Characterization of Depressive Symptom Trajectories in Women between Childbirth and Diagnosis

The inhomogeneity of postpartum mood and mother-child attachment was estimated from immediately after childbirth to 12 weeks postpartum in a cohort of 598 young mothers. At 3-week intervals, depressed mood and mother-child attachment were assessed using the EPDS and the MPAS, respectively. The diagnosis was based on clinical interviews at the end of the 12-week follow-up. The latent class mixed model estimated multiple distinct patterns in depressed mood and mother-child attachment. The baseline EPDS cluster contained 72% of the study population and showed low EPDS values during the follow-up period, while the five remaining clusters showed either deterioration or improvement of the EPDS levels. The majority of women with postpartum depression showed deteriorating, and the majority of adjustment disorder cases improving, behavior. While the cases with more pronounced EPDS values were found to constitute more homogeneous clusters in terms of diagnosis, subclinical or only temporarily increased EPDS levels represented less homogeneous clusters. Higher EPDS levels correlated with the higher risk factor profiles. The four MPAS/EPDS clusters demonstrated that higher EPDS lead to lower mother-child attachment, and vice versa.