In our clinic, we often see women who come in for the treatment of depression and/or anxiety after the cessation of breastfeeding. Many question if breastfeeding may protect against postpartum depression and if the cessation of breastfeeding is a trigger for postpartum depression and/or anxiety. However, the research examining the association between postpartum depression and breastfeeding has been somewhat difficult to interpret.
While much research has demonstrated that maternal depression may negatively affect the child, leading to increased risk of developmental delays, behavioral problems, and psychiatric illness. Less research, however, has detailed the impact of paternal depression; several recent studies have focused on better understanding the risk factors for paternal depression and how paternal depression affects children.
Multiple studies have demonstrated that childhood maltreatment is associated with subsequent difficulties. Researchers from the University of Michigan assessed parenting behaviors in women with a history of childhood abuse and neglect (n?=?97) and a healthy control comparison group (n?=?53). Participants were assessed at 6 weeks, 4 months, and 6 months postpartum. At 6 months, a home visit was conducted and mothers and infants participated in a dyadic play interaction later coded for positive parenting behaviors by blinded raters.
In 2009, the Australian government launched the National Perinatal Depression Initiative (NPDI) in order “to improve the prevention and early detection of antenatal and postnatal depression and to provide better support and treatment for expectant and new mothers experiencing depression.” Its scope is very much like the MOTHERS Act, which became law in the United States in 2010. Both initiatives seek to increase public awareness of perinatal depression, to provide support and treatment for pregnant and postpartum women with depression, to fund research in this area, and to implement training of health care professionals.
About 10-30% of children have functional somatic symptoms (FSS). These are physical complaints, such as headaches, pain, fatigue, and dizziness, that cannot be explained medically. A new study suggests that when a child is exposed to depression or anxiety in the mother during the first year of life, he or she is more likely to report these somatic symptoms later on.
This is a small case report but is an important one, demonstrating the effectiveness of ultra-brief electroconvulsive therapy (ECT) for the treatment of severe postpartum depression. While most women with postpartum illness have mild to moderate illness, there are some women with severe depression that significantly impairs their ability to function and to care for their child. Women with severe PPD are also at higher risk for suicide.
A recent study from McGill University has assessed the prevalence and course of Post-Traumatic Stress Disorder (PTSD) following childbirth. The sample included 308 women who were assessed at four time points: 25-40 weeks gestation, 4-6 weeks postpartum, 3 and 6 months postpartum. Current and prior PTSD were assessed using the Structured Clinical Interview for DSM-IV (SCID-I) and the Modified PTSD Symptom Scale Self-Report (MPSS-SR).
While postpartum depression can affect all women, there are certain populations which appear to be at particularly high risk, including women of lower socioeconomic status. These women have limited access to resources and have multiple stressors including housing problems, financial strain, and being a single parent. Researchers recently piloted an intervention randomized controlled trial involving 540 participants at an inner-city hospital in East Harlem, New York. The primary goal of this psychoeducational intervention was to reduce the risk of postpartum depression among black and Latina mothers.
Post-traumatic stress disorder (PTSD) occurs in approximately 10% of all women at some point in their lifetime. PTSD tends to occur more commonly in women during their childbearing years, yet we have only recently begun to look more closely at the incidence of PTSD associated with childbirth.
Women with bipolar disorder or history of postpartum psychosis are at high risk for postpartum psychosis; appropriate interventions significantly decrease this risk.
