Format

Send to

Choose Destination
J Obstet Gynaecol Can. 2015 Sep;37(9):798-803. doi: 10.1016/S1701-2163(15)30150-X.

Generalized Anxiety Disorder and Major Depressive Disorder in Pregnant and Postpartum Women: Maternal Quality of Life and Treatment Outcomes.

Author information

1
Reproductive Mental Health Program, BC Children's and Women's Hospital, Vancouver BC; Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC; Department of Psychiatry, University of British Columbia, Vancouver BC; BC Mental Health and Addiction Services, Provincial Health Services Authority, Vancouver BC.
2
Reproductive Mental Health Program, BC Children's and Women's Hospital, Vancouver BC; Department of Psychiatry, University of British Columbia, Vancouver BC.

Abstract

in English, French

OBJECTIVES:

Comorbid generalized anxiety disorder (GAD) and major depressive disorder (MDD) in perinatal women is often under-diagnosed, resulting in suboptimal treatment and leading to significant maternal dysfunction. We describe a prospective, longitudinal study of the course, treatment outcomes, and quality of life (QoL) in pregnant and postpartum women with MDD and anxiety disorders.

METHODS:

Two separate cohorts of women were recruited through the Reproductive Mental Health Program, Women's and Children's Hospital, Vancouver, British Columbia, for pharmacotherapy of depressed mood. One cohort was recruited during pregnancy and followed to one month postpartum; the other cohort was recruited postpartum and followed for 12 weeks. All women met the DSM-5 criteria for MDD and anxiety disorders. This non-lactating perinatal population completed measures of depression, anxiety, worry symptoms, and QoL at multiple study visits. Depressed women with GAD or excessive worry were compared to those without GAD in each cohort.

RESULTS:

Analysis revealed that despite the majority of women with MDD having remission of symptoms with treatment, those with postpartum GAD displayed a poorer quality of life, with persistent worry symptoms, and their illness was slower to remit. Pregnant depressed women with uncontrollable worry (a GAD indicator) showed a lower probability of achieving remission of symptoms with treatment than those without uncontrollable worry.

CONCLUSION:

All pregnant and postpartum women with GAD and MDD responded to pharmacotherapy, and the majority attained complete remission of MDD. However, their GAD symptoms persisted, and their QoL was compromised. Given the chronic debilitating course of concomitant MDD and GAD in the perinatal population, it is essential to focus on adjunctive therapies to aim for full recovery.

KEYWORDS:

anxiety disorders; comorbidity; major depressive disorder; postpartum period; pregnancy; quality of life

PMID:
26605449
DOI:
10.1016/S1701-2163(15)30150-X
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center