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Objective: To identify risk factors for early‐ and late‐onset postpartum depression (PPD) among a wide range of variables, including sociodemographic characteristics, childhood trauma, stressful life events during pregnancy and history of personal and family psychiatric disorders, and to assess the contribution of each risk factor. Design: Nested case–control study in a prospective longitudinal cohort study. Setting: Eight maternity departments in the Paris metropolitan area, France. Sample: A cohort of 3310 women with deliveries between November 2011 and June 2016. Methods: Cases were women with early‐ or late‐onset PPD. Controls were women without depression during pregnancy or the postpartum period. Logistic regression adjusted on sociodemographic variables was performed for each outcome and a multivariable model was proposed based on a stepwise selection procedure. Main outcome measures: Early‐ and late‐onset PPD assessed at 2 months and 1 year postpartum, respectively. Results: Stressful life events during pregnancy have a dose–response relationship with both early‐ and late‐onset PPD. Conclusions: Early‐ and late‐onset PPD presented distinct patterns of determinants. These results have important consequences in terms of prevention and specific care. Early‐ and late‐onset postpartum depression are associated with stressful life events and psychiatric history. Early‐ and late‐onset postpartum depression are associated with stressful life events and psychiatric history. [ABSTRACT FROM AUTHOR]

Résumé Du fait d’une extension de leurs indications, les antipsychotiques sont des molécules que tout praticien est amené à prescrire ou à reconduire, tant dans des situations aiguës telles que certains troubles du comportement, que dans le traitement de troubles psychiatriques caractérisés comme les troubles psychotiques ou le trouble bipolaire. La prescription de ces molécules nécessite une évaluation précise de la balance bénéfice/risque en tenant compte des particularités propres à chaque situation clinique. En effet, les antipsychotiques sont associés à une augmentation de la morbi-mortalité du fait de leurs effets secondaires parfois sévères, principalement neurologiques (syndrome extrapyramidal, dyskinésies, akathisie), métaboliques et cardiovasculaires. D’une manière générale, les antipsychotiques de seconde génération doivent être privilégiés aux antipsychotiques de première génération du fait d’un meilleur profil de tolérance, et ce particulièrement en cas de prescription prolongée. Ainsi, la surveillance du traitement, tant de son efficacité sur les symptômes ciblés, que de sa tolérance, est essentielle dans la prise en charge de patients traités par antipsychotiques. Antipsychotics are commonly prescribed in the general population since they have many indications. They can be used in acute care such as agitation or behavior disorders, or to treat more characterized psychiatric disorders like psychotic or mood disorders. Consequently, any practitioner will have to prescribe or renew a prescription of antipsychotics. These treatments require a benefit/risk balance assessment taking into account the specific context of each patient. Indeed, antipsychotics have many side effects, mainly neurological (extrapyramidal syndrome, dyskinesia, akathisia), metabolic and cardiac. If these complications are poorly controlled, they could dramatically increase the morbidity and the mortality. Second-generation antipsychotics should be preferred to first-generation antipsychotics because of their better safety profile, especially in case of prolonged prescribing. Treatment monitoring, including effectiveness on the targeted symptoms, tolerance and observance, are major issues in the management of patients treated with antipsychotics. [ABSTRACT FROM AUTHOR]