Common mental disorders and perinatal depressive symptoms: an integrative review

Silva, Bruno Pereira da; Neves, Paulo A R; Mazzaia, Maria Cristina; Gabrielloni, Maria Cristina

doi:10.1590/0034-7167-2019-0823

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Revista Brasileira de Enfermagem

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Sumário

REVIEW • Rev. Bras. Enferm. 73 (Suppl 1) • 2020 • https://doi.org/10.1590/0034-7167-2019-0823 copy

Common mental disorders and perinatal depressive symptoms: an integrative review

Trastorno mental común y síntoma depresivo perinatal: revisión integrativa

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to investigate occurrence and risk factors for common mental disorders and perinatal depressive symptoms.

Methods:

an integrative literature review using CINAHL, Embase, PubMed, PsycINFO, and LILACS, looking for studies conducted between 2014 and 2019. Data collection took place between June and July 2019. Health Sciences Descriptors (DeCS) and Medical Subject Heading (MeSH) were used in the search strategies employed in each database.

Results:

thirteen articles were included. Most studies were conducted in Brazil and with a cross-sectional design. The highest prevalence of common mental disorders (63%) and depressive symptoms (30%) were found in Brazilian studies.

Conclusion:

high frequencies were found for perinatal mental disorder, with emphasis on studies carried out in Brazil. Low socioeconomic status, being a single mother, history of mental disorder, unplanned pregnancy and multiparity were risk factors for the investigated disorders.

Descriptors:
Depression; Mental Disorders; Women’s Health; Psychiatric Status Rating Scales; Review

Database	Search strategy
CINAHL	(((MH "Pregnancy") OR TI Pregnancy OR AB Pregnancy) OR ((MH "Depression, Postpartum") OR TI ("postpartum depression" or "postnatal depression" or ppd) OR AB ("postpartum depression" or "postnatal depression" or ppd)) AND ("common mental disorder" OR "common mental disorders"))
Embase	("common mental disorder"/exp OR "common mental disorder" OR "common mental disorders") AND ("postnatal depression"/exp OR "pregnancy"/exp) AND [Embase]/lim
LILACS	tw: (("transtorno mental comum" OR "transtornos mentais comuns" OR "common mental disorder" OR "common mental disorders")) AND (instance: "regional") AND (mh: ("Gravidez" OR "Depressão Pós - Parto") AND db: ("LILACS" OR "BDENF" OR "INDEXPSI" OR "SMS-SP"))
PubMed/MEDLINE	(("common mental disorder" OR "common mental disorders")) AND ((("Pregnancy" [Mesh] OR "Pregnancy" [tiab])) OR ("Depression, Postpartum" [Mesh] OR "Depression, Postpartum" [tiab]))
PsycINFO	"COMMON MENTAL DISORDER" OR Any Field: "COMMON MENTAL DISORDERS" AND (Any Field: PREGNANCY OR Any Field: "POSTPARTUM DEPRESSION")

Author, year, country	Design	Sample	Perinatal period	Occurrence	Instruments and scores	Level of Evidence
Alvarenga, Frizzo, 2017, Brazil⁽¹⁶16 Alvarenga P, Frizzo GB. Stressful life events and women’s mental health during pregnancy and postpartum period. Paidéia (Ribeirão Preto). 2017;27(66):51-59. doi: 10.1590/1982-43272766201707 https://doi.org/10.1590/1982-43272766201... ⁾	Cohort	79	3^rd gestational trimester	63% CMD☐	SRQ-20 ≥8	III
	Cohort	79	30 days after birth	30.4% MIDS 16.5% MDS 3.8% SDS	BDI-I 12-18 MIDS 20-35 MDS ≥36 SDS	III
Aryal, et al, 2018, Nepal⁽¹⁷17 Aryal KK, Alvik A, Thapa N, Mehata S, Roka T, Thapa P, et al. Anxiety and depression among pregnant women and mothers of children under one year in Sindupalchowk District, Nepal. J Nepal Health Res Counc. 2018;16(2):195-204.⁾	Cross-sectional	164☐	Gestation☐	21% (95% CI 15,7-28.3) AS 24% (95% CI17.8-31.0) DS 14.6% (95% CI: 10.0-21.0) CMD	HSCL 25 ≥17.5 AS ≥24.5 DS	V
	Cross-sectional	567	After birth (up to 12 months)	19% (95% CI15.7-2.1) AS 15% (95% CI 12.4-18.4) DS 11.5% (95% CI: 9.1-14.4) CMD	HSCL 25 ≥17.5 AS ≥24.5 DS	V
Bekele, et al, 2017, Ethiopia⁽¹⁸18 Bekele D, Worku A, Wondimagegn D. Prevalence and associated factors of mental distress during pregnancy among antenatal care attendees at Saint Paul’s Hospital, Addis Ababa. Ob Gynecol Int J. 2017;7(6):1-7. doi: 10.15406/ogij.2017.07.00269 https://doi.org/10.15406/ogij.2017.07.00... ⁾	Cross-sectional	753	3^rd gestational trimester	26.2% (95% CI 23.04-29.36) CMD	SRQ-20 ≥6	V
Clarke, et al, 2014, Nepal⁽¹⁹19 Clarke K, Saville N, Shrestha B, Costello A, King M, Manandhar D, et al. Predictors of psychological distress among postnatal mothers in rural Nepal: a cross-sectional community-based study. J Affect Disord. 2014;156(100):76-86. doi: 10.1016/j.jad.2013.11.018. https://doi.org/10.1016/j.jad.2013.11.01... ⁾	Cross-sectional	9.078	41 days after birth	9.8% CMD	GHQ-12 ≥6	V
Estrin, et al, 2019, England⁽²⁰20 Estrin GL, Ryan EG, Trevillion K, Demilew J, Bick D, Pickles A, Howard LM. Young pregnant women and risk for mental disorders: findings from an early pregnancy cohort. BJ Psych Open. 2019;5(2):e21,1-7. doi: 10.1192/bjo.2019.6 https://doi.org/10.1192/bjo.2019.6... ⁾	Cross-sectional	488 < 25 years old☐	1^st gestational trimester	45.1% (95% CI 23.5-68,7) CMD <25 years old	SCID-I-Research Version^* * Diagnostic instrument, without scoring;	V
	Cross-sectional	57 ≥25 years old	1^st gestational trimester	15.5% (95% CI 12.0-19.8) CMD ≥25 years old		V
Filha, et al, 2016, Brazil⁽¹⁰10 Theme Filha MM, Ayers S, Gama SGN, Leal MDC. Factors associated with postpartum depressive symptomatology in Brazil: the Birth in Brazil National Research Study, 2011/2012. J Affect Disord. 2016;194:159-67. doi: 10.1016/j.jad.2016.01.020 https://doi.org/10.1016/j.jad.2016.01.02... ⁾	Cross-sectional	23.894	12 months after birth	26.3% DS☐	EPDS ≥13	V
Hain, et al, 2016, Germany⁽²¹21 Hain S, Oddo-Sommerfeld S, Bahlmann F, Louwen F, Schermelleh-Engel K. Risk and protective factors for antepartum and postpartum depression: a prospective study. J Psychosom Ob Gynecol. 2016;37(4):119-29. doi: 10.1080/0167482X.2016.1197904 https://doi.org/10.1080/0167482X.2016.11... ⁾	Cohort	297	3^rd gestational trimester	10% DS☐	BDI-V EPDS^ Score not described in the study.	III
		278	6 weeks after birth	10% DS☐
		266	20 weeks after birth	6% DS☐
Lucchese, et al, 2017, Brazil⁽²²22 Lucchese R, Simões ND, Monteiro LHB, Vera I, Fernandes IL, Castro PA, et al. Factors associated with the probability of common mental disorders in pregnant women: a cross-sectional study. Esc Anna Nery. 2017;21(3):e20160094. doi: 10.1590/2177-9465-ean-2016-0094 https://doi.org/10.1590/2177-9465-ean-20... ⁾	Cross-sectional	229	2^nd gestational trimester	51.7% (95% CI 51.7-62.6) CMD	SRQ-20 ≥7	V
MacLean, et al, 2015, Brazil⁽²³23 Maclean JV, Faisal-Cury A, Chan Y, Menezes PR, Winters A, Joseph R, et al. The relationship between sleep disturbance in pregnancy and persistent common mental disorder in the perinatal period (sleep disturbance and persistent CMD). J Ment Health. 2015;24(6):375-378. doi: 10.3109/09638237.2015.1036969 https://doi.org/10.3109/09638237.2015.10... ⁾	Cohort	831	Between 20-30 gestational weeks	36.2% CMD☐	SRQ-20 ≥8	III
	Cohort	219	11 months after birth	NPR	SRQ-20 ≥8	III
Reichenheim, et al, 2014, Brazil⁽²⁴24 Reichenheim ME, Moraes CL, Lopes CS, Lobato G. The role of intimate partner violence and other health-related social factors on postpartum common mental disorders: a survey-based structural equation modeling analysis. BMC Public Health. 2014;14:427. doi:10.1186/1471-2458-14-427 https://doi.org/10.1186/1471-2458-14-427... ⁾	Cross-sectional	810	5 months after birth	25.4% (95% CI 22.4-28.4) CMD	SRQ-20 ≥7	V
Tran, 2014, et al, Vietnan⁽²⁵25 Tran TD, Biggs BA, Tran T, Simpson JA, Mello MC, Hanieh S, et al. Perinatal common mental disorders among women and the social and emotional development of their infants in rural Vietnam. J Affect Disord. 2014;160:104-112. doi: 10.1016/j.jad.2013.12.034 https://doi.org/10.1016/j.jad.2013.12.03... ⁾	Cohort	378	12-20 gestational weeks	38.9% CMD☐	EPDS-V ≥4	III
			≥ 32 gestational weeks	28% CMD☐
			8 weeks after birth	10.8% CMD☐
			6 months after birth	12.4% CMD☐
Usuda, et al, 2016, Japan⁽²⁶26 Usuda K, Nishi D, Makino M, Tachimori H, Matsuoka Y, Sano Y, et al. Erratum to: prevalence and related factors of common mental disorders during pregnancy in Japan: a cross-sectional study. Biopsychosoc Med. 2016;10(1):26. doi: 10.1186/s13030-016-0077-1 https://doi.org/10.1186/s13030-016-0077-... ⁾	Cross-sectional	177	12-24 gestational weeks	1.1% (95% CI 0.00-0.04) DS	EPDS ≥9	V
	Cross-sectional	177	12-24 gestational weeks	6.2% (95% CI 0.03-0.11) CMD	MINI^* * Diagnostic instrument, without scoring;	V
Wikman, et al, 2019, Sweden⁽²⁷27 Wikman A, Axfors C, Iliadis S, Cox J, Fransson E, Skalkidou A. Characteristics of women with different perinatal depression trajectories. J Neurosci Res. 2019;00:1-15. doi:10.1002/jnr.24390 https://doi.org/10.1002/jnr.24390... ⁾	Cohort	1.491	Between 17-32 gestational weeks	8.5% DS☐	EPDS ≥13 gestation ≥12 after birth	III
			6 weeks after birth	10.9% DS☐
			6 months after birth	5.4% DS☐
			All trajectories☐	14.6% PDS☐

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[1] Corresponding author: Bruno Pereira da Silva. E-mail: pereira-bs@hotmail.com