Jumat, 15 Maret 2013

Study: Postpartum Depression Affects 1 in 7 Mothers

By Cristina Mestre

Almost 22 percent of women in the U.S. suffer from postpartum depression in the first year after giving birth, a significant public health problem given that a woman’s mental health has a profound effect on a child’s physical and emotional development. 

According to Dr. Dorothy Sit, assistant professor of Psychiatry at the University of Pittsburgh and researcher at Western Psychiatric Institute and Clinic of UPMC, a lot of women don’t understand what is happening to them during this time and mistake their emotions for being normal after having a baby.  Unfortunately, the vast majority of these depressed women are not identified or treated even though they are at higher risk for psychiatric disorders. 

A new study released Wednesday in the Journal of the American Medical Association (JAMA) takes a close look at postpartum depression and reveals some startling findings.  The study of 10,000 women who recently delivered babies at Magee-Womens Hospital of UPMC found a surprisingly large percentage who suffered recurrent episodes of major depression.  Dr. Sit, one of the study’s lead authors, noted that this is the largest-scale depression screening of postpartum women to date.

The study found that 14 percent of the 10,000 women screened tested positive for depression within four to six weeks after delivery.  Of that group, 826 received full psychiatric assessments during at-home visits. This represented the first time a full psychiatric assessment was done in a large study of postpartum women who screened positive for depression.

Some of the key findings from those assessments: 
  • Many women who screened positive for major depression postpartum had already experienced at least one episode of depression previously. The study found 33 percent of women had depression onset prior to pregnancy, 40 percent postpartum and 27 percent during pregnancy.
  • More than two-thirds of these women also had an anxiety disorder.  Moreover, women who screened positive for depression frequently had thoughts of self-harm – the authors detected 19.3 percent with thoughts of harming themselves. (Suicide accounts for about 20 percent of postpartum deaths and is the second most common cause of death in postpartum women.)
  • Among women with increased depression risk, 22 percent had bipolar disorders. The actual percentage may be even higher given that not all bipolar patients show depressive symptoms (and this study only looked at those postpartum patients with depressive symptoms/depression risk).  The finding is significant because this a very high rate of bipolar disorder that has never been reported in a population screened for postpartum depression before
So what does this all mean?  Dr. Sit said that awareness and detection of bipolar illness in mothers with postpartum symptoms is critically important because a proper diagnosis will help to guide appropriate treatment decisions. In the study, researchers were able to provide fast and responsive care for mothers who were identified as having suicidal symptoms.  By identifying mothers with depression risk, the study authors believe screening will save lives.

Dr. Sit believes that depression screening both prenatal and postpartum is essential, but that the health care field must develop cost effective and accessible treatment for those diagnosed.

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