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J Affect Disord. 2019 Feb 15;245:965-970. doi: 10.1016/j.jad.2018.11.062. Epub 2018 Nov 5.

Course of a major postpartum depressive episode: A prospective 2 years naturalistic follow-up study.

Author information

1
Unitat de Salut Mental Perinatal CLINIC-BCN, Hospital Clínic, Barcelona, Spain; Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Psychiatry and Clinical Psychology, Universitat de Barcelona, Barcelona, Spain.
2
Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Bellaterra, Spain.
3
Unitat de Salut Mental Perinatal CLINIC-BCN, Hospital Clínic, Barcelona, Spain.
4
Servei de Psicologia, Regidoria de Polítiques de Gènere Ajuntament de Terrassa, Terrassa, Spain.
5
Unitat de Crisi i Prevenció del Suicidi, CPB-Dreta Eixample, Barcelona, Spain.
6
Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Psychiatry and Clinical Psychology, Hospital Clinic, Barcelona, Spain; Department of Medicine, Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), Spain.
7
Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Biostatistics Unit, Public Health Department, Universitat de Barcelona, Barcelona, Spain.
8
Unitat de Salut Mental Perinatal CLINIC-BCN, Hospital Clínic, Barcelona, Spain; Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. Electronic address: LESTEVE@clinic.cat.

Abstract

BACKGROUND:

Survival methodology has not already been used in studies about postpartum depression (PPD) course. The aims of the present study were to estimate the duration of a Major Postpartum Depressive Episode (MPDE) during 2 years, as well as to explore factors associated with the course.

METHOD:

This was a prospective, naturalistic, longitudinal study with a cohort of 165 women with a MPDE (DSM-IV criteria). Potential predictors of prognosis were recorded at baseline. Follow-up was conducted using the Longitudinal Interval Follow-up Evaluation (LIFE).

RESULTS:

Of the total sample, 110 (66.7%) completed the 2 years follow-up. The mean time to full remission was 49.4 weeks (95% CI: 44.0-59.8). The probability of recovering was 30.2% (95% CI: 22.1%-37.4%) at 6 months of follow-up, 66.3% (95% CI: 57.4%-73.4%) at 12 months of follow-up, and 90.3% (95% CI: 79.8%-95.4%) at 24 months of follow-up. Mothers with financial difficulties, onset of depressive episode previous to birth, and those with prior treated depressive episodes took longer in achieving full remission.

LIMITATIONS:

Results are only generalizable to mothers with PPD treated in a psychiatric outpatient setting. Psychopharmacological treatment was uncontrolled and personality was not assessed.

CONCLUSIONS:

Our findings suggest that PPD could become a chronic disorder, particularly in mothers with an onset of the episode previous to birth, with a history of depression or with financial problems. Knowledge of these factors may help to improve the guidelines of depression management and treatment during the perinatal period.

KEYWORDS:

Course; Longitudinal study; Postpartum depression; Risk factors

PMID:
30699882
DOI:
10.1016/j.jad.2018.11.062
[Indexed for MEDLINE]

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