Depression Scale ◽

Binary Logistic Regression ◽

Cross Sectional Study ◽

University Education ◽

P Value ◽

Cross Sectional ◽

The Relationship

Background: The relationship between gestational diabetes and postpartum depression (PPD) is poorly understood and seldom studied. Objective: In an effort to explore this issue, the present study investigated the relationship between gestational diabetes and PPD. Methods: The present cross-sectional study was performed with 342 women who were referred to four urban health centers of Hamadan city, west of Iran. We used convenience sampling as a method to recruit women in each health center. We used a researcher-made checklist for gathering data on socio-demographic characteristics and potential risk factors of PPD. The Persian validated version of the Edinburgh Postnatal Depression Scale (EPDS) was used to assess PPD. Univariate and multivariable binary logistic regression was applied to estimate the odds ratio (OR) (95% confidence interval [CI]). Results: Gestational diabetes was identified as the most important risk factor for PPD with OR (95% CI) of 2.19 (1.11, 4.31); P-value=0.02 after adjusting for other variables. Moreover, the adjusted odds ratio showed that PPD among lesseducated women (primary school) was 3.5 times higher compared to women with a university education (OR=3.54, 95% CI: 1.27, 9.84; P-value=0.01). Conclusion: Our findings suggested that PPD is more likely among women with gestational diabetes and those who were less educated. Interventional and educational activities for reducing the risk of PPD can be targeted for use with this population.

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