Childhood adversity and sleep are associated with symptom severity in perinatal women presenting for psychiatric care

Abstract

This study leverages psychiatric intake data from treatment-seeking perinatal women aiming to explore the understudied associations between childhood adversity, sleep quality, and severity of perinatal mental illness in this population. The sample is 578 perinatal women presenting for initial evaluation to a university-based perinatal psychiatry clinic. At intake, we collected demographics, adverse childhood experiences (ACEs), sleep quality, and diagnosis and symptom severity of depression, anxiety, and posttraumatic stress disorder (PTSD). Clinician-rated diagnoses showed that 65% of women met criteria for major depression, 23% for generalized anxiety disorder and 4% for PTSD; almost 30% of women had childhood adversity and 98.2% reported poor perinatal sleep quality. Regression analyses revealed differential associations between ACEs and sleep quality and perinatal mood symptoms; ACEs were significantly associated with pregnancy and postpartum PTSD, whereas sleep quality was associated with perinatal depression and generalized anxiety. Screening for ACEs and sleep quality during perinatal intake has high clinical utility, as these two factors significantly contribute to symptom severity across peripartum.

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Acknowledgements

WIMH Group (Women and Infants Mental Health Group) comprises all faculty, staff, and trainees who are serving perinatal women presenting for specialized clinical care to the Women and Infants Mental Health Clinic at the Department of Psychiatry, University of Michigan.

Funding

Financial support was provided via internal funds through the Department of Psychiatry, University of Michigan. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Correspondence to Maria Muzik.

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The authors and the individuals in the WIMH Group 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 national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Menke, R.A., Swanson, L., Erickson, N.L. et al. Childhood adversity and sleep are associated with symptom severity in perinatal women presenting for psychiatric care. Arch Womens Ment Health 22, 457–465 (2019). https://doi.org/10.1007/s00737-018-0914-2

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Keywords

  • ACEs
  • Sleep quality
  • Perinatal psychopathology
  • Perinatal psychiatric care