Self-reported Depressive Symptomatology Research Articles

Dimensions of Depressive Symptoms in Young Children: Factor Analysis of the Preschool Feelings Checklist-Scale.

The current study is an investigation of the dimensionality of the Preschool Feelings Checklist-Scale (PFC-S), a caregiver-report questionnaire of early childhood depressive symptom severity. Caregivers of 450 young children, ages 3-8 years (M = 5.62, SD = 0.95; 49% female; 7% Hispanic; 66% White), completed the PFC-S and questionnaires on child emotion regulation and expression and self-reported depressive symptomatology. Confirmatory factor analyses indicated that a one-factor structure did not adequately fit the current PFC-S data. Using exploratory factor analysis, a three-factor structure emerged as interpretable and structurally sound, yielding reliable factors related to social and behavioral anhedonia, emotional and behavioral dysregulation, and excessive guilt and sadness. This factor structure showed configural and scalar invariance across preschool-aged and early middle childhood-aged children as well as children assigned male and female sex at birth. Correlations between the three factors and constructs related to depression suggested preliminary construct validity. The current study provides initial evidence for a multidimensional structure of the PFC-S and improves our understanding of early childhood depressive symptoms.

Associations between elementary teachers’ mental health and students’ engagement across content areas

Teachers’ mental health has been recognized as relevant to teacher effectiveness, with past work identifying impacts of teachers’ mental health on teacher, classroom, and student outcomes. However, much still needs to be understood about the extent to which teachers’ mental health is associated with students’ learning experiences, including in which learning contexts and among which student groups effects might surface most pointedly. We investigated associations among fourth grade teachers’ (N = 65) self-reported depressive and anxious symptomatology and their students’ (N = 805) self-reported behavioral engagement in mathematics, science, and English language arts and whether these associations varied for students based on their enrollment status in a Free and Reduced Meal (FARM) program, a broad indicator of economic disadvantage. Multilevel modeling revealed interaction effects such that, among disadvantaged students, teachers’ depressive symptoms were associated with decreased mathematics and science engagement. Results highlight the importance of providing mental health support for teachers, as well highlight teachers’ well-being as relevant to issues of equity in elementary STEM education.

Adherence to Mediterranean Diet and Depressive Symptomatology Among Boston Area Puerto Ricans.

Higher Mediterranean diet (MeD) adherence has been linked with lower depressive symptomatology, but research examining this association is limited, especially among Latinos, including mainland U.S. Puerto Ricans. Hence, we examined cross-sectional and longitudinal associations between MeD adherence and self-reported depressive symptomatology in Boston area Puerto Rican adults. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to evaluate depressive symptoms. Adherence to MeD was assessed at all 3 visits. We used multivariable linear regression for baseline cross-sectional analysis, and linear mixed effects modeling over 3 waves of follow-up for longitudinal analysis. We also assessed whether baseline MeD adherence affected 5y CES-D trajectory. We conducted sensitivity analyses among participants without diabetes, and among participants with complete MeD and CES-D measures at all visits. MeD adherence was significantly associated with CES-D score at baseline (β = -2.0, 95% confidence interval [CI] -4.0, -0.04 for highest vs lowest tertile, p trend = .04) and across 3 waves (β = -1.9, 95% CI = -3.0, -0.8 for highest vs lowest tertile, p trend = .0005). Results were similar in analyses restricted to participants without diabetes, as well as among participants with complete CES-D and MeD scores at all visits. While CES-D score was consistently lower in those with higher MeD adherence over 5 years of follow up, no relationship between baseline MeD adherence and 5y CES-D trajectory was observed.

The Role of Impulsivity in Major Depression: A Systematic Review

The goal of the current review was to examine recent (within the past 5 years) evidence of impulsivity, broadly defined to include both (a) self-report and (b) behavioral measures including measures of decision-making, inhibition, and inattention, as a feature of Major Depressive Disorder in terms of (a) differences between MDD groups compared to controls and (b) associations between impulsivity and self-reported depressive symptomatology. Of the 3304 studies screened, 21 met the inclusion criteria. Findings support higher levels of impulsivity in individuals with MDD compared to controls and an association between various facets of impulsivity and MDD. There is consistent evidence for impulsivity as a transdisease process influencing MDD. This evidence may be dependent on the facet of impulsivity being measured.

Serum Vitamin D and Depressive Symptomatology among Boston-Area Puerto Ricans

Low vitamin D status, assessed using serum 25-hydroxyvitamin D [25(OH)D] concentration, has been associated with depression, but research among minority populations, such as Puerto Ricans is limited. We examined the association between serum 25(OH)D and self-reported depressive symptomatology across 3 waves of follow-up in a cohort of Puerto Rican adults residing in Massachusetts. We evaluated the cross-sectional and longitudinal associations between serum 25(OH)D and self-reported depressive symptoms in the Boston Puerto Rican Health Study (BPRHS) cohort. Participants of the BPRHS were evaluated for depressive symptoms using the Center for Epidemiologic Studies Depression Scale (CES-D). Serum 25(OH)D was measured at baseline (n=1434), year 2 (n=1218), and year 5 (n=914). We categorized serum 25(OH)D concentration as sufficient (≥20ng/mL), insufficient (12 to <20ng/mL), and deficient (<12ng/mL). Multivariable linear regression was used for cross-sectional analyses at baseline, and repeated measures mixed effects modeling was used over 3 waves of follow-up for longitudinal analyses. We conducted sensitivity analyses in vitamin D supplement nonusers and participants with complete data on baseline serum 25(OH)D and CES-D at all 3 visits. Serum 25(OH)D concentration was not associated with CES-D score in cross-sectional analysis [β = -0.85; 95% CI: -2.80, 1.10 for deficient compared with sufficient 25(OH)D; P-trend=0.59] or in longitudinal analyses over 5 y [β = -0.41; 95% CI: -1.95, 1.13 for deficient compared with sufficient 25(OH)D; P-trend=0.93]. Results were similar in sensitivity analyses restricted to vitamin D supplement nonusers (n=1371) and in analyses conducted in participants with complete measures of baseline serum 25(OH)D and CES-D score at all 3 visits (n=887) [β = -0.12; 95% CI: -1.98, 1.74 for deficient compared with sufficient 25(OH)D; P-trend=0.93]. We did not observe a significant association between serum 25(OH)D and depressive symptomatology in the BPRHS cohort.

Adverse Childhood Experiences, Maternal/Fetal Attachment, and Maternal Mental Health.

Background: This pilot study investigated the potential impact of exposure to childhood adversity on variables known to be related to posttraumatic stress (including attachment, mental health, and perceived stress) in a clinic sample of pregnant women.Materials and Methods: Participants consisted of 101 pregnant women recruited from the Virginia Commonwealth University Health System in Richmond, VA. All participants completed the Adverse Childhood Experience (ACE) questionnaire, Parental Bonding Instrument, Maternal Fetal Attachment Scale, Posttraumatic Stress Disorder (PTSD) Checklist, Symptom Checklist, and the Perceived Stress Scale.Results: Increased exposure to ACEs was negatively associated with retrospective report of viewing one's mother and father as caring and involved. ACE exposure was a statistically significant predictor of viewing one's mother and father as intrusive and controlling. ACEs were positively associated with self-reported PTSD symptoms, depressive and anxious symptomatology, and perceived stress. No direct effect of adverse childhood events on maternal/fetal attachment was found.Conclusions: ACE associations are discussed in terms of study methodology and needs for future research. Providers may consider incorporating the ACE questionnaire to identify exposure to childhood adversity and events that may increase an individual's risk for toxic stress and negative health outcomes.

Severity of self-reported depressive symptomatology and relevant factors in children with primary monosymptomatic nocturnal enuresis and their mothers

Nocturnal enuresis (NE) may negatively affect social and emotional life as well as mood in both children and their mothers. The aim of this study is to evaluate severity of self-reported depressive symptomatology and determine the relevant factors in children with primary monosymptomatic nocturnal enuresis (MNE) and their mothers by using depression inventories. Children Depression Inventory (CDI) for children and Beck Depression Inventory (BDI) for mothers were administered to the study group. The children and mothers in the patient and control groups were compared according to the depression inventory scores. The relationship of various sociodemographic factors with those scores was also investigated. BDI scores of the mothers of children with primary MNE demonstrated minor depressive symptomatology and were significantly higher than the mothers in the control group (p = 0.002). Moreover, although within the normal range, CDI scores of the children with primary MNE were also significantly higher than the controls (p = 0.031). Main factors associated with BDI scores were the presence of primary MNE, maternal educational level, and CDI scores. School achievement of the children, monthly income of the family, and BDI scores were found to be correlated to the CDI scores. Primary MNE was found to be associated with negative mood of the mothers in the present study. As misinformed parental attitudes adversely affect family dynamics, improved awareness of, and maternal education regarding primary MNE is vital in improving the holistic outcome of families affected by MNE.

Are Short-Term Temporal Relationships between Depressive and Anxious Symptoms Moderated by Sex?

The chief goal of the present study was to elucidate whether the short-term temporal relationships between depressive and anxious symptoms vary by sex. Three hundred and fifty-seven undergraduate students self-reported depressive and anxious symptomatology with the Beck Depression Inventory (BDI-II) and the Beck Anxiety Index (BAI) two times 11 weeks apart. A latent variable path model analysis found support for a bi-directional relationship between depressive symptoms and anxious symptoms for the overall sample. An equality constraint analysis revealed that depressive symptoms predicted anxious symptoms over time to a similar extent as anxious symptoms predicted depressive symptoms over time. However, several temporal relationships significantly varied by sex, namely, females demonstrated greater stability of depressive symptoms over time, and evidenced a stronger cross-lag relationship from depressive symptoms at Time 1 to anxious symptoms at Time 2, and males, on the other hand, exhibited a marginally more stable anxious symptoms test-retest relationship over time. The results supported the existence of a bi-directional relationship between depressive and anxious symptoms over a short-term period of time for emerging adults. We conclude that current states of depressive symptoms may be more influential for females’ subsequent negative affective states, whereas anxious symptoms may be more important for males’ subsequent negative affective states.

B-37 Examining Self-Reported Depressive Symptoms: A SPECT Exploratory Analysis

Abstract Objective To examine regional cerebral blood flow (rCBF) differences between those with self-reported high and low levels of depressive symptoms. Method Participants were selected from a de-identified archival SPECT database. Depressive symptoms were determined by self-reported factors related to depression which included eight questions rated on a six point Likert scale. Groups were separated into highest and lowest 20% of ratings on this scale. Low reported depressive symptoms group (n = 2453,Mage = 42.85,SD = 18.35,male = 64%,Caucasian = 67%); high reported depressive symptoms group consisted (n = 2673,Mage = 38.52,SD = 13.44,male = 58%,Caucasian = 70%). Differences between groups were assessed across 17 brain regions at baseline. Results One-way ANCOVAs were conducted (p &lt; .001) controlling for age and gender across 17 brain regions. Significant differences were found between groups in the left cerebellum (F[1,5122] = 19.396,p &lt; .001),left frontal(F[1,5122] = 17.870,p &lt; .001),right frontal (F[1,5122] = 22.175,p &lt; .001),left motor sensory(F[1,5122] = 28.974,p &lt; .001),and right motor sensory(F[1,5122] = 31.534,p &lt; .001),such that the low depressive symptoms group exhibited higher rCBF in the left and right frontal and left and right motor sensory,whereas, the high depressive symptoms group exhibited higher rCBF in the left cerebellum. Conclusion Results indicate increased self-reported depressive symptomatology may be associated with decreased frontal lobe. The motor sensory region can result in deficits involving encoding or motor output showing slower motor/sensory processing in those with increased self-reported depressive symptoms. Research has shown increased activity in the cerebellum during sadness which may explain the higher rCBF in the depressed group. These findings demonstrate that neurological differences exist between varying degrees of self-reported depressive symptom severity. As a result, SPECT may be a useful objective measure to monitor and assess self-reported depressive severity throughout the course of treatment.

Depressive Symptomatology among Norwegian Adolescent Boys and Girls: The Patient Health Questionnaire-9 (PHQ-9) Psychometric Properties and Correlates.

This study explored the potential contribution of the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV)-based Patient Health Questionnaire-9 item (PHQ-9) instrument to the developmental epidemiology research in Norway, by examining depressive symptoms in a school sample of adolescents (N = 846). The average PHQ-9 scores were 6.89 (SD = 5.13) for girls, and 4.57 (SD = 3.98) for boys; 8.5% of girls and 2.6% of boys were classified into the originally proposed categories indicative of Major Depressive Disorder (MDD; PHQ-9 scores ≥ 15). Multi-group confirmatory factor analysis (CFA) confirmed a single-factor structure for the PHQ-9 with solid psychometric properties and high internal consistency for both genders. However, even though configural equality was observed, there was no evidence for metric or scalar equality across genders, warranting further investigation of measurement equivalence for the current Norwegian version of the PHQ-9. We observed no major associations between the PHQ-9 scores and adolescent religion or immigrant background. Further, school grade, not living together with both biological parents, and diagnosed chronic illness were differently associated with elevated depressive symptoms for boys and girls. Finally, high residential instability, perceived low SES, school dissatisfaction, lack of close friendships, history of suicide attempts and self-harm, and elevated emotional problems were all significantly and consistently associated with greater depression for both genders. Overall, the PHQ-9 appears to be a promising research tool, potentially offering clinically-relevant classification of adolescent self-reported depressive symptomatology in addition to the symptom severity captured by continuous scores. Nevertheless, further investigation concerning the observed measurement non-equivalence, as well as the comprehensive validation and comparison against the gold standard is required before the PHQ-9 is to be used for diagnostic screening in Norway.

The Relationship Between Physical Activity and Depressive Symptoms in Healthy Older Women.

Objective: Depression and inactivity in the elderly are major health problems with significant ramifications for healthy aging. Research shows an inverse relationship between depression and physical activity levels. The purpose of the current investigation is to examine the relationship between physical activity and depressive symptoms in healthy older women, first within the framework of exercise programs, and second via the impact of an intervention. Method: Two experiments were conducted. In the first, 65 women, all above the age of 60, participated. Measures of physical activity were gained by self-report using the International Physical Activity Questionnaire while the measure of depressive symptomatology was the Beck Depression Inventory. In the second, 11 women participated in a line dancing intervention, and their self-reported depressive symptomatology was measured prior to and just after the 6-week exercise intervention using the Beck Depression Inventory. In addition, during the second experiment, pedometer data were gathered during the fourth week. Results and Conclusion: The data of the first study revealed a relationship between the total amount of physical activity and scores on the Beck Depression Inventory; that is, the more active a person is, the lower her self-reported depressive symptoms. Significant correlations were found between the Beck Depression Inventory and the reports of vigorous and moderate exercise levels, but not with walking. Participants who were part of an organized exercise group exercised significantly more than those who exercised on their own. In the second study, those who participated in a line dancing intervention had significantly lower Beck Depression Inventory scores post intervention. The implications of these findings for public health are discussed.

Neurofeedback implementation in subjective attention deficits accompanied with depressive symptoms: a case study

Neurofeedback implementation in subjective attention deficits accompanied with depressive symptoms: a case study

The Association of Hair Cortisol with Self-Reported Chronic Psychosocial Stress and Symptoms of Anxiety and Depression in Women Shortly after Delivery.

Psychosocial stress during pregnancy including anxiety and depression is known to have adverse health effects on newborns. However, measuring these psychological constructs is complex with psychological, endocrinological, and physiological systems being affected. Hair cortisol concentrations (HCC), assumed to reflect long-term endocrine consequences of stress exposure, represent a promising instrument for epidemiological research. However, the association between HCC and questionnaire-based instruments is unclear. In the Ulm SPATZ Health Study, mothers were recruited shortly after delivery in the University Medical Centre Ulm, Germany between April 2012 and May 2013. HCC of 768 participants were determined in scalp-near 3 cm maternal hair segments, assumed to reflect cortisol exposure over the last trimester of pregnancy. Chronic stress, anxiety, and depressive symptomatology were self-reported in questionnaire-based instruments. Spearman correlation coefficients between HCC and these instruments as well as means of HCC in highly and low stressed subgroups were calculated. HCC were not correlated with self-reported chronic stress, anxiety, or depressive symptomatology. Furthermore, the investigation of sub-populations did not reveal substantial differences of HCC across highly and low stressed women. HCC were not found to correlate with self-reports of chronic stress, anxiety, or depressive symptomatology. Among other things, these findings could reflect problems with questionnaire-based assessments obtained shortly after delivery such as recall bias and/or suggest that associations between cortisol secretion and psychosocial stress are difficult to detect due to, e.g. a strong physiological increase of cortisol in the last trimester.

Depression, Control, and Climate: An Examination of Factors Impacting Teaching Quality in Preschool Classrooms

Research Findings: This study investigated the relationship of preschool teachers’ self-reported depressive symptomatology, perception of classroom control, and perception of school climate to classroom quality as measured by the Classroom Assessment Scoring System Pre-K. The sample consisted of 59 urban preschool classrooms serving low-income and linguistically diverse students in the northeastern and southeastern United States. Results of hierarchical linear modeling revealed that teachers’ individual reports of depressive symptomatology were significantly and negatively predictive of the observed quality of their instructional support and classroom organization. Practice or Policy: The findings of this study have implications for increasing access to mental health supports for teachers in an effort to minimize depressive symptoms and potentially improve classroom quality.

A Service-Based Evaluation of a Therapist-Supported Online Cognitive Behavioral Therapy Program for Depression

BackgroundEvidence suggests that Internet-delivered cognitive behavioral therapy (CBT) may be as effective as face-to-face delivery for depression, but attrition and engagement rates remain a challenge.ObjectiveThis service-based study aimed to evaluate an online, therapist-supported, CBT-based program for depression. The program was specifically designed to address engagement issues, most notably by integrating online therapist support and communication within the platform.MethodsParticipants were 80 adults who were registered university students. Participants used the modular online program over 8 weeks, supported by a therapist. Engagement information was gathered automatically by the online system, and analyzed for all participants. Severity of participants’ self-reported symptoms of depression were assessed preintervention and postintervention using the Beck Depression Inventory-II (BDI-II). Postintervention measures were completed by 53 participants.ResultsA high level of engagement was observed compared to a previous study within the same service, along with extensive use of a range of program features. A statistically significant (P<.001) decrease in self-reported depressive symptomatology from preintervention (mean BDI-II 25.47) to postintervention (mean BDI-II 15.53) with a large effect size (d=1.17) was also observed.ConclusionsThe results indicate the potential of unintrusive and easily provided online support to enhance engagement with online interventions. The system described in the paper also illustrates how such online support can be tightly integrated with interactive online programs by using a range of design strategies intended to improve the user experience.

Does breastfeeding offer protection against maternal depressive symptomatology?: A prospective study from pregnancy to 2 years after birth.

Mothers who breastfeed typically exhibit lower levels of depressive symptomatology than mothers who do not. However, very few studies have investigated the directionality of this relationship. Of the prospective studies published, all but one focus exclusively on whether maternal depression reduces rates of subsequent breastfeeding. This study again examines this relationship, but also the reverse-that breastfeeding might predict lower levels of later depression. Using multilevel modeling, we investigated the relationship between breastfeeding and self-reported depressive symptomatology in 205 women followed prenatally and at 3, 6, 12, and 24 months after birth. Consistent with previous research, women with prenatal depressive symptomatology weaned their infants 2.3 months earlier, on average, than women without such symptomatology. We also found, however, that women who breastfed more frequently at 3 months postpartum showed greater subsequent declines in depressive symptomatology over time compared to women who breastfed less frequently, resulting in lower absolute levels of depressive symptoms by 24 months postpartum, controlling for important confounds. In sum, these findings are consistent with a bidirectional association between breastfeeding and depression, with prenatal depression predicting less breastfeeding soon after birth and breastfeeding predicting declines in maternal depression up to 2 years after birth. We discuss mechanisms that could potentially explain these associations and avenues for future research.

Shock-related anxiety and sexual function in adults with congenital heart disease and implantable cardioverter-defibrillators

An increasing number of adults with congenital heart disease (CHD) require implantable cardioverter-defibrillators (ICDs), yet little is known about their impact on psychological well-being and sexual function. To assess shock-related anxiety in adults with CHD and its association with depression and sexual function. A prospective, multicenter, cross-sectional study was conducted on adult patients with CHD with (ICD(+)) and without (ICD(-)) ICDs. The Florida Shock Anxiety Scale was administered to patients with ICD(+) and the Beck Depression Inventory-II to all patients. Men completed the Sexual Health Inventory for Men, and women completed the Female Sexual Function Index. A total of 180 adults with CHD (ICD(+): n = 70; ICD(-): n = 110; median age 32 years [interquartile range 27-40 years]; 44% women) were enrolled. The complexity of CHD was classified as mild in 32 (18%), moderate in 93 (52%), and severe in 54 (30%) subjects. In ICD recipients, a high level of shock-related anxiety was identified (Florida Shock Anxiety Scale score 16; interquartile range 12-23.5), which was slightly higher than the median score for ICD recipients in the general population (P = .057). A higher level of shock-related anxiety was associated with poorer sexual function scores in both men (Spearman's ρ =-.480; P<.001) and women (Spearman's ρ =-.512; P<.01). It was also associated with self-reported depressive symptomatology (Spearman's ρ = .536; P< .001). Adults with CHD and ICDs demonstrate a high level of shock-related anxiety, which is associated with lower sexual functioning scores in men and women. These results underscore the need for increased clinical attention related to ICD-related shock anxiety and impaired sexual function in this population.

Longitudinal Results of Cognitive Behavioral Treatment for Youths with Inflammatory Bowel Disease and Depressive Symptoms

Youths with chronic physical illnesses face increased rates of psychological problems and the burden of coping with physical illness-related challenges. The following data describes treatment outcome maintenance results from a randomized clinical trial investigating the impact of a cognitive behavioral intervention Primary and Secondary Control Enhancement Therapy-Physical Illness (PASCET-PI) as compared to treatment as usual (TAU) on youths with inflammatory bowel disease (IBD). Forty-one participants aged 11-17 with IBD and concurrent depressive symptomatology were randomized to PASCET-PI (n=22) or TAU (n=19). Self-reported depressive features, global functioning, and DSM-IV depressive symptomatology were assessed immediately post-treatment (T2), followed by assessments at 6-months (T3) and 12-months (T4) post-treatment initiation. Repeated measure models revealed significantly improved global psychosocial functioning in youths randomized to PASCET-PI compared to youths randomized to TAU. Improvements in self-reported depressive features and DSM-IV depressive symptoms were found at the trend level for youths randomized to PASCET-PI relative to those receiving TAU. Effect size estimates for all outcome variables suggested large to medium treatment effects.

Abstract 86: Does Exercise Post Stroke have a Beneficial Effect on Post-Stroke Depression: A Meta-Analysis

Given the high prevalence and negative personal and social consequences of post-stroke depression (PSD), identification and application of safe and effective treatments is imperative. While recent publications examining the evidence regarding the impact of physical activity on depression suggest that, in the general population, exercise is associated with significant benefit in terms of reduction of depressive symptomatology, it is not clear that physical activity has the same benefit for individuals who have experienced stroke. Objective: To examine the effectiveness of exercise or physical activity on depressive symptomatology following stroke. Methods: We undertook a literature review to identify stroke-specific clinical trials examining the effectiveness of exercise or exercise programs when compared to a control condition that included longitudinal assessment of depression as a primary or secondary study outcome. Identified studies were evaluated for methodological quality using the PEDro scale and, where possible, results entered into a pooled, random effect analysis based on reported means and standard deviations from repeated assessments. Pre-post test correlations were estimated using published test/re-test reliability coefficients. Results: Eight studies were identified for inclusion; total PEDro scores ranged from 4 to 8. Depression was assessed at baseline and post-intervention using 4 self-report and 1 interview-based assessment tool(s). Participants were community-dwelling individuals; mean age ranged from 56 to 87. Only two trials reported significant between group differences for the outcome of depression, although several noted significant improvement within the intervention group only. Of the 8 identified studies, 6 reported sufficient data for inclusion in pooled analysis. Based on data from 276 participants, there was a moderate reduction in self-reported symptoms of depression associated with post-stroke exercise (ES=0.576; 95% CI 0.22, 0.93). No significant publication bias was identified (Egger’s intercept = 1.21, p=0.64). Conclusions: Although previous trials have reported a positive trend toward improvement of the self-reported symptoms of depression associated with exercise, the impact of exercise on depression has not been clear. On pooled analysis, however, it is apparent that participation in exercise is associated with a moderate and significant reduction in self-reported depressive symptomatology in older, community-dwelling individuals with stroke. Since physical impairments may limit participation in exercise programs for many individuals following stroke, additional research is required to examine exercise frequency and/or intensity required to demonstrate benefit.

Seasonality patterns in postpartum depression

To investigate the possible association between postpartum depressive symptoms and season of delivery. During 1 year, delivering women in the Uppsala University Hospital were asked to participate in the study by filling out 3 postpartum questionnaires containing the Edinburgh Postnatal Depression scale and questions assessing life style, medical history, breastfeeding, and social support. Two thousand three hundred eighteen women participated. Women delivering in the last 3 months of the year had a significantly higher risk of self-reported depressive symptomatology both at 6 weeks (odds ratio, 2.02, 95% confidence interval, 1.32-3.10) and at 6 months after delivery (odds ratio, 1.82, 95% confidence interval, 1.15-2.88), in comparison to those delivering April-June, both before and after adjustment for possible confounders. Women delivering during the last quartile of the year had a significantly higher risk for depressive symptoms 6 weeks and 6 months postpartum and would thus benefit from a closer support and follow-up after delivery.