Hostname: page-component-7c8c6479df-24hb2 Total loading time: 0 Render date: 2024-03-27T20:17:11.879Z Has data issue: false hasContentIssue false

Psychological and social correlates of the onset of affective disorders among pregnant women1

Published online by Cambridge University Press:  09 July 2009

T. Kitamura*
Affiliation:
National Institute of Mental Health, Tokyo Metropolitan University and Kawasaki Municipal Hospital, Japan
S. Shima
Affiliation:
National Institute of Mental Health, Tokyo Metropolitan University and Kawasaki Municipal Hospital, Japan
M. Sugawara
Affiliation:
National Institute of Mental Health, Tokyo Metropolitan University and Kawasaki Municipal Hospital, Japan
M. A. Toda
Affiliation:
National Institute of Mental Health, Tokyo Metropolitan University and Kawasaki Municipal Hospital, Japan
*
2Address for correspondence: Dr T. Kitamura, National Institute of Mental Health, 1–7–3 Konodai, Ichikawa, Chiba 272, Japan.

Synopsis

One hundred and twenty women recruited from attenders at the antenatal clinic of the Obstetrics Department of a general hospital were asked to complete ad hoc questionnaires during pregnancy; they were then interviewed by psychiatrists using a structured diagnostic interview, the Schedule for Affective Disorders and Schizophrenia (SADS). Nineteen (16%) women were identified as having an onset of an affective disorder during the period of pregnancy, mainly (68%) during the first trimester. As compared with the women without any such onset (controls), the women with pregnancy-related affective disorder (PRAD) were characterized by (1) it being their first pregnancy or first delivery with past termination of pregnancy, (2) early loss of either parent by death, (3) high Eysenck Personality Questionnaire (EPQ) Neuroticism (N) and Psychoticism (P) scores, (4) living in a flat with either a plan to stay there after the forthcoming childbirth or an expectation that their accommodation would be crowded, and (5) negative response to the news of the pregnancy by the husband with low intimacy. The effects of these factors were additive since the probability of developing a PRAD episode was highly correlated with the number of factors reported.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1993

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

1

A summary of this paper was presented at the 6th International Conference of the Marcé Society, Edinburgh, 4 September 1992.

References

Akiskal, H., Hirschfeld, R. M. A. & Yerevanian, B. I. (1983). The relationship of personality to affective disorders: a critical review. Archives of General Psychiatry 40, 801810.CrossRefGoogle Scholar
Belsey, E. M., Greer, H. S., Lal, S., Lewis, S. C. & Beard, R. W. (1977). Predictive factors in emotional response to abortion: King's termination study. IV. Social Science and Medicine 11, 7182.CrossRefGoogle ScholarPubMed
Boyce, P., Hadzi-Pavlovic, D., Parker, G., Brodaty, H., Hickie, I., Mitchell, P. & Wilhem, K. (1990). Depressive type and state effects on personality measures. Acta Psychiatrica Scandinavica 81, 197200.CrossRefGoogle ScholarPubMed
Boyce, P., Hickie, I. & Parker, G. (1991 a). Parents, partners or personality? Risk factors for post-natal depression. Journal of Affective Disorders 21, 245255.CrossRefGoogle ScholarPubMed
Boyce, P., Parker, G., Barnett, B., Cooney, M. & Smith, F. (1991 b). Personality as a vulnerability factor to depression. British Journal of Psychiatry 159, 106114.CrossRefGoogle ScholarPubMed
Brown, G. W., Andrews, B., Harris, T., Adler, Z. & Bridge, L. (1986). Social support, self-esteem and depression. Psychological Medicine 16, 813831.CrossRefGoogle ScholarPubMed
Brugha, T., Conroy, R., Walsh, N., Delaney, W., O'Hanlon, J., Dondero, E., Daly, L., Hickey, N. & Bourke, G. (1982). Social networks attachments and support in minor affective disorders: a replication. British Journal of Psychiatry 141, 249255.CrossRefGoogle ScholarPubMed
Campbell, E. A. (1988). Neurotic disturbance in pregnancy – a review. Psychiatric Developments 6, 311328.Google ScholarPubMed
Campbell, E. A., Cope, S. J. & Teasdale, J. D. (1983). Social factors and affective disorder: an investigation of Brown and Harris's model. British Journal of Psychiatry 143, 548553.CrossRefGoogle Scholar
Cooper, P. J., Campbell, E. A., Day, A., Kennerley, H. & Bond, A. (1988). Non-psychotic psychiatric disorder after childbirth: a prospective study of prevalence, incidence, course and nature. British Journal of Psychiatry 152, 799806.CrossRefGoogle ScholarPubMed
Cox, J. L. (1979). Psychiatric morbidity and pregnancy: a controlled study of 263 semi-rural Ugandan women. British Journal of Psychiatry 134, 401405.CrossRefGoogle ScholarPubMed
Cox, J. L., Connor, Y. & Kendell, R. E. (1982). Prospective study of the psychiatric disorders of childbirth. British Journal of Psychiatry 14, 111117.CrossRefGoogle Scholar
Eisemann, M. (1985). Depressed patients and non-psychiatric controls: discriminant analysis on social environment variables. Acta Psychiatrica Scandinavica 71, 495498.CrossRefGoogle ScholarPubMed
Eisemann, M., Perris, C., Perris, H. & Knorring, L. V. (1984). Perceived parental rearing practices in depressed patients in relation to social class. Acta Psychiatrica Scandinavica 70, 568572.CrossRefGoogle ScholarPubMed
Endicott, J., Andreasen, N. & Spitzer, R. L. (1978). Family History-Research Diagnostic Criteria (FH-BDC). Biometric Research New York State Psychiatric Institute: New York.Google Scholar
Eysenck, H. & Eysenck, S. G. B. (1975). Manual of the Eysenck Personality Questionnaire. Hodder & Stoughton: London.Google Scholar
Greenblatt, M., Becerra, R. M. & Serafetinides, E. A. (1982). Social network and mental health: an overview. American Journal of Psychiatry 139, 977984.Google Scholar
Greer, H. S., Lal, S., Lewis, S. C., Belsley, E. M. & Beard, R. W. (1976). Psychosocial consequences of therapeutic abortion: King's termination study. III. British Journal of Psychiatry 128, 7479.CrossRefGoogle ScholarPubMed
Hallstrom, T. (1986). Social origins of major depression: the role of provoking agents and vulnerability factors. Acta Psychiatrica Scandinavica 73, 383389.CrossRefGoogle ScholarPubMed
Hamill, E. & Ingram, I. M. (1974). Psychiatric and social factors in the abortion decision. British Journal of Medicine i, 229232.CrossRefGoogle Scholar
Henderson, A. S. (1981). Social relationships, adversity and neurosis: an analysis of prospective observations. British Journal of Psychiatry 138, 391398.CrossRefGoogle ScholarPubMed
Henderson, A. S., Byrne, D. G., Duncan-Jones, P., Scott, R. & Adrock, S. (1980). Social relationships, adversity and neurosis: a study of associations in a general population sample. British Journal of Psychiatry 136, 574583.CrossRefGoogle Scholar
Henderson, A. S., Byrne, D. G. & Duncan-Jones, P. (1981). Neurosis and the Social Environment. Academic Press: Sydney.Google Scholar
Hirschfeld, R. M. A., Klerman, G. L., Clayton, P. J. & Keller, M. B. (1983). Personality and depression: empirical findings. Archives of General Psychiatry 40, 993998.CrossRefGoogle ScholarPubMed
Hirschfeld, R. M. A., Klerman, G. L., Clayton, P. J., Keller, M. B., McDonald-Scott, P. & Larkin, B. H. (1987). Assessing personality: effects of the depressive state on trait measurement. American Journal of Psychiatry 140, 695699.Google Scholar
Katz, R. & McGuffin, P. (1987). Neuroticism in familial depression. Psychological Medicine 17, 155161.CrossRefGoogle ScholarPubMed
Kellet, J. (1989). Health and housing. Journal of Psychosomatic Research 33, 255268.CrossRefGoogle Scholar
Kendell, R. E. & DiScipio, W. J. (1968). Eysenck personality inventory scores of patients with depressive illnesses. British Journal of Psychiatry 114, 767770.CrossRefGoogle ScholarPubMed
Kitamura, T. (1978). Family history questionnaire. Bulletin of Institute of Psychiatry Tokyo 21, 153160.Google Scholar
Kitamura, T. & Suzuki, T. (1993 a). A validity study of the Parental Bonding Instrument in a Japanese population. Japanese Journal of Psychiatry and Neurology 47, 2936.Google Scholar
Kitamura, T. & Suzuki, T. (1993 b). Perceived rearing attitudes and morbidity among Japanese adolescents. Japanese Journal of Psychiatry and Neurology. (In the press.)CrossRefGoogle Scholar
Kitamura, T., Shima, S., Sakio, E. & Kato, M. (1984). Reliability study on Family History-Research Diagnostic Criteria (FH-RDC) by using case vignettes. Japanese Journal of Social Psychiatry 7, 308312. (In Japanese.)Google Scholar
Kitamura, T., Shima, S., Sakio, E. & Kato, M. (1986). Research Diagnostic Criteria and International Classification of Diseases to case vignettes. Journal of Clinical Psychiatry 47, 7880.Google ScholarPubMed
Kumar, R. (1982). Neurotic disorders in childbearing women. In Motherhood and Mental Illness (ed. Brockington, I. F. and Kumar, R.), pp. 71118, Academic Press: London.Google Scholar
Kumar, R. & Robson, K. M. (1984). A prospective study of emotional disorders in childbearing women. British Journal of Psychiatry 144, 3548.CrossRefGoogle ScholarPubMed
Lloyd, C. (1980). Life events and depressive disorder reviewed. I. Events as predisposing factors. Archives of General Psychiatry 37, 529535.CrossRefGoogle ScholarPubMed
Martin, C. J., Brown, G. W., Goldberg, D. P. & Brockington, I. F. (1989). Psycho-social stress and puerperal depression. Journal of Affective Disorders 16, 283293.CrossRefGoogle ScholarPubMed
Matussek, P. & Wiegand, M. (1985). Partnership problems as causes of endogenous and neurotic depressions. Acta Psychiatrica Scandinavica 71, 95104.CrossRefGoogle ScholarPubMed
Morris, J. A. & Gardner, M. J. (1988). Calculating confidence intervals for relative risks (odds ratios) and standardised ratios and rates. British Medical Journal 296, 13131316.CrossRefGoogle ScholarPubMed
O'Hara, M. W. (1986). Social support, life events, and depression during pregnancy and the puerperium. Archives of General Psychiatry 43, 569576.CrossRefGoogle ScholarPubMed
Pare, C. M. B. & Raven, H. (1970). Follow-up of patients referred for termination of pregnancy. Lancet i, 635638.CrossRefGoogle Scholar
Parker, G. (1979). Parental characteristics in relation to depressive disorders. British Journal of Psychiatry 134, 138147.CrossRefGoogle ScholarPubMed
Parker, G. (1981 a). Parental reports of depressives: an investigation of several explanations. Journal of Affective Disorders 3, 131140.CrossRefGoogle ScholarPubMed
Parker, G. (1981 b). Parental representation of patients with anxiety neurosis. Acta Psychiatrica Scandinavica 63, 3336.CrossRefGoogle ScholarPubMed
Parker, G. (1983). Parental ‘affectionless control’ as an antecedent to adult depression: a risk factor delineated. Archives of General Psychiatry 40, 956960.CrossRefGoogle ScholarPubMed
Parker, G., Tupling, H. & Brown, L. B. (1979). A parental bonding instrument. British Journal of Medical Psychology 52, 110.CrossRefGoogle Scholar
Paykel, E. S. (1982). Life events and early environment. In Handbook of Affective Disorders (ed. Paykel, E. S.), pp. 146161, Churchill Livingstone: Edinburgh.Google Scholar
Sharp, D. J. (1988). Validity of the 30-item General Health Questionnaire in early pregnancy. Psychological Medicine 18, 503507.CrossRefGoogle ScholarPubMed
Spitzer, R. L. & Endicott, J. (1978 a). Schedule for Affective Disorders and Schizophrenia (SADS) (3rd edn). Biometric Research, New York State Psychiatric Institute: New York.Google Scholar
Spitzer, R. L. & Endicott, J. (1978 b). Schedule for Affective Disorders and Schizophrenia: Change Version (SADS-C) (3rd. edn). Biometric Research, New York State Psychiatric Institute: New York.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1978). Research Diagnostic Criteria (RDC) for a Selected Group of Functional Disorders. Biometric Research, New York State Psychiatric Institute: New York.Google Scholar
SPSS Inc. (1986). SPSS User's Guide (2nd edn). SPSS Inc.: Chicago.Google Scholar
Tennant, C. (1988). Parental loss in childhood: its effect in adult life. Archives of General Psychiatry 45, 10451050.CrossRefGoogle ScholarPubMed
Waring, E. M. & Patton, D. (1984). Marital intimacy and depression. British Journal of Psychiatry 145, 645648.CrossRefGoogle ScholarPubMed
Watson, J. P., Elliott, S. A., Rugg, A. J. & Brough, D. I. (1984). Psychiatric disorder in pregnancy and the first postnatal year. British Journal of Psychiatry 144, 453462.CrossRefGoogle ScholarPubMed
Zajicek, E. (1981). Psychiatric problems during pregnancy. In Pregnancy: A Psychological and Social Study (ed. Wolkind, S. and Zajicek, E.), pp. 5773. Academic Press: London.Google Scholar