Preconception personality disorder and antenatal maternal mental health: A population-based cohort study

JOURNAL OF AFFECTIVE DISORDERS

卷:209

Article

Hudson, Charlotte^1,2,3  Spry, Elizabeth^1,2,4  Borschmann, Rohan^1,2,5  Becker, Denise^1,2  Moran, Paul⁶  Olsson, Craig^1,2,4,7  Coffey, Carolyn^1,2  Romaniuk, Helena^1,2,8  Bayer, Jordana K.^1,2,3,7  Patton, George C.^1,2 

[1] Royal Childrens Hosp, Murdoch Childrens Res Inst, 50 Flemington Rd, Parkville, Vic 3052, Australia

[2] Royal Childrens Hosp, Ctr Adolescent Hlth, Parkville, Vic, Australia

[3] La Trobe Univ, Sch Psychol & Publ Hlth, Melbourne, Vic, Australia

[4] Deakin Univ, Sch Psychol, Ctr Social & Early Emot Dev, Geelong, Vic, Australia

[5] Univ Melbourne, Melbourne Sch Populat & Global Hlth, Ctr Mental Hlth, Melbourne, Vic, Australia

[6] Univ Bristol, Sch Social & Community Med, Ctr Acad Mental Hlth, Bristol, Avon, England

[7] Univ Melbourne, Dept Pediat, Melbourne, Vic, Australia

[8] Royal Childrens Hosp, Clin Epidemiol & Biostat Unit, Parkville, Vic, Australia

关键词: Maternal health;    Mental disorders;    Personality disorders;    Epidemiology;   

DOI  :  10.1016/j.jad.2016.11.022

来源: Elsevier

【 摘 要 】

Background: Prior anxiety and depression have been identified as risk factors for maternal perinatal mental health problems, but other preconception mental disorders have not been prospectively examined. This study investigated prospectively whether women with preconception personality disorder have increased rates of antenatal anxiety and/or depressive symptoms. Methods: 244 women in a population cohort were assessed for personality disorder at age 24 using the Standardised Assessment of Personality. Five to twelve years later, women were screened with the Clinical Interview Schedule, Revised Anxiety Subscale and the Edinburgh Postnatal Depression Scale during the third trimester of 328 pregnancies. Results: Preconception personality disorder was associated with a three-fold increase in the odds of antenatal anxiety symptoms, which remained with adjustment for preconception background factors and preconception common mental disorder (adjusted OR 2.84, 95% CI 1.31-6.15). Preconception personality disorder was associated with doubled odds of antenatal depressive symptoms, however this was attenuated with adjustment for preconception background factors and preconception common mental disorder (adjusted OR 1.98, 95% CI 0.81-4.81). Limitations: Our findings are restricted to pregnant women aged 29-35 years. Anxiety and depression may have been under-identified because they were assessed at a single antenatal time point. Residual confounding of the associations by preconception common mental disorder at other time points may have occurred. Conclusions: Women with personality disorder are at heightened risk of anxiety symptoms in pregnancy, over and above risks associated with prior common mental disorder. This raises a possibility that pregnancy brings particular emotional challenges for women with personality disorders.

【 授权许可】

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