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A Review of Postpartum Depression: Focused on Psychoneuroimmunological Interaction

산후 우울의 고찰: 정신신경면역계 상호작용을 중심으로

  • Kim, Yunmi (College of Nursing, Gachon University) ;
  • Ahn, Sukhee (College of Nursing, Chungnam National University)
  • Received : 2015.03.09
  • Accepted : 2015.05.24
  • Published : 2015.06.20

Abstract

Purpose: The purpose of this review was to describe a psychoneuroimmunology (PNI) framework for postpartum depression (PPD) and discuss its implications for nursing research and practice for postpartum women. Methods: This study explored the role of hypothalamic-pituitary-adrenal (HPA) axis and inflammation as possible mediators of risk factors for PPD through literature review. Results: From this PNI view, human bodies are designed to respond with the reciprocal interactions among the neuro-endocrine and immune system when they are faced with physical or psychological stressors. Chronic stress induces alterations in the function of HPA axis, and a chronic low-grade inflammatory response is associated with depression. The dysfunctions of cytokines and HPA axis have been observed during the postpartum period. Stress promotes glucocorticoid receptor resistance, which can promote inflammatory responses. This, in turn, can contribute to the pathophysiology of depression. This can especially affect populations at vulnerable time-points, such as women in the postpartum. Conclusion: From a PNI perspective, well-designed prospective research evaluating the role of stress and inflammation as an etiology of PPD and the effect of stress reduction is warranted to prevent PPD.

Keywords

References

  1. Beck CT. State of the science on postpartum depression: What nurse researchers have contributed-Part 1. MCN. The American Journal of Maternal Child Nursing. 2008;33(2):121-126. https://doi.org/10.1097/01.NMC.0000313421.97236.cf
  2. Barker ED, Jaffee SR, Uher R, Maughan B. The contribution of prenatal and postnatal maternal anxiety and depression to child maladjustment. Depression and Anxiety. 2011;28(8): 696-702. https://doi.org/10.1002/da.20856
  3. Jones NA. Delayed reactive cries demonstrate emotional and physiological dysregulation in newborns of depressed mothers. Biological Psychology. 2012;89(2):374-381. https://doi.org/10.1016/j.biopsycho.2011.11.011
  4. Murray L, Arteche A, Fearon P, Halligan S, Goodyer I, Cooper P. Maternal postnatal depression and the development of depression in offspring up to 16 years of age. Journal of the American Academy of Child and Adolescent Psychiatry. 2011; 50(5):460-470. https://doi.org/10.1016/j.jaac.2011.02.001
  5. McCoy SJ, Beal JM, Watson GH. Endocrine factors and postpartum depression. A selected review. Journal of Reproductive Medicine. 2003;48(6):402-408.
  6. Bloch M, Rubinow DR, Schmidt PJ, Lotsikas A, Chrousos GP, Cizza G. Cortisol response to ovine corticotropin-releasing hormone in a model of pregnancy and parturition in euthymic women with and without a history of postpartum depression. Journal of Clinical Endocrinology & Metabolism. 2005; 90(2):695-699. https://doi.org/10.1210/jc.2004-1388
  7. Sacher J, Wilson AA, Houle S, Rusjan P, Hassan S, Bloomfield PM, et al. Elevated brain monoamine oxidase A binding in the early postpartum period. Archive of General Psychiatry. 2010; 67(5):468-474. https://doi.org/10.1001/archgenpsychiatry.2010.32
  8. Glynn LM, Davis EP, Sandman CA. New insights into the role of perinatal HPA-axis dysregulation in postpartum depression. Neuropeptides. 2013;47(6):363-370. https://doi.org/10.1016/j.npep.2013.10.007
  9. Kendall-Tackett K. A new paradigm for depression in new mothers: The central role of inflammation and how breastfeeding and anti-inflammatory treatments protect maternal mental health. International Breastfeeding Journal. 2007;2:6. https://doi.org/10.1186/1746-4358-2-6
  10. Corwin EJ, Pajer K. The psychoneuroimmunology of postpartum depression. Journal of Women's Health (Larchmt). 2008;17(9):1529-1534. https://doi.org/10.1089/jwh.2007.0725
  11. Osborne LM, Monk C. Perinatal depression-the fourth inflammatory morbidity of pregnancy? Theory and literature review. Psychoneuroendocrinology. 2013;38(10):1929-1952. https://doi.org/10.1016/j.psyneuen.2013.03.019
  12. Song HR, Woo YS, Bahk WM. Depression as an Inflammatory Disease. Korean Journal of Psychopharmacology. 2013;24 (1):5-10.
  13. Zunszain PA, Anacker C, Cattaneo A, Carvalho LA, Pariante CM. Glucocorticoids, cytokines and brain abnormalities in depression. Progress in Neuropsychopharmacology & Biological Psychiatry. 2011;35(3):722-729. https://doi.org/10.1016/j.pnpbp.2010.04.011
  14. Bockting CL, Lok A, Visser I, Assies J, Koeter MW, Schene AH, et al. Lower cortisol levels predict recurrence in remitted patients with recurrent depression: A 5.5 year prospective study. Psychiatry Research. 2012;200(2-3):281-287. https://doi.org/10.1016/j.psychres.2012.03.044
  15. Leonard BE. Impact of inflammation on neurotransmitter changes in major depression: An insight into the action of antidepressants. Progress in Neuropsychopharmacology & Biological Psychiatry. 2014;48:261-267. https://doi.org/10.1016/j.pnpbp.2013.10.018
  16. Corwin EJ, Guo Y, Pajer K, Lowe N, McCarthy D, Schmiege S, et al. Immune dysregulation and glucocorticoid resistance in minority and low income pregnant women. Psychoneuroendocrinology. 2013;38(9):1786-1796. https://doi.org/10.1016/j.psyneuen.2013.02.015
  17. Maes M. Depression is an inflammatory disease, but cell-mediated immune activation is the key component of depression. Progress in Neuropsychopharmacology & Biological Psychiatry. 2011;35(3):664-675. https://doi.org/10.1016/j.pnpbp.2010.06.014
  18. Berk M, Williams LJ, Jacka FN, O'Neil A, Pasco JA, Moylan S, et al. So depression is an inflammatory disease, but where does the inflammation come from? BMC Medicine. 2013;11:200. https://doi.org/10.1186/1741-7015-11-200
  19. Glynn LM, Sandman CA. Evaluation of the association between placental corticotrophin-releasing hormone and postpartum depressive symptoms. Psychosomatic Medicine. 2014; 76(5):355-362. https://doi.org/10.1097/PSY.0000000000000066
  20. Mastorakos G, Ilias I. Maternal and fetal hypothalamic-pituitary- adrenal axes during pregnancy and postpartum. Annals of New York Academy of Sciences. 2003;997:136-149. https://doi.org/10.1196/annals.1290.016
  21. Jolley SN, Elmore S, Barnard KE, Carr DB. Dysregulation of the hypothalamic-pituitary-adrenal axis in postpartum depression. Biological Research for Nursing. 2007;8(3):210-222. https://doi.org/10.1177/1099800406294598
  22. Groer MW, Morgan K. Immune, health and endocrine characteristics of depressed postpartum mothers. Psychoneuroendocrinology. 2007;32(2):133-139. https://doi.org/10.1016/j.psyneuen.2006.11.007
  23. Taylor A, Glover V, Marks M, Kammerer M. Diurnal pattern of cortisol output in postnatal depression. Psychoneuroendocrinology. 2009;34(8):1184-1188. https://doi.org/10.1016/j.psyneuen.2009.03.004
  24. Groer ME, Jevitt C, Ji M. Immune changes and dysphoric moods across the postpartum. American Journal of Reproductive Immunology. 2015;73(3):193-198. https://doi.org/10.1111/aji.12322
  25. Corwin EJ, Johnston N, Pugh L. Symptoms of postpartum depression associated with elevated levels of interleukin-1 beta during the first month postpartum. Biological Research for Nursing. 2008;10(2):128-133. https://doi.org/10.1177/1099800408323220
  26. Boufidou F, Lambrinoudaki I, Argeitis J, Zervas IM, Pliatsika P, Leonardou AA, et al. CSF and plasma cytokines at delivery and postpartum mood disturbances. Journal of Affective Disorder. 2009;115(1-2):287-292. https://doi.org/10.1016/j.jad.2008.07.008
  27. Kondo N, Suda Y, Nakao A, Oh-Oka K, Suzuki K, Ishimaru K, et al. Maternal psychosocial factors determining the concentrations of transforming growth factor-beta in breast milk. Pediatric Allergy and Immunology. 2011;22(8):853-861. https://doi.org/10.1111/j.1399-3038.2011.01194.x
  28. Fransson E, Dubicke A, Bystrom B, Ekman-Ordeberg G, Hjelmstedt A, Lekander M. Negative emotions and cytokines in maternal and cord serum at preterm birth. American Journal of Reproductive Immunology. 2012;67(6):506-514. https://doi.org/10.1111/j.1600-0897.2011.01081.x
  29. Yim IS, Tanner Stapleton LR, Guardino CM, Hahn-Holbrook J, Dunkel Schetter C. Biological and psychosocial predictors of postpartum depression: Systematic review and call for integration. Annual Review of Clinical Psychology. 2015;11:99-137. https://doi.org/10.1146/annurev-clinpsy-101414-020426
  30. Logsdon MC, Tomasulo R, Eckert D, Beck C, Dennis CL. Identification of mothers at risk for postpartum depression by hospital- based perinatal nurses. MCN. American Journal of Maternal Child Nursing. 2012;37(4):218-225. https://doi.org/10.1097/NMC.0b013e318251078b

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