AUTHOR=Kubota Chika , Inada Toshiya , Shiino Tomoko , Ando Masahiko , Aleksic Branko , Yamauchi Aya , Sato Maya , Ohara Masako , Murase Satomi , Morikawa Mako , Nakamura Yukako , Okada Takashi , Goto Setsuko , Kanai Atsuko , Ozaki Norio 

TITLE=Relation Between Perinatal Depressive Symptoms, Harm Avoidance, and a History of Major Depressive Disorder: A Cohort Study of Pregnant Women in Japan

JOURNAL=Frontiers in Psychiatry

VOLUME=Volume 10 - 2019

YEAR=2019

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2019.00515

DOI=10.3389/fpsyt.2019.00515

ISSN=1664-0640

ABSTRACT=Abstract
Introduction: The relationship between perinatal depressive symptoms, harm avoidance (HA), and a history of major depressive disorder (MDD) was examined in a prospective cohort study.
Methods: This study was conducted from May 1, 2011 to December 31, 2016. A history of MDD was evaluated using the Inventory to Diagnose Depression, Lifetime version during pregnancy. Depressive state and HA were evaluated in early pregnancy and at 1 month postnatal using the Edinburgh Postnatal Depression Scale (EPDS) and Temperament and Character Inventory, respectively. The relationship between these variances was examined using structural equation modeling.
Results: A total of 338 participants with complete data were included in the present study. Pregnant women with compared with those without a history of MDD were observed to have a significantly higher intensity of HA and more severe depressive symptoms in both the prenatal and postnatal periods. A history of MDD affected the severity of depressive symptoms (standardized path coefficient [SPC]=0.25, p<0.001) and the intensity of HA during pregnancy (SPC=0.36, p<0.001). The intensity of HA during pregnancy affected that at 1 month postnatal (SPC=0.78, p<0.001), while the severity of depressive symptoms as assessed by the EPDS during pregnancy affected that at 1 month postnatal (SPC=0.41, p<0.001). The SPC for perinatal HA to postnatal depressive symptoms (SPC=0.13, p=0.014) was significant and higher than that for perinatal depressive symptoms to postnatal HA (SPC=0.06, p=0.087).
Conclusion: The present results suggest that early intervention in pregnant women with a history of MDD or a high intensity of HA is important to prevent postnatal depressive symptoms.