The behavior over time of postnatal depression symptomatology and its early detection via the Edinburgh Postnatal Depression Scale: An Italian longitudinal study

  • Authors

    • Maria Caterina Cattaneo Consultorio Familiare Accreditato ASL“Genitori Oggi”-CAV Mangiagalli, Milan, Italy.Fondazione IRCCS Cà Granda- Ospedale Maggiore Policlinico, Milan, Italy.
    • Sara Roveraro Consultorio Familiare Accreditato ASL“Genitori Oggi”-CAV Mangiagalli, Milan, Italy.Fondazione IRCCS Cà Granda- Ospedale Maggiore Policlinico, Milan, Italy.
    • Valentina Chiorino Consultorio Familiare Accreditato ASL“Genitori Oggi”-CAV Mangiagalli, Milan, Italy.Fondazione IRCCS Cà Granda- Ospedale Maggiore Policlinico, Milan, Italy.
    • Elena Alessandra Macchi Consultorio Familiare Accreditato ASL“Genitori Oggi”-CAV Mangiagalli, Milan, Italy.Fondazione IRCCS Cà Granda- Ospedale Maggiore Policlinico, Milan, Italy.
    • Roberta Salerno Consultorio Familiare Accreditato ASL“Genitori Oggi”-CAV Mangiagalli, Milan, Italy.Fondazione IRCCS Cà Granda- Ospedale Maggiore Policlinico, Milan, Italy.
    • Monica Gatti Department of Psychology Università Cattolica del Sacro Cuore – Milan, Italy.
    • Laura Arcaro Consultorio Familiare Accreditato ASL“Genitori Oggi”-CAV Mangiagalli, Milan, Italy.Fondazione IRCCS Cà Granda- Ospedale Maggiore Policlinico, Milan, Italy.
    • Francesco Barretta Department of Clinical Sciences and Community Health, University of Milan. Epidemiology Unit, Department of Preventive Medicine, Fondazione IRCCS Cà Granda- Ospedale Maggiore Policlinico, Milan, Italy.
    • Camilla Barbara Fontana NICU, Fondazione IRCCS Cà Granda - Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
    • Lorenzo Colombo NICU, Fondazione IRCCS Cà Granda - Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
    • Piero Giorgio Rossi Department of Obstetrics and Gynecology, Fondazione IRCCS Cà Granda- Ospedale Maggiore Policlinico, Milan, Italy.
    • Fabio Mosca NICU, Fondazione IRCCS Cà Granda - Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
    2015-02-24
    https://doi.org/10.14419/ijans.v4i1.3931
  • EPDS, Maternal Depressive Symptoms, Postnatal Depression, Postpartum Depression Symptomatology, Screening
  • Background: Becoming a mother for the first time is a significant developmental transition and postpartum mood disorders represents the most frequent form of maternal morbidity following delivery.

    Objective: To investigate the ability of Edinburgh Postnatal Depression Scale (EPDS) to detect, in the first days postpartum, mothers at risk of developing depressive symptomatology over time.

    Results: The percentage of mothers with an EPDS score ≥10 decreases over time: 23.77% at 2/5 days postpartum, 15.57% at 2 months and 9.02% at 6 months after delivery. Among mothers with a depressive symptomatology after 2/5 days postpartum, 41.38% maintained an EPDS score ≥10 at 2 months too, while 20.69% of them manifested depressive symptoms at 6 months as well. Both correlation and linear regression showed a significant association between EPDS scores in all three administrations of the study but EPDS score at 2/5 days postpartum is more associated and predictive to maternal mood at two months than at six months postpartum.

    Method: A longitudinal study was conducting on 122 primiparous mothers who filled out EPDS and a General Information Questionnaire at 2/5 days postpartum, at 2/3 and 6/7 months after delivery. Women with high EPDS scores (≥10) were compared to those who had scored <10 in all the three steps and longitudinal analysis were conducted.

    Conclusion: Implementing EPDS in the first week postpartum allows identifying women at high risk to maintain depressive symptoms over time. These findings could be useful for health care interventions after delivery and for researchers involved in the study of transcultural aspects of postnatal depression.

  • References

    1. [1] Affonso DD, De AK, Horowitz JA & Mayberry LL (2000) An international study exploring levels of postpartum depressive symptomatology. Journal of Psychosomatic Research, 49, 207-216.

      http://dx.doi.org/10.1016/S0022-3999(00)00176-8.

      [2] Agostini F, Monti F, Marano G & Lupi F (2005) L’Edinburgh Postnatal Depression Scale (EPDS) a 3, 9, 18 mesi dopo il parto. Psychofrenia VIII, 12. DOI: 10.1285/i17201632vVIIIn12p63.

      [3] Banti S, Mauri M, Oppo A, Borri C, Rambelli C, Ramacciotti D, Montagnani MS, Camilleri V, Cortopassi S, Rucci P & Cassano G (2011) From the third month of pregnancy to 1 year postpartum. Prevalence, incidence, recurrence, and new onset of depression. Results from the Perinatal Depression–Research & Screening Unit study. Comprehensive Psychiatry, 52, 343-351.

      http://dx.doi.org/10.1016/j.comppsych.2010.08.003.

      [4] Benvenuti P, Ferrara M, Niccolai C, Valoriani V & Cox JL (1999) The Edinburgh postnatal depression scale: Validation for an italian sample. Journal of Affective Disorder, 53, 137 – 141.

      http://dx.doi.org/10.1016/S0165-0327(98)00102-5.

      [5] Brugha TS, Wheatley S, Taub NA, Culverwell A, Friedman T, Kirwan P, Jones DR & Shapiro DA (2000) Pragmatic randomized trial of antenatal intervention to prevent post-natal depression by reducing psychosocial risk factors. Psychological Medicine 30, 1273-1281. https://lra.le.ac.uk/bitstream/2381/63/1/brugha_pragmatic.pdf. http://dx.doi.org/10.1017/S0033291799002937.

      [6] Burt VK & Stein K (2002) Epidemiology of depression throughout the female life cycle. Journal of Clinical Psychiatry, 63 Suppl. 7: 9- 15.

      [7] Cooper PJ & Murray L (1995) The course and recurrence of post-natal depression. British Journal of Psychiatry, 166, 191-195. http://dx.doi.org/10.1192/bjp.166.2.191.

      [8] Cox J, Holden J & Sagovsky R (1987) Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782 -786. http://dx.doi.org/10.1192/bjp.150.6.782.

      [9] Cox J & Holden JM (2003) Perinatal Mental Health: A guide to the Edinburgh Postnatal Depression Scale. Gaskell, Glasgow. http://dx.doi.org/10.1007/s00737-008-0028-3.

      [10] Danaci AE, Dinc G, Deveci A, Sen FS & Icelli I (2002) Postnatal depression in Turkey: Epidemiological and cultural aspects. Soc. Psychiatry. Social Psychiatry and Psychiatric Epidemiology 37, 125–9. http://dx.doi.org/10.1007/s001270200004.

      [11] Dennis CL (2004) Can we identify mothers at risk for postpartum depression in the immediate postpartum period using the Edinburgh Postnatal Depression Scale? Journal of Affective Disorder 78, 163 -169. http://dx.doi.org/10.1111/j.1600-0447.2004.00337.x.

      [12] Dennis CL, Janssen PA & Singer J (2004) Identifying women at-risk for postpartum depression in the immediate postpartum period. Acta Psychiatrica Scandinavica, 110, 338–346. http://dx.doi.org/10.1111/j.1600-0447.2004.00337.x.

      [13] Dennis CL & Ross LE (2006) Depressive symptomatology in the immediate postnatal period: Identifying maternal characteristics related to true-and false-positive screening scores. Canadian Journal of Psychiatry, 51, 265-273.

      https://ww1.cpa-apc.org/Publications/Archives/CJP/2006/april/cjp-apr-06-dennis-OR.pdf.

      [14] Dørheim SK, Bondevik GT, Eberhard-Gran M & Bjorvatn B (2009) Sleep and Depression in Postpartum Women: A Population-Based Study. Sleep, 32, 847-855. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2704916/pdf/aasm.32.7.847.pdf

      [15] Edhborg M (2008) Comparisons of different instruments to measure blues and to predict depressive symptoms 2 months postpartum: A study of new mothers and fathers. Scandinavian Journal of Caring Sciences, 22, 186-195.

      http://dx.doi.org/10.1111/j.1471-6712.2007.00512.x.

      [16] Evins G & Theofrastous J (1997) Postpartum depression: A review of postpartum screening. Primary Care Update for Ob/Gyns, 4, 241 – 245. http://dx.doi.org/10.1016/S1068-607X(97)00105-4.

      [17] Gameiro S, Moura-Ramos M & Canavarro MC (2009) maternal adjustment to the birth of a child: Primiparity versus multiparity. Journal of Reproductive and Infant Psychology, 27, 269 – 286. http://dx.doi.org/10.1080/02646830802350898.

      [18] Giakoumaki O, Vasilaki K, Lili L, Skouroliakou M & Liosis G (2009) The role of maternal anxiety in the early postpartum period: Screening for anxiety and depressive symptomatology in Greece. Journal of Psychosomatic Obstetrics & Gynecology, 30, 21-28. http://dx.doi.org/10.1080/01674820802604839.

      [19] Giardinelli L, Innocenti A, Benni L, Stefanini MC, Lino G, Lunardi C, Svelto V, Sfshar S, Bovani R & Castellini G (2011) Depression and anxiety in perinatal period: Prevalence and risk factors in an Italian Sample. Archive of Women Mental Health, 15, 21-30. http://dx.doi.org/10.1007/s00737-011-0249-8.

      [20] Grussu P, Nasta MT, Quatraro RM, Sichel M & Cerutti R (2001) La salute psicologica del 1° anno dopo il parto: Studio longitudinale su un campione di donne primipare. Giornale Italiano di Psicologia, 28, 133-135. DOI: 10.1421/334.

      [21] Grussu P & Quatraro RM (2009) Prevalence and risk factors for a high level of postnatal depression symptomatology in Italian women: A sample drawn from ante-natal classes. European Psychiatry, 24, 327 – 333. http://dx.doi.org/10.1016/j.eurpsy.2009.01.006.

      [22] Hannah P, Adams D & Lee A, Glover V & Sandler M (1992) Links between early post-partum mood and post-natal depression. British Journal of Psychiatry 160, 777 – 780. http://dx.doi.org/10.1192/bjp.160.6.777.

      [23] Hung CH (2004) Predictors of postpartum women’s health status. Journal of Nursing Scholarship, 36, 345–351. http://dx.doi.org/10.1016/S1976-1317(08)60016-X.

      [24] Jardri R, Pelta J, Maron M, Thomas P, Delion P, Codaccioni X & Goudemand M (2006) Predictive validation study of the Edinburgh Postnatal Depression Scale in the first week after delivery and risk analysis for postnatal depression. Journal of Affective Disorder, 93, 169 – 176. http://dx.doi.org/10.1016/j.jad.2006.03.009.

      [25] Leahy-Warren P, McCarthty G & Corcoran P (2011) Postnatal depression in first time mothers: Prevalence and relationships between functional and structural social support at 6 a 12 weeks postpartum. Archives of Psychiatric Nursing, 25, 174-184. http://dx.doi.org/10.1016/j.apnu.2010.08.005.

      [26] Lilja G, Edhborg ME & Nissen E (2012) Depressive mood in women at childbirth predicts their mood and relationship with infant and partner during the first year postpartum. Scandinavian Journal of Caring Sciences, 26, 245-253.

      http://dx.doi.org/10.1111/j.1471-6712.2011.00925.x.

      [27] MacMahon C, Barnett B, Kowalenko N & Tennant C (2005) Psychological factors associated with persistent postnatal depression: Past and current relationships, defence styles and the mediating role of insecure attachment style. Journal of Affective Disorder, 84, 15 -24. http://dx.doi.org/10.1016/j.jad.2004.05.005.

      [28] Monti F & Agostini F (2006) La depressione postnatale. Carocci, Roma.

      [29] Monti F, Agostini F & Marano G (2006) Depressione post-partum e interazioni madre- bambino a 3 mesi dopo il parto. Psicologia clinica dello sviluppo. Il Mulino, Bologna.

      [30] Murray L & Carothers AD (1990) The validation of the Edinburgh Post-natal Depression Scale on a community sample. British Journal of Psychiatry, 157, 288-290. http://dx.doi.org/10.1192/bjp.157.2.288.

      [31] Nonacs R & Cohen LS (1998) postpartum mood disorders: Diagnosis and treatment guidelines. Journal of Clinical Psychiatry, 59, 34-40.

      [32] Robertson E, Grace S, Wallington T & Stewaert DE (2004) Antenatal risk factors for post-partum depression: A synthesis of recent literature. Geneneral Hospital Psychiatry, 26, 289-295. http://dx.doi.org/10.1016/j.genhosppsych.2004.02.006.

      [33] Skari H, Skreden M, Malt UF, Dalholt M, Ostensen AB, Egeland T & Emblem R (2002) Comparative levels of psychological distress, stress symptoms, depression and anxiety after childbirth—a prospective population-based study of mothers and fathers. BJOG: An International Journal of Obstetrics and Gynaecology, 109, 1154-1163. http://dx.doi.org/10.1111/j.1471-0528.2002.00468.x.

      [34] Stern DN (1985) The interpersonal world of the infant. Basic Books, New York.

      [35] Stocky a & Lynch J (2000) Acute psychiatric disturbance in pregnancy and puerperium. Baillière's Clinical Obstetrics and Gynaecology, 14, 37 – 87. http://dx.doi.org/10.1053/beog.1999.0064.

      [36] Teissedre F & Chabrol H (2004) Detecting women at risk for postnatal depression using the EPDS at 2 to 3 days postpartum. Canadian Journal of Psychiatry, 49, 51 – 54. http://ww1.cpa-apc.org/Publications/Archives/CJP/2004/January/teissedre.pdf

      [37] Trevarthen C & Aitken KJ (2001) Infant intersubjectivity: Research, theory, and clinical applications. Journal of Child Psychology and Psychiatry, 42, 3–48. http://dx.doi.org/10.1111/1469-7610.00701.

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    Cattaneo, M. C., Roveraro, S., Chiorino, V., Macchi, E. A., Salerno, R., Gatti, M., Arcaro, L., Barretta, F., Fontana, C. B., Colombo, L., Rossi, P. G., & Mosca, F. (2015). The behavior over time of postnatal depression symptomatology and its early detection via the Edinburgh Postnatal Depression Scale: An Italian longitudinal study. International Journal of Advanced Nursing Studies, 4(1), 23-29. https://doi.org/10.14419/ijans.v4i1.3931