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Network Structure of Perinatal Depressive Symptoms Among Women in Rural Bihar
Sanjna Shukla1, Jothilakshmi Durairaj1, Homam A Khan2
1Schizophrenia Research Foundation, Chennai, Tamil Nadu, India.
Indian Journal of Psychological Medicine
|May 19, 2026
Summary
Perinatal depression (PND) symptom networks in rural India reveal that feeling unhappy and crying are central. Understanding these symptom connections can inform targeted interventions for maternal mental health.
Area of Science:
- Mental Health Research
- Epidemiology
- Psychiatry
Background:
- Perinatal depression (PND) is a significant global mental health concern.
- Limited research exists on the intricate relationships between PND symptoms.
- This study investigates PND symptom networks in rural Indian women.
Purpose of the Study:
- To examine the network structure of perinatal depressive symptoms.
- To identify the relative importance and interconnectedness of these symptoms.
- To explore symptom interactions in a rural Indian population.
Main Methods:
- A community-based cross-sectional study was conducted.
- The Edinburgh Postnatal Depression Scale (EPDS) was used for screening.
- Network analysis with R 4.0.3 and the qgraph package visualized symptom relationships.
Main Results:
- Analysis included 132 women with elevated depressive symptoms.
- The symptom 'I have been so unhappy that I have been crying' was most central.
- Strongest association found between 'laughing/seeing the funny side of things' and 'looking forward with interest and pleasure.'
Conclusions:
- This study provides novel insights into PND symptom networks in rural India.
- Mood and interest/pleasure symptoms demonstrated higher centrality.
- Findings can guide future evidence-based interventions for maternal mental health in underserved regions.
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