Prospective Study on the Association between Harm Avoidance and Postpartum Depressive State in a Maternal Cohort of Japanese Women

BACKGROUND: Recent studies have displayed increased interest in examining the relationship between personality traits and the onset, treatment response patterns, and relapse of depression. This study aimed to examine whether or not harm avoidance (HA) was a risk factor for postpartum depression measured by the Edinburgh Postnatal Depression Scale (EPDS) and the state dependency of HA. METHODS: Pregnant women (n=460; mean age 31.9±4.2 years) who participated in a prenatal program completed the EPDS as a measure of depressive state and the Temperament and Character Inventory (TCI) as a measure of HA during three periods: early pregnancy (T1), late pregnancy (around 36 weeks), and 1 month postpartum (T2). Changes in EPDS and HA scores from T1 to T2 were compared between the non depressive (ND) group and the postpartum depressive (PD) group. RESULTS: There was no significant difference in the level of HA between the ND and PD groups at T1. In the ND group, EPDS and HA scores did not change significantly from T1 to T2. In the PD group, both scores increased significantly from T1 to T2 (EPDS, p<0.0001; HA, p<0.048). In the ND and PD groups, a significant positive correlation was observed in changes in EPDS and HA scores from T1 to T2 (r=0.31, p=0.002). CONCLUSIONS: These results suggest that HA cannot be considered a risk factor for the development of postpartum depression measured by EPDS. Furthermore, HA may be state dependent

HA scores in the ND and PD groups.

<p>HA: harm avoidance.</p><p>T1: early pregnancy (before 25 weeks).</p><p>T2: postpartum (1 month).</p>a<p>: Paired t-test in HA scores between T1 and T2 in the ND and PD groups.</p

Participant profiles in the four groups.

<p>+: EPDS>8, −: EPDS<9.</p><p>T1: early pregnancy (before 25 weeks).</p><p>late: late pregnancy (around 36 weeks).</p><p>T2: postpartum (1 month).</p>a<p>: ANOVA was used to test the mean differences of age within the four groups.</p

Correlations between HA and EPDS score changes from T1 to T2 in the ND and PD groups.

<p>r: Pearson's r.</p

EPDS scores in the ND and PD groups.

<p>EPDS: Edinburgh Postnatal Depression Scale.</p><p>ND group: non depressive group.</p><p>PD group: postpartum depressive group.</p><p>T1: early pregnancy (before 25 weeks).</p><p>T2: postpartum (1 month).</p><p>SD: standard deviation.</p><p>a: Paired t-test.</p

PBI scores in the ND and PD groups.

<p>PBI: Parental Bonding Instrument.</p><p>ND group: non depressive group.</p><p>PD group: postpartum depressive group.</p><p>T1: early pregnancy (before 25 weeks).</p><p>T2: postpartum (1 month).</p><p>SD: standard deviation.</p><p>a: Paired t-test between T1 and T2.</p

PBI scores in the ND and PD groups at T1.

<p>PBI: Parental Bonding Instrument.</p><p>T1: early pregnancy (before 25 weeks).</p><p>ND group: non depressive group.</p><p>PD group: postpartum depressive group.</p><p>SD: standard deviation.</p><p>a: Student’s t-test between the ND and PD group.</p

Correlations between PBI and EPDS score changes from T1 to T2 in the ND and PD groups.

<p>PBI: Parental Bonding Instrument.</p><p>EPDS: Edinburgh Postnatal Depression Scale.</p><p>T1: early pregnancy (before 25 weeks).</p><p>T2: postpartum (1 month).</p><p>ND group: non depressive group.</p><p>PD group: postpartum depressive group.</p><p>r: Pearson’s r.</p

Participant profiles in the four initial subject categories.

<p>T1: early pregnancy (before 25 weeks).</p><p>late: late pregnancy (around 36 weeks).</p><p>T2: postpartum (1 month).</p><p>+: EPDS >8, − : EPDS <9.</p><p>a: ANOVA was used to test the mean differences of age within the four groups.</p