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The role of progesterone metabolites...

Ross, Lori Elizabeth.

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The role of progesterone metabolites and psychosocial factors in mood during pregnancy and postpartum: A biopsychosocial model.

Record Type:	Language materials, printed : Monograph/item
Title/Author:	The role of progesterone metabolites and psychosocial factors in mood during pregnancy and postpartum: A biopsychosocial model./
Author:	Ross, Lori Elizabeth.
Description:	260 p.
Notes:	Advisers: Edward M. Sellers; Myroslava K. Romach.
Contained By:	Dissertation Abstracts International63-12B.
Subject:	Health Sciences, Mental Health. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=NQ74735
ISBN:	0612747352

The role of progesterone metabolites and psychosocial factors in mood during pregnancy and postpartum: A biopsychosocial model.
Ross, Lori Elizabeth.

The role of progesterone metabolites and psychosocial factors in mood during pregnancy and postpartum: A biopsychosocial model. - 260 p.

Advisers: Edward M. Sellers; Myroslava K. Romach.

Thesis (Ph.D.)--University of Toronto (Canada), 2002.

Postpartum depression (PPD) is a potentially devastating mood disorder that affects up to 15% of childbearing women. Although a number of putative biological and psychosocial risk factors for PPD have previously been identified, causal relationships between these variables and PPD have not been established. Further, previous work in this area has largely ignored the overlap between “biological” and “psychosocial” risk factors. The present work set out to test a model of postpartum mood disturbance in 150 women to quantify potential interactions between biological and psychosocial variables, specifically through their effects on stress. First, hormonal variables, and specifically centrally active progesterone (FROG) metabolites, were investigated in relation to perinatal mood. Results suggested that depressed women may have marginally increased PROG synthesis, and reduced PROG metabolism, relative to healthy subjects. Demographic, psychosocial and clinical predictors for depression during late pregnancy and postpartum were then identified. Multiple linear regression revealed psychosocial factors such as lack of social support to be most closely correlated with current depression, and psychiatric history and prenatal depression to be the strongest predictors of depression. Because of the potential role for anxiolytic progesterone metabolites in PPD, the prevalence of symptoms of anxiety was then examined in this population. Nearly half of women with PPD showed comorbid anxiety, and this anxiety accounted for 35%–50% of the total score on the Edinburgh Postnatal Depression Scale. Finally, structural equation modeling (SEM) techniques were used to test a model of perinatal mood disturbance which proposed that risks that are assumed to be predominantly biological (e.g., hormone levels) influence mood and anxiety indirectly through interactions with risks that are assumed to be predominantly psychosocial (e.g., social support). Results of the modeling suggest that biological variables, and specifically PROD, play a statistically significant though subtle role in mediating mood during late pregnancy and postpartum. This role is an indirect one, mediated through differential sensitivity to psychosocial stressors. If this is correct, it would explain past difficulties in isolating hormonal risk factors in research which did not simultaneously measure non-biological factors.

ISBN: 0612747352Subjects--Topical Terms:

1017693
Health Sciences, Mental Health.

The role of progesterone metabolites and psychosocial factors in mood during pregnancy and postpartum: A biopsychosocial model.
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100 1 $a Ross, Lori Elizabeth. $3 1261723
245 1 0 $a The role of progesterone metabolites and psychosocial factors in mood during pregnancy and postpartum: A biopsychosocial model.
300 $a 260 p.
500 $a Advisers: Edward M. Sellers; Myroslava K. Romach.
500 $a Source: Dissertation Abstracts International, Volume: 63-12, Section: B, page: 5757.
502 $a Thesis (Ph.D.)--University of Toronto (Canada), 2002.
520 $a Postpartum depression (PPD) is a potentially devastating mood disorder that affects up to 15% of childbearing women. Although a number of putative biological and psychosocial risk factors for PPD have previously been identified, causal relationships between these variables and PPD have not been established. Further, previous work in this area has largely ignored the overlap between “biological” and “psychosocial” risk factors. The present work set out to test a model of postpartum mood disturbance in 150 women to quantify potential interactions between biological and psychosocial variables, specifically through their effects on stress. First, hormonal variables, and specifically centrally active progesterone (FROG) metabolites, were investigated in relation to perinatal mood. Results suggested that depressed women may have marginally increased PROG synthesis, and reduced PROG metabolism, relative to healthy subjects. Demographic, psychosocial and clinical predictors for depression during late pregnancy and postpartum were then identified. Multiple linear regression revealed psychosocial factors such as lack of social support to be most closely correlated with current depression, and psychiatric history and prenatal depression to be the strongest predictors of depression. Because of the potential role for anxiolytic progesterone metabolites in PPD, the prevalence of symptoms of anxiety was then examined in this population. Nearly half of women with PPD showed comorbid anxiety, and this anxiety accounted for 35%–50% of the total score on the Edinburgh Postnatal Depression Scale. Finally, structural equation modeling (SEM) techniques were used to test a model of perinatal mood disturbance which proposed that risks that are assumed to be predominantly biological (e.g., hormone levels) influence mood and anxiety indirectly through interactions with risks that are assumed to be predominantly psychosocial (e.g., social support). Results of the modeling suggest that biological variables, and specifically PROD, play a statistically significant though subtle role in mediating mood during late pregnancy and postpartum. This role is an indirect one, mediated through differential sensitivity to psychosocial stressors. If this is correct, it would explain past difficulties in isolating hormonal risk factors in research which did not simultaneously measure non-biological factors.
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790 1 0 $a Sellers, Edward M., $e advisor
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