By Cristina Mestre
Almost
22 percent of women in the U.S. suffer from
postpartum depression in the first year after giving birth, a significant public health problem given that a
woman’s mental health has a profound effect on a child’s physical and emotional development.
According to Dr. Dorothy Sit, assistant professor
of Psychiatry at the University of Pittsburgh and researcher
at Western Psychiatric Institute and Clinic of UPMC, a lot of women don’t understand what is happening to them
during this time and mistake their emotions for being normal after having a baby.
Unfortunately, the vast majority of these depressed women are not
identified or treated even though they are at higher risk for psychiatric
disorders.
A new study released Wednesday in the Journal of the
American Medical Association (JAMA) takes a
close look at postpartum depression and reveals some startling findings. The study of 10,000
women who recently delivered babies at Magee-Womens Hospital of UPMC found a
surprisingly large percentage who suffered recurrent episodes
of major depression. Dr. Sit, one of the
study’s lead authors, noted that this is the largest-scale depression screening
of postpartum women to date.
The study found that 14
percent of the 10,000 women screened tested positive for depression within four to six weeks after delivery. Of that group, 826 received full psychiatric assessments
during at-home visits. This represented the first time a full psychiatric
assessment was done in a large study of postpartum women who screened
positive for depression.
Some
of the key findings from those assessments:
- Many
women who screened positive for major depression postpartum had already
experienced at least one episode of depression previously. The study found 33 percent of women had depression onset prior to pregnancy, 40 percent postpartum and 27 percent during pregnancy.
- More than two-thirds of these women also had an anxiety
disorder. Moreover, women who screened positive for depression frequently
had thoughts of self-harm – the authors detected 19.3 percent with thoughts of
harming themselves. (Suicide accounts for about 20 percent of postpartum deaths
and is the second most common cause of death in postpartum women.)
- Among
women with increased depression risk, 22 percent had bipolar disorders. The actual
percentage may be even higher given that not all bipolar patients show
depressive symptoms (and this study only looked at those postpartum patients
with depressive symptoms/depression risk). The finding is significant
because this a very high rate of bipolar disorder that has never been reported
in a population screened for postpartum depression before.
So
what does this all mean? Dr. Sit said that awareness and detection of
bipolar illness in mothers with postpartum symptoms is critically important
because a proper diagnosis will help to guide appropriate treatment decisions. In the study, researchers
were able to provide fast and responsive care for mothers who were identified
as having suicidal symptoms. By identifying mothers with depression risk,
the study authors believe screening will save lives.
Dr.
Sit believes that depression screening both prenatal and postpartum is essential, but that the health care field must develop
cost effective and accessible treatment for those diagnosed.
