Prevalence, Incidence, and Persistence of Postpartum Anxiety, Depression, and Comorbidity: A Cohort Study Among Women in Havana Cuba.

Abstract

To estimate the prevalence, incidence, and persistence of postpartum anxiety, depression, and comorbid symptoms over the first 6 months postpartum in a cohort of Havana women and to evaluate the sensitivity, specificity, and predictive power of the Edinburgh Postnatal Depression Scale (EPDS) and the State-Trait Anxiety Inventory (STAI) at 4 weeks postpartum on depressive and anxiety symptoms at 12 and 24 weeks. A cohort study with 273 women in Havana, Cuba. Participants were assessed at 4, 12, and 24 weeks postpartum for anxiety, depression, and comorbid symptoms. Prevalence rates were highest at 4 weeks postpartum: 20.0% women reported elevated levels of anxiety and 16.4% reported depressive symptoms. The prevalence of comorbid anxiety and depression was 5.8%. While rates of anxiety steadily decreased to 13.8% at 24 weeks, rates of depression persisted to 24 weeks postpartum with 14.5% still experiencing elevated symptoms. Comorbid anxiety and depression decreased across time. There were limited sensitivity and poor predictive values for both the STAI and the EPDS. This study is the first to examine perinatal mental illness in Cuba. While anxiety and depression rates found among Cuban women are lower than those reported in other low-income countries, the rates paralleled high-income countries.