The comorbidity of anxiety and depression symptoms during pregnancy trimesters Justyna Morylowska-Topolska 1, Marta Makara- 2

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1 ORIGINAL PAPER The comorbidity of anxiety and depression symptoms during pregnancy trimesters Justyna Morylowska-Topolska 1, Marta Makara- 2 1 Katedra i Klinika Psychiatrii, Uniwersytet Medyczny, Lublin 2 Samodzielna Pracownia Zdrowia Psychicznego, Uniwersytet Medyczny, Lublin Cel pracy. e badanymi parametrami wykonano z wykorzystaniem ecim i no tanu o- w trzecim trymestrze. o- i depr niepra The scientific aim of this work was the assessment of anxiety and depressive symptoms in particular pregnancy trimesters and the analysis of different types of anxiety: anxiety as a state and anxiety as a trait. Material and methods. The research was conducted in gynecologic-obstetric clinics in the area of Lublin and Mazovian provinces from January 2011 to May It was longitudinal prospective trial. Each woman was examined three times: during first, second and third questionnaire of own construction, utive trimesters, women were given a set of questionnaires for filling in and they returned them at next visit. The examined group consisted of 314 pregwomen. dard deviation, median, minimal and maxim the following nonparametric tests were used: U Mann-Whitney test and ANOVA of Kruskal-Wallis. The analysis of mutual correlation between examined parameters was performed using the Spearman range correlation test. Five percent Results Anxiety symptoms in the first trimester of pregnancy were experienced by of respondents, in the second trimester by, in the third by. ymptoms occurred less frequently, and so: in the first trimester in in the Copyright 2012 Medical University of Lublin

o- i depr niepra The scientific aim of this work was the assessment of anxiety and depressive symptoms in particular pregnancy trimesters and the analysis of different types of anxiety: anxiety as a

2 232 J. Morylowska-Topolska, M. Makara- second in in the third- in the women. At least once the symptoms of anxiety were experienced by the respondents, depressive symptoms - by Percentages of the women, in whom anxiety and depressive symptoms coexisted in different trimesters, amounted to the respondents in the firstand 12.4trimester of pregnancy. Anxiety symptoms were present in in all trimesters of pregnancy, and in in the two trimesters. For depression, these percentages were respectively. The relation between the severity of symptoms of anxiety and depression severity in different trimesters was confirmed, but this relationship was stronger in the first and third trimester than in the second trimester. scales (anxiety as a state and as a trait) of the Inventory of State and Trait Anxiety correlated with the severity of symptoms of hospital anxiety and depression scale (Anxiety as a state most strongly correlated with symptoms of anxiety in the third trimester and with depression in the first trimester. Anxiety as a trait most strongly correlated with symptoms of anxiety and depression in the third trimester. Conclusions Introducing of screening tests regarding anxiety and depression during pregnancy, conducted systematically during this period, creates possibility for earlier diagnosis and quicker provision of appropriate interventions. Earlier diagnosis and appropriate interventions in case of anxiety and depression development during pregnancy creates a possibility of preventing their effects, such as postpartum depression and disturbed psychophysical development of child. : anxiety, depression, pregnancy a- e- o- y Nowsze badania, opublikowane po roku 2000 do- y- o- c- o- ogicznym dystresem u matki w okresie o- i- e i e- a- i d- a rel - o b- zna czy zesp - o- k- y w- powo o- b- cecha). ogiczno- mazowieckim w okresie od stycznia 201 i- o- w- - i- w- kontrolnych w gabinecie ginekologiczno- i- i Cechy Laficzny. a-

trimesters, amounted to the respondents in the firstand 12.4trimester of pregnancy. Anxiety symptoms were present in in all trimesters of pregnancy, and in in the two trimesters.

3 233 akt ewag a- u podskali od pkt. 21 za In Trait Anxiety Inventory (STAI) opracowanego w przez erger, Strelau, Tysarczyk a- stan) o- (lek dskala X- X-2 do ba w podskali X- teraz, w tym momencie, a w podskali X- k wynikami uzyskanymi w obu ska- owych na steny. Kwestionariusz demograficzno epidemiologicz- zamieszka w- z- psychicznych. cz e- y- u ego 314 kobiet. Uzyskane wyniki poddano analizie staty- i Analizy statystyczne przeprowadzono w oparciu o- o- dodatni wynik w podskali la- kobiet wy tryme dla pierw a kowych o- a- r- anych nie de y-

teraz, w tym momencie, a w podskali X- k wynikami uzyskanymi w obu ska- owych na steny.

4 234 J. Morylowska-Topolska, M. Makara- badanych y- tryme trymestrach. Wyso w pierwszym trymestrze (3 w pierw tryme w po ugiego trymestru Zmienna (X-1) (X-2) N liczba badanych Wynik I trymestr II trymestr III trymestr N N N niski ,3 41, , , ,4 wysoki 20,1 niski ,2 111 wysoki 40 12, ,1 -e 1 estrze estrze estrze a- depresynych w poszc Stwierdzono istotne statystycznie dodatnie korela a- ecim trymestrze (Tabela II). ami uzyska zedstawiona w Tabelach III i IV. Stwierdzono istotne statystycznie dodatnie kore- w pierwszym trymestrze, drugim i trzecim trymestrze. obserwowano w trzecim trymestrze. e- a w pierwszym trymestrze (Tabela III).

41,1 121 41,1 133 42,3 130 41,4 wysoki 20,1 niski 173 173 101 32,2 111 wysoki 40 12,7 30 12,1 -e 1 estrze estrze estrze a- depresynych w poszc Stwierdzono istotne

5 -Spearmana -1 (L-e- w I trymestrze w II trymestrze w III trymestrze 0,47 0,70 estrze estrze 0,41 estrze 0, - -2 (L-ych trymestrach w I trymestrze w II trymestrze w III trymestrze 0,70 0,42 estrze estrze ymestrze 0,43 Stwierdzono istotne statystycznie dodatnie ko- i wyni hy Inwentarza STAI w pierwszym trymestrze, drugim i trzecim trymestrze. obserwowano w pierwszym trymestrze (Tabela IV). dzono do niedawna, hroni kobiet przed za- h- ego w- zabu niedo dono orodo a- aniu e- cze- e ikami a- o i- W tamtym badaniu, przeprowadzonym w 2007 roku, a-

hy Inwentarza STAI w pierwszym trymestrze, drugim i trzecim trymestrze. obserwowano w pierwszym trymestrze (Tabela IV).

6 J. Morylowska-Topolska, M. Makara- nia de (2,2-u- - e- u e- a- h metod diagnostycznych, o czym d w danym trymestr a- e- o- e- a a- e- o n- o- e- a- a o- ystkich trymestrach. Przy czym e- trymestrze. Obie podskale Inwentarza Stanu i Cechy a i- midzy innymi Field i wsp. (2002), Sutter- o- e- 1. z- s owania. 2. o- e- raz cka. 1.epression: 2. epression during pregnancy following antidepressant discontinuation: a preliminary prospective study. Arch ptoms during pregnancy and low birth weight at term: longitu- 4. Alder J., Fink N., et al. iety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. J Matern Fetal Neonatal Med Field T.,., -Reif M. et al. Chronic prenatal depression and neonatal outcome. Int J Neurosci rmedi 7. anie atycz

epression during pregnancy following antidepressant discontinuation: a preliminary prospective study. Arch 221. 3. ptoms during pregnancy and low birth weight at term: longitu- 4. Alder J., Fink N.

7 237 ogicznych, gnancy 10. ssion during pregnancy and the puerperium. Arch Gen Psy- 11. epressive symptoms in late pregnancy and postpartum. 12. atal outcomes in offspring of women with anxiety and depres- 13. Lee AM., Keung Lam S., Sze Mun Lau SM. et al. Prevalence, Course Risk Factors for Antenatal Anxiety and ssion, Obstet. Gnecolo alence of depression during pregnancy: systematic review. Obstet ptoms among pregnant women screened in obstetrics -Reif M. Prenatal depression effects on the foetus and neonate in different ethnic and socio-economic status groups. J Repr Inf Psychology 2002,20: 17. Sutter- Giaconne-Marcesche V., Glatigny et al. Women with anxiety disorders during pregnancy are at increased risk of intense postnatal depressive symptoms: A prospective survey of the MAT- Eur Psychiatry 2004; Justyna Morylowska-Topolska Klinika Psychiatrii UM w Lublinie -442

14. alence of depression during pregnancy: systematic review. Obstet ptoms among pregnant women screened in obstetrics -Reif M.

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