Predictors for exacerbation/improvement of postpartum depression--a focus on anxiety, the mothers' experiences of being cared for by their parents in childhood and borderline personality: a perspective study in Japan

J Affect Disord. 2013 Sep 5;150(2):507-12. doi: 10.1016/j.jad.2013.04.051. Epub 2013 May 25.


Objective: To investigate the course and influencing factors of postpartum depression in women during the child rearing period.

Methods: Data were collected during 0-year-old baby check-ups and a follow-up investigation. 262 participants were included in the analysis. Both surveys employed the Zung Self-Rating Depression Scale (ZSDS). The first also comprised the State Trait Anxiety Inventory, Parental Bonding Instrument (PBI), and Borderline Scale Index, enabling sub-division of participating subjects into healthy/pathological groups. ZSDS group and survey scores were compared using the t-test.

Results: The average ages of the children and the ZSDS scores in both surveys were 7.0±3.2 and 21.8±2.4 months, 40.6±7.9 and 40.1±8.7, respectively, with no significant differences among depression scores. When subjects were divided according to individual scale scores, and survey scores compared, depression significantly improved in the high trait/state anxiety group, high PBI maternal care score group, nonborderline personality (BP) trait group, and breast feeding group, whereas depression was significantly exacerbated in the low PBI maternal care score group.

Discussion: Postpartum depression characterized by strong anxiety and a depressive state in mothers with favorable psychological backgrounds showed gradual improvement. We noted an exacerbation of depression during the separation period in mothers who had received poor maternal care. We assume that the feeling of abandonment induced by individuation of their children is a major factor.

Limitations: There is concern that some depressive women may have dropped out due to a performance bias.

Conclusions: Sharing our findings about exacerbation/improvement of depression among medical staff may be beneficial for postpartum mothers.

Keywords: Borderline personality; Feeding method; Maternal anxiety; Parental bonding; Postpartum depression.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anxiety Disorders / psychology
  • Borderline Personality Disorder / ethnology
  • Borderline Personality Disorder / psychology*
  • Child, Preschool
  • Depression, Postpartum / ethnology*
  • Depression, Postpartum / psychology*
  • Depressive Disorder / psychology
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Japan
  • Mother-Child Relations / ethnology*
  • Mothers / psychology
  • Object Attachment
  • Personality Inventory / statistics & numerical data
  • Self Report
  • Young Adult