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Perinatal mental illness: Definition, description and aetiology
Open accessAbstract
Perinatal mental illness is a significant complication of pregnancy and the postpartum period. These disorders include depression, anxiety disorders, and postpartum psychosis, which usually manifests as bipolar disorder. Perinatal depression and anxiety are common, with prevalence rates for major and minor depression up to almost 20% during pregnancy and the first 3 months postpartum. Postpartum blues are a common but lesser manifestation of postpartum affective disturbance. Perinatal psychiatric disorders impair a woman's function and are associated with suboptimal development of her offspring. Risk factors include past history of depression, anxiety, or bipolar disorder, as well psychosocial factors, such as ongoing conflict with the partner, poor social support, and ongoing stressful life events. Early symptoms of depression, anxiety, and mania can be detected through screening in pregnancy and the postpartum period. Early detection and effective management of perinatal psychiatric disorders are critical for the welfare of women and their offspring.
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In the paper
“Postpartum blues are a common but lesser manifestation of postpartum affective disturbance.”
§ Perinatal mental illness: Definition, description and aetiology > Abstract
What the sources say
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In the paper
“Prevalence estimates for perinatal depressive disorders vary considerably depending upon the definition of the disorder and the period over which prevalence is determined [9,10].”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Perinatal depression
What the sources say
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“Perinatal depression and anxiety are common, with prevalence rates for major and minor depression up to almost 20% during pregnancy and the first 3 months postpartum.”
§ Perinatal mental illness: Definition, description and aetiology > Abstract
What the sources say
- Not checked yetcites [9] Gavin, 2005, Perinatal depression: a systematic review of prevalence and incidence, Obstet Gynecol source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesThe paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“As with perinatal depression, the major risk factor for perinatal anxiety disorders is a history of anxiety disorders.”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Postpartum anxiety disorders
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“In a US study, however, only 1.9% of pregnant women met criteria for GAD [18].”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Postpartum anxiety disorders
What the sources say
- Not checked yetcites [18] Mota, 2008, The relationship between mental disorders, quality of life, and pregnancy: findings from a nationally representative sample, J Affect Disord source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“In a large-scale postpartum screening study with follow-up diagnostic evaluations [20], 66% of women with major depression in the postpartum period had comorbid anxiety disorders.”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Postpartum anxiety disorders
What the sources say
- Not checked yetcites [20] Wisner, 2013, Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings, JAMA Psychiatry source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“Women are vulnerable to affective psychoses after birth more than at any other time during their lives [28].”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Postpartum psychosis: bipolar disorder
What the sources say
- Not checked yetcites [28] Munk-Olsen, 2009, Risks and predictors of readmission for a mental disorder during the postpartum period, Arch Gen Psychiatry source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“All of these reviews and empirical studies conclude that depression is common during pregnancy and after delivery in developing and developed countries.”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Perinatal depression
Strength:boosted· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“The recognition and clinical diagnosis of bipolar disorder is by far the most important prerequisite for adequate treatment [40].”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Postpartum psychosis: bipolar disorder
What the sources say
- Not checked yetcites [40] Arvilommi, 2007, Adequacy of treatment received by diagnosed and undiagnosed patients with bipolar I and II disorders, J Clin Psychiatry source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“Women with bipolar disorder are particularly vulnerable to developing psychotic and non-psychotic episodes in the postpartum period [29,30].”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Postpartum psychosis: bipolar disorder
What the sources say
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
- It may state two separate claims as one. 31
- The quote only partly states this claim. 1
- Probably not a substantial claim. 7
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Perinatal psychiatric disorders impair a woman’s function and are associated with suboptimal development of her offspring.”
§ Perinatal mental illness: Definition, description and aetiology > Abstract
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes? Based: unclearIt may state two separate claims as one.
In the paper
“For example, the most recent quantitative review of the prevalence of perinatal depression found that the period prevalence (over the first 3 months postpartum) of depression broadly defined was 19.2%, but the prevalence of the more narrowly defined (and more severe) major depression was 7.2% [9].”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Perinatal depression
What the sources say
- Not checked yetcites [9] Gavin, 2005, Perinatal depression: a systematic review of prevalence and incidence, Obstet Gynecol source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Risk factors include past history of depression, anxiety, or bipolar disorder, as well psychosocial factors, such as ongoing conflict with the partner, poor social support, and ongoing stressful life events.”
§ Perinatal mental illness: Definition, description and aetiology > Abstract
What the sources say
- Not checked yetcites [58] O'Hara, 2013, Postpartum depression: current status and future directions, Annu Rev Clin Psychol source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“To the extent that negative biopsychosocial exposures can be diminished, eliminated, or replaced with positive factors, childbearing outcomes and the subsequent health of the mother of an offspring can be improved.”
§ Perinatal mental illness: Definition, description and aetiology > Introduction
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes? Based: unclearThe quote only partly states this claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“These disorders include depression, anxiety disorders, and postpartum psychosis, which usually manifests as bipolar disorder.”
§ Perinatal mental illness: Definition, description and aetiology > Abstract
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
In the paper
“High levels of stress and associated mental illnesses affect maternal and fetal outcomes, and also long-term offspring health into adulthood.”
§ Perinatal mental illness: Definition, description and aetiology > Introduction
What the sources say
- Not checked yetcites [6] Misra, 2003, Integrated perinatal health framework. A multiple determinants model with a life span approach, Am J Prev Med source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“The United Kingdom Confidential Enquiry into All Maternal Deaths (1997–1999) [35] revealed that 10% of postpartum deaths resulted from suicide, and 12% resulted from psychiatric causes (e.g. accidental overdose, deaths from medical conditions due to substance use, and violent”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Postpartum psychosis: bipolar disorder
What the sources say
- Not checked yetcites [35] Oates, 2003, Suicide: the leading cause of maternal death, Br J Psychiatry source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“The incidence of postpartum psychosis is one or two per 1000 births [21].”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Postpartum psychosis: bipolar disorder
What the sources say
- Not checked yetcites [21] Sit, 2006, A review of postpartum psychosis, J Womens Health (Larchmt) source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Negative mood symptoms have been found to peak between day 3 and day 5 postpartum, perhaps reflecting hormonal readjustments after delivery [49–51].”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Postpartum blues
What the sources say
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Antidepressant drug monotherapy for bipolar disorder may precipitate rapid cycling, induce mania, or increase treatment resistance [40].”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Postpartum psychosis: bipolar disorder
What the sources say
- Not checked yetcites [40] Arvilommi, 2007, Adequacy of treatment received by diagnosed and undiagnosed patients with bipolar I and II disorders, J Clin Psychiatry source
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Fisher et al. [12] reported separately on prevalence of perinatal depression in low- and middle-income countries. The mean prevalence of postpartum depression in these countries was estimated to be 19.8% (15.6% during pregnancy).”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Perinatal depression
What the sources say
- Not checked yetcites [12] Fisher, 2012, Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review, Bull World Health Organ source
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“For women with bipolar disorder, the first 30 days after birth carries a relative risk of 23.3 of having a psychiatric admission compared with women at any other period after birth, and 30–60 days after birth incurs a risk of 6.3 [29].”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Postpartum psychosis: bipolar disorder
What the sources say
- Not checked yetcites [29] Munk-Olsen, 2006, New parents and mental disorders: a population-based register study, JAMA source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“The prevalence of depression across pregnancy was estimated at 18.4% (12.7% major depression).”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Perinatal depression
What the sources say
- Not checked yetcites [9] Gavin, 2005, Perinatal depression: a systematic review of prevalence and incidence, Obstet Gynecol source
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“One of the few screening measures for bipolar disorder, and the most commonly used, is the Mood Disorders Questionnaire (MDQ) [38].”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Postpartum psychosis: bipolar disorder
What the sources say
- Not checked yetcites [38] Hirschfeld, 2000, Development and validation of a screening instrument for bipolar spectrum disorder: the Mood Disorder Questionnaire, Am J Psychiatry source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Rates of obsessive–compulsive disorder (OCD) during pregnancy ranged from 1.2% to 5.2%, and the rate was about 4.0% at 6 months postpartum.”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Postpartum anxiety disorders
What the sources say
- Not checked yetcites [19] Wenzel, 2011
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Viguera et al. [37] retrospectively compared recurrence rates and survival functions for women with bipolar disorder in two groups receiving tertiary psychiatric care treatment. One group discontinued lithium during childbearing, and the other discontinued lithium but was non-childbearing. Rates of recurrence over the first 40 weeks after lithium discontinuation were similar for pregnant (52%) and”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Postpartum psychosis: bipolar disorder
What the sources say
- Not checked yetcites [37] Viguera, 2000, Risk of recurrence of bipolar disorder in pregnant and nonpregnant women after discontinuing lithium maintenance, Am J Psychiatry source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“With panic disorder, rates ranged from 1.4% to 9.1% during pregnancy and 0.5% to 2.9% between 6 and 10 weeks postpartum.”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Postpartum anxiety disorders
What the sources say
- Not checked yetcites [19] Wenzel, 2011
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Postpartum psychosis presents rapidly after birth, with mood fluctuation, confusion, and marked cognitive impairment suggestive of delirium, bizarre behaviour, insomnia, visual and auditory hallucinations, and unusual (i.e. tactile and olfactory) hallucinations [25].”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Postpartum psychosis: bipolar disorder
What the sources say
- Not checked yetcites [25] Wisner, 1994, Symptomatology of affective and psychotic illnesses related to childbearing, J Affect Disord source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Postpartum depressions are generally independent of the blues, but the postpartum blues do represent a risk factor for postpartum depression [46].”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Postpartum blues
What the sources say
- Not checked yetcites [46] O'Hara, 1991, Prospective study of postpartum blues. Biologic and psychosocial factors, Arch Gen Psychiatry source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Given the deleterious effects of significant maternal anxiety on the developing fetus, and the way in which it complicates early parenting, the obstetrician should be as alert for anxiety symptoms as for depressive symptoms in the perinatal period.”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Postpartum anxiety disorders
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✗ Based: failsProbably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The causes of post-birth decompensation in women with bipolar disorder include genetic factors [31–33] and massive gonadal steroid withdrawal after birth in women who are neurobiologically sensitive to hormonal change [34].”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Postpartum psychosis: bipolar disorder
What the sources say
- Not checked yetcites [31] Binder, 2010, A serotonin transporter gene polymorphism predicts peripartum depressive symptoms in an at-risk psychiatric cohort, J Psychiatr Res source
- Not checked yetcites [32] Mahon, 2009, Genome-wide linkage and follow-up association study of postpartum mood symptoms, Am J Psychiatry source
- Not checked yetcites [33] Sanjuan, 2008, Mood changes after delivery: role of the serotonin transporter gene, Br J Psychiatry source
- Not checked yetcites [34] Bloch, 2000, Effects of gonadal steroids in women with a history of postpartum depression, Am J Psychiatry source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“In women with postpartum onset major depression, 57% reported obsessional thoughts of harm to their baby, and most had checking compulsions (i.e. highly repetitive night-time checking to make sure the baby is breathing) [44].”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Postpartum psychosis: bipolar disorder
What the sources say
- Not checked yetcites [44] Wisner, 1999, Obsessions and compulsions in women with postpartum depression, J Clin Psychiatry source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Finally, rates for social anxiety disorder in pregnancy ranged from 2.0% to 6.4%, and in the early postpartum period prevalence rates ranged from 0.2% to 6.5% [19].”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Postpartum anxiety disorders
What the sources say
- Not checked yetcites [19] Wenzel, 2011
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Unfortunately, no established criteria for the blues exist, although O’Hara et al. [46] adapted the work of Handley et al. [48] and proposed diagnostic criteria that led to their determination of a 26% prevalence rate.”
§ Perinatal mental illness: Definition, description and aetiology > Types of perinatal disorders > Postpartum blues
What the sources say
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Biologic factors also play a significant role in the development of perinatal mental illness.”
§ Perinatal mental illness: Definition, description and aetiology > Conclusion
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✗ Based: failsProbably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Postpartum blues are a common and less serious manifestation of affective disturbance, which emerge early in the postpartum period but have few negative sequelae.”
§ Perinatal mental illness: Definition, description and aetiology > Conclusion
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✗ Based: failsProbably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.
In the paper
“Other relevant risk factors that have smaller associations with postpartum depression include low socioeconomic status, being single, unwanted pregnancy, obstetrical stressors, and difficult infant temperament.”
§ Perinatal mental illness: Definition, description and aetiology > Causal factors > Psychological and environmental underpinnings
What the sources say
- Not checked yetcites [58] O'Hara, 2013, Postpartum depression: current status and future directions, Annu Rev Clin Psychol source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Monoamine oxidase A levels were 43% greater 4–6 days after birth; therefore, neurotransmitters are more rapidly depleted.”
§ Perinatal mental illness: Definition, description and aetiology > Causal factors > Biological underpinnings
What the sources say
- Not checked yetcites [61] Sacher, 2010, Elevated brain monoamine oxidase A binding in the early postpartum period, Arch Gen Psychiatry source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Perinatal depression, anxiety, bipolar disorder, and postpartum psychosis represent mental health problems that, in the case of depression and anxiety, are relatively common and serious, and in the case of bipolar disorder and psychosis, while relatively less common, can have devastating consequences for the mother and her family.”
§ Perinatal mental illness: Definition, description and aetiology > Conclusion
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✗ Based: failsProbably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.
In the paper
“On the basis of these reviews, risk factors with moderate to strong associations with postpartum depression include history of depression, depression and anxiety during pregnancy, neuroticism, low self-esteem, postpartum blues, stressful life events, poor marital relationship, and poor social support [58].”
§ Perinatal mental illness: Definition, description and aetiology > Causal factors > Psychological and environmental underpinnings
What the sources say
- Not checked yetcites [58] O'Hara, 2013, Postpartum depression: current status and future directions, Annu Rev Clin Psychol source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“In a landmark study, Bloch et al. [34] simulated the withdrawal of hormones at birth by inducing a hypogonadal state in women with leuprolide, adding back supraphysiologic doses of oestradiol and progesterone for 8 weeks, then withdrawing both steroids under double-blind conditions. Five of eight women with a history of postpartum depression, compared with 0 of the 8 women without a history of”
§ Perinatal mental illness: Definition, description and aetiology > Causal factors > Biological underpinnings
What the sources say
- Not checked yetcites [34] Bloch, 2000, Effects of gonadal steroids in women with a history of postpartum depression, Am J Psychiatry source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Of course, depression is common among women, and the ages at which women are most likely to have children are those at which women seem to have the highest rates of depression across the life-span [56,57].”
§ Perinatal mental illness: Definition, description and aetiology > Distinctiveness of perinatal mental illness
What the sources say
- Not checked yetcites [56] Blazer, 1994, The prevalence and distribution of major depression in a national community sample: the National Comorbidity Survey, Am J Psychiatry source
- Not checked yetcites [57] Eaton, 2012, An invariant dimensional liability model of gender differences in mental disorder prevalence: evidence from a national sample, J Abnorm Psychol source
Strength:hedged· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The data are equivocal, and most reviews have concluded that little evidence is available for increased risk of depression in the postpartum period [9,10].”
§ Perinatal mental illness: Definition, description and aetiology > Distinctiveness of perinatal mental illness
What the sources say
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“During pregnancy, the brain is exposed to a 100-fold increase in oestradiol levels, which abruptly decrease in the first few postpartum days.”
§ Perinatal mental illness: Definition, description and aetiology > Causal factors > Biological underpinnings
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source says what the claim attributes to it.
In the citing paper
“The prevalence of maternal depression therefore depends on the definition and/or the tool used to diagnose PPD.3,6–8”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [3]
The cited source says what the claim attributes to it.
In the citing paper
“Maternal PPD is prevalent, affecting up to 20 % of women within the first three months after childbirth (O'Hara and Wisner, 2014).”
From PandaMom – Feasibility and acceptability of an internet- and mobile-based intervention to enhance peripartum mental well-being and to prevent postpartum depression (2024) · cites this paper as O'Hara and Wisner, 2014
In the citing paper
“Risk factors for PND include stressful life events, history of depression, poor social support, unplanned and unwanted pregnancies, poor relationship quality, current or previous abuse, and low socioeconomic status.”
From Perinatal Depression: Challenges and Opportunities (2021) · cites this paper as [19]
In the citing paper
“Factors with smaller associations included low socioeconomic status, single marital status, unintended pregnancy, obstetrical stressors, and an infant with a difficult temperament.19”
From Perinatal Depression: Challenges and Opportunities (2021) · cites this paper as [19]
In the citing paper
“A 2014 review of the literature and existing meta-analyses revealed that the following factors have moderate to strong associations with PPD: history of depression, AND and antenatal anxiety, neurotic personality, low self-esteem, maternity blues, stressful life events, poor marital quality, and poor social support.19”
From Perinatal Depression: Challenges and Opportunities (2021) · cites this paper as [19]
Citations
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Perinatal Depression: A Systematic Review of Prevalence and Incidence
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Rates and risk of postpartum depression – a meta-analysis
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Self-citationMerikangas, K. R., Akiskal, H. S., Angst, J., Greenberg, P. E., Hirschfeld, R. M. A., Petukhova, M., & Kessler, R. C. (2007) · Archives of General Psychiatry · doi:10.1001/archpsyc.64.5.543 · Cited by 2,399
Predictors of Postpartum Depression
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Antenatal risk factors for postpartum depression: a synthesis of recent literature
Robertson, E., Grace, S., Wallington, T., & Stewart, D. E. (2004) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2004.02.006 · Cited by 1,886
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Metadata
- Authors
- O'Hara, M. W., & Wisner, K. L.
- Affiliations
- Northwestern University (US)
- ORCID
- Wisner, Katherine L.
- Venue
- Best Practice & Research Clinical Obstetrics & Gynaecology
- Publisher
- Elsevier BV
- Published
- 2014-01
- Volume
- 28
- Issue
- 1
- Pages
- 3-12
- ISSN
- 1521-6934 (ISSN-L)
- PMC
- PMC7077785
- OpenAlex
- W2071802871
- Cited by
- 986
- References
- 63
- Citations by year
- 2026: 88 · 2025: 101 · 2024: 113 · 2023: 107 · 2022: 116 · 2021: 94 · 2020: 82 · 2019: 83 · 2018: 64 · 2017: 36 · 2016: 48 · 2015: 42 · 2014: 9
- FWCI
- 4.72
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Best Practice & Research Clinical Obstetrics & Gynaecology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH071825)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy-related medical research
- Keywords
- perinatal mental disorders, perinatal depression, perinatal anxiety, postpartum psychosis, bipolar disorder, postpartum blues, etiology, risk factors, screening, maternal mental health, offspring development
- MeSH terms
- Anxiety Disorders, Bipolar Disorder, Female, Humans, Mothers, Pregnancy, Depression, Postpartum, Peripartum Period
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-09-28, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-09-28 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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