Course of a major postpartum depressive episode: A prospective 2 years naturalistic follow-up study

• Published in: Journal of affective disorders Vol. 245; pp. 965 - 970
• Main Authors: Torres, Anna, Gelabert, Estel, Roca, Alba, Navarro, Purificación, Plaza, Anna, Subirà, Susana, Martin-Santos, Rocío, Ascaso, Carlos, Garcia-Esteve, Lluïsa
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15.02.2019
• Subjects: Adolescent; Adult; Chronic Disease; Cohort Studies; Course; Depression, Postpartum - psychology; Depressive Disorder, Major - psychology; Diagnostic and Statistical Manual of Mental Disorders; Disease Progression; Female; Follow-Up Studies; Humans; Longitudinal Studies; Longitudinal study; Mothers; Personality; Postpartum depression; Pregnancy; Pregnancy Complications - psychology; Prognosis; Prospective Studies; Risk factors; Socioeconomic Factors; Young Adult; Postpartum depression; Course; Risk factors; Longitudinal study
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2018.11.062

•Major postpartum depressive episodes (MPDE) can be long and at risk of chronification.•There is a delay in the recovery of MPDE compared with non–postpartum samples.•Only 66.3% of mothers with MPDE achieved full remission at 12 months postpartum.•The onset of the depressive episode previous to childbirth was a poor prognostic factor. Survival methodology has not already been used in studies about postpartum depression (PPD) course. The aims of the present study were to estimate the duration of a Major Postpartum Depressive Episode (MPDE) during 2 years, as well as to explore factors associated with the course. This was a prospective, naturalistic, longitudinal study with a cohort of 165 women with a MPDE (DSM-IV criteria). Potential predictors of prognosis were recorded at baseline. Follow-up was conducted using the Longitudinal Interval Follow-up Evaluation (LIFE). Of the total sample, 110 (66.7%) completed the 2 years follow-up. The mean time to full remission was 49.4 weeks (95% CI: 44.0–59.8). The probability of recovering was 30.2% (95% CI: 22.1%–37.4%) at 6 months of follow-up, 66.3% (95% CI: 57.4%–73.4%) at 12 months of follow-up, and 90.3% (95% CI: 79.8%–95.4%) at 24 months of follow-up. Mothers with financial difficulties, onset of depressive episode previous to birth, and those with prior treated depressive episodes took longer in achieving full remission. Results are only generalizable to mothers with PPD treated in a psychiatric outpatient setting. Psychopharmacological treatment was uncontrolled and personality was not assessed. Our findings suggest that PPD could become a chronic disorder, particularly in mothers with an onset of the episode previous to birth, with a history of depression or with financial problems. Knowledge of these factors may help to improve the guidelines of depression management and treatment during the perinatal period.