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Background: Pregnancy is a unique physiological state with systemic changes including cardiovascular, autonomic, hemodynamic and psychological. Increase in incidence of stress and depression in antenatal period has been reported. Autonomic changes in pregnancy and its dysfunction in depression are well documented. However, there is lack of evidence associating cardiovascular autonomic dysfunction to stress and depressed mood in pregnant women., Methods: In this correlation study, we assessed cardiovascular autonomic functions of 172 pregnant women using heart rate variability (HRV) and baroreflex sensitivity (BRS). The Edinburg postnatal depression scale (EPDS) was used to evaluate depressive symptoms and perceived stress scale (PSS) was used to assess stress. The HRV and BRS parameters were correlated with EPDS and PSS. Multiple regression analysis was performed for EPDS and PSS individually to study their association with cardiac autonomic functions(CAF)., Results: HRV and BRS were well correlated to EPDS and PSS scores. The depression and stress were found to be significantly associated to autonomic dysfunctions as increased sympathetic and decreased parasympathetic activity. Among various CAF parameters, LF:HF ratio and BRS were found to be significantly associated with depression and stress among these women., Conclusion: LF:HF ratio and BRS may be associated with depression during antenatal period. The depression in antenatal period may add on to cardiovascular risk in expecting mothers., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background and Goals: Sleep disturbances have been noted not only during affective episodes in bipolar disorder, but also between affective episodes. The goal of this study was to assess and identify determinants of sleep quality in patients with bipolar I disorder., Methods: This cross-sectional study enrolled patients with bipolar disorder who were currently in remission. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Mood symptoms were evaluated using the Young Mania Rating Scale (YMRS) and the Hamilton Depression Rating Scale (Ham-D). Adherence was assessed using the Medication Adherence Rating Scale., Results: The mean age in the sample (N=103) was 37.4 years; 44.7% of the sample were men. On the basis of PSQI scores, 41 patients (39.8%) were poor sleepers. Poor sleepers had significantly higher Ham-D scores (mean score of 1.8 vs. 0.9, P=0.012) and higher rates of medication nonadherence (36.6% vs. 11.3%, P=0.002). The relationship between Ham-D scores and sleep quality did not remain significant when the sleep-related items on the Ham-D were removed. Logistic regression analysis suggested that medication nonadherence was the only independent predictor of poor sleep quality in this study., Conclusions: A significant proportion of patients with bipolar disorder who are in remission have sleep problems that seem to be independent of core symptoms of depression.

Introduction: Dhat syndrome is a condition described in the Indian subcontinent, in which patients present with concerns about loss of semen. Though this condition has been conceptualized as a culture-bound syndrome, some authors have also considered it a manifestation of depression. This calls for a closer examination of the possible genetic link between Dhat syndrome and depression., Method: We examined the relationship between Dhat syndrome and the depressive spectrum, as conceptualized by Winokur, using a retrospective design. The case records of 46 patients with Dhat syndrome were reviewed, and patients were divided into two groups - family history positive (FH+) and family history negative (FH-) - based on the presence of depressive spectrum conditions in first degree relatives. These two groups were compared in terms of demographic variables, symptom profile and comorbidity., Results: The FH+ group had significantly higher rates of depressive disorders and substance use disorders (alcohol and nicotine dependence). They were also more likely to report concerns about penile size., Discussion: These results suggest that a subgroup of patients with the Dhat syndrome can be viewed as suffering from a depressive spectrum disorder. Dhat syndrome may be better understood as a heterogeneous group than as a single diagnostic entity. Identifying such sub-groups can help in choosing optimal treatments for patients with Dhat syndrome, such as selecting antidepressants for the group described in this study., (Copyright © 2014 Elsevier B.V. All rights reserved.)

: To assess the incidence of postpartum depression, maternal confidence about parenting and maternal–infant bonding characteristics in first-time mothers. : First-time mothers are usually unprepared for the transition into motherhood and may find it difficult to cope-up with this challenge leading to parenting stress, maternal–infant bonding disorders, and mental health problems. : This cross-sectional study was conducted in a tertiary centre in South India, on 151 primigravid mothers who delivered a live-born healthy infant after 37 weeks' gestation. Assessment was done using Patient Health Questionnaire scale, Tamil version of the Postpartum Bonding Questionnaire and Maternal Confidence Questionnaire on the 2nd or 3rd postpartum day. : Incidence of postpartum depression was found to be 18.5%, with 6% having features of severe depression. All mothers had good perceived maternal confidence. Nearly one-third had one or more of the maternal–infant bonding disorders. Those who had a vaginal delivery were associated with bonding disorders (OR = 10.3; 95% CI 2.13–47.21) whereas moderate to severe postpartum depression was not associated with it on multivariate analysis. : First-time mothers were found to have good confidence in the transition to motherhood. However, the high incidence of maternal–infant bonding difficulty, especially in those with moderate to severe depression, suggests the need for initiating systematic and routine screening for postpartum mental health problems. [ABSTRACT FROM AUTHOR]

Objective: To assess the incidence of postpartum depression (PPD) and its risk factors in women with potentially life‐threatening complications. Methods: Eight hundred and ninety women admitted to a tertiary center in South India with potentially life‐threatening complications were recruited for the study. Within seven days of delivery, women underwent mental health assessments using the EPDS and PHQ‐9 scale. Counseling was provided and follow‐up assessment carried out at 3 months postpartum. Bivariate and multivariate analysis was done to assess the association of risk factors to depression. Results: PPD was observed in 21% of the study cohort. Women with no formal education (OR −2.66, 95% CI: 1.10– 6.40) and those who had a stillbirth (OR 2.48, 95%CI: 1.57–3.93) were found to be associated with PPD after adjusting for other factors. Occurrence of an obstetric near‐miss event did not increase the risk of depression. Most women recovered with postnatal counseling, with only three requiring medication at the end of 3 months. Conclusion: One in five women who develop potentially life‐threatening complications developed PPD. A strategy of screening focused on this high‐risk group, especially in low resource settings, can lead to early recognition and treatment. This in turn can lead to a reduction in the long‐term morbidity associated with PPD. Synopsis: Screening for postpartum depression among women who develop potentially life‐threatening complications during pregnancy and postpartum can be an effective strategy, especially in low resource settings. [ABSTRACT FROM AUTHOR]