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The Hormonal Environment of Postnatal Depression

Published online by Cambridge University Press:  02 January 2018

Brian Harris ,
Sandra Johns ,
Hedi Fung ,
Roger Thomas ,
Richard Walker ,
Graham Read  and
Diana Riad-Fahmy
Brian Harris*
Affiliation:
Department of Psychological Medicine, University Hospital of Wales, Cardiff
Sandra Johns
Affiliation:
Cefn Coed Hospital, Swansea
Hedi Fung
Affiliation:
King's College Hospital Group, Denmark Hill, London SE5 9RS
Roger Thomas
Affiliation:
Whitchurch Hospital, Cardiff
Richard Walker
Affiliation:
Tenovus Institute, University of Wales College of Medicine
Graham Read
Affiliation:
Tenovus Institute, University of Wales College of Medicine
Diana Riad-Fahmy
Affiliation:
Tenovus Institute, University of Wales College of Medicine, Heath Park, Cardiff
*
∗Correspondence
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Abstract

The incidence of postnatal depression is high, and dramatic changes in steroid hormones and prolactin occur in the postpartum period. In an attempt to correlate these events, 147 mothers, six to eight weeks after delivery of a healthy infant, completed standard psychological tests, including the Edinburgh, Montgomery-åsberg, and Raskin scales. They also provided matched samples of plasma for assay of cortisol, oestradiol, progesterone and prolactin, and saliva for assay of cortisol and progesterone. All steroid concentrations were within the appropriate normal ranges. Of the mothers, 14.9% were depressed on all three scales. Significant correlations were seen between depression ratings and salivary progesterone and prolactin. In bottle-feeders, salivary progesterone was positively associated with depression, whereas in breast-feeders it was negatively associated. Plasma prolactin levels were inappropriately low in depressed breast-feeders. These data indicate that differing therapies may be appropriate for depression in breast- and bottle-feeders.

Type
Papers
Information
The British Journal of Psychiatry , Volume 154 , Issue 5 , May 1989 , pp. 660 - 667
Copyright
Copyright © Royal College of Psychiatrists, 1989 

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References

Anderson, P. J. B., Hancock, K. W. & Oakey, R. E. (1985) Nonprotein bound oestradiol and progesterone in human peripheral plasma before labour and delivery. Journal of Endocrinology, 104, 7–15.CrossRefGoogle Scholar
Beck, A. T., Ward, C. H., Mendelson, M., et al (1961) An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.CrossRefGoogle ScholarPubMed
Biegon, A., Reches, A., Snyder, L., et al (1983) Serotonergic and noradrenergic receptors in the rat brain: modulation by chronic exposure to ovarian hormones. Life Sciences, 32, 2015–2021.CrossRefGoogle ScholarPubMed
Butler, J. & Leonard, B. E. (1986) Postpartum depression and the effect of nomifensine treatment. International Clinical Psychopharmacology, 1, 244–252.CrossRefGoogle ScholarPubMed
Carroll, B. J., Feinberg, M., Greden, J. F., et al (1981) A specific laboratory test for the diagnosis of melancholia. Archives of General Psychiatry, 38, 15–22.Google Scholar
Cook, N., Harris, B., Walker, R., et al (1986) Clinical utility of the dexamethasone suppression test assessed by plasma and salivary cortisol determinations. Psychiatry Research, 18, 143–150.Google Scholar
Cox, J. L., Connor, Y. & Kendell, R. E. (1982) Prospective study of the psychiatric disorders of childbirth. British Journal of Psychiatry, 140, 111–117.Google Scholar
Cox, J. L., Holden, J. M. & Sagovsky, R. (1987) Detection of postnatal depression – development of the 10 item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782–786.CrossRefGoogle ScholarPubMed
Dalton, K. (1983) Prophylactic progesterone treatment for postnatal depression. Abstracts of Marce Society Annual Meeting. London: Marce Society.Google Scholar
Darne, J., McGarrigle, H. H. G. & Lachelin, G. C. L. (1987) Increased saliva oestradiol to progesterone before idiopathic pre-term delivery, a possible predictor for pre-term labour. British Medical Journal, 294, 270–272.Google Scholar
Durber, S. M. & Daly, J. R. (1976) A simple method for the determination of free cortisol in plasma, with normal levels in men and women, incuding women taking low-oestrogen contraceptives. Clinica Chimica Acta, 68, 43–48.CrossRefGoogle Scholar
Feksi, A., Harris, B., Walker, R. F., et al (1984) “Maternity blues” and hormone levels in saliva. Journal of Affective Disorders, 6, 351–355.Google Scholar
Fung, H. Y. M., Kologlu, M., Collison, K., et al (1988) Post partum thyroid dysfunction in Mid Glamorgan. British Medical Journal, 296, 241–244.Google Scholar
Gard, P. R., Handley, S. L., Parsons, A. D., et al (1986) A multivariate investigation of postpartum mood disturbance. British Journal of Psychiatry, 148, 567–575.Google Scholar
Handley, S. L., Dunn, T. L., Waldron, G., et al (1980) Tryptophan, cortisol and puerperal mood. British Journal of Psychiatry, 136, 498–508.CrossRefGoogle ScholarPubMed
Klaiber, E. L., Broverman, D. M., Vogel, W., et al (1979) Oestrogen therapy for severe persistent depressions in women. Archives of General Psychiatry, 36, 550–554.CrossRefGoogle ScholarPubMed
Kumar, R. & Robson, K. M. (1984) A prospective study of emotional disorders in childbearing women. British Journal of Psychiatry, 144, 35–47. McEwen, B. S. & Parsons, B. (1982) Gonadal steroid action on the brain: neurochemistry and neuropharmacology. Annual Review of Pharmacology and Toxicology, 22, 555–598.Google Scholar
McEwen, B. S. & Pfaff, D. W. (1985) Hormone effects on hypothalamic neurons: analysing gene expression and neuromodulator action. Trends in Neurosciences, 8, 105–110.CrossRefGoogle Scholar
Metz, A., Stump, K., Cowen, P. J., et al (1983) Changes in platelet alpha 2-adrenoceptor and 2-adrenoceptor binding postpartum. Possible relation to maternity blues. Lancet, i, 495–498.CrossRefGoogle Scholar
Mishra, N., Hamilton, C. A., Jones, C. R., et al (1985) Adrenoceptor changes after oestrogen treatment in platelets and other tissues in female rabbits. Clinical Science, 69, 235–238.Google Scholar
Montgomery, S. A. & Åsberg, M. (1979) A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382–389.Google Scholar
Nott, P. N., Franklin, M., Armitage, C., et al (1976) Hormonal changes and mood in the puerperium. British Journal of Psychiatry, 128, 379–383.Google Scholar
Paykel, E. S., Emms, E. M., Fletcher, J., et al (1980) Life events and social support in puerperal depression. British Journal of Psychiatry, 136, 339–346.CrossRefGoogle ScholarPubMed
Pitt, B. (1968) Atypical depression following childbirth. British Journal of Psychiatry, 114, 1325–1335.Google Scholar
Railton, I. E. (1961) The use of corticoids in postpartum depression. Journal of the American Medical Women's Association, 16, 450–452.Google ScholarPubMed
Raskin, A., Schulterbrandt, J., Reatig, N., et al (1970) Differential response to chlorpromazine, imipramine and placebo. A study of subgroups of hospitalised depressed patients. Archives of General Psychiatry, 23, 164–173.CrossRefGoogle ScholarPubMed
Riad-Fahmy, D., Read, G. F., Gaskell, S. J., et al (1979) A simple direct radioimmunoassay for plasma cortisol featuring a 125I radio-ligand and a solid-phase separation technique. Clinical Chemistry, 25, 665–668.Google Scholar
Riad-Fahmy, D., Read, G. F., Walker, R. F., et al (1982) Steroids in saliva for assessing endocrine function. Endocrine Reviews, 3, 367–395.Google Scholar
Rodriguez-Sierra, J. F., Hagley, M. T. & Hendricks, S. E. (1986) Anxiolytic effects of progesterone are sexually dimorphic. Life Sciences, 38, 1841–1845.Google Scholar
Snaith, R. P., Harrop, F. M., Newby, D. A., et al (1986) Grade scores of the Montgomery-Åsberg depression and the clinical anxiety scales. British Journal of Psychiatry, 148, 599–601.Google Scholar
Vining, R. F., McGinley, R. A., Maksvytis, J. J., et al (1983) Salivary cortisol: a better measure of adrenal cortical function than serum cortisol. Annals of Clinical Biochemistry, 20, 329–335.Google Scholar
Walker, R. F., Riad-Fahmy, D. & Read, G. F. (1978) Adrenal status assessed by direct radioimmunoassay of cortisol in whole saliva or parotid fluid. Clinical Chemistry, 24, 1460–1463.CrossRefGoogle ScholarPubMed
Walker, R. F., Read, G. F. & Riad-Fahmy, D. (1979) Radioimmunoassay of progesterone in saliva: application to the assessment of ovarian function. Clinical Chemistry, 25, 2030–2032.CrossRefGoogle Scholar
Watson, J. P., Elliott, S. A., Rugg, A. J., et al (1984) Psychiatric disorder in pregnancy and the first postnatal year. British Journal of Psychiatry, 144, 453–462.CrossRefGoogle ScholarPubMed
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