Postpartum Depression
According to a Medscape Treatment Update on reproductive psychiatry by Misri and Kostaras,[3] "during pregnancy, depressive symptoms such as changes in sleep and appetite are often difficult to distinguish from the normal experiences of pregnancy."[4] Although up to 70% of women report experiencing negative mood symptoms during pregnancy, the prevalence of pregnant women who actually fulfill the diagnostic criteria for major depression is between 10% and 16%.[5] The course of depression varies throughout pregnancy; most studies report a symptom peak during the first trimester, improvement during the second trimester, and an increase again during the third trimester.[6,7]
Several controlled studies have reported that between 12% and 16% of women experience a postpartum depressive episode,[8] and this rate is as high as 26% in adolescent mothers.[9] However, there is some disagreement over the defined time frame of the postpartum period.
Although the DSMIV-TR defines PPD as a major depressive episode occurring within 4 weeks of childbirth, other studies of PPD report that symptoms manifest themselves most often in the 6-12 weeks following delivery,[10] and several researchers have defined the postpartum period as extending from 6-12 months after the birth. PPD can also be precipitated by a miscarriage.
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