Клиническая депрессия

Postpartum Depression Effects, Risk Factors and Interventions: A Review

Abstract

Tiffany Field

This review involved a literature search on postpartum depression effects, risk factors and interventions on Pubmed and PsycInfo. Empirical studies, systematic reviews and meta-analyses published in the years 2014-2016 are briefly summarized here. The approximate 10 - 20% postpartum depression prevalence rate and the effects on the mother such as altered connectivity in brain regions, effects on the father (17% depressed) and on the social, behavioural and cognitive problems of the offspring have led to screening mandates that have been effective. In this recent literature, risk factors for postpartum depression have included socio-demographic factors such as low income and social support, being an immigrant, and experiencing a deployment during delivery. Mothers’ early childhood experiences including disorganized attachment, maltreatment and childhood sexual abuse are also risk factors. The most frequently published risk factors in the 2014-16 time period have been prenatal depression, sleep disturbances, elevated cortisol and low levels of oxytocin. With respect to interventions, antidepressants have been rarely studied in contrast to cognitive behavioural therapy, interpersonal therapy, and mother-infant psychotherapy and biochemical interventions including oxytocin. Given the ethical problem of random assignment once treatments are known to be effective, very few randomized controlled trials appear in the literature, and the screening/diagnostic problems have limited the number of prospective longitudinal studies.