Perinatal anxiety disorder prevalence and incidence (original) (raw)
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Mood and anxiety disorders in a sample of Canadian perinatal women referred for psychiatric care
Archives of Womens Mental Health, 2011
Perinatal depression currently receives considerable attention, but not all perinatal women presenting for psychiatric care are depressed. The Edinburgh Postnatal Depression Scale (EPDS) is now routinely administered, but high scores are interpreted as evidence for depressive illness only. This study examined psychiatric diagnoses and mean EPDS scores among perinatal women at a tertiary center. Women accessing care between March 2006 and June 2008 completed a clinical diagnostic interview and the EPDS. Mean EPDS scores were calculated for each psychiatric diagnosis; sensitivity and specificity were calculated for major depressive episode (MDE) and generalized anxiety disorder (GAD). The majority of the sample (N = 91), 49.5%, had GAD comorbid with MDE or another anxiety disorder, followed by MDE (38.5%) comorbid with an anxiety disorder. One third (29.7%) met criteria for MDE and GAD. Only 3.3% had MDE alone and 5.5% had GAD alone. Half the sample (50.5%) had more than one psychiatric disorder. Mean EPDS scores exceeded 11 for the majority of diagnostic groups. Sensitivity of the EPDS for MDE was 0.78 and 0.70 for GAD. Most women had an anxiety disorder and met criteria for more than one psychiatric disorder. Mean EPDS scores were consistently high. Sensitivity of the EPDS for MDE and GAD was comparable.
Journal of Affective Disorders, 2010
Objective: Literature underlines that the Edinburgh Postnatal Depression Scale (EPDS) is the most common measure to assess postpartum depression (PPD) worldwide and suggests that the rate of false positives is high. Furthermore, the EPDS does not distinguish between depression and anxiety. This study describes different definitions of PPD and whether pregnancy anxiety disorders are risk factors for different PPDs at both 1 month and 1 year postpartum. Method: 1066 women were recruited during pregnancy and followed until the 12th month postpartum (N = 500). Women were administered the SCID and completed the PDPI-R during pregnancy. During the postpartum women who had an EPDS score of 13 or more were administered the SCID to distinguish minor or major depressive episodes (mMD) from false positives. Results: 41.5% and 44.9% of the PPD assessed with the EPDS were false positives at the 1st month and during the 1st year postpartum respectively. The difference observed in prevalence rates estimated with EPDS and SCID was statistically significant both at the 1st month and during the 1st year postpartum. Overall the effect of anxiety diagnoses in predicting PPD was stronger at the 1st month than during the 1st year postpartum. The role of panic disorder is associated both with probable depression (ES = 0.82) and with mMD (ES = 0.87) at the 1st month postpartum, and predicted mMD during the 1st year postpartum (ES = 0.71). OCD predicted false positives at the 1st month postpartum (ES = 0.89). Conclusion: An antenatal screening of specific anxiety diagnoses could be extremely useful for the prevention of possible postpartum distress outcomes.
CBU International Conference Proceedings
Problem Statement: The anxiety and depression experienced during pregnancy and in the postpartum period is of considerable importance in terms of the health of the mother and her infant.Purpose of the Study: The aim of this study was to determine the status of anxiety and depression during pregnancy and in the postpartum period.Methods: The research sample consisted of 100 primiparae and 100 multiparae who had consented to participate in the study. Data was collected with a questionnaire, the State and Trait Anxiety Inventory (STAI), the Beck Anxiety Inventory (BAI), and the Edinburgh Postpartum Depression Scale (EPDS).Findings and Results: It was found that during pregnancy and in the postpartum period, primiparae experienced a higher level of state and trait anxiety compared to multiparae and that the rate of depression was higher in multiparae compared to primiparae.Conclusions and Recommendations: It was determined that primiparae experienced more anxiety than multiparae (p<0...
Open Journal of Psychiatry, 2013
Objective: Anxiety is common among pregnant women. However, research attention in the area of reproductive mental health has mainly focused on postpartum depression in past decades. Given adverse outcomes of antenatal anxiety, there is an urgent need to fill the research gaps. The objectives of the present study were to determine the prevalence of antenatal anxiety symptoms and examine the risk factors and effects of anxiety symptoms in early pregnancy on anxiety and depressive symptoms in later pregnancy and early postpartum period. Methodology: A prospective longitudinal design with quantitative approach was adopted. A consecutive sample of 1470 Chinese pregnant women from hospitals in Hong Kong was invited to participate in the study and was assessed using standardized instruments on 3 time points including first and third trimesters of pregnancy and 6-week postpartum. Results: The results showed that 17.7% of pregnant women manifested anxiety symptoms in the first trimester of pregnancy. Single mothers, younger mothers, mothers who smoked before pregnancy and mothers who received low education level reported significantly higher levels of anxiety symptoms in the first trimester. Unwanted pregnancy, low self esteem, low marital satisfaction and perceived low social support were significant psychosocial risk factors for anxiety symptoms in the first trimester. Anxiety symptoms in the first trimester were independent predictors for anxiety symptoms in the third trimester (β = 0.26, t = 5.74, p < 0.001), however anxiety symptoms in the first trimester no longer significantly predicted anxiety and depressive symptoms in 6 weeks postpartum after adjusting for the effects of potential confounders. Discussions: The present study points to the need for greater research and clinical attention to antenatal anxiety given that antenatal anxiety is a prevalent problem and has serious impacts on maternal wellbeing. Such findings also contribute to the understanding of maternal anxiety and have implications for the design of effective identification, prevention and treatment of these significant clinical problems
The course of anxiety and depression through pregnancy and the postpartum in a community sample
Journal of Affective Disorders, 2004
Background: Postnatal and antenatal depression are a focus of considerable clinical and research attention, but little is known about the patterns of anxiety across this period. Methods: Self-reported anxiety and depression were assessed at 18 and 32 weeks gestation and 8 weeks and 8 months postnatally in a prospective longitudinal study of a community sample of women in England (n = 8323). Results: The majority of cases of postnatal depression were preceded by antenatal depression; similarly, postnatal anxiety was preceded by antenatal anxiety. Despite the stability of anxiety and depression across this period, there was a mean decrease in both anxiety and depression. Finally, antenatal anxiety predicted postnatal depression at 8 weeks and 8 months, even after controlling for antenatal depression (OR = 3.22, p < 0.001). Limitations: Data were based on self-report only and there was evidence of selective attrition. Conclusion: The findings confirm that antenatal anxiety occurs frequently, overlaps with depression and increases the likelihood of postnatal depression. D
Examining the relationship between antenatal anxiety and postnatal depression
Journal of Affective Disorders, 2007
Background: Antenatal anxiety has received increased attention with regards to both its impact on infant outcomes and as a risk factor for postnatal depression. The measurement of anxiety in the perinatal setting, however, has proven to be challenging. The aims of the present study are to: determine whether antenatal anxiety as measured by the Brief Measure of Worry Severity (BMWS) is a significant predictor of postnatal depression (PND); examine the psychometric properties of a new measure of anxietythe BMWSin an antenatal sample; and examine the comparative capacity of the BMWS to the Speilberger State Trait Anxiety Inventory (STAI) in predicting PND. Method: A sample of 748 women completed the BMWS and STAI during the third trimester of pregnancy and returned the Edinburgh Postnatal Depression Scale (EPDS) at 8 weeks postpartum. Results: Women with high antenatal anxiety on the BMWS were 2.6 times more likely to have probable PND than those with low scores, even after controlling for confounding factors, including level of antenatal depression on the EPDS. In contrast, the STAI was no longer a significant predictor of PND after controlling for these variables. The BMWS has good construct validity, with scores on this scale correlating strongly with scores on other measures of anxiety, depression and perinatal risk. Limitations: When compared to those who participated in the follow-up at 8 weeks postnatally, those who did not participate appeared to be at greater risk of developing PND, raising the possibility of attrition bias within this sample. Conclusions: The findings from this study suggest that the BMWS has utility in measuring antenatal anxiety in both clinical and research settings and that antenatal anxiety is an important precursor of PND.
Pregnancy and Childbirth: Postpartum Anxiety (PPA) and Support for New Mothers
Journal of the Motherhood Initiative for Research and Community Involvement, 2018
Perinatal mood and anxiety disorders (PMADs) are a significant mental health concern worldwide. In Canada, researchers, maternal mental health advocates, and practitioners are working to increase understanding of mental health in the perinatal period. This article focuses on the necessity to expand and build upon current understanding of PMADs, particularly postpartum anxiety disorders (PPA). The traditional construct of postpartum depression (PPD) is inadequate to understand, assess, diagnose, and treat the wide range of postpartum mood disorders. Anxiety disorders may be underdiagnosed among new mothers. Specific risk factors are explored for this population and support interventions are provided for PPA. Additionally, this article explores ways to improve understanding of PMADs from a sociocultural perspective and to improve protective factors that may enhance a new mother’s mental health. Addressing the gaps and needs in postpartum mental health will positively affect mothers, f...
Journal of Affective Disorders, 2010
Objective: Literature underlines that the Edinburgh Postnatal Depression Scale (EPDS) is the most common measure to assess postpartum depression (PPD) worldwide and suggests that the rate of false positives is high. Furthermore, the EPDS does not distinguish between depression and anxiety. This study describes different definitions of PPD and whether pregnancy anxiety disorders are risk factors for different PPDs at both 1 month and 1 year postpartum. Method: 1066 women were recruited during pregnancy and followed until the 12th month postpartum (N = 500). Women were administered the SCID and completed the PDPI-R during pregnancy. During the postpartum women who had an EPDS score of 13 or more were administered the SCID to distinguish minor or major depressive episodes (mMD) from false positives. Results: 41.5% and 44.9% of the PPD assessed with the EPDS were false positives at the 1st month and during the 1st year postpartum respectively. The difference observed in prevalence rates estimated with EPDS and SCID was statistically significant both at the 1st month and during the 1st year postpartum. Overall the effect of anxiety diagnoses in predicting PPD was stronger at the 1st month than during the 1st year postpartum. The role of panic disorder is associated both with probable depression (ES = 0.82) and with mMD (ES = 0.87) at the 1st month postpartum, and predicted mMD during the 1st year postpartum (ES = 0.71). OCD predicted false positives at the 1st month postpartum (ES = 0.89). Conclusion: An antenatal screening of specific anxiety diagnoses could be extremely useful for the prevention of possible postpartum distress outcomes.
BMC Pregnancy and Childbirth, 2019
Background: Maternal depression and anxiety have distinct constellations of symptom trajectories, which are associated with factors that may vary between different groups of women. The aim of this study was to identify subgroups of women who exhibit unique longitudinal trajectory patterns of depressive and anxiety symptoms from pregnancy to 5 years postpartum and the antenatal predictors associated with these maternal groups. Methods: The study used a longitudinal data collected from 615 women in Saskatchewan from pregnancy to 5 years postpartum. Semiparametric group-based models were used to identify latent maternal depressive and anxiety trajectory groups. Multinomial logit models were then used to assess the association between maternal characteristics and the identified latent trajectory groups. Results: We identified four trajectory groups of maternal depressive symptoms: low-stable (35%); moderate-stable (54%); moderate-increasing (5%); and high-decreasing (6%), and three trajectory groups of maternal anxiety symptoms: very low-stable (13%); low-stable (58%); and moderate-stable (29%). We also identified several risk factors, most notably history of depression and stress, that were significantly associated with these trajectories. Conclusion: History of depression and increased stress are significant risk factors that can be identified during regular perinatal visits; therefore, clinicians should inquire about these risk factors to identify women at high risk of ongoing depression or anxiety.