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Perinatal Depression: symptoms and hormones

Research output: Chapter in Book/Report/Conference proceedingChapter

Alyx Taylor, V Glover, Martin Kammerer

Original languageEnglish
Title of host publicationNew Research on Postpartum Depression
Place of PublicationNew York
PublisherNY: Nova Science Publishers
ISBN (Print)1-60021-284-0
Publication statusPublished - 2006

King's Authors

Abstract

Abstract
There is growing evidence that perinatal depression does not arise and develop in the same way for all women. We show here examples of how, for some, the symptoms start in pregnancy and resolve postpartum. For other women the symptoms are triggered by parturition itself. In a third group women experience a constant level of symptoms throughout. To enable research into the biochemical basis for these differences, the subtypes must be identified.
There is a large rise in plasma oestrogen, progesterone, corticotropic releasing hormone (CRH), and cortisol levels during pregnancy; cortisol, in late gestation, reaches levels found in Cushing’s syndrome and major melancholic depression. Upon parturition levels of all these hormones decrease rapidly. Cortisol, oestrogen and progesterone all have strong psychoactive effects, and their sudden withdrawal may contribute to mood changes. It is possible that depression that starts in pregnancy more closely resembles the melancholic type associated with hypercortisolaemia, while depression that arises postpartum shows more of the symptomatology of the atypical type. Some women experience mild bipolar II depression postpartum, a subtype also associated with atypical symptoms. Different putative factors (genetic, hormonal and social) probably play a greater or lesser part in the etiology of postnatal depression in different women. It is important to distinguish time of onset and resolution of perinatal affective disorder when investigating causal factors and symptom profile.

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