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Different patterns of attentional bias in antenatal and postpartum depression
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktiv hälsa.ORCID-id: 0000-0002-6246-7218
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning.ORCID-id: 0000-0002-4935-7532
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktiv hälsa.
Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
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2017 (Engelska)Ingår i: Brain and Behavior, ISSN 2162-3279, E-ISSN 2162-3279, Vol. 7, nr 11, artikel-id e00844Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BackgroundBiased information processing in attention, memory, and interpretation is proposed to be central cognitive alterations in patients with major depressive disorder, but studies in women with peripartum depression are scarce. Because of the many similarities with depression in nonperipartum states as regards symptom profile and risk factors, we hypothesized that women with antenatal and postpartum depression would display attentional bias to negatively and positively valenced words. MethodsOne hundred and seventy-seven pregnant and 157 postpartum women were included. Among these, 40 suffered from antenatal depressive disorder and 33 from postpartum depressive disorder. An emotional Stroop task with neutral, positive, negative, and negatively valenced obstetric words was used. ResultsNo significant difference in emotional interference scores was noted between women with antenatal depression and nondepressed pregnant women. In contrast, women with postpartum depression displayed shorter reaction times to both positive (p=.028) and negative (p=.022) stimuli, compared with neutral words. Pregnant women on antidepressant treatment displayed longer reaction times to negatively valenced obstetric words in comparison with untreated depressed women (p=.012), and a trend toward greater interference in comparison with controls (p=.061). ConclusionsIn contrast with the hypothesis, we found no evidence of attentional bias to emotionally valenced stimuli in women with untreated peripartum depression. However, the shorter reaction times to emotional stimuli in women with postpartum depression may indicate emotional numbing, which in turn, is a functional impairment that may have repercussions for child development and well-being. Our findings emphasize the need to identify and treat women with postpartum depression at the earliest possible time point to ensure swift recovery and support for the family.

Ort, förlag, år, upplaga, sidor
2017. Vol. 7, nr 11, artikel-id e00844
Nyckelord [en]
antenatal depression, attentional bias, emotional Stroop, postpartum depression, pregnancy, women
Nationell ämneskategori
Reproduktionsmedicin och gynekologi Psykiatri
Identifikatorer
URN: urn:nbn:se:uu:diva-342913DOI: 10.1002/brb3.844ISI: 000416063200009PubMedID: 29201545OAI: oai:DiVA.org:uu-342913DiVA, id: diva2:1185861
Forskningsfinansiär
VetenskapsrådetTillgänglig från: 2018-02-26 Skapad: 2018-02-26 Senast uppdaterad: 2018-12-05Bibliografiskt granskad
Ingår i avhandling
1. Biological Aspects of Peripartum Depression
Öppna denna publikation i ny flik eller fönster >>Biological Aspects of Peripartum Depression
2019 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Peripartum depression affects around 12% of women in pregnancy and postpartum, and about 2–3% of European pregnant women use antidepressants, mostly selective serotonin reuptake inhibitors (SSRIs). An increased risk of poor pregnancy outcomes has been described in women with antenatal depression and SSRI treatment during pregnancy. The biological mechanisms behind these complications are not fully understood and here we investigated several biological correlates of peripartum depression, and discriminated between the effects of antidepressant treatment and depression itself.

In Paper I, attentional biases in pregnant and postpartum women were studied by using the Emotional Stroop Task, measuring reaction times to different stimuli. The major finding was shorter reaction times in postpartum depressed women, for emotionally valenced stimuli, which can be interpreted as emotional numbing.

In Paper II, peripheral inflammatory markers were assessed by proximity extension assay technology in depressed, SSRI-treated and healthy pregnant women. Lower levels of 23 markers were found in women with antenatal depression, independent of treatment, compared with healthy controls. These findings suggest a dysregulated switch to the anti-inflammatory M2 milieu characterizing a normal third trimester.

In Paper III, normal changes in inflammatory markers across pregnancy and postpartum were assessed in healthy pregnant and postpartum women. The majority (41) of the 50 markers that differed between groups were lower postpartum. These results clearly reflect the change in the immune system in pregnancy to postpartum transition.

In Paper IV, placental gene and protein expression were investigated and nominally significant findings were noted for serotonin receptor 1A (HTR1A) and neuropeptide Y2 receptor (NPY2R), where women with untreated depression displayed higher gene expression than healthy controls. Protein expression analyses revealed higher levels of HTR1A in placentas from SSRI-treated women, compared with healthy controls and women with untreated depression. This suggests possible involvement of HTR1A in the effect of antenatal depression on the placenta.

Overall, peripartum depression is associated with altered cognitive-emotional processing, lower levels of several mostly anti-inflammatory markers, and altered placental gene and protein expression. However, we found no major differences between untreated and treated depression.

Ort, förlag, år, upplaga, sidor
Uppsala: Acta Universitatis Upsaliensis, 2019. s. 114
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1520
Nyckelord
Peripartum depression, antenatal depression, postpartum depression, antidepressant treatment, selective serotonin reuptake inhibitor, SSRI, pregnancy, postpartum, attentional bias, Emotional Stroop Task, inflammatory markers, proximity extension assay, placenta, gene expression, TaqMan low-density array, protein expression, immunohistochemistry, HTR1A, NPY2R
Nationell ämneskategori
Reproduktionsmedicin och gynekologi
Identifikatorer
urn:nbn:se:uu:diva-367385 (URN)978-91-513-0522-6 (ISBN)
Disputation
2019-02-01, Sal IX, Universitetshuset, Biskopsgatan 3, Uppsala, 09:15 (Svenska)
Opponent
Handledare
Tillgänglig från: 2019-01-09 Skapad: 2018-12-05 Senast uppdaterad: 2019-01-21

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Edvinsson, ÅsaSkalkidou, AlkistisHellgren, CharlotteGingnell, MalinEkselius, LisaWillebrand, MimmieSundström Poromaa, Inger

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Edvinsson, ÅsaSkalkidou, AlkistisHellgren, CharlotteGingnell, MalinEkselius, LisaWillebrand, MimmieSundström Poromaa, Inger
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Reproduktiv hälsaObstetrisk och reproduktiv hälsoforskningInstitutionen för psykologiPsykiatri, Akademiska sjukhuset
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