Mothers with breastfeeding difficulties more likely to suffer postpartum depression, study finds

ScienceDaily (July 19, 2011) — Women who have breastfeeding difficulties in the first two weeks after giving birth are more likely to suffer postpartum depression two months later compared to women without such difficulties.

For that reason, women with breastfeeding difficulties should be screened for depressive symptoms, according to a new study by researchers at the University of North Carolina at Chapel Hill.

"We found that women who said they disliked breastfeeding were 42 percent more likely to experience postpartum depression at two months compared to women who liked breastfeeding. We also found that women with severe breast pain at day one and also at two weeks postpartum were twice as likely to be depressed compared to women that did not experience pain with nursing," said Stephanie Watkins, MSPH, MSPT, lead author of the study and a doctoral student in the UNC Gillings School of Global Public Health.

The idea for the study, published online ahead of print by the journal Obstetrics & Gynecology, grew from the clinical experience of senior author, Alison Stuebe, MD, an assistant professor in the Department of Obstetrics and Gynecology in the UNC School of Medicine.

"We found that very commonly the same moms who were struggling with breastfeeding were also depressed," she said. "There was a tremendous clinical overlap."

In the study, Stuebe, Watkins and UNC co-authors Samantha Meltzer-Brody, MD, MPH and Denniz Zolnoun, MD, MPH, set out to determine if this anecdotal association would be backed up by statistical analysis of relevant data. For this purpose, they used data collected as part of the Infant Feeding and Practices Study II, and assessed the postpartum depression status of the 2,586 women in that study with the Edinburgh Postnatal Depression Scale.

Of those women, 8.6 percent met the criteria for major depression two months after giving birth. Women who reported disliking breastfeeding during the first week were 1.42 times as likely to be depressed at two months. Women who reported severe breastfeeding pain on their first day were 1.96 times as likely to be depressed at two months.

For health care providers, this study shows that mothers with breastfeeding difficulties should be screened for depression and referred to counseling when depression is confirmed. But the study also provides a message for mothers, Stuebe said.

"If they're struggling with breastfeeding, they should seek help and tell their provider. If they don't have joy in their life, if they wake up in the morning and think, 'I just can't do this another day' -- that's a medical emergency. They shouldn't just say, 'I'm going to power through this and snap out of it.' They should call their provider and say, 'I just don't feel right, I'm wondering if I could be depressed, can I come in and talk to you about it?' "

The study is scheduled for publication in the August 2011 print issue of the journal.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of North Carolina School of Medicine.

Journal Reference:

Stephanie Watkins, Samantha Meltzer-Brody, Denniz Zolnoun, Alison Stuebe. Early Breastfeeding Experiences and Postpartum Depression. Obstetrics & Gynecology, 2011; DOI: 10.1097/AOG.0b013e3182260a2d

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here sciencedaily.com

Mothers with breastfeeding difficulties more likely to suffer postpartum depression, study finds

ScienceDaily (July 19, 2011) — Women who have breastfeeding difficulties in the first two weeks after giving birth are more likely to suffer postpartum depression two months later compared to women without such difficulties.

For that reason, women with breastfeeding difficulties should be screened for depressive symptoms, according to a new study by researchers at the University of North Carolina at Chapel Hill.

"We found that women who said they disliked breastfeeding were 42 percent more likely to experience postpartum depression at two months compared to women who liked breastfeeding. We also found that women with severe breast pain at day one and also at two weeks postpartum were twice as likely to be depressed compared to women that did not experience pain with nursing," said Stephanie Watkins, MSPH, MSPT, lead author of the study and a doctoral student in the UNC Gillings School of Global Public Health.

The idea for the study, published online ahead of print by the journal Obstetrics & Gynecology, grew from the clinical experience of senior author, Alison Stuebe, MD, an assistant professor in the Department of Obstetrics and Gynecology in the UNC School of Medicine.

"We found that very commonly the same moms who were struggling with breastfeeding were also depressed," she said. "There was a tremendous clinical overlap."

In the study, Stuebe, Watkins and UNC co-authors Samantha Meltzer-Brody, MD, MPH and Denniz Zolnoun, MD, MPH, set out to determine if this anecdotal association would be backed up by statistical analysis of relevant data. For this purpose, they used data collected as part of the Infant Feeding and Practices Study II, and assessed the postpartum depression status of the 2,586 women in that study with the Edinburgh Postnatal Depression Scale.

Of those women, 8.6 percent met the criteria for major depression two months after giving birth. Women who reported disliking breastfeeding during the first week were 1.42 times as likely to be depressed at two months. Women who reported severe breastfeeding pain on their first day were 1.96 times as likely to be depressed at two months.

For health care providers, this study shows that mothers with breastfeeding difficulties should be screened for depression and referred to counseling when depression is confirmed. But the study also provides a message for mothers, Stuebe said.

"If they're struggling with breastfeeding, they should seek help and tell their provider. If they don't have joy in their life, if they wake up in the morning and think, 'I just can't do this another day' -- that's a medical emergency. They shouldn't just say, 'I'm going to power through this and snap out of it.' They should call their provider and say, 'I just don't feel right, I'm wondering if I could be depressed, can I come in and talk to you about it?' "

The study is scheduled for publication in the August 2011 print issue of the journal.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of North Carolina School of Medicine.

Journal Reference:

Stephanie Watkins, Samantha Meltzer-Brody, Denniz Zolnoun, Alison Stuebe. Early Breastfeeding Experiences and Postpartum Depression. Obstetrics & Gynecology, 2011; DOI: 10.1097/AOG.0b013e3182260a2d

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here

Patients who use anti-depressants are more likely to suffer relapse, researcher finds

ScienceDaily (July 19, 2011) — Patients who use anti-depressants are much more likely to suffer relapses of major depression than those who use no medication at all, concludes a McMaster researcher.

In a paper that is likely to ignite new controversy in the hotly debated field of depression and medication, evolutionary psychologist Paul Andrews concludes that patients who have used anti-depressant medications can be nearly twice as susceptible to future episodes of major depression.

Andrews, an assistant professor in the Department of Psychology, Neuroscience & Behaviour, is the lead author of a new paper in the journal Frontiers of Psychology.

The meta-analysis suggests that people who have not been taking any medication are at a 25 per cent risk of relapse, compared to 42 per cent or higher for those who have taken and gone off an anti-depressant.

Andrews and his colleagues studied dozens of previously published studies to compare outcomes for patients who used anti-depressants compared to those who used placebos.

They analyzed research on subjects who started on medications and were switched to placebos, subjects who were administered placebos throughout their treatment, and subjects who continued to take medication throughout their course of treatment.

Andrews says anti-depressants interfere with the brain's natural self-regulation of serotonin and other neurotransmitters, and that the brain can overcorrect once medication is suspended, triggering new depression.

Though there are several forms of anti-depressants, all of them disturb the brain's natural regulatory mechanisms, which he compares to putting a weight on a spring. The brain, like the spring, pushes back against the weight. Going off antidepressant drugs is like removing the weight from the spring, leaving the person at increased risk of depression when the brain, like the compressed spring, shoots out before retracting to its resting state.

"We found that the more these drugs affect serotonin and other neurotransmitters in your brain -- and that's what they're supposed to do -- the greater your risk of relapse once you stop taking them," Andrews says. "All these drugs do reduce symptoms, probably to some degree, in the short-term. The trick is what happens in the long term. Our results suggest that when you try to go off the drugs, depression will bounce back. This can leave people stuck in a cycle where they need to keep taking anti-depressants to prevent a return of symptoms."

Andrews believes depression may actually be a natural and beneficial -- though painful -- state in which the brain is working to cope with stress.

"There's a lot of debate about whether or not depression is truly a disorder, as most clinicians and the majority of the psychiatric establishment believe, or whether it's an evolved adaptation that does something useful," he says.

Longitudinal studies cited in the paper show that more than 40 per cent of the population may experience major depression at some point in their lives.

Most depressive episodes are triggered by traumatic events such as the death of a loved one, the end of a relationship or the loss of a job. Andrews says the brain may blunt other functions such as appetite, sex drive, sleep and social connectivity, to focus its effort on coping with the traumatic event.

Just as the body uses fever to fight infection, he believes the brain may also be using depression to fight unusual stress.

Not every case is the same, and severe cases can reach the point where they are clearly not beneficial, he emphasizes.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by McMaster University.

Journal Reference:

Michael C. Neale, Charles O. Gardner, Lisa J. Halberstadt, Susan G. Kornstein, Paul W. Andrews. Blue Again: Perturbational Effects of Antidepressants Suggest Monoaminergic Homeostasis in Major Depression. Frontiers in Psychology, 2011; 2 DOI: 10.3389/fpsyg.2011.00159

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

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More men with migraine suffer from PTSD than women, study finds

ScienceDaily (June 6, 2011) — A recently published paper highlights that while the risk of post-traumatic stress disorder (PTSD) is more common in those with migraine than those without migraine irrespective of sex, the risk is greater in male migraineurs than female migraineurs.

Study details are now available in Headache: The Journal of Head and Face Pain, published by Wiley-Blackwell on behalf of the American Headache Society.

In this paper, lead author B. Lee Peterlin and colleagues review the epidemiology of PTSD and migraine, underscoring the established sex differences. While individually both migraine and PTSD are more common in women than men, a recent study by Peterlin and colleagues -- the only study to date to look at sex differences in the PTSD-migraine association -- suggests that men with migraines had up to a four-fold greater odds of PTSD than females who experience migraine headaches. This finding suggests that sex hormones play an important role in the PTSD-migraine association.

The age of the traumatic life event resulting in PTSD may also be an important factor for the sex differences in the PTSD-migraine association. When a traumatic life event occurs before 13 years of age, the risk of depression is greater than the risk of PTSD; however, when the traumatic life event occurs after 12 years of age, the risk of PTSD is greater.37 Although the migraine population has a documented high prevalence of abuse, the peak age of vulnerability for childhood sexual abuse, is under 13 years of age. In contrast transportation accidents and combat, (two of the most common traumatic events reported by migraineurs with PTSD in one study), may be more commonly experienced by those older than 12 years of age. It is therefore possible that in the migraine population, sex differences in the type and age of traumatization contributes to the sex differences in the risk of PTSD.

Studies have also shown that the presence of PTSD in those with migraine is associated with greater headache-related disability than in migraine sufferers without PTSD. Dr. Peterlin explains, "The current data indicate that behavioral PTSD treatment alone can positively influence chronic pain conditions and disability. Therefore, physicians should consider screening migraine sufferers for PTSD, and men in particular. Further, in those migraineurs with PTSD, behavioral therapy should be considered, alone or in combination with pharmacological treatment." The authors suggest that further research investigating the sex differences in the association between PTSD and migraine is necessary to validate the sex differences found in their study, as well as to determine suitable treatment options in those migraineurs suffering with PTSD.

A second related article published this month in Headache also reviews sex and gender differences in those with headache. Todd Smitherman, PhD, from the University of Mississippi and Thomas Ward, MD, of the Dartmouth Medical School in New Hampshire reviewed extant medical literature to examine the psychosocial factors of gender and social role expectations, and coping strategies as they relate to sex and gender differences in headache pain.

A distinction was made in this paper between sex -- the biologically-based indicators of male or female; and gender -- "the traits and behaviors characteristic of and appropriate to members of each sexual category" (Unger, 1976) given that pain-related differences between men and women established in the medical literature cannot be reduced solely to biological determinants.

The authors suggest that women's pain experiences, multiple role responsibilities, and coping strategies likely influence the sex and gender differences in pain perception and response. "Gender-based differences are not strictly biological and important psychosocial issues are involved with headache pain as well," Dr. Smitherman concluded. "Further research of the impact of sex and gender on psychosocial variables may help clinicians tailor treatment plans that reduce pain and disability for headache patients."

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Wiley-Blackwell, via AlphaGalileo.

Journal References:

B. Lee Peterlin, Satnam S. Nijjar, Gretchen E. Tietjen. Post-Traumatic Stress Disorder and Migraine: Epidemiology, Sex Differences, and Potential Mechanisms. Headache: The Journal of Head and Face Pain, 2011; DOI: 10.1111/j.1526-4610.2011.01907.xTodd A. Smitherman, Thomas N. Ward. Psychosocial Factors of Relevance to Sex and Gender Studies in Headache. Headache: The Journal of Head and Face Pain, 2011; DOI: 10.1111/j.1526-4610.2011.01919.x

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here