Course of a major postpartum depressive episode: A prospective 2 years naturalistic follow-up study

J Affect Disord. 2019 Feb 15:245:965-970. doi: 10.1016/j.jad.2018.11.062. Epub 2018 Nov 5.

Abstract

Background: Survival methodology has not already been used in studies about postpartum depression (PPD) course. The aims of the present study were to estimate the duration of a Major Postpartum Depressive Episode (MPDE) during 2 years, as well as to explore factors associated with the course.

Method: This was a prospective, naturalistic, longitudinal study with a cohort of 165 women with a MPDE (DSM-IV criteria). Potential predictors of prognosis were recorded at baseline. Follow-up was conducted using the Longitudinal Interval Follow-up Evaluation (LIFE).

Results: Of the total sample, 110 (66.7%) completed the 2 years follow-up. The mean time to full remission was 49.4 weeks (95% CI: 44.0-59.8). The probability of recovering was 30.2% (95% CI: 22.1%-37.4%) at 6 months of follow-up, 66.3% (95% CI: 57.4%-73.4%) at 12 months of follow-up, and 90.3% (95% CI: 79.8%-95.4%) at 24 months of follow-up. Mothers with financial difficulties, onset of depressive episode previous to birth, and those with prior treated depressive episodes took longer in achieving full remission.

Limitations: Results are only generalizable to mothers with PPD treated in a psychiatric outpatient setting. Psychopharmacological treatment was uncontrolled and personality was not assessed.

Conclusions: Our findings suggest that PPD could become a chronic disorder, particularly in mothers with an onset of the episode previous to birth, with a history of depression or with financial problems. Knowledge of these factors may help to improve the guidelines of depression management and treatment during the perinatal period.

Keywords: Course; Longitudinal study; Postpartum depression; Risk factors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Chronic Disease
  • Cohort Studies
  • Depression, Postpartum / psychology*
  • Depressive Disorder, Major / psychology*
  • Diagnostic and Statistical Manual of Mental Disorders
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Mothers
  • Personality
  • Pregnancy
  • Pregnancy Complications / psychology*
  • Prognosis
  • Prospective Studies
  • Socioeconomic Factors
  • Young Adult