Disordered personality traits and psychiatric morbidity in pregnancy: a population-based study

Grace Crowley,Louise M Howard,Selina Nath,Kylee Trevillion,Paul Moran,Emma Molyneaux

doi:10.1007/s00737-018-0937-8

Abstract

This study aims to investigate the characteristics and mental health status of pregnant women with disordered personality traits. A cross-sectional study of a stratified sample of 545 women attending antenatal booking at a South London maternity service was conducted. Disordered personality traits were assessed using the Standardised Assessment of Personality-Abbreviated Scale (SAPAS). Mental disorders were assessed using the Structured Clinical Interview DSM-IV (SCID). Logistic regression was used to model associations, adjusting for confounders. Complete SAPAS data were collected for over 99% of women (n = 541). The weighted prevalence of elevated disordered personality traits (SAPAS ≥ 3) was 16.2% (95% CI 12.6–20.5). Women with elevated disordered personality traits were younger, less likely to live alone and more likely to report living in insecure accommodation. Among women with elevated disordered personality traits, the most common mental disorders were anxiety disorders (31.4%) and depressive disorders (17.6%). Each extra item endorsed on the SAPAS was associated with an 82% higher odds of meeting criteria for an Axis I mental disorder (adjusted OR 1.82 (1.42–2.33); p < 0.001). Women with elevated disordered personality traits were at significantly increased risk of experiencing thoughts of self-harm (adjusted OR 2.12 (1.33–3.40); p = 0.002). Pregnant women with disordered personality traits are a particularly vulnerable population, with multiple psychosocial problems that are likely to require tailored support to ameliorate future health risks for mother and baby.

Highlights

Grace Crowley and Emma Molyneaux are joint first author
The majority of research into maternal mental health has focused on depression and anxiety, and very few studies have examined the association between maternal personality and mental health during the perinatal period (Howard et al 2014)
This is a notable gap in the literature—about 1 in 20 of the general population are affected by personality disorder (PD) (Coid et al 2006), a condition associated with considerable disease burden (Moran et al 2016a, b), poor general health (Dixon-Gordon et al 2018) and raised mortality (Fok et al 2012)

Summary

Introduction

Grace Crowley and Emma Molyneaux are joint first author. Paul Moran and Louise M. The majority of research into maternal mental health has focused on depression and anxiety, and very few studies have examined the association between maternal personality and mental health during the perinatal period (Howard et al 2014). This is a notable gap in the literature—about 1 in 20 of the general population are affected by personality disorder (PD) (Coid et al 2006), a condition associated with considerable disease burden (Moran et al 2016a, b), poor general health (Dixon-Gordon et al 2018) and raised mortality (Fok et al 2012)

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Methods

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Conclusion