Depression and anxiety in perinatal period: prevalence and risk factors in an Italian sample.

Accumulating evidence suggests that pregnancy does not protect women from mental illness. The aim of this study was to assess the prevalence, sociodemographic correlates, and the risks factors for perinatal depression and anxiety. Five hundred ninety women between 28th and the 32nd gestational weeks were recruited and submitted to a sociodemographic, obstetric, and psychological interview. The Edinburgh Postnatal Depression Scale (EPDS) and the state-trait anxiety inventory (STAI-Y) were also administered in antenatal period and 3 months postnatally. The Structured Clinical Interview for DSM-IV (SCID-I) was used to diagnose mood and anxiety disorders. Three months after delivery, EPDS was administered by telephone interview. Women with an EPDS score ≥10 were 129 in antenatal period (21.9%) and 78 in postnatal period (13.2%). During pregnancy 121 women (20.5%) were positive for STAI-Y state and 149 women (25.3%) for STAI-Y trait. The most important risk factors for antenatal depression are: foreign nationality, conflictual relationship with family and partner, and lifetime psychiatric disorders. The principal risk factors for postnatal depression are: psychiatric disorders during pregnancy and artificial reproductive techniques. Psychiatric disorders, during and preceding pregnancy, are the strongest risk factors for antenatal state and trait anxiety. Antenatal depressive and anxiety symptoms appear to be as common as postnatal symptoms. These results provide clinical direction suggesting that early identification and treatment of perinatal affective disorders is particularly relevant to avoid more serious consequences for mothers and child.

Eating attitudes and behavior throughout the menstrual cycle in obese women: a case-control study.

Premenstrual variations of eating behavior are reported in several studies, but their relationship with mood is unclear. Eating behavior and physical and psychological complaints during the menstrual cycle were studied in 107 obese patients and 93 matched controls using retrospective (Weekly Bulimic Test Edinburgh, W-BITE and Premenstrual Assessment Form, PAF) and prospective (Daily Rating Form, DR) questionnaires. Eating disorder symptoms increased in the premenstrual phase, as shown by the W-BITE scores both in patients (6.2 +/- 5.3 premenstrual week vs 4.9 +/- 4.4 postmenstrual week, p < 0.05) and in control subjects (4.9 +/- 4.1 premenstrual week vs 4.2 +/- 3.0 postmenstrual week, p < 0.05) and were correlated to premenstrual complaints in control subjects (r = 0.5; p < 0.05) but not in obese women (r = 0.2; p = NS). A close relationship between physical and psychological premenstrual disturbances was observed in obese patients only. Premenstrual variation of eating behavior could be the target of specific treatment.

[Mood changes and premenstrual syndrome]. / Modificazioni timiche e sindrome premestruale.

The Authors consider particularly significant the studies on premenstrual syndrome (PMS) which point out a relationship between affective disorders and premenstrual depression indicated by several Authors as useful pattern for studying depression. Considering this results, the Authors studied a sample of women suffering from PMS sharing it on the basis of subjective depressive feelings. The Authors obtained two groups which were submitted to a further clinical study in order to point out specific personality and psychopathologies. The Authors used the Premenstrual Assessment Form (PAF) and the Daily Ratings Form (DR). The results showed that premenstrual depression can be considered a marker of the seriousness of the syndrome and it is closely linked to anxiety symptomatology. In women with PMS the Authors did not point out important psychopathological aspects, therefore the PMS is not evidence for psychiatric illness.

Epidemiology of anxiety disorders in Florence.

A structured interview designed to diagnose anxiety disorders according to DSM-III (plus infrequent panic attacks and generalized anxiety disorder using DSM-III-R criteria) was given to 1110 people registered with 6 general practitioners (GPs), whether they consulted the doctor or not. As each citizen in Italy has to be registered with a GP, the sample was representative of the population. The interviews were carried out by the GPs, who were also third- or fourth-year trainees in psychiatry. The lifetime prevalence and point prevalence were: 0.36% and 0.27% for agoraphobia; 0.90% and 0.72% for agoraphobia with panic; 1.35% and 0.27% for panic disorder; 0.63% and 0.45% for simple phobia; 0.49% and 45% for social phobia, 5.41% and 2.79% for generalized anxiety disorder; and 0.72% and 0.63% for obsessive-compulsive disorder. These figures are lower than those reported in other surveys; possible explanations may be the use of a hierarchical diagnostic model and the fact that diagnosticians were psychiatrists instead of lay interviewers as in most studies in the United States. On the whole, 62% of anxiety cases consult a GP, 50% consult a psychiatrist and 7% are hospitalized.