Univaikeudet raskauden aikana - riskitekijä synnytyksen jälkeiselle masennukselle

In the general population, sleeping problems can precede an episode of depression. We hypothesized that sleeping problems during pregnancy, including insomnia symptoms, shortened sleep, and daytime tiredness, are related to maternal postnatal depressiveness. We conducted a prospective study evaluating sleep and depressive symptoms, both prenatally (around gestational week 32) and postnatally (around 3months after delivery) in the longitudinal CHILD-SLEEP birth cohort in Finland. Prenatally, 1667 women returned the questionnaire, of which 1398 women participated also at the postnatal follow-up. Sleep was measured with the Basic Nordic Sleep Questionnaire (BNSQ) and depressive symptoms with a 10-item version of the Center for Epidemiological Studies Depression Scale (CES-D). Altogether, 10.3% of the women had postnatal depressiveness (CES-D 10 points). After adjusting for main background characteristics and prenatal depressiveness (CES-D 10), poor general sleep quality (AOR 1.87, 95% CI 1.21-2.88), tiredness during the day (AOR 2.19, 95% CI 1.41-3.38), short sleep 6 and 7h, sleep latency >20min, and sleep loss 2h were associated with postnatal depressiveness (all pPeer reviewe

Trajectories of mothers’ and fathers’ depressive symptoms from pregnancy to 24 months postpartum

ObjectivesThis study investigated trajectories of mothers’ and fathers’ depressive symptoms from prenatal to 24 months postpartum. Prenatal correlates of the trajectories were also examined. MethodsMothers (N=1,670) and fathers (N=1,604) from the Finnish CHILD-SLEEP birth cohort, reported depressive symptoms at 32nd pregnancy week and 3, 8, and 24 months postpartum using the Center for Epidemiologic Studies Depression Scale (CES-D, 10-item). Profile analysis was used to group participants according to their longitudinal patterns of depressive symptoms. Prenatal predictors (sociodemographic, health, substance use, sleep, and stress related factors, family atmosphere) of depressive symptom trajectories as well as association between parents’ trajectories were analyzed using multinomial logistic regression. ResultsFor both mothers and fathers, a solution with three stable depressive symptom trajectories (low: 63.1% mothers and 74.9% fathers; moderate: 28.1% and 22.6%; high: 8.8% and 2.6%) was considered the best fitting and most informative. Insomnia, earlier depression, anxiousness, stressfulness, and poor family atmosphere predicted the moderate and high (compared to low) depressive symptom trajectories among both mothers and fathers in multivariate analyses. Mother's higher depressive symptom trajectory was significantly associated with father's higher symptom trajectory (p<0.001). LimitationsNumber of cases in the high depressive symptom trajectory group among fathers was low. ConclusionsMaternal and paternal depressive symptom trajectories from prenatal period up to two years postpartum seem stable, indicating the chronic nature of perinatal depressive symptoms. Mothers’ and fathers’ trajectories are associated with each other and their strongest predictors are common to both.Objectives This study investigated trajectories of mothers’ and fathers’ depressive symptoms from prenatal to 24 months postpartum. Prenatal correlates of the trajectories were also examined. Methods Mothers (N = 1670) and fathers (N = 1604) from the Finnish CHILD-SLEEP birth cohort, reported depressive symptoms at 32nd pregnancy week and 3, 8, and 24 months postpartum using the Center for Epidemiologic Studies Depression Scale (CES-D, 10-item). Profile analysis was used to group participants according to their longitudinal patterns of depressive symptoms. Prenatal predictors (sociodemographic, health, substance use, sleep, and stress related factors, family atmosphere) of depressive symptom trajectories as well as association between parents’ trajectories were analyzed using multinomial logistic regression. Results For both mothers and fathers, a solution with three stable depressive symptom trajectories (low: 63.1% mothers and 74.9% fathers; moderate: 28.1% and 22.6%; high: 8.8% and 2.6%) was considered the best fitting and most informative. Insomnia, earlier depression, anxiousness, stressfulness, and poor family atmosphere predicted the moderate and high (compared to low) depressive symptom trajectories among both mothers and fathers in multivariate analyses. Mother's higher depressive symptom trajectory was significantly associated with father's higher symptom trajectory (p < 0.001). Limitations Number of cases in the high depressive symptom trajectory group among fathers was low. Conclusions Maternal and paternal depressive symptom trajectories from prenatal period up to two years postpartum seem stable, indicating the chronic nature of perinatal depressive symptoms. Mothers’ and fathers’ trajectories are associated with each other and their strongest predictors are common to both.Peer reviewe

Anxiety symptoms in a major mood and schizophrenia spectrum disorders

Background: Comorbid anxiety symptoms and disorders are present in many psychiatric disorders, but methodological variations render comparisons of their frequency and intensity difficult. Furthermore, whether risk factors for comorbid anxiety symptoms are similar in patients with mood disorders and schizophrenia spectrum disorders remains unclear. Methods: The Overall Anxiety Severity and Impairment Scale (OASIS) was used to measure anxiety symptoms in psychiatric care patients with schizophrenia or schizoaffective disorder (SSA, n = 113), bipolar disorder (BD, n = 99), or depressive disorder (DD, n = 188) in the Helsinki University Psychiatric Consortium Study. Bivariate correlations and multivariate linear regression models were used to examine associations of depressive symptoms, neuroticism, early psychological trauma and distress, self-efficacy, symptoms of borderline personality disorder, and attachment style with anxiety symptoms in the three diagnostic groups. Results: Frequent or constant anxiety was reported by 40.2% of SSA, 51.5% of BD, and 55.6% of DD patients; it was described as severe or extreme by 43.8%, 41.4%, and 41.2% of these patients, respectively. SSA patients were significantly less anxious (P = 0.010) and less often avoided anxiety-provoking situations (P = 0.009) than the other patients. In regression analyses, OASIS was associated with high neuroticism, symptoms of depression and borderline personality disorder and low self-efficacy in all patients, and with early trauma in patients with mood disorders. Conclusions: Comorbid anxiety symptoms are ubiquitous among psychiatric patients with mood or schizophrenia spectrum disorders, and in almost half of them, reportedly severe. Anxiety symptoms appear to be strongly related to both concurrent depressive symptoms and personality characteristics, regardless of principal diagnosis. (C) 2016 Elsevier Masson SAS. All rights reserved.Peer reviewe

Self-reported psychosis-like experiences in patients with mood disorders

Background: Self-reported psychosis-like experiences (PEs) may be common in patients with mood disorders, but their clinical correlates are not well known. We investigated their prevalence and relationships with self-reported symptoms of depression, mania, anxiety, borderline (BPD) and schizotypal (SPD) personality disorders among psychiatric patients with mood disorders. Methods: The Community Assessment of Psychic Experiences (CAPE-42), Mood Disorder Questionnaire (MDQ), McLean Screening Instrument (MSI), The Beck Depressive Inventory (BDI), Overall Anxiety Severity and Impairment Scale (OASIS) and Schizotypal Personality Questionnaire-Brief form (SPQ-B) were filled in by patients with mood disorders (n = 282) from specialized care. Correlation coefficients between total scores and individual items of CAPE-42 and BDI, SPQ-B, MSI and MDQ were estimated. Hierarchical multivariate regression analysis was conducted to examine factors influencing the frequency of self-reported PE. Results: PEs are common in patients with mood disorders. The "frequency of positive symptoms" score of CAPE-42 correlated strongly with total score of SPQ-B (rho = 0.63; P <0.001) and moderately with total scores of BDI, MDQ OASIS and MSI (rho varied from 0.37 to 0.56; P <0.001). Individual items of CAPE-42 correlated moderately with specific items of BDI, MDQ SPQ-B and MSI (r(phi) varied from 0.2 to 0.5; P <0.001). Symptoms of anxiety, mania or hypomania and BPD were significant predictors of the "frequency of positive symptoms" score of CAPE-42. Conclusions: Several, state- and trait-related factors may underlie self-reported PEs among mood disorder patients. These include cognitive-perceptual distortions of SPD; distrustfulness, identity disturbance, dissociative and affective symptoms of BPD; and cognitive biases related to depressive or manic symptoms. (C) 2016 Elsevier Masson SAS. All rights reserved.Peer reviewe

Self-reported symptoms of schizotypal and borderline personality disorder in patients with mood disorders

Background: Distinguishing between symptoms of schizotypal (SPD) and borderline personality disorders (BPD) is often difficult due to their partial overlap and frequent co-occurrence. We investigated correlations in self-reported symptoms of SPD and BPD in questionnaires at the levels of both total scores and individual items, examining overlapping dimensions. Methods: Two questionnaires, the McLean Screening Instrument (MSI) for BPD and the Schizotypal Personality Questionnaire Brief (SPQ-B) for SPD, were filled in by patients with mood disorders (n = 282) from specialized psychiatric care in a study of the Helsinki University Psychiatric Consortium. Correlation coefficients between total scores and individual items of the MSI and SPQ-B were estimated. Multivariate regression analysis (MRA) was conducted to examine the relationships between SPQ-B and MSI. Results: The Spearman's correlation between total scores of the MSI and SPQ-B was strong (rho = 0.616, P <0.005). Items of MSI reflecting disrupted relatedness and affective dysregulation correlated moderately (r(phi) varied between 0.2 and 0.4, P <0.005) with items of SPQ. Items of MSI reflecting behavioural dysregulation correlated only weakly with items of SPQ. In MRA, depressive symptoms, sex and MSI were significant predictors of SPQ-B score, whereas symptoms of anxiety, age and SPQ-B were significant predictors of MSI score. Conclusions: Items reflecting cognitive-perceptual distortions and affective symptoms of BPD appear to overlap with disorganized and cognitive-perceptual symptoms of SPD. Symptoms of depression may aggravate self-reported features of SPQ-B, and symptoms of anxiety features of MSI. Symptoms of behavioural dysregulation of BPD and interpersonal deficits of SPQ appear to be non-overlapping. (C) 2016 Elsevier Masson SAS. All rights reserved.Peer reviewe

Gene expression changes related to immune processes associate with cognitive endophenotypes of schizophrenia

Schizophrenia is a heterogeneous disorder characterized by a spectrum of symptoms and many different underlying causes. Thus, instead of using the broad diagnosis, intermediate phenotypes can be used to possibly decrease the underlying complexity of the disorder. Alongside the classical symptoms of delusions and hallucinations, cognitive deficits are a core feature of schizophrenia. To increase our understanding of the biological processes related to these cognitive deficits, we performed a genome-wide gene expression analysis. A battery of 14 neuropsychological tests was administered to 844 individuals from a Finnish familial schizophrenia cohort. We grouped the applied neuropsychological tests into five factors for further analysis. Cognitive endophenotypes, whole blood mRNA, genotype, and medication use data were studied from 47 individuals. Expression level of several RNA probes were significantly associated with cognitive performance. The factor representing Verbal Working Memory was associated with altered expression levels of 11 probes, of which one probe was also associated with a specific sub-measure of this factor (WMS-R Digit span backward). While, the factor Processing speed was related to one probe, which additionally associated among 55 probes with a specific sub-measure of this factor (WAIS-R Digit symbol). Two probes were associated with the measure recognition memory performance. Enrichment analysis of these differentially expressed probes highlighted immunological processes. Our findings are in line with genome-wide genetic discoveries made in schizophrenia, suggesting that immunological processes may be of biological interest for future drug design towards schizophrenia and the cognitive dysfunctions that underlie it.Peer reviewe

Paternal perinatal stress is associated with children's emotional problems at 2 years

Background: Paternal mental health in pregnancy and postpartum has been increasingly highlighted as important both in its own right, but also as crucial for the development of children. Rates of help-seeking among fathers is low, possibly due to conceptualising their own difficulties as stress rather than problems with mood. The relationship between paternal stress and child outcomes has not been investigated. Methods: This study used data from the Finnish CHILD-SLEEP birth cohort. Data were available for 901 fathers and 939 mothers who completed questionnaires on demographics, stress, anxiety and depression at 32 weeks gestation, 3 months, 8 months and 24 months postpartum. Parental report of child emotional and behavioural problems was collected at 24 months. Results: Around 7% of fathers experienced high stress (over 90% percentile) at each timepoint measured in the perinatal period, rising to 10% at 2 years postpartum. Paternal stress measured antenatally, at 3 and 24 months was associated with child total problems at 24 months, while paternal depression and anxiety were not related to child outcomes when in the same model. After adjusting for concurrent maternal depression, anxiety and stress, an association remained between paternal stress at each timepoint and child total problem scores at 24 months. The strongest association was with paternal stress at 3 months (OR 3.17; 95% CI 1.63–6.16). There were stronger relationships between paternal stress and boys' rather than girls' total problem scores, although the interactions were not statistically significant. Conclusions: Paternal stress is an important manifestation of perinatal distress and is related to child mental health, particularly when present in the early postpartum months. Paternal stress should therefore be assessed in the perinatal period, which presents opportunities for early intervention and prevention of difficulties for both father and child.publishedVersionPeer reviewe