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Predictors of Depressive Relapse in Women Undergoing Infertility Treatment.
- Source :
-
Journal of women's health (2002) [J Womens Health (Larchmt)] 2018 Nov; Vol. 27 (11), pp. 1408-1414. Date of Electronic Publication: 2018 Aug 01. - Publication Year :
- 2018
-
Abstract
- Background: Despite high prevalence rates among women of mood disorders and of infertility, there is a paucity of systematic data to inform the treatment of women at risk for psychiatric morbidity in the context of assisted reproductive technologies (ART). The objective was to delineate predictors of depressive relapse in women with histories of mood disorders during ART, including the role of psychotropic medication continuation.<br />Methods: This was a prospective observational study of women undergoing ART with past diagnoses of major depressive disorder (MDD) or bipolar depression. For 6-months, follow-up included assessments of mood, perceived stress, and partner support. A subsample participated in biomarker collection. Depressive relapse was confirmed using Mini-International Neuropsychiatric Interview.<br />Results: N = 38 were evaluable. Participants with MDD (N = 25) experienced a depressive relapse rate of 44.0%. Relapse rates among antidepressant maintainers (N = 15; relapse rate = 40.0%) and antidepressant discontinuers (N = 10; relapse rate = 50.0%) were not significantly different. Among participants with bipolar disorder (N = 13), the overall relapse rate was 30.8%. Among psychotropic medication maintainers (N = 10), 40.0% relapsed, and among discontinuers (N = 3), none relapsed. Scores on the Perceived Stress Scale correlated with relapse risk (odds ratio [OR] = 1.17, 95% confidence interval [CI]: 1.08-1.26, p = 0.0065). C-reactive protein was associated with relapse (OR = 1.92, 95% CI: 1.43-2.55, p < 0.0001); blood cortisol and interleukin-6 were not.<br />Conclusions: Risk of depressive relapse among women undergoing ART is considerable. Medication continuation does not adequately confer relapse prevention. Stress and inflammation appear to contribute to risk of relapse. Additional strategies to mitigate depressive relapse in at-risk women undergoing ART are needed.
- Subjects :
- Adult
Female
Humans
Massachusetts epidemiology
Prospective Studies
Psychiatric Status Rating Scales
Recurrence
Risk Assessment
Secondary Prevention
Antidepressive Agents therapeutic use
Depressive Disorder, Major diagnosis
Depressive Disorder, Major drug therapy
Depressive Disorder, Major physiopathology
Infertility, Female psychology
Infertility, Female therapy
Reproductive Techniques, Assisted psychology
Reproductive Techniques, Assisted statistics & numerical data
Stress, Psychological diagnosis
Stress, Psychological etiology
Stress, Psychological physiopathology
Stress, Psychological prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1931-843X
- Volume :
- 27
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Journal of women's health (2002)
- Publication Type :
- Academic Journal
- Accession number :
- 30067141
- Full Text :
- https://doi.org/10.1089/jwh.2017.6878