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PLoS One. 2019 Feb 22;14(2):e0212964. doi: 10.1371/journal.pone.0212964. eCollection 2019.

Recurrence of depression in the perinatal period: Clinical features and associated vulnerability markers in an observational cohort.

Author information

1
The Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands.
2
The Department of Psychiatry, Amsterdam University Medical Centers, location AMC, University of Amsterdam, Amsterdam, The Netherlands.
3
The Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands.
4
The Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
5
Faculty of Science, School of Psychology, The University of New South Wales, Sydney, Australia.
6
The Department of Child and Adolescent Psychiatry, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands.

Abstract

OBJECTIVE:

Antidepressant medication is commonly used for the prevention of depression recurrence in the perinatal period, yet it is unknown what vulnerability markers may play a role in recurrence. The objective of the current study was to provide a descriptive overview of the associated characteristics of women who experienced a perinatal recurrence of depression despite ongoing antidepressant use, and further, to identify clinically measurable vulnerability markers associated with recurrence.

METHODS:

Eighty-five pregnant women with a history of depression who used antidepressants (e.g. Selective Serotonin Reuptake Inhibitors or Serotonin and Noradrenaline Reuptake Inhibitors) at the start of the study were included. Clinical features, including information on psychiatric history and antidepressant use, were collected throughout the perinatal period (in this study defined as the period between 12 weeks of pregnancy untill three months postpartum). The clinical features of women experiencing recurrence of depression were described in detail. To identify vulnerability markers associated with recurrence of depression, we performed exploratory univariable logistic regression analyses.

RESULTS:

Eight women (9.4%) experienced a recurrence of depression; two during pregnancy and six in the first 12 weeks postpartum. All women with recurrence of depression had first onset of depression during childhood or adolescence and had at least 2 psychiatric co-morbidities. Identification of vulnerability markers associated with recurrence of depression yielded associations with depressive symptoms around 16 weeks of pregnancy (OR 1.28, 95%CI 1.08-1.52), number of psychiatric co-morbidities (OR 1.89, 95%CI 1.16-3.09) and duration of antidepressant use (OR 1.01, 95%CI 1.00-1.02).

CONCLUSION:

Implementing adequate risk assessment in pregnant women who use antidepressants can help identify predictors for recurrence of depression in future studies and thus ultimately lead to improved care.

Conflict of interest statement

The authors have declared that no competing interests exist.

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