Abstract
Women in the perinatal period are at risk for psychiatric disorders. They suffer from depression, anxiety disorders, puerperal psychosis, and bipolar disorder in both the antenatal and postnatal periods. If the affected mothers could not function properly, as a result, the children’s growth and development would be negatively affected. In severe cases mothers may even commit suicide. Depression is common. Incidence of postpartum depression ranges from 10% to 15%. Early detection, effective interventions, and importantly prevention should be delivered by well-trained health providers. Women with past psychiatric history of depression or depression during pregnancy are likely to have depression postnatally with a three to fourfold increase. Because of high incidence of depression and insufficient accessibility to mental health services, several screening methods including the Edinburgh Postnatal Depression Scale are widely used. Some women with perinatal depressive disorders have comorbid anxiety disorders or obsessive-compulsive disorder. Most of their symptoms are relatively mild or moderate. Women with severe symptoms need to be on psychotropic medication. The adverse impact on fetus and breastfed babies should be taken into consideration. There is little evidence of negative outcomes among the infants whose mothers were on psychotropic drugs. Therefore, maternal symptoms should be viewed as priority. This issue is important and recently many projects are in progress for well-being of infants, mothers, and families.
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References
Betcher HK, Wisner KL (2019) Psychotropic treatment during pregnancy: research synthesis and clinical care principles. J Womens Health (Larchmt). https://doi.org/10.1089/jwh.2019.7781
Boyce P, Hickey A (2005) Psychosocial risk factors to major depression after childbirth. Soc Psychiatry Psychiatr Epidemiol 40(8):605–612
Brockington IF (2016) Emotional rejection of the infant: status of the concept. Psychopathology 49:247–260
Brockington IF, Fraser C, Wilson D (2006a) The postpartum bonding questionnaire: a validation. Arch Womens Ment Health 9(5):233–242
Brockington IF, Aucamp HM, Fraser C (2006b) Severe disorders of the mother- infant relationship: definitions and frequency. Arch Womens Ment Health 9(5):243–251
Brown HK, Potvin LA, Lunsky Y, Vigod SN (2018) Maternal intellectual or developmental disability and newborn discharge to protective services. Pediatrics 142(6). pii: e20181416. https://doi.org/10.1542/peds.2018-1416
Chaudron LH, Szilagyi PG, Tang W, Anson E, Talbot NL, Wadkins HI, Tu X, Wisner KL (2010) Accuracy of depression screening tools for identifying postpartum depression among urban mothers. Pediatrics 125:e609–e617
Clark CT, Wisner KL (2018) Treatment of peripartum bipolar disorder. Obstet Gynecol Clin N Am 45(3):403–417. https://doi.org/10.1016/j.ogc.2018.05.002
Coates AO, Schaefer CA, Alexander JL (2004) Detection of postpartum depression and anxiety in a large health plan. J Behav Health Serv Res 31(2):117–133
Cox JL (2019) Thirty years with the Edinburgh Postnatal Depression Scale: voices from the past and recommendations for the future. Br J Psychiatry 214(3):127–129
Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 150:782–786
Crawford P, Hudson S (2003) Understanding the information needs of women with epilepsy at different life stages: results of the ‘Ideal World’ survey. Seizure 12(7):502–507
Dadi AF, Miller ER, Mwanri L (2020) Antenatal depression and its association with adverse birth outcomes in low and middle-income countries: a systematic review and meta-analysis. PLoS One. https://doi.org/10.1371/journal.pone.0227323. Jan 10 2020
Deave T, Heron J, Evans J, Emond A (2008) The impact of maternal depression in pregnancy on early child development. BJOG 115(8):1043–1051. https://doi.org/10.1111/j.1471-0528.2008.01752.x
Fisher J, Cabral de Mello M, Patel V, Rahman A, Tran T, Holton S, Holmes W (2012) Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review. Bull World Health Organ 90(2):139G–149G. https://doi.org/10.2471/BLT.11.091850. Epub 2011 Nov 24. Review
Fornaro M, Maritan E, Ferranti R, Zaninotto L, Miola A, Anastasia A, Murru A, Solé E, Stubbs B, Carvalho AF, Serretti A, Vieta E, Fusar-Poli P, McGuire P, Young AH, Dazzan P, Vigod SN, Correll CU, Solmi M (2020) Lithium exposure during pregnancy and the postpartum period: a systematic review and meta-analysis of safety and efficacy outcomes. Am J Psychiatry 177(1):76–92. https://doi.org/10.1176/appi.ajp.2019.19030228
Gerrard J, Holden JM, Elliott SA, McKenzie P, McKenzie J, Cox JL (1993) A trainer’s perspective of an innovative programme teaching health visitors about the detection, treatment and prevention of postnatal depression. J Adv Nurs 18(11):1825–1832
Gjerdingen DK, Yawn BP (2007) Postpartum depression screening: importance, methods, barriers, and recommendations for practice. J Am Board Fam Med 20:280–288
Glangeaud-Freudenthal NM, Howard LM, Sutter-Dallay AL (2014) Treatment – mother-infant inpatient units. Best Pract Res Clin Obstet Gynaecol 28(1):147–157. https://doi.org/10.1016/j.bpobgyn.2013.08.015
Glover V (2014) Maternal depression, anxiety and stress during pregnancy and child outcome; what needs to be done. Best Pract Res Clin Obstet Gynaecol 28:25–35
Gustafsson HC, Goodman SH, Feng T, Choi J, Lee S, Newport DJ, Knight B, Pingeton B, Stowe ZN, Monk C (2018) Major depressive disorder during pregnancy: psychiatric medications have minimal effects on the fetus and infant yet development is compromised. Dev Psychopathol 30(3):773–785. https://doi.org/10.1017/S0954579418000639
Howard LM, Piot P, Stein A (2014) No health without perinatal mental health. Lancet 384(9956):1723–1724. https://doi.org/10.1016/S0140-6736(14)62040-7
Howard LM, Ryan EG, Trevillion K, Anderson F, Bick D, Bye A, Byford S, O’Connor S, Sands P, Demilew J, Milgrom J, Pickles A (2018) Accuracy of the Whooley questions and the Edinburgh Postnatal Depression Scale in identifying depression and other mental disorders in early pregnancy. Br J Psychiatry 212(1):50–56. https://doi.org/10.1192/bjp.2017.9
Jones I, Craddock N (2001) Familiality of the puerperal trigger in bipolar disorder: results of a family study. Am J Psychiatry 158(6):913–917
Jones I, Shakespeare J (2014) Postnatal depression. BMJ 349:g4500. https://doi.org/10.1136/bmj.g4500
Kendell RE, Chalmers JC, Platz C (1987) Epidemiology of puerperal psychoses. Br J Psychiatry 150:662–673
Kessler RC, Petukhova M, Sampson NA, Zaslavsky AM, Wittchen H-U (2012) Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. Int J Methods Psychiatr Res 21:169–184
Kitamura T, Shima S, Sugawara M, Toda MA (1993) Psychological and social correlates of the onset of affective disorders among pregnant women. Psychol Med 23(4):967–975
Klompenhouwer J, van Hulst A, Tulen J, Jacobs M, Jacobs B, Segers F (1995) The clinical features of postpartum psychoses. Eur Psychiatry 10(7):355–367. https://doi.org/10.1016/0924-9338(96)80337-3
Kozinszky Z, Dudas RB (2015) Validation studies of the Edinburgh Postnatal Depression Scale for the antenatal period. J Affect Disord 176:95–105. https://doi.org/10.1016/j.jad.2015.01.044
Kumar R (1997) “Anybody’s child”: severe disorders of mother-to infant bonding. Br J Psychiatry 171:175–181
Larsen ER, Damkier P, Pedersen LH, Fenger-Gron J, Mikkelsen RL, Nielsen RE, Linde VJ, Knudsen HED, Skaarup L, Videbech P, Danish Psychiatric Society, Danish Society of Obstetrics and Gynecology, Danish Paediatric Society, Danish Society of Clinical Pharmacology (2015) Use of psychotropic drugs during pregnancy and breast-feeding. Acta Psychiatr Scand Suppl 445:1–28
Marchesi C, Ossola P, Amerio A, Daniel BD, Tonna M, De Panfilis C (2016) Clinical management of perinatal anxiety disorders: a systematic review. J Affect Disord 190:543–550. https://doi.org/10.1016/j.jad.2015.11.004
Martínez-Paredes JF, Jácome-Pérez N (2019) Depression in pregnancy. Rev Colomb Psiquiatr 48(1):58–65. https://doi.org/10.1016/j.rcp.2017.07.003
Martini J, Petzoldt J, Einsle F, Beesdo-Baum K, Höfler M, Wittchen HU (2015) Risk factors and course patterns of anxiety and depressive disorders during pregnancy and after delivery: a prospective-longitudinal study. J Affect Disord 175:385–395
Meltzer-Brody S, Stuebe A (2014) The long-term psychiatric and medical prognosis of perinatal mental illness. Best Pract Res Clin Obstet Gynecol 8(1):49–60
Morrell CJ, Sutcliffe P, Booth A, Stevens J, Scope A, Stevenson M, Harvey R, Bessey A, Cantrell A, Dennis CL, Ren S, Ragonesi M, Barkham M, Churchill D, Henshaw C, Newstead J, Slade P, Spiby H, Stewart-Brown S (2016) A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression. Health Technol Assess 20(37):1–414
Nath S, Ryan EG, Trevillion K, Bick D, Demilew J, Milgrom J, Pickles A, Howard LM (2018) Prevalence and identification of anxiety disorders in pregnancy: the diagnostic accuracy of the two-item Generalised Anxiety Disorder scale (GAD-2). BMJ Open 8(9):e023766. https://doi.org/10.1136/bmjopen-2018-023766
National Institute for Health and Care Excellence (2014) Antenatal and Postnatal mental health guidelines – clinical guidelines CG192. National Institute for Health and Care Excellence (NICE), London, updated 2020
O’Connor TG, Heron J, Golding J, Beveridge M, Glover V (2002) Maternal antenatal anxiety and children’s behavioural/emotional problems at 4 years. Report from the Avon Longitudinal Study of Parents and Children. Br J Psychiatry 180:502–508
O’Hara MW, Wisner KL (2014) Perinatal mental illness: definition, description and aetiology. Best Pract Res Clin Obstet Gynecol 28(1):3–12
Ogbo FA, Eastwood J, Hendry A, Jalaludin B, Agho KE, Barnett B, Page A (2018) Determinants of antenatal depression and postnatal depression in Australia. BMC Psychiatry 18(1):49. https://doi.org/10.1186/s12888-018-1598-x
Oppo A, Mauri M, Ramacciotti D, Camilleri V, Banti S, Borri C, Rambelli C, Montagnani MS, Cortopassi S, Bettini A, Ricciardulli S, Montaresi S, Rucci P, Beck CT, Cassano GB (2009) Risk factors for postpartum depression: the role of the Postpartum Depression Predictors Inventory-Revised (PDPI-R). Results from the Perinatal Depression-Research and Screening Unit (PNDReScU) study. Arch Womens Ment Health 12:239–249
Osborne LM (2018) Recognizing and managing postpartum psychosis: a clinical guide for obstetric providers. Obstet Gynecol Clin N Am 45(3):455–468. https://doi.org/10.1016/j.ogc.2018.04.005
Payne JL (2019) Psychopharmacology in pregnancy and breastfeeding. Med Clin North Am 103(4):629–650
Pitt B (1973) Maternity blues. Br J Psychiatry 122(569):431–433
Poels EMP, Bijma HH, Galbally M, Bergink V (2018) Lithium during pregnancy and after delivery: a review. Int J Bipolar Disord 6:26. https://doi.org/10.1186/s40345-018-0135-7
Poobalan AS, Aucott LS, Ross L, Smith WC, Helms PJ, Williams JH (2007) Effects of treating postnatal depression on mother-infant interaction and child development: systematic review. Br J Psychiatry 191:378–386
Priest SR, Austin MP, Barnett B, Buist A (2008) A psychosocial risk assessment model (PRAM) for use with pregnant and postpartum women in primary care settings. Arch Women Ment Health. https://doi.org/10.1007/s00737-008-0028-3
Raffaeli G, Cavallaro G, Allegaert K, Wildschut ED, Fumagalli M, Agosti M, Tibboel D, Mosca F (2017) Neonatal abstinence syndrome: update on diagnostic and therapeutic strategies. Pharmacotherapy 37(7):814–823. https://doi.org/10.1002/phar.1954
Robertson E, Sherry G, Wallington T, Stewart DE (2004) Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry 26:289–295
Robin AM (1962) Psychological changes of normal parturition. Psychiatry Q 36:129–150
Royal College of Psychiatrists (2018) Mother and baby units (MBUs). https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/mother-and-baby-units-(mbus)
Ryan D, Milis L, Misri N (2005) Depression during pregnancy. Can Fam Physician 51:1087–1093
Seneviratne G, Conroy S, Marks M (2003) Parenting assessments in a psychiatric mother and baby unit. Br J Soc Work 33:535–555
Sharma V, Smith A, Khan M (2004) The relationship between duration of labour, time of delivery, and puerperal psychosis. J Affect Disord 83(2–3):215–220
Sit DK, Wisner KL (2009) Identification of postpartum depression. Clin Obstet Gynecol 52(3):456–468
South London and Maudsley NHS Foundation Trust (2020) Mother and baby unit (Bethlem Royal hospital). https://www.slam.nhs.uk/our-services/service-finder-details?CODE=SU0320
Stein A, Pearson RM, Goodman SH, Rapa E, Rahman A, McCallum M, Howard LM, Pariante CM (2014) Effects of perinatal mental disorders on the foetus and child. Lancet 384:1800–1819
Terp IM, Mortensen PB (1998) Post-partum psychoses. Clinical diagnoses and relative risk of admission after parturition. Br J Psychiatry 172(6):521–526
Thombs BD, Benedetti A, Kloda LA, Levis B, Riehm KE, Azar M, Cuijpers P, Gilbody S, Ioannidis JP, McMillan D, Patten SB, Shrier I, Steele RJ, Ziegelstein RC, Tonelli M, Mitchell N, Comeau L, Schinazi J, Vigod S (2015) Diagnostic accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for detecting major depression in pregnant and postnatal women: protocol for a systematic review and individual patient data meta-analyses. BMJ Open 5(10):e009742. https://doi.org/10.1136/bmjopen-2015-009742
Trevillion K, Shallcross R, Ryan E, Heslin M, Pickles A, Byford S, Jones I, Johnson S, Pawlby S, Stanley N, Rose D, Seneviratne G, Wieck A, Jennings S, Potts L, Abel KM, Howard LM (2019) Protocol for a quasi-experimental study of the effectiveness and cost-effectiveness of mother and baby units compared with general psychiatric inpatient wards and crisis resolution team services (The ESMI study) in the provision of care for women in the postpartum period. BMJ Open 9(3):e025906. https://doi.org/10.1136/bmjopen-2018-025906
Uguz F (2015) Pharmacotherapy of obsessive-compulsive disorder during pregnancy: a clinical approach. Braz J Psychiatry 7(4):334–342. https://doi.org/10.1590/1516-4446-2015-1673
Ukatu N, Clare CA, Brulja M (2018) Postpartum depression screening tools: a review. Psychosomatics 59(3):211–219. https://doi.org/10.1016/j.psym.2017.11.005
Valdimarsdóttir U, Hultman CM, Harlow B, Cnattingius S, Sparén P (2009) Psychotic illness in first-time mothers with no previous psychiatric hospitalizations: a population-based study. PLoS Med 6(2):e13
Whelehan A, Delanty N (2019) Therapeutic strategies for treating epilepsy during pregnancy. Expert Opin Pharmacother 20(3):323–332. https://doi.org/10.1080/14656566.2018.1550073
Whitelaw AG, Cummings AJ, McFadyen IR (1981) Effect of maternal lorazepam on the neonate. Br Med J (Clin Res Ed) 282(6270):1106–1108
Whooley MA Whooley questions for depression screening. University of California, San Francisco, https://whooleyquestions.ucsf.edu/content/test-characteristics. Accessed 29 Feb 2020
Whooley MA, Avins AL, Miranda J, Browner WS (1997) Case-finding instruments for depression. Two questions are as good as many. J Gen Intern Med 12:439–445
Wisner KL, Perel JM, Peindl KS, Hanusa BH, Findling RL, Rapport D (2001) Prevention of recurrent postpartum depression: a randomized clinical trial. J Clin Psychiatry 62:82–86
Wisner KL, Sit DK, McShea MC, Rizzo DM, Zoretich RA, Hughes CL, Eng HF, Luther JF, Wisniewski SR, Costantino ML, Confer AL, Moses-Kolko EL, Famy CS, Hanusa BH (2013) Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings. JAMA Psychiat 70(5):490–498. https://doi.org/10.1001/jamapsychiatry.2013.87
Word Health Organization (2017) Depression and other common mental disorders: global health estimates. World Health Organization, Geneva
Yamashita H, Yoshida K, Nakano H, Tashiro N (2000) Postnatal depression in Japanese women. Detecting the early onset of postnatal depression by closely monitoring the postpartum mood. J Affect Disord 58(2):145–154
Yonkers KA, Gilstad-Hayden K, Forray A, Lipkind HS (2017) Association of panic disorder, generalized anxiety disorder, and benzodiazepine treatment during pregnancy with risk of adverse birth outcomes. JAMA Psychiat 74(11):1145–1152
Yoshida K, Marks MN, Kibe N, Kumar R, Nakano H, Tashiro N (1997) Postnatal depression in Japanese women who have given birth in England. J Affect Disord 43:69–77
Yoshida K, Yamashita H, Conroy S, Marks M, Kumar C (2012) A Japanese version of Mother-to-Infant Bonding Scale: factor structure, longitudinal changes and links with maternal mood during the early postnatal period in Japanese mothers. Arch Womens Ment Health 15(5):343–352. https://doi.org/10.1007/s00737-012-0291-1
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Yoshida, K., Iwayama, M., Das, P., Howard, L.M. (2020). Perinatal Psychiatry. In: Taylor, E., Verhulst, F., Wong, J., Yoshida, K. (eds) Mental Health and Illness of Children and Adolescents. Mental Health and Illness Worldwide. Springer, Singapore. https://doi.org/10.1007/978-981-10-2348-4_26
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