Mood Disorders in Women From Adolescence to Late Life: An Overview

Prior Antidepressant Treatment Trials May Predict a Greater Risk of Depressive Relapse During Antidepressant Maintenance Therapy

BACKGROUND

We examined the influence of prior antidepressant treatment trials on the likelihood of depressive relapse, and time to depressive relapse, during maintenance therapy of bipolar II disorder in treatment-responsive subjects who had recovered from a major depressive episode.

METHODS

Data were derived from a prospective, randomized, double-blind trial of 148 adult subjects with bipolar II major depressive episode who were initially administered open-label fluoxetine monotherapy for 12 weeks. Remitters with a final Hamilton Rating Scale for Depression score of 8 or lower were then randomized to continuation therapy with either fluoxetine (n = 28), lithium (n = 26), or placebo (n = 27) for 50 additional weeks.

RESULTS

An increase in the number of prior antidepressant treatment trials was significantly associated with a greater likelihood of depressive relapse for all treatment conditions taken together [odds ratio (OR) = 1.42, z = 2.49, P = 0.01] and for the 2 active treatment conditions together (OR = 1.51, z = 2.28, P = 0.02). An increase in the number of prior antidepressant trials was also associated with a trend-level shortening in the time to relapse for all treatment conditions taken together (hazard ratio = 1.15; confidence interval, 0.99-1.35; P = 0.07) and a significantly shorter time to relapse for subjects in the 2 active treatment conditions (hazard ratio = 1.30; confidence interval, 1.05-1.62; P = 0.02).

CONCLUSIONS

These findings support prior evidence of a negative influence of the number of prior antidepressant treatment trials on the likelihood of response and suggest that the number of prior antidepressant trials may also be associated with a greater odds of depressive relapse, and a shorter time to relapse, during antidepressant maintenance therapy in recovered depressed subjects with bipolar II disorder.

Exploring Maternal and Child Effects of Comorbid Anxiety Disorders among African American Mothers with Depression

Comorbid depression and anxiety disorders are commonly experienced in mothers. Both maternal depression and anxiety as well as their comorbidity has been shown to increase psychopathology in children, however, there is limited research focusing on African American families. The aim of this study is to examine whether comorbid anxiety disorders are associated with maternal depression severity, kinship support, and child behavioral problems in a sample of African American mothers with depression. African American mothers (n = 77) with a past year diagnosis of a depressive disorder and a child between the ages of ages 8-14 were administered a clinician interview and measures of maternal depression severity, kinship support, and child behavior problems (internalizing and externalizing) in a cross-sectional design. Results showed that more than half (58%) of the mothers had a comorbid anxiety disorder and a third had Posttraumatic Stress Disorder (PTSD). Regression analyses showed that comorbid PTSD and Social Phobia were positively associated with maternal depression severity. Maternal comorbid Obsessive Compulsive Disorder (OCD) was associated with child internalizing symptoms. The findings are consistent with other research demonstrating negative outcomes with maternal comorbidity of depression and anxiety, however, there is limited research focused on maternal depression and OCD or PTSD. The study suggests that it is important to consider comorbid anxiety and cultural issues when conceptualizing, studying, and treating mothers with depression and their families.

Postpartum Depressive Score and Related Factors Pre- and Post-delivery

PURPOSE

This study aimed to identify the scores of postpartum depression(PPD) on the first day, 1st week, and 6th week after the delivery and to explore their related factors before and after delivery in postpartum women.

METHODS

With a survey design, 293 postpartum women were recruited from a postpartum unit, Ilsin Christian hospital in Pusan via convenience sampling and were followed at 1st week and 6th week in the outpatient clinic.

RESULTS

Results showed that the scores of PPD(EPDS score) were low at postpartum 1st day, 1st week and 6th week but prevalence of PPD(EPDS > or =13) was 3.1% at 1st day, 8.2% at 1st week and 7.5% at 6th week, respectively. The pre-delivery factors were experience of depression, and the post-delivery factors were baby's sex(1st day), no caregiver for baby(1st week), and no help and concern for taking care of baby from husband and family(1st day and 6th week). The greater satisfaction with becoming a mother and her life, and greater maternal attachment were related to lower level of PPD at the three time points.

CONCLUSION

Regular screening for postpartum depression and supportive and informative education is needed for postpartum women visiting the outpatient clinic for follow-up.

The prevalence of depression in older U.S. women: 2006 behavioral risk factor surveillance system

Depression, a type of mood disorder, is associated with psychological distress and suffering, and it can lead to impairments in physical, mental, and social functioning. The goal of this commentary is to provide an estimate of the prevalence of current depression and lifetime diagnosis for 14,425 community-dwelling U.S. women aged 65 and older. Using information from the 2006 Behavioral Risk Factor Surveillance System (BRFSS), participants reported their lifetime diagnosis of depression and completed the Patient Health Questionnaire 8 to assess current depression and its severity. Our findings indicate that 5.9% of women 65 years old and older have current depression, 94.1% reported either no depressive symptoms or mild depressive symptoms, and 12.3% reported a lifetime diagnosis of depression. Mental health is integral to overall health and well-being and should be treated in older women with the same urgency as physical health. Depression is a mental health issue of particular concern for women, given their increasing numbers, higher proportion in the US population, and role as caregivers. Continued surveillance from a system such as the BRFSS is needed to track changes in the mental health of older adults.