Untreated depression in the first trimester of pregnancy leads to postpartum depression: high rates from a natural follow-up study

Abstract

Esra Yazici,1 Tulay Sati Kirkan,2 Puren Akcali Aslan,3 Nazan Aydin,4 Ahmet Bulent Yazici1 1Department of Psychiatry, Faculty of Medicine, Sakarya University, Adapazari, Turkey; 2Bolge Training and Research Hospital, Erzurum, Turkey; 3Adana Training and Research Hospital, Adana, Turkey; 4Bakirkoy Nervous and Mental Disease Education and Research Hospital, Istanbul, Turkey Background: This is a natural follow-up study that presents the postpartum results of women who experienced depression during pregnancy. Methods: This study involved 78 women diagnosed with depression in the first trimester of pregnancy. All patients were diagnosed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) in the first trimester and all were referred to a psychiatric center for treatment. Of the 78, 73 were contacted postpartum and reassessed by SCID-I. Treatment anamnesis was evaluated retrospectively. Results: The women were divided into two groups at the postpartum evaluation according to anamnesis of psychiatric treatment. Twenty-one of the 73 (28.7%) had received treatment during pregnancy (treated group). Fifty-two women had not been treated (untreated group). In the treated group, no postpartum depression was determined (0%). In the untreated group, 92% (n=48) of women had a depressive disorder postpartum (P<0.01). In addition, scores regarding depression, functionality, and perceived social support were worse postpartum for the untreated group. Conclusion: Untreated depression during pregnancy is an important predictor of postpartum depression. This natural follow-up study is important because it presents very striking rates of postpartum depression. Referral of patients with depression during pregnancy to psychiatric treatment should be provided and is strongly encouraged. Keywords: untreated depression, pregnancy, postpartum, perinatal, depression, mood