Trajectories of Depressive and Anxiety Symptoms Across Pregnancy and Postpartum in Selective Serotonin Reuptake Inhibitor-Treated Women.
Autor: | Mesches GA; Department of Psychiatry and Behavioral Sciences Northwestern University Feinberg School of Medicine Chicago Illinois USA., Ciolino JD; Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago Illinois USA., Stika CS; Department of Obstetrics and Gynecology Northwestern University Feinberg School of Medicine Chicago Illinois USA., Sit DK; Department of Psychiatry and Behavioral Sciences Northwestern University Feinberg School of Medicine Chicago Illinois USA., Zumpf K; Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago Illinois USA., Fisher S; Department of Psychiatry and Behavioral Sciences Northwestern University Feinberg School of Medicine Chicago Illinois USA., Clark CT; Department of Psychiatry and Behavioral Sciences Northwestern University Feinberg School of Medicine Chicago Illinois USA.; Department of Obstetrics and Gynecology Northwestern University Feinberg School of Medicine Chicago Illinois USA., George AL; Department of Pharmacology Northwestern University Feinberg School of Medicine Chicago Illinois USA., Avram MJ; Department of Anesthesiology Northwestern University Feinberg School of Medicine Chicago Illinois USA., Rasmussen-Torvik LJ; Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago Illinois USA., Erickson DL; Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago Illinois USA., Caritis S; Department of Obstetrics, Gynecology, and Reproductive Sciences University of Pittsburgh Magee Womens Hospital Pittsburgh Pennsylvania USA., Fischer D; Department of Obstetrics, Gynecology, and Reproductive Sciences University of Pittsburgh Magee Womens Hospital Pittsburgh Pennsylvania USA., Venkataramanan R; Department of Pharmaceutical Sciences University of Pittsburgh School of Pharmacy Pittsburgh Pennsylvania USA.; Department of Pathology University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA., Costantine M; Department of Maternal-Fetal Medicine The Ohio State University Wexner Medical Center Columbus Ohio USA., West H; Department of OB/GYN University of Texas Medical Branch Galveston Texas USA., Welch E; Department of OB/GYN University of Texas Medical Branch Galveston Texas USA., Clark S; Department of OB/GYN University of Texas Medical Branch Galveston Texas USA., Wisner KL; Department of Psychiatry and Behavioral Sciences Northwestern University Feinberg School of Medicine Chicago Illinois USA.; Department of Obstetrics and Gynecology Northwestern University Feinberg School of Medicine Chicago Illinois USA., Gollan JK; Department of Psychiatry and Behavioral Sciences Northwestern University Feinberg School of Medicine Chicago Illinois USA.; Department of Obstetrics and Gynecology Northwestern University Feinberg School of Medicine Chicago Illinois USA. |
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Jazyk: | angličtina |
Zdroj: | Psychiatric research and clinical practice [Psychiatr Res Clin Pract] 2022 Mar 04; Vol. 4 (2), pp. 32-41. Date of Electronic Publication: 2022 Mar 04 (Print Publication: 2022). |
DOI: | 10.1176/appi.prcp.20210034 |
Abstrakt: | Objective: Tracking perinatal mood and anxiety disorders is championed by the American Psychiatric Association and the International Marcé Society for Perinatal Mental Health. We conducted this study to examine trajectories of monthly depressive and anxiety symptoms through pregnancy and postpartum. Methods: This is a prospective longitudinal observational cohort study of pregnant women interviewed at baseline (≤18th gestational week), every four weeks through delivery and at 6 and 14 weeks postpartum at three urban academic medical centers ( N = 85) and a single rural health center ( N = 3) from 2016 to 2020. Pregnant women had at least one prior episode of major depressive disorder, were not in a current episode, and were treated with sertraline, fluoxetine, citalopram, or escitalopram. Of 192 women screened, 88 (46%) women enrolled, and 77 (88%) women completed the postpartum follow-up. Symptom trajectories were generated with scores from the Edinburgh Postnatal Depression Scale, the Quick Inventory of Depressive Symptoms, the Generalized Anxiety Disorder Scale, 7-item, and the Patient-Reported Outcomes Measurement Information System Global Health measure. A semi-parametric, group-based mixture model (trajectory analysis) was applied. Results: Three relatively stable depression trajectories emerged, described as Minimal, Mild, and Subthreshold, in each group across pregnancy. Two of the four anxiety trajectories were stable, including Asymptomatic and Minimal, while the third, termed Breakthrough, was ascending with increasing symptoms and the fourth trajectory, described as Mild, had descending symptoms. Conclusions: Screening for anxiety with depression for pregnant women will yield a comprehensive view of psychiatric symptoms and treatment targets in perinatal women. (© 2022 The Authors. Psychiatric Research and Clinical Practice published by Wiley Periodicals LLC on behalf of American Psychiatric Association.) |
Databáze: | MEDLINE |
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