Online Program

Lifetime substance use and postpartum mental health

Tuesday, November 3, 2015

Betty-Shannon Prevatt, MA, Department of Psychology, North Carolina State University, Raleigh, NC
Sarah Desmarais, Ph.D., Department of Psychology, North Carolina State University, Raleigh, NC
Patti Janssen, PhD, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
background: Approximately 10-20% of women experience postpartum mood disorders (PPMD) (CDC, 2008). Unfortunately, only about 25% of women receive treatment, in part due to underdetection (Goodman & Tyer-Viola, 2010). Lifetime substance use has received limited attention in screening for PPMD, despite being a robust predictor of mood disorders in other populations (Regier, et al., 1990). The present study examined the contributions of lifetime substance use to the prediction of PPMD.

method: One hundred women participated in semi-structured interviews within 3 months postpartum. In addition to reporting on their sociodemographic characteristics and history of mental health problems, women completed instruments assessing their overall postpartum mood and symptoms of anxiety, stress, posttraumatic stress disorder (PTSD), depression, obsessive-compulsive disorder (OCD), and lifetime alcohol and drug use.

results: Hierarchical regression models showed that consideration of lifetime substance use improved the prediction of postpartum mood overall (p=.036), anxiety (p=.074), stress (p=.054), and PTSD (p=.008)—but not depression (p=.329) or OCD (p=.242) —above and beyond sociodemographic characteristics and mental health history. Lifetime drug use was a unique predictor of overall postpartum mood (p=.022), symptoms of anxiety (p=.044), and stress (p=.020). Lifetime drug use was not a unique predictor of PTSD (p=.093). Lifetime alcohol use was not a unique predictor of any PPMD symptoms (ps>.955).

conclusions: This study provides the first evidence that screening for lifetime drug use during antenatal and postpartum care may improve identification of women at risk for PPMD. Findings will be discussed with respect to the development of early intervention and prevention strategies.

Learning Areas:

Assessment of individual and community needs for health education
Planning of health education strategies, interventions, and programs
Public health or related research
Social and behavioral sciences

Learning Objectives:
Explain the querying women's lifetime substance use in antenatal and postpartum screening for mood disorders.

Keyword(s): Mental Health, Maternal and Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a masters's level clinical psychologist licensed in North Carolina since 2002. I have had a private practice specializing in reproductive mental health since 2007. My interest in community-level interventions for postpartum mood disorders lead to my return to graduate school to pursue my PhD.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.