The peripartum period is a potentially difficult time in a woman's life, a time when up to 70% of women experience transient mood symptoms and approximately 15% will suffer from a severe mood event which impacts not just her, but her family as well. The symptoms and clinical features of the mood symptoms are linked to Major Depressive Disorder (MDD) and Bipolar Disorder (BD). Appropriate diagnosis as early as possible has a critical impact on the immediate and long-term health of the peripartum woman, especially in those with a bipolar diathesis. While treatment for BD versus MDD may be markedly different, it can be difficult to distinguish between the two, especially during a depressed episode, with postpartum onset. To date, no study has evaluated the Edinburgh Postnatal Depression Scale (EPDS) for its value as a screening measure for the differentiation of BD versus MDD in the postpartum period.
This study sought to: 1) to describe the demographic differences between women diagnosed with BD versus MDD seeking treatment for a major depressive episode, with postpartum onset; 2) to characterize the features of the major depressive episode; with postpartum onset in women diagnosed with BD versus MDD; and 3) to examine scale characteristics of the EPDS as a predictor of the diagnosis of BD versus MDD.
Results revealed that postpartum depressed women diagnosed with BD reported a) an earlier age of onset, b) a greater number of prior mood episodes, c) greater incidence of psychotic symptoms in the current depressive episode, and d) lower overall scores on the EPDS versus postpartum depressed women diagnosed with MDD. There were no reliable differences between the groups on family history of a) mood disorders; b) number of generations; c) weeks postpartum at symptom onset; d) scores on a 4-item subscale of the EPDS; e) suicidal/homicidal ideation; nor the incidence of symptoms of f) atypical depression, g) generalized anxiety disorder, or h) obsessive-compulsive disorder. The findings support the use of a thorough clinical and demographic history when evaluating postpartum depressed women and the use of a measure in place of or in addition to the EPDS to ensure the appropriate differentiation of BD versus MDD.
|Advisor:||Williams, Katherine E., Russell, Robert|
|Commitee:||Howell, Shelley K.|
|School:||Palo Alto University|
|School Location:||United States -- California|
|Source:||DAI-B 77/04(E), Dissertation Abstracts International|
|Subjects:||Mental health, Medicine, Behavioral psychology, Womens studies, Clinical psychology, Cognitive psychology|
|Keywords:||Anxiety, Bipolar disorder, Depression, Differential diagnosis, Peripartum, Postpartum|
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