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Lifetime substance use as a predictor of postpartum mental health

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Abstract

Postpartum mood disorders (PPMD) affect approximately 10–20% of women and have adverse consequences for both mom and baby. Lifetime substance use has received limited attention in relation to PPMD. The present study examined associations of lifetime alcohol and drug use with postpartum mental health problems. Women (n = 100) within approximately 3 months postpartum (M = 2.01, SD = 1.32) participated in semi-structured interviews querying lifetime substance use, mental health history, and postpartum symptoms of anxiety, stress, posttraumatic stress disorder (PTSD), depression, and obsessive compulsive disorder. The study was conducted in an urban Canadian city from 2009 to 2010. Analyses revealed that lifetime substance use increased the variability explained in postpartum PTSD (p = .011), above and beyond sociodemographic characteristics and mental health history. The same trend, though not significant, was observed for stress (p = .059) and anxiety (p = .070). Lifetime drug use, specifically, was associated with postpartum stress (p = .021) and anxiety (p = .041), whereas lifetime alcohol use was not (ps ≥ .128). Findings suggest that lifetime drug use is associated with PPMD. Future research should examine whether screening for lifetime drug use during antenatal and postpartum care improves identification of women experiencing PPMD.

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Notes

  1. All women were recruited within 0–3 months postpartum; however, some participants were ultimately not interviewed until 4 (n = 10) or 5 (n = 3) months postpartum due to scheduling difficulties. These participants were retained in all analyses, as there were no significant differences in any of the outcome variables or SASSI-3 scales as a function of baby age (ps ≥ .220).

References

  • Alcorn KL, O’Donovan A, Patrick JC, Creedy D, Devilly GJ (2010) A prospective longitudinal study of the prevalence of post-traumatic stress disorder resulting from childbirth events. Psychol Med 40(11):1849–1859. doi:10.1017/S0033291709992224

    Article  CAS  PubMed  Google Scholar 

  • Allison KC, Wenzel A, Kleiman K, Sarwer DB (2011) Development of a brief measure of postpartum distress. J Womens Health (2002) 20(4):617–623. doi:10.1089/jwh.2010.1989

    Article  Google Scholar 

  • American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders, 5th edn. American Psychiatric Association, Arlington

    Book  Google Scholar 

  • Antony MM, Bieling PJ, Cox BJ, Enns MW, Swinson RP (1998) Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychol Assess 10(2):176–181

    Article  Google Scholar 

  • Ashley JM, Harper BD, Arms-Chavez CJ, LoBello SG (2015) Estimated prevalence of antenatal depression in the US population. Arch Womens Ment Health. doi:10.1007/s00737-015-0593-1

    PubMed  Google Scholar 

  • Belli RF (1998) The structure of autobiographical memory and the event history calendar: potential improvements in the quality of retrospective reports in surveys. Memory 6(4):383–406. doi:10.1080/741942610

    Article  CAS  PubMed  Google Scholar 

  • Belli RF, Shay WL, Stafford FP (2001) Event history calendars and question list surveys: a direct comparison of interviewing methods. Public Opin Q 65(1):45–74. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/11264054

  • Boyd RC, Le HN, Somberg R (2005) Review of screening instruments for postpartum depression. Arch Womens Ment Health 8(3):141–153. doi:10.1007/s00737-005-0096-6

    Article  CAS  PubMed  Google Scholar 

  • Brady KT, Sinha R (2005) Reviews and overviews co-occurring mental and substance use disorders: the neurobiological effects of chronic stress. Am J Psychiatr 162:1483–1493

    Article  PubMed  Google Scholar 

  • Bryan TL, Georgiopoulos BA, Harms RW, Huxsahl JE, Larson DR, Yawn BP (1999) Incidence of postpartum depression in Olmsted County, Minnesota. J Reprod Med 44(4)351–358

  • Centers for Disease Control (2008) Prevalence of self-reported postpartum depressive symptoms—17 states, 2004–2005. Morb Mortal Wkly Rep 57(14):361–6. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/18401329

  • Coffey SF, Gudmundsdottir B, Beck G, Palyo SA, Miller L (2006) Screening for PTSD in motor vehicle accident survivors using the PSS-SR and IES. J Trauma Stress 19(1):119–128. doi:10.1115/1.3071969.Automating

    Article  PubMed  PubMed Central  Google Scholar 

  • Daley M, Argeriou M, McCarty D (1998) Substance abuse treatment for pregnant women: a window of opportunity? Addict Behav 23(2):239–249. doi:10.1016/S0306-4603(97)00029-4

    Article  CAS  PubMed  Google Scholar 

  • Darke S (1998) Self-report among injecting drug users: a review. Drug Alcohol Depend 51:253–263. doi:10.1016/S0376-8716(98)00028-3

    Article  CAS  PubMed  Google Scholar 

  • de Graaf R, Bijl RV, Spijker J, Beekman ATF, Vollebergh WAM (2003) Temporal sequencing of lifetime mood disorders in relation to comorbid anxiety and substance use disorders: findings from the Netherlands Mental Health Survey and Incidence Study. Soc Psychiatry Psychiatr Epidemiol 38:1–11. doi:10.1007/s00127-003-0597-4

    Article  PubMed  Google Scholar 

  • Desmarais SL, Pritchard A, Lowder EM, Janssen PA (2014) Intimate partner abuse before and during pregnancy as risk factors for postpartum mental health problems. BMC Pregnancy Childbirth 14(1)132. doi:10.1186/1471-2393-14-132

  • Earls MF (2010) Incorporating recognition and management of perinatal and postpartum depression into pediatric practice. Pediatrics 126(5):1032–1039. doi:10.1542/peds.2010-2348

    Article  PubMed  Google Scholar 

  • Ernhart CB, Morrow-Tlucak M, Sokol RJ, Martier S (1988) Underreporting of alcohol use in pregnancy. Alcohol Clin Exp Res 12(4):506–511

    Article  CAS  PubMed  Google Scholar 

  • Farr SL, Dietz PM, Rizzo JH, Vesco KK, Callaghan WM, Bruce FC, … Berg CJ (2013) Health care utilisation in the first year of life among infants of mothers with perinatal depression or anxiety. Paediatr Perinat Epidemiol 27(1):81–8. doi:10.1111/ppe.12012

  • Field T (2010) Postpartum depression effects on early interactions, parenting, and safety practices: a review. Infant Behav Dev 33(1):1–6. doi:10.1016/j.infbeh.2009.10.005

    Article  PubMed  Google Scholar 

  • Finkelstein N (1994) Treatment issues for alcohol- and drug-dependent pregnant and parenting women—ProQuest. Health Soc Work 19(1):7–15. Retrieved from http://search.proquest.com.prox.lib.ncsu.edu/docview/210563160?accountid=12725

  • Foa EB, Riggs DS, Dancu CV, Rothbaum BO (1993) Reliability and validity of a brief instrument for assessing post-traumatic stress disorder. J Trauma Stress 6(4):457–473

    Article  Google Scholar 

  • Gavin NI, Gaynes BN, Lohr KN, Meltzer-brody S, Gartlehner G, Swinson T (2005) Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol 106(5):1071–1083

    Article  PubMed  Google Scholar 

  • Gaynes BN, Gavin N, Meltzer-Brody S, Lohr KN, Swinson T, Gartlehner G, … Miller WC (2005) Perinatal depression: prevalence, screening accuracy, and screening outcomes. Evid Rep Technol Assess (119):1–8. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15760246

  • Goodman SH, Gotlib IH (1999) Risk for psychopathology in the children of depressed mothers: a developmental model for understanding mechanisms of transmission. Psychol Rev 106(3):458–490. doi:10.1037/0033-295X.106.3.458

    Article  CAS  PubMed  Google Scholar 

  • Goodman WK, Price L, Rasmussen S, Mazure C, Delgado P, Heninger G, Charney D (1989a) The Yale-Brown Obsessive Compulsive Scale: 2. Validity. Arch Gen Psychiatry 46(11):1012–1016

    Article  CAS  PubMed  Google Scholar 

  • Goodman WK, Price L, Rasmussen S, Mazure C, Fleischmann R, Hill C, … Charney D (1989) The Yale-Brown Obsessive Compulsive Scale: 1. Development, use and reliability. Arch Gen Psychiatry 46(11):1006–1011

  • Grant BF, Stinson FS, Dawson DA, Chou SP, Dufour MC, Compton W, … Kaplan K (2004) Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders on alcohol and related conditions. Arch Gen Psychiatry 61:807–816

  • Horrigan TJ, Piazza NJ, Weinstein L (1996) The substance abuse subtle screening inventory is more cost effective and has better selectivity than urine toxicology for the detection of substance abuse in pregnancy. J Perinatol 16(5):326–330

    CAS  PubMed  Google Scholar 

  • Jacobson SW, Jacobson JL, Sokol RJ, Martier SS, Ager JW, Kaplan MG (1991) Maternal recall of alcohol, cocaine, and marijuana use during pregnancy. Neurotoxicol Teratol 13(5):535–540. doi:10.1016/0892-0362(91)90062-2

    Article  CAS  PubMed  Google Scholar 

  • Kessler RC, Nelson CB, McGonagle KA, Edlund MJ, Frank RG, Leaf PJ (1996) The epidemiology of co-occurring addictive and mental disorders: implications for prevention and service utilization. Am J Orthopsychiatry 66(1):17–31. doi:10.1037/h0080151

    Article  CAS  PubMed  Google Scholar 

  • Ko JY, Farr SL, Dietz PM, Robbins CL (2012) Depression and treatment among U.S. pregnant and nonpregnant women of reproductive age, 2005–2009. J Womens Health (2002) 21(8):830–836. doi:10.1089/jwh.2011.3466

    Article  Google Scholar 

  • Lancaster CA, Gold KJ, Flynn HA, Yoo H, Marcus SM, Davis MM (2010) Risk factors for depressive symptoms during pregnancy: a systematic review. Am J Obstet Gynecol 202(1):5–14. doi:10.1016/j.ajog.2009.09.007

    Article  PubMed  PubMed Central  Google Scholar 

  • Lazowski LE, Miller FG (2013) Estimates of the reliability and criterion validity of the adult SASSI-3. The SASSI Institute, Springville

    Google Scholar 

  • Lazowski LE, Miller FG, Boye MW, Miller GA (1998) Efficacy of the Substance Abuse Subtle Screening Inventory-3 (SASSI-3) in identifying substance dependence disorders in clinical settings. J Pers Assess 71(1):114–128. doi:10.1207/s15327752jpa7101_8

    Article  CAS  PubMed  Google Scholar 

  • Lester BM, Andreozzi L, Appiah L (2004) Substance use during pregnancy: time for policy to catch up with research. Harm Reduct J 1(1):5. doi:10.1186/1477-7517-1-5

    Article  PubMed  PubMed Central  Google Scholar 

  • Lewin AB, De Nadai AS, Park J, Goodman WK, Murphy TK, Storch EA (2011) Refining clinical judgment of treatment outcome in obsessive-compulsive disorder. Psychiatry Res 185(3):394–401. doi:10.1016/j.psychres.2010.08.021

    Article  PubMed  Google Scholar 

  • Lovibond SH, Lovibond PF (1995) Manual for the Depression Anxiety Stress Scales, 2nd edn. Psychology Foundation of Australia, Sydney

    Google Scholar 

  • Substance Abuse and Mental Health Services Administration (2014) Results from the 2013 national survey on drug use and health: summary of national findings. Rockville, MD. Retrieved from http://oas.samhsa.gov/NSDUH/2k10NSDUH/2k10Results.pdf

  • Miller FG, Lazowski LE (1999) The Adult SASSI-3 Manual. The SASSI Institute, Springville

    Google Scholar 

  • Morrow-Tlucak M, Ernhart C, Sokol RJ, Martier S, Ager J, Emhart CB, … Ager J (1989) Underreporting of alcohol use in pregnancy: relationship to alcohol problem history. Alcohol Clin Exp Res 13(3):399–401. doi:10.1111/j.1530-0277.1989.tb00343.x

  • Murray L, Cooper PJ (1997) Effects of postnatal depression on infant development. Arch Dis Child 77(2):99–101. doi:10.1136/adc.77.2.99

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • NIDA (1997) The validity of self-reported drug use: improving the accuracy of survey estimates. In: Harrison L, Hughes A (eds) NIDA research monograph (NIH Public, Vol. 167). National Institute on Drug Abuse, Rockville

    Google Scholar 

  • Nieuwenhuijsen K, de Boer AGEM, Verbeek JHAM, Blonk RWB, van Dijk FJH (2003) The Depression Anxiety Stress Scales (DASS): detecting anxiety disorder and depression in employees absent from work because of mental health problems. Occup Environ Med 60(Suppl 1(phase 2)):i77–i82. doi:10.1136/oem.60.suppl_1.i77

    Article  PubMed  PubMed Central  Google Scholar 

  • Ornoy A, Ergaz Z (2010) Alcohol abuse in pregnant women: effects on the fetus and newborn, mode of action and maternal treatment. Int J Environ Res Public Health 7(2):364–379. doi:10.3390/ijerph7020364

    Article  PubMed  PubMed Central  Google Scholar 

  • Pinto SM, Dodd S, Walkinshaw SA, Siney C, Kakkar P, Mousa HA (2010) Substance abuse during pregnancy: effect on pregnancy outcomes. Eur J Obstet Gynecol Reprod Biol 150(2):137–141. doi:10.1016/j.ejogrb.2010.02.026

    Article  CAS  PubMed  Google Scholar 

  • Reck C, Struben K, Backenstrass M, Stefenelli U, Reinig K, Fuchs T, … Mundt C (2008) Prevalence, onset and comorbidity of postpartum anxiety and depressive disorders. Acta Psychiatr Scand 118(6):459–468. doi:10.1111/j.1600-0447.2008.01264.x

  • Regier DA, Farmer ME, Rae DS, Locke BZ, Keith SJ, Judd LL, Goodwin FK (1990) Comorbidity of mental disorders with alcohol and other drug abuse: results from the Epidemiologic Catchment Area (ECA) Study. JAMA 264(19):2511–2518

    Article  CAS  PubMed  Google Scholar 

  • Regier DA, Narrow WE, Rae DS, Manderscheid RW, Locke BZ, Goodwin FK (1993) The de facto US mental and addictive disorders service system: epidemiologic catchment area prospective 1-year prevalence rates of disorders and services. Arch Gen Psychiatry 50(2):85–94. doi:10.1001/archpsyc.1993.01820140007001

    Article  CAS  PubMed  Google Scholar 

  • Robertson E, Grace S, Wallington T, Stewart DE (2004) Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry 26(4):289–295. doi:10.1016/j.genhosppsych.2004.02.006

    Article  PubMed  Google Scholar 

  • Ross LE, Dennis C-L (2009) The prevalence of postpartum depression among women with substance use, an abuse history, or chronic illness: a systematic review. J Women’s Health 18(4):475–486. doi:10.1089/jwh.2008.0953

    Article  Google Scholar 

  • Ross LE, McLean LM (2006) Anxiety disorders during pregnancy and postpartum period: a systematic review. J Clin Psychiatry 67(8):1285–1298. doi:10.4088/JCP.v67n0818

    Article  PubMed  Google Scholar 

  • Schwarz N, Oyserman D (2001) Asking questions about behavior: cognition, communication, and questionnaire construction. Am J Eval 22(2):127–160. doi:10.1177/109821400102200202

    Article  Google Scholar 

  • Sin G-L, Abdin E, Lee J (2012) The PSS-SR as a screening tool for PTSD in first-episode psychosis patients. Early Interv Psychiatry 6(2):191–194. doi:10.1111/j.1751-7893.2011.00327.x

    Article  PubMed  Google Scholar 

  • Siu AL, Bibbins-Domingo K, Grossman DC, Baumann LC, Davidson KW, Ebell M, … Pignone MP (2016) Screening for depression in adults: US preventive services task force recommendation statement. J Am Med Assoc 315(4):380. doi:10.1001/jama.2015.18392

  • Stone SD, Menken AE (2008) Perspectives on risk factors, screening and diagnosis. In: Perinatal and postpartum mood disorders: perspectives and treatment guide for the health care practitioner (p 85–166). Springer Publishing, New York. Retrieved from http://site.ebrary.com.prox.lib.ncsu.edu/lib/ncsu/reader.action?docID=10265608&ppg=116

  • U.S. Department of Health and Human Services. Office of Disease Prevention and Health Promotion (2011) Healthy People 2020. Washington, DC. Retrieved from http://www.healthypeople.gov/

  • Wenzel A, Haugen EN, Jackson LC, Brendle JR (2005) Anxiety symptoms and disorders at eight weeks postpartum. J Anxiety Disord 19(3):295–311. doi:10.1016/j.janxdis.2004.04.001

    Article  PubMed  Google Scholar 

  • Witt WP, Mandell KC, Wisk LE, Cheng ER, Chatterjee D, Wakeel F, … Zarak D (2016) Infant birthweight in the US: the role of preconception stressful life events and substance use. Arch Womens Ment Health. doi:10.1007/s00737-015-0595-z

  • Zambaldi CF, Cantilino A, Montenegro AC, Paes JA, de Albuquerque TLC, Sougey EB (2009) Postpartum obsessive-compulsive disorder: prevalence and clinical characteristics. Compr Psychiatry 50(6):503–509. doi:10.1016/j.comppsych.2008.11.014

    Article  PubMed  Google Scholar 

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Acknowledgements

Funding for this study was provided by the British Columbia Mental Health and Addictions Research Network, the Social Sciences and Humanities Research Council of Canada, and the Michael Smith Foundation for Health Research.

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Authors and Affiliations

  1. Department of Psychology, North Carolina State University, Campus Box 7650, Raleigh, NC, 27695-7650, USA

    Betty-Shannon Prevatt & Sarah L. Desmarais

  2. School of Population and Public Health, University of British Columbia, Rm 103, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada

    Patricia A. Janssen

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  1. Betty-Shannon Prevatt
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Correspondence to Betty-Shannon Prevatt.

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Betty-Shannon Prevatt, Sarah L. Desmarais, and Patricia A. Janssen declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Prevatt, BS., Desmarais, S.L. & Janssen, P.A. Lifetime substance use as a predictor of postpartum mental health. Arch Womens Ment Health 20, 189–199 (2017). https://doi.org/10.1007/s00737-016-0694-5

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