History Of Postpartum Depression Research Articles

A review of postpartum depression for the primary care physician.

Postpartum depression (PPD) occurs more commonly in U.S. women than most physicians realize. PPD is present in at least 10% and up to 20% of women in the United States within the first 6 months of delivery. The rate may be 25% or higher in women with a history of postpartum depression after a previous delivery. Over half of all women who develop postpartum depression still suffer symptoms a year later. This condition causes tremendous morbidity in terms of suffering and decreased quality of life. As with other psychiatric disorders, patients with PPD are more likely to seek help from their primary care doctors than from mental health professionals. Therefore, these providers should be equipped with the knowledge and tools necessary to properly care for women with PPD.

Dr. Roca and Colleagues Reply

Article AbstractLetter to the Editor Sir: We appreciate the thoughtful and astute questions posed by Drs. Soares and Cohen. They correctly raise the possibility that women who display susceptibility to mood disturbance during the menstrual cycle might be vulnerable to depression during other periods of reproductive endocrine change. Although one of the patients (and none of the controls) had a history of postpartum depression, the Structured Clinical Interview for DSM-IV did not enable us to determine retrospectively the occurrence of postpartum blues. While the role of gonadal steroids in postpartum blues, a fairly ubiquitous phenomenon, has not been determined, we have recently shown that euthymic women with a history of postpartum depression will experience depression in association with gonadal steroid manipulations that are without effect in women lacking a history of postpartum depression, thus reinforcing the relevance of the first question raised by Drs. Soares and Cohen

Correlations between mood scores, LH, adrenocortical steroids, and urine volumes in a patient with a history of postpartum depression and monthly psychotic episodes

A simple semantic differential test was administered twice daily and urinary hormones measured as described previously. The subjects included the patient and two controls, one of whom experienced premenstrual physical, but not mental, discomfort. The test scores of the two controls, administered for five weeks, did not differ significantly from one another but greatly differed from those of the patient. The highest scores in the patient (indicating improved mood) were obtained during the week containing the urinary LH peak, and daily ratings correlated significantly with LH values. Significant, positive, correlations were also found between mood and ratios for aldosterone/cortisol, 18-hydroxydeoxycorticosterone(18-OH-DOC)/cortisol, and 18-OH-DOC/18-hydroxycorticosterone. Urine volumes correlated positively with cortisol, negatively with 18-OH-DOC, and negatively with mood (P<0.01). Urinary hormone assays, affording the advantages of a non-invasive technique may thus reveal relationships of potential interest. Whether these are causal, rather than casual, remains to be assessed.