AccScience Publishing / JCBP / Volume 2 / Issue 4 / DOI: 10.36922/jcbp.4089
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ORIGINAL RESEARCH ARTICLE

Changes in core depressive symptoms over time in peripartum women: A network analysis

Yuqun Zhang1 ,  Ju Gao2 ,  Meixia Qin3 ,  Weiying Zhao3 ,  Yi Ding4 ,  Xin Yue4*
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1 Department of Humanities and Nursing, School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
2 Department of Psychiatry, Institute of Mental Health, Suzhou Psychiatric Hospital, the Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu, China
3 Department of Obstetrics and Gynecology, Jiangbei Campus, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, China
4 Department of Obstetrics and Gynecology, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
JCBP 2024, 2(4), 4089 https://doi.org/10.36922/jcbp.4089
Submitted: 30 June 2024 | Accepted: 3 September 2024 | Published: 17 October 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Perinatal depression (PND) is a prevalent mental health condition that affects women during pregnancy and after childbirth. Distinct clinical subtypes of PND exist, with the timing of symptom onset being a pivotal element in the classification of these subtypes. However, the specific manifestations of PND across the various stages of pregnancy and the postpartum period remain to be elucidated. This study aimed to explore the changes in depression symptoms with the stage of pregnancy. Women in their second (n = 161) and third trimesters (n = 248) of pregnancy as well as those in their first 6 weeks of the postpartum period (n = 110) were recruited. Each patient was evaluated using the Edinburgh Postnatal Depression Scale. A network analysis approach was used to explore the interconnections among depressive symptoms across the different time periods. Women in the postpartum period exhibited the most pronounced prevalence of PND and severity of depressive symptoms. In the second and third trimesters, “sadness and misery” was the most central symptom. However, its prominence diminished after childbirth. “Fear and panic” was the predominant symptom in the postpartum network. The structural integrity of PND symptom networks was maintained across all three periods, with consistent strength and closeness. This study demonstrates the temporal evolution of PND’s central symptoms in women during and after pregnancy, transitioning from depression-centric to anxiety-centric manifestations. These findings advocate for symptom-specific interventions to enhance the mental well-being of mothers and their offspring. Furthermore, this study offers clinical insights into the biological underpinnings of PND subtypes, facilitating precise diagnosis and targeted treatment strategies.

Keywords
Perinatal depression
Different periods
Central symptoms
Network analysis
Subtype
Funding
This work was funded by the Qing Lan Project of Jiangsu Higher Education Institutions, Jiangsu Government Scholarship for Overseas Studies (grant number, 2020- 039), National Natural Science Foundation of China (grant number, 82001426), School-based Youth Project Funding (grant number, NZY82001426) and Doctoral Talent Program of Suzhou Guangji Hospital (2022B01).
Conflict of interest
Yuqun Zhang is an Editorial Board Member of this journal but was not in any way involved in the editorial and peer-review process conducted for this paper, directly or indirectly. Separately, other authors declared that they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper.
References
  1. Tirumalaraju V, Suchting R, Evans J, et al. Risk of depression in the adolescent and adult offspring of mothers with perinatal depression: A systematic review and meta-analysis. JAMA Netw Open. 2020;3(6):e208783. doi: 10.1001/jamanetworkopen.2020.8783

 

  1. Oliveira TA, Luzetti GGC, Rosalem MMA, Mariani Neto C. Screening of perinatal depression using the Edinburgh postpartum depression scale. Rev Bras Ginecol Obstet. 2022;44(5):452-457. doi: 10.1055/s-0042-1743095

 

  1. Cheng CY, Chou YH, Chang CH, Liou SR. Trends of perinatal stress, anxiety, and depression and their prediction on postpartum depression. Int J Environ Res Public Health. 2021;18(17):9307. doi: 10.3390/ijerph18179307

 

  1. Yin X, Sun N, Jiang N, et al. Prevalence and associated factors of antenatal depression: Systematic reviews and meta-analyses. Clin Psychol Rev. 2021;3:101932. doi: 10.1016/j.cpr.2020.101932

 

  1. Wang Z, Liu J, Shuai H, et al. Mapping global prevalence of depression among postpartum women. Transl Psychiatry. 2021;11(1):543. doi: 10.1038/s41398-021-01663-6

 

  1. Wisner KL, Sit DK, McShea MC, et al. Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings. JAMA Psychiatry. 2013;70(5):490-498. doi: 10.1001/jamapsychiatry.2013.87

 

  1. Dagher RK, Bruckheim HE, Colpe LJ, Edwards E, White DB. Perinatal depression: Challenges and opportunities. J Womens Health (Larchmt). 2021;30(2):154-159. doi: 10.1089/jwh.2020.8862

 

  1. Muskens L, Boekhorst MGB, Kop WJ, van den Heuvel MI, Pop VJM, Beerthuizen A. The association of unplanned pregnancy with perinatal depression: A longitudinal cohort study. Arch Womens Ment Health. 2022;25(3):611-620. doi: 10.1007/s00737-022-01225-9

 

  1. Earls MF, Yogman MW, Mattson G, Rafferty J, Committee on Psychosocial Aspects of Child and Family Health. Incorporating recognition and management of perinatal depression into pediatric practice. Pediatrics. 2019;143(1):e20183259. doi: 10.1542/peds.2018-3259

 

  1. Paulson JF, Bazemore SD. Prenatal and postpartum depression in fathers and its association with maternal depression: A meta-analysis. JAMA. 2010;303(19):1961-1969. doi: 10.1001/jama.2010.605

 

  1. Putnam KT, Wilcox M, Robertson-Blackmore E, et al. Clinical phenotypes of perinatal depression and time of symptom onset: Analysis of data from an International consortium. Lancet Psychiatry. 2017;4(6):477-485. doi: 10.1016/S2215-0366(17)30136-0

 

  1. Rondon MB, Stewart DE. Disentangling the heterogeneity of perinatal depression. Lancet Psychiatry. 2017;4(6):432-433. doi: 10.1016/S2215-0366(17)30192-X

 

  1. Bloch M, Schmidt PJ, Danaceau M, Murphy J, Nieman L, Rubinow DR. Effects of gonadal steroids in women with a history of postpartum depression. Am J Psychiatry. 2000;157(6):924-930. doi: 10.1176/appi.ajp.157.6.924

 

  1. Postpartum Depression: Action Towards Causes and Treatment (PACT) Consortium. Heterogeneity of postpartum depression: A latent class analysis. Lancet Psychiatry. 2015;2(1):59-67. doi: 10.1016/S2215-0366(14)00055-8

 

  1. Borsboom D. A network theory of mental disorders. World Psychiatry. 2017;16(1):5-13. doi: 10.1002/wps.20375

 

  1. Cai H, Bai W, Liu H, et al. Network analysis of depressive and anxiety symptoms in adolescents during the later stage of the COVID-19 pandemic. Transl Psychiatry. 2022;12(1):98. doi: 10.1038/s41398-022-01838-9

 

  1. Zavlis O, Butter S, Bennett K, et al. How does the COVID-19 pandemic impact on population mental health? A network analysis of COVID influences on depression, anxiety and traumatic stress in the UK population. Psychol Med. 2021;16:1-9. doi: 10.1017/S0033291721000635

 

  1. Wang Y, Hu Z, Feng Y, Wilson A, Chen R. Changes in network centrality of psychopathology symptoms between the COVID-19 outbreak and after peak. Mol Psychiatry. 2020;25(12):3140-3149. doi: 10.1038/s41380-020-00881-6

 

  1. Kim ST, Seo JH, Park CI, et al. Core clinical symptoms and suicidal ideation in patients with obsessive-compulsive disorder: A network analysis. Psychiatry Clin Neurosci. 2023;77(2):110-117. doi: 10.1111/pcn.13503

 

  1. McNally RJ. Can network analysis transform psychopathology? Behav Res Ther. 2016;86:95-104. doi: 10.1016/j.brat.2016.06.006

 

  1. Speyer LG, Hall HA, Ushakova A, Murray AL, Luciano M, Auyeung B. Links between perinatal risk factors and maternal psychological distress: A network analysis. Acta Obstet Gynecol Scand. 2021;100(5):917-926. doi: 10.1111/aogs.14056

 

  1. Harris RA, Chen D, Santos HP, Jr. Which roads lead to depression in Latinas? A network analysis of prenatal depressive symptoms, discrimination, acculturative stress, and low birth weight. Res Nurs Health. 2022;45(3):350-363. doi: 10.1002/nur.22210

 

  1. Santos H, Jr., Fried EI, Asafu-Adjei J, Ruiz RJ. Network structure of perinatal depressive symptoms in Latinas: Relationship to stress and reproductive biomarkers. Res Nurs Health. 2017;40(3):218-228. doi: 10.1002/nur.21784

 

  1. Meltzer-Brody S, Boschloo L, Jones I, Sullivan PF, Penninx BW. The EPDS-Lifetime: Assessment of lifetime prevalence and risk factors for perinatal depression in a large cohort of depressed women. Arch Womens Ment Health. 2013;16(6):465-473. doi: 10.1007/s00737-013-0372-9

 

  1. Tanuma-Takahashi A, Tanemoto T, Nagata C, et al. Antenatal screening timeline and cutoff scores of the Edinburgh postnatal depression scale for predicting postpartum depressive symptoms in healthy women: A prospective cohort study. BMC Pregnancy Childbirth. 2022;22(1):527. doi: 10.1186/s12884-022-04740-w

 

  1. Epskamp S, Fried EI. A tutorial on regularized partial correlation networks. Psychol Methods. 2018;23(4):617-634. doi: 10.1037/met0000167

 

  1. Friedman J, Hastie T, Tibshirani R. Sparse inverse covariance estimation with the graphical lasso. Biostatistics. 2008;9(3):432-441. doi: 10.1093/biostatistics/kxm045

 

  1. Zhao YJ, Bai W, Cai H, et al. The backbone symptoms of depression: A network analysis after the initial wave of the COVID-19 pandemic in Macao. PeerJ. 2022;10:e13840. doi: 10.7717/peerj.13840

 

  1. Epskamp S, Borsboom D, Fried EI. Estimating psychological networks and their accuracy: A tutorial paper. Behav Res Methods. 2018;50(1):195-212. doi: 10.3758/s13428-017-0862-1

 

  1. Epskamp S Cramer AOJ, Waldorp LJ, Schmittmann VD, Borsboom D. qgraph: Network visualizations of relationships in psychometric data. J Stat Softw. 2012;48:1-18. doi: 10.18637/jss.v048.i04

 

  1. Yoo H, Ahn S, Park S, Kim J, Oh J, Koh M. Factors influencing prenatal and postpartum depression in Korea: A prospective cohort study. Korean J Women Health Nurs. 2021;27(4): 326-336. doi: 10.4069/kjwhn.2021.11.17

 

  1. McKean M, Caughey AB, Yuracko McKean MA, Cabana MD, Flaherman VJ. Postpartum depression: When should health care providers identify those at risk? Clin Pediatr (Phila). 2018;57(6):689-693. doi: 10.1177/0009922817733696

 

  1. Pampaka D, Papatheodorou SI, AlSeaidan M, et al. Postnatal depressive symptoms in women with and without antenatal depressive symptoms: Results from a prospective cohort study. Arch Womens Ment Health. 2019;22(1):93-103. doi: 10.1007/s00737-018-0880-8

 

  1. Schiller CE, Meltzer-Brody S, Rubinow DR. The role of reproductive hormones in postpartum depression. CNS Spectr. 2015;20(1):48-59. doi: 10.1017/S1092852914000480

 

  1. Lin PY, Chiu TH, Ho M, Pei-Chen Chang J, Hui-Chih Chang C, Su KP. Major depressive episodes during pregnancy and after childbirth: A prospective longitudinal study in Taiwan. J Formos Med Assoc. 2019;118(11):1551-1559. doi: 10.1016/j.jfma.2019.03.003

 

  1. Stewart DE, Vigod SN. Postpartum depression: Pathophysiology, treatment, and emerging therapeutics. Annu Rev Med. 2019;70:183-196. doi: 10.1146/annurev-med-041217-011106

 

  1. Nayak AS, Nachane HB. Maternal anthropometric determinants as risk markers of suicidality and severity of illness in women with postnatal depression. J Postgrad Med. 2020;66(1):11-16. doi: 10.4103/jpgm.JPGM_541_18

 

  1. Luo F, Zhu Z, Du Y, Chen L, Cheng Y. Risk factors for postpartum depression based on genetic and epigenetic interactions. Mol Neurobiol. 2023;60:3979-4003. doi: 10.1007/s12035-023-03313-y

 

  1. Yasuma N, Narita Z, Sasaki N, et al. Antenatal psychological intervention for universal prevention of antenatal and postnatal depression: A systematic review and meta-analysis. J Affect Disord. 2020;273:231-239. doi: 10.1016/j.jad.2020.04.063

 

  1. Deady M, Collins DAJ, Johnston DA, et al. The impact of depression, anxiety and comorbidity on occupational outcomes. Occup Med (Lond). 2022;72(1):17-24. doi: 10.1093/occmed/kqab142

 

  1. Nakic Rados S, Tadinac M, Herman R. Anxiety during pregnancy and postpartum: Course, predictors and comorbidity with postpartum depression. Acta Clin Croat. 2018;57(1):39-51. doi: 10.20471/acc.2018.57.01.05

 

  1. Storozheva ZI, Akhapkin RV, Bolotina OV, et al. Sensorimotor and sensory gating in depression, anxiety, and their comorbidity. World J Biol Psychiatry. 2021;22(3):183-193. doi: 10.1080/15622975.2020.1770859

 

  1. Koller D, Pathak GA, Wendt FR, et al. Epidemiologic and genetic associations of endometriosis with depression, anxiety, and eating disorders. JAMA Netw Open. 2023;6(1):e2251214. doi: 10.1001/jamanetworkopen.2022.51214

 

  1. Choi KW, Kim YK, Jeon HJ. Comorbid anxiety and depression: Clinical and conceptual consideration and transdiagnostic treatment. Adv Exp Med Biol. 2020;1191:219-235. doi: 10.1007/978-981-32-9705-0_14

 

  1. Cuijpers P, Karyotaki E. The effects of psychological treatment of perinatal depression: An overview. Arch Womens Ment Health. 2021;24(5):801-806. doi: 10.1007/s00737-021-01159-8
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Journal of Clinical and Basic Psychosomatics, Electronic ISSN: 2972-4414 Print ISSN: 3060-8562, Published by AccScience Publishing
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