One in seven women suffers from depression before, during or after pregnancy, a new study finds.
The consequences of depression can be devastating to the mother, her baby and her entire family, according to the report in the October issue of The American Journal of Psychiatry.
"The prevalence of women diagnosed with depression before, during and after pregnancy was pretty similar," said lead author Patricia Dietz, an epidemiologist at the U.S. Centers for Disease Control and Prevention's Division of Reproductive Health.
"There are a lot of women who are becoming pregnant with depression, and that's really important for people providing prenatal care to be aware of," she said.
Screening for depression needs to occur during pregnancy and right afterward, Dietz said.
The consequences of postpartum depression, which affects 400,000 women in the United States, can be significant. It can inhibit a woman's ability to bond with her baby, relate to the child's father, and perform daily activities, according to background information for the study.
For the study, sponsored by Kaiser Permanente, Dietz's team collected data on 4,398 women who gave birth between 1998 and 2001. They found that 8.7 percent of the women experienced depression in the nine months before pregnancy, 6.9 percent during pregnancy, and 10.4 percent in the nine months following childbirth.
Some 15.4 percent of the women were depressed during at least one of these periods. Almost 75 percent of women with postpartum depression also suffered from depression before pregnancy. And more than 50 percent of women who were depressed before pregnancy were depressed during pregnancy, Dietz said.
"For many women, it's a chronic condition," she said.
In addition, 93.4 percent of the women who were diagnosed with depression before, during or after pregnancy had seen a mental health professional or were taking antidepressants.
Among women with depression, 75 percent had taken antidepressants -- 77 percent before pregnancy, 67 percent during pregnancy and 82 percent after delivery, the researchers found.
Women should report any signs of depression to their doctor, Dietz said.
"There is effective treatment out there for women. You are supposed to be elated when you've had a baby. It is sometimes difficult to even bring depression up," she said. "But doctors should ask."
Dr. David L. Katz, director of Yale University School of Medicine's Prevention Research Center, said the finding that depression is very common before and after, as well as during, pregnancy is of clear importance.
"There are two potential explanations. Either the challenges of pregnancy -- from hormonal changes to psychological adjustment -- induce depression, or the medical monitoring that occurs around the time of pregnancy identifies depression that otherwise would have gone undiagnosed. Of course, both factors may be in play," he said.
There are opportunities for prevention if pregnancy is causing depression, Katz said. "If pregnancy is merely unmasking depression in the population at large, it highlights the need to screen more effectively. Finding depression is prerequisite to treating it," he said.
Dietz thinks that before a woman starts a program of antidepressants, she should discuss the risks and benefits with her doctor.
According to the March of Dimes, a woman who is depressed feels sad or "blue" for two weeks or longer. Other symptoms of depression include:
Trouble sleeping.
Sleeping too much.
Lack of interest.
Feelings of guilt.
Loss of energy.
Difficulty concentrating.
Changes in appetite.
Restlessness, agitation or slowed movement.
Thoughts or ideas about suicide.
Monday, October 1, 2007
Trouble at Home Boosts Kids' Asthma
Poor family support and bad neighborhoods can aggravate asthma symptoms in kids, Canadian research suggests.
Edith Chen and colleagues at the University of British Columbia in Vancouver examined the degree of support that 78 children with asthma received from family and peers. They also looked at social problems, such as crime and violence, in the children's neighborhoods.
They then assessed the children's lung function, asthma symptoms, and certain behaviors that can affect asthma.
The results indicated a correlation between social environment and asthma symptoms and lung function. Children who reported less family support and lived in worse neighborhoods experienced greater asthma symptoms, the team said. Those who reported less family support had poorer lung function.
Further analysis revealed that low levels of family support were associated with greater lung inflammation which, in turn, was associated with poorer asthma outcomes. Family support did not appear to influence behaviors that can affect asthma.
The researchers also concluded that living in worse neighborhoods was associated with higher rates of child smoking and exposure to smoke, which is associated with poorer asthma outcomes.
"Poor family relations may foster psychological experiences with direct physiologic consequences, whereas problematic neighborhoods may operate by providing the role models for maladaptive behaviors," the study authors wrote.
Peer group support had no significant effect on asthma symptoms or lung function. The study was published in the first issue for October of the American Journal of Respiratory and Critical Care Medicine.
Edith Chen and colleagues at the University of British Columbia in Vancouver examined the degree of support that 78 children with asthma received from family and peers. They also looked at social problems, such as crime and violence, in the children's neighborhoods.
They then assessed the children's lung function, asthma symptoms, and certain behaviors that can affect asthma.
The results indicated a correlation between social environment and asthma symptoms and lung function. Children who reported less family support and lived in worse neighborhoods experienced greater asthma symptoms, the team said. Those who reported less family support had poorer lung function.
Further analysis revealed that low levels of family support were associated with greater lung inflammation which, in turn, was associated with poorer asthma outcomes. Family support did not appear to influence behaviors that can affect asthma.
The researchers also concluded that living in worse neighborhoods was associated with higher rates of child smoking and exposure to smoke, which is associated with poorer asthma outcomes.
"Poor family relations may foster psychological experiences with direct physiologic consequences, whereas problematic neighborhoods may operate by providing the role models for maladaptive behaviors," the study authors wrote.
Peer group support had no significant effect on asthma symptoms or lung function. The study was published in the first issue for October of the American Journal of Respiratory and Critical Care Medicine.
Kids' TV Viewing Tied to Behavioral Problems
But the 'off' switch may reverse the chance of trouble down the road, study says
-- If your toddler is watching a lot of TV, turn it off now and save yourself a lot of trouble later.
That's the conclusion of a new study that suggests that the negative effects of lots of early TV viewing on children can be overcome by limiting viewing before the age of 6.
The study doesn't confirm that television is actually bad for young kids. Nor does it show exactly how much of a cutback would help children exposed to lots of TV early in life. Still, lead author Kamila Mistry, a doctoral candidate at Johns Hopkins Bloomberg School of Public Health, said it makes a strong case for a "significant" difference in behavioral problems in kids depending on their viewing.
"It's never too late," Mistry said. "That's an important message for parents as well as pediatricians, encouraging parents to turn off the TV and think about alternative activities for kids."
Television, of course, has long been blamed for a variety of ills among children, from lethargy and obesity to shortened attention spans. The American Academy of Pediatrics discourages kids under 2 from watching any TV at all, and it says older kids shouldn't watch more than two hours a day.
Why take another look at TV and children? According to Mistry, the new study is unusual, because it followed kids over time -- from 2.5 years to 5.5 years -- and measured the effects of changing levels of TV watching.
The researchers looked at the results of surveys of 2,702 families who enrolled in a national study between 1996 and 1998. The kids were followed from birth to age 5.5.
Twenty percent of parents said their kids watched at least two hours of TV a day at both 2.5 and 5.5 years. Four in 10 children had TVs in their bedrooms at age 5.5.
Even when the researchers adjusted the study results to account for factors such as income and "parental involvement," they found that kids who watched two or more hours of TV daily at both ages were more likely to suffer from sleep, attention and aggressive behavior problems, and "externalizing of problem behaviors." Also, those who watched more TV over time had greater problems dealing with others.
But those children who reduced TV watching between the two ages didn't have a greater likelihood of either social or behavioral problems.
The researchers also found that kids with TVs in their bedrooms were more likely to have sleeping problems.
The findings are published in the October issue of Pediatrics.
The structure of the study didn't allow the researchers to say how much more likely kids were to have problems depending on their viewing habits, Mistry said. She added that it's not a cause-and-effect study. It's possible that behavioral and social problems may contribute to TV viewing, not the other way around, she said.
The study also didn't look at whether the children were watching educational programming, like "Sesame Street," or other programs, such as those geared toward adults.
"I hesitate to say TV is horrible," Mistry said, "but excessive amounts of any activity is probably not good."
Madeline A. Dalton, director of the Hood Center for Families and Children at Dartmouth Medical School, said she's not sure that reducing heavy early exposure to TV will eliminate the risk of problems. She thinks more research is needed to determine that and to figure out if it's possible that "parents may be more likely to sit their children in front of the TV if they have behavioral problems."
However, "time spent watching TV is likely to reduce the amount of time children spend interacting with adults and other children," Dalton said. "Therefore, it is not surprising that this may have an impact on ability to interact socially."
She added: "We are raising our children in a media-saturated world. That's not necessarily a bad thing, but our knowledge of how media affects children -- both in terms of behavior and health -- has clearly lagged behind its use."
But the 'off' switch may reverse the chance of trouble down the road, study says
-- If your toddler is watching a lot of TV, turn it off now and save yourself a lot of trouble later.
That's the conclusion of a new study that suggests that the negative effects of lots of early TV viewing on children can be overcome by limiting viewing before the age of 6.
The study doesn't confirm that television is actually bad for young kids. Nor does it show exactly how much of a cutback would help children exposed to lots of TV early in life. Still, lead author Kamila Mistry, a doctoral candidate at Johns Hopkins Bloomberg School of Public Health, said it makes a strong case for a "significant" difference in behavioral problems in kids depending on their viewing.
"It's never too late," Mistry said. "That's an important message for parents as well as pediatricians, encouraging parents to turn off the TV and think about alternative activities for kids."
Television, of course, has long been blamed for a variety of ills among children, from lethargy and obesity to shortened attention spans. The American Academy of Pediatrics discourages kids under 2 from watching any TV at all, and it says older kids shouldn't watch more than two hours a day.
Why take another look at TV and children? According to Mistry, the new study is unusual, because it followed kids over time -- from 2.5 years to 5.5 years -- and measured the effects of changing levels of TV watching.
The researchers looked at the results of surveys of 2,702 families who enrolled in a national study between 1996 and 1998. The kids were followed from birth to age 5.5.
Twenty percent of parents said their kids watched at least two hours of TV a day at both 2.5 and 5.5 years. Four in 10 children had TVs in their bedrooms at age 5.5.
Even when the researchers adjusted the study results to account for factors such as income and "parental involvement," they found that kids who watched two or more hours of TV daily at both ages were more likely to suffer from sleep, attention and aggressive behavior problems, and "externalizing of problem behaviors." Also, those who watched more TV over time had greater problems dealing with others.
But those children who reduced TV watching between the two ages didn't have a greater likelihood of either social or behavioral problems.
The researchers also found that kids with TVs in their bedrooms were more likely to have sleeping problems.
The findings are published in the October issue of Pediatrics.
The structure of the study didn't allow the researchers to say how much more likely kids were to have problems depending on their viewing habits, Mistry said. She added that it's not a cause-and-effect study. It's possible that behavioral and social problems may contribute to TV viewing, not the other way around, she said.
The study also didn't look at whether the children were watching educational programming, like "Sesame Street," or other programs, such as those geared toward adults.
"I hesitate to say TV is horrible," Mistry said, "but excessive amounts of any activity is probably not good."
Madeline A. Dalton, director of the Hood Center for Families and Children at Dartmouth Medical School, said she's not sure that reducing heavy early exposure to TV will eliminate the risk of problems. She thinks more research is needed to determine that and to figure out if it's possible that "parents may be more likely to sit their children in front of the TV if they have behavioral problems."
However, "time spent watching TV is likely to reduce the amount of time children spend interacting with adults and other children," Dalton said. "Therefore, it is not surprising that this may have an impact on ability to interact socially."
She added: "We are raising our children in a media-saturated world. That's not necessarily a bad thing, but our knowledge of how media affects children -- both in terms of behavior and health -- has clearly lagged behind its use."
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