A Prospective Cohort Study of Depression During Pregnancy and the Postpartum Period in Women With Epilepsy vs Control Groups
Assess the incidence and factors associated with major depressive episodes (MDEs) and symptoms of depression and anxiety during pregnancy and postpartum periods in pregnant women with epilepsy (PWWE) compared with healthy pregnant women (HPW) and nonpregnant women with epilepsy (NPWWE) in comparable...
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| Veröffentlicht in: | Neurology 2022-10, Vol.99 (15), p.e1573-e1583 |
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| creator | Meador, Kimford J. Stowe, Zachary N Brown, Carrie Anne Robalino, Chelsea P Matthews, Abigail G Kalayjian, Laura A Voinescu, P. Emanuela Gerard, Elizabeth E Penovich, Patricia Gedzelman, Evan Cavitt, Jennifer Pennell, Page B |
| description | Assess the incidence and factors associated with major depressive episodes (MDEs) and symptoms of depression and anxiety during pregnancy and postpartum periods in pregnant women with epilepsy (PWWE) compared with healthy pregnant women (HPW) and nonpregnant women with epilepsy (NPWWE) in comparable timeframes. Previous studies have reported higher rates of postpartum depression in women with epilepsy compared with women without epilepsy. However, the incidence of MDE using a structured interview during pregnancy and postpartum has not been directly compared with control groups, and the comparison of depression and anxiety symptoms and the role of associated factors remain ambiguous.
The Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs study is a multicenter NIH-funded prospective observational parallel group cohort study of PWWE and their children. This report examines mood disorders. Unlike previous epilepsy pregnancy studies, the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV (SCID) provided lifetime diagnoses, and repeated SCID mood modules assessed for MDE, the a priori primary outcome. Symptoms of depression (Beck Depression Inventory [BDI] and Edinburg Postnatal Depression Scale [EPDS]) and anxiety (Beck Anxiety Inventory [BAI]) were also assessed along with multiple clinical factors.
This study included PWWE (n = 331) and HPW (n = 102) during pregnancy and postpartum and NPWWE (n = 102) at comparable times. No difference in SCID-diagnosed MDE incidence was found across groups, but BDI depressive symptoms were worse during pregnancy in PWWE vs NPWWE and during postpartum vs HPW and NPWWE. BAI anxiety symptoms were worse during pregnancy in PWWE vs HPW and NPWWE and during postpartum vs HPW. Factors associated with MDE during pregnancy/postpartum for PWWE included >1 seizure/90 days, anticonvulsant polytherapy, unplanned pregnancy, and lifetime history of mood disorder. Suicidal ideation from BDI or EPDS was related to BAI anxiety symptoms.
Although SCID-based MDE did not differ across groups, this prospective study confirms higher rates of psychiatric symptoms in patients with epilepsy during pregnancy and postpartum, provides new data on associated factors, and underscores the importance of anxiety in risk for depression and thoughts of death/dying or suicide. Given the risks, PWWE should be routinely assessed and symptomatic patients should be offered treatment.
This study is regis |
| doi_str_mv | 10.1212/WNL.0000000000200958 |
| format | Article |
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The Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs study is a multicenter NIH-funded prospective observational parallel group cohort study of PWWE and their children. This report examines mood disorders. Unlike previous epilepsy pregnancy studies, the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV (SCID) provided lifetime diagnoses, and repeated SCID mood modules assessed for MDE, the a priori primary outcome. Symptoms of depression (Beck Depression Inventory [BDI] and Edinburg Postnatal Depression Scale [EPDS]) and anxiety (Beck Anxiety Inventory [BAI]) were also assessed along with multiple clinical factors.
This study included PWWE (n = 331) and HPW (n = 102) during pregnancy and postpartum and NPWWE (n = 102) at comparable times. No difference in SCID-diagnosed MDE incidence was found across groups, but BDI depressive symptoms were worse during pregnancy in PWWE vs NPWWE and during postpartum vs HPW and NPWWE. BAI anxiety symptoms were worse during pregnancy in PWWE vs HPW and NPWWE and during postpartum vs HPW. Factors associated with MDE during pregnancy/postpartum for PWWE included >1 seizure/90 days, anticonvulsant polytherapy, unplanned pregnancy, and lifetime history of mood disorder. Suicidal ideation from BDI or EPDS was related to BAI anxiety symptoms.
Although SCID-based MDE did not differ across groups, this prospective study confirms higher rates of psychiatric symptoms in patients with epilepsy during pregnancy and postpartum, provides new data on associated factors, and underscores the importance of anxiety in risk for depression and thoughts of death/dying or suicide. Given the risks, PWWE should be routinely assessed and symptomatic patients should be offered treatment.
This study is registered at ClinicalTrials.gov as NCT01730170.</description><identifier>ISSN: 0028-3878</identifier><identifier>EISSN: 1526-632X</identifier><identifier>DOI: 10.1212/WNL.0000000000200958</identifier><identifier>PMID: 35977832</identifier><language>eng</language><publisher>United States: Lippincott Williams & Wilkins</publisher><subject>Anticonvulsants ; Child ; Cohort Studies ; Control Groups ; Depression - epidemiology ; Depression, Postpartum - epidemiology ; Depressive Disorder, Major - psychology ; Epilepsy - drug therapy ; Epilepsy - epidemiology ; Female ; Humans ; Postpartum Period ; Pregnancy ; Pregnancy, Unplanned ; Prospective Studies ; Psychiatric Status Rating Scales</subject><ispartof>Neurology, 2022-10, Vol.99 (15), p.e1573-e1583</ispartof><rights>Lippincott Williams & Wilkins</rights><rights>2022 American Academy of Neurology.</rights><rights>2022 American Academy of Neurology 2022 American Academy of Neurology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4538-ad5d8a42e3b1a6d0ebdd35ae3f529b3b20642d3647c26a9de67928bc302cd2653</citedby><cites>FETCH-LOGICAL-c4538-ad5d8a42e3b1a6d0ebdd35ae3f529b3b20642d3647c26a9de67928bc302cd2653</cites><orcidid>0000-0001-5216-2018</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35977832$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Meador, Kimford J.</creatorcontrib><creatorcontrib>Stowe, Zachary N</creatorcontrib><creatorcontrib>Brown, Carrie Anne</creatorcontrib><creatorcontrib>Robalino, Chelsea P</creatorcontrib><creatorcontrib>Matthews, Abigail G</creatorcontrib><creatorcontrib>Kalayjian, Laura A</creatorcontrib><creatorcontrib>Voinescu, P. Emanuela</creatorcontrib><creatorcontrib>Gerard, Elizabeth E</creatorcontrib><creatorcontrib>Penovich, Patricia</creatorcontrib><creatorcontrib>Gedzelman, Evan</creatorcontrib><creatorcontrib>Cavitt, Jennifer</creatorcontrib><creatorcontrib>Pennell, Page B</creatorcontrib><creatorcontrib>MONEAD Investigator Group</creatorcontrib><creatorcontrib>on behalf of MONEAD Investigator Group</creatorcontrib><title>A Prospective Cohort Study of Depression During Pregnancy and the Postpartum Period in Women With Epilepsy vs Control Groups</title><title>Neurology</title><addtitle>Neurology</addtitle><description>Assess the incidence and factors associated with major depressive episodes (MDEs) and symptoms of depression and anxiety during pregnancy and postpartum periods in pregnant women with epilepsy (PWWE) compared with healthy pregnant women (HPW) and nonpregnant women with epilepsy (NPWWE) in comparable timeframes. Previous studies have reported higher rates of postpartum depression in women with epilepsy compared with women without epilepsy. However, the incidence of MDE using a structured interview during pregnancy and postpartum has not been directly compared with control groups, and the comparison of depression and anxiety symptoms and the role of associated factors remain ambiguous.
The Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs study is a multicenter NIH-funded prospective observational parallel group cohort study of PWWE and their children. This report examines mood disorders. Unlike previous epilepsy pregnancy studies, the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV (SCID) provided lifetime diagnoses, and repeated SCID mood modules assessed for MDE, the a priori primary outcome. Symptoms of depression (Beck Depression Inventory [BDI] and Edinburg Postnatal Depression Scale [EPDS]) and anxiety (Beck Anxiety Inventory [BAI]) were also assessed along with multiple clinical factors.
This study included PWWE (n = 331) and HPW (n = 102) during pregnancy and postpartum and NPWWE (n = 102) at comparable times. No difference in SCID-diagnosed MDE incidence was found across groups, but BDI depressive symptoms were worse during pregnancy in PWWE vs NPWWE and during postpartum vs HPW and NPWWE. BAI anxiety symptoms were worse during pregnancy in PWWE vs HPW and NPWWE and during postpartum vs HPW. Factors associated with MDE during pregnancy/postpartum for PWWE included >1 seizure/90 days, anticonvulsant polytherapy, unplanned pregnancy, and lifetime history of mood disorder. Suicidal ideation from BDI or EPDS was related to BAI anxiety symptoms.
Although SCID-based MDE did not differ across groups, this prospective study confirms higher rates of psychiatric symptoms in patients with epilepsy during pregnancy and postpartum, provides new data on associated factors, and underscores the importance of anxiety in risk for depression and thoughts of death/dying or suicide. Given the risks, PWWE should be routinely assessed and symptomatic patients should be offered treatment.
This study is registered at ClinicalTrials.gov as NCT01730170.</description><subject>Anticonvulsants</subject><subject>Child</subject><subject>Cohort Studies</subject><subject>Control Groups</subject><subject>Depression - epidemiology</subject><subject>Depression, Postpartum - epidemiology</subject><subject>Depressive Disorder, Major - psychology</subject><subject>Epilepsy - drug therapy</subject><subject>Epilepsy - epidemiology</subject><subject>Female</subject><subject>Humans</subject><subject>Postpartum Period</subject><subject>Pregnancy</subject><subject>Pregnancy, Unplanned</subject><subject>Prospective Studies</subject><subject>Psychiatric Status Rating Scales</subject><issn>0028-3878</issn><issn>1526-632X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkU1v1DAQhi0EokvhHyDkI5e0jh0n9gWp2pZSaQUrASo3y7FnN4YkTm1nq5X48Ri6LB9z8Eied54ZzYvQy5KclbSk57fvV2fkGJQQycUjtCg5rYua0S-P0SJ_i4KJRpygZzF-JSQXG_kUnTAum0YwukDfL_A6-DiBSW4HeOk7HxL-mGa7x36DL2EKEKPzI76cgxu3WQ3bUY9mj_VoceoAr31Mkw5pHvAagvMWuxHf-gHy61KHrybXwxT3eBczf0zB9_g6-HmKz9GTje4jvDjkU_T57dWn5bti9eH6ZnmxKkzFmSi05VboigJrS11bAq21jGtgG05ly1pK6opaVleNobWWFupGUtEaRqixtObsFL154E5zO4A1kJfQvZqCG3TYK6-d-rcyuk5t_U5JzqXkJANeHwDB380QkxpcNND3egQ_R0UbwqRo8nmztHqQmnzWGGBzHFMS9dM4lY1T_xuX2179veKx6bdTf7j3vk8Q4rd-voegOtB96n7x6rKsCikP3IIQJgT7AfiOpkQ</recordid><startdate>20221011</startdate><enddate>20221011</enddate><creator>Meador, Kimford J.</creator><creator>Stowe, Zachary N</creator><creator>Brown, Carrie Anne</creator><creator>Robalino, Chelsea P</creator><creator>Matthews, Abigail G</creator><creator>Kalayjian, Laura A</creator><creator>Voinescu, P. Emanuela</creator><creator>Gerard, Elizabeth E</creator><creator>Penovich, Patricia</creator><creator>Gedzelman, Evan</creator><creator>Cavitt, Jennifer</creator><creator>Pennell, Page B</creator><general>Lippincott Williams & Wilkins</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-5216-2018</orcidid></search><sort><creationdate>20221011</creationdate><title>A Prospective Cohort Study of Depression During Pregnancy and the Postpartum Period in Women With Epilepsy vs Control Groups</title><author>Meador, Kimford J. ; Stowe, Zachary N ; Brown, Carrie Anne ; Robalino, Chelsea P ; Matthews, Abigail G ; Kalayjian, Laura A ; Voinescu, P. 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Emanuela</creatorcontrib><creatorcontrib>Gerard, Elizabeth E</creatorcontrib><creatorcontrib>Penovich, Patricia</creatorcontrib><creatorcontrib>Gedzelman, Evan</creatorcontrib><creatorcontrib>Cavitt, Jennifer</creatorcontrib><creatorcontrib>Pennell, Page B</creatorcontrib><creatorcontrib>MONEAD Investigator Group</creatorcontrib><creatorcontrib>on behalf of MONEAD Investigator Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Meador, Kimford J.</au><au>Stowe, Zachary N</au><au>Brown, Carrie Anne</au><au>Robalino, Chelsea P</au><au>Matthews, Abigail G</au><au>Kalayjian, Laura A</au><au>Voinescu, P. Emanuela</au><au>Gerard, Elizabeth E</au><au>Penovich, Patricia</au><au>Gedzelman, Evan</au><au>Cavitt, Jennifer</au><au>Pennell, Page B</au><aucorp>MONEAD Investigator Group</aucorp><aucorp>on behalf of MONEAD Investigator Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Prospective Cohort Study of Depression During Pregnancy and the Postpartum Period in Women With Epilepsy vs Control Groups</atitle><jtitle>Neurology</jtitle><addtitle>Neurology</addtitle><date>2022-10-11</date><risdate>2022</risdate><volume>99</volume><issue>15</issue><spage>e1573</spage><epage>e1583</epage><pages>e1573-e1583</pages><issn>0028-3878</issn><eissn>1526-632X</eissn><abstract>Assess the incidence and factors associated with major depressive episodes (MDEs) and symptoms of depression and anxiety during pregnancy and postpartum periods in pregnant women with epilepsy (PWWE) compared with healthy pregnant women (HPW) and nonpregnant women with epilepsy (NPWWE) in comparable timeframes. Previous studies have reported higher rates of postpartum depression in women with epilepsy compared with women without epilepsy. However, the incidence of MDE using a structured interview during pregnancy and postpartum has not been directly compared with control groups, and the comparison of depression and anxiety symptoms and the role of associated factors remain ambiguous.
The Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs study is a multicenter NIH-funded prospective observational parallel group cohort study of PWWE and their children. This report examines mood disorders. Unlike previous epilepsy pregnancy studies, the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV (SCID) provided lifetime diagnoses, and repeated SCID mood modules assessed for MDE, the a priori primary outcome. Symptoms of depression (Beck Depression Inventory [BDI] and Edinburg Postnatal Depression Scale [EPDS]) and anxiety (Beck Anxiety Inventory [BAI]) were also assessed along with multiple clinical factors.
This study included PWWE (n = 331) and HPW (n = 102) during pregnancy and postpartum and NPWWE (n = 102) at comparable times. No difference in SCID-diagnosed MDE incidence was found across groups, but BDI depressive symptoms were worse during pregnancy in PWWE vs NPWWE and during postpartum vs HPW and NPWWE. BAI anxiety symptoms were worse during pregnancy in PWWE vs HPW and NPWWE and during postpartum vs HPW. Factors associated with MDE during pregnancy/postpartum for PWWE included >1 seizure/90 days, anticonvulsant polytherapy, unplanned pregnancy, and lifetime history of mood disorder. Suicidal ideation from BDI or EPDS was related to BAI anxiety symptoms.
Although SCID-based MDE did not differ across groups, this prospective study confirms higher rates of psychiatric symptoms in patients with epilepsy during pregnancy and postpartum, provides new data on associated factors, and underscores the importance of anxiety in risk for depression and thoughts of death/dying or suicide. Given the risks, PWWE should be routinely assessed and symptomatic patients should be offered treatment.
This study is registered at ClinicalTrials.gov as NCT01730170.</abstract><cop>United States</cop><pub>Lippincott Williams & Wilkins</pub><pmid>35977832</pmid><doi>10.1212/WNL.0000000000200958</doi><orcidid>https://orcid.org/0000-0001-5216-2018</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Neurology, 2022-10, Vol.99 (15), p.e1573-e1583 |
| issn | 0028-3878 1526-632X |
| language | eng |
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| source | MEDLINE; Alma/SFX Local Collection; Journals@Ovid Complete |
| subjects | Anticonvulsants Child Cohort Studies Control Groups Depression - epidemiology Depression, Postpartum - epidemiology Depressive Disorder, Major - psychology Epilepsy - drug therapy Epilepsy - epidemiology Female Humans Postpartum Period Pregnancy Pregnancy, Unplanned Prospective Studies Psychiatric Status Rating Scales |
| title | A Prospective Cohort Study of Depression During Pregnancy and the Postpartum Period in Women With Epilepsy vs Control Groups |
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