Co-Occurring Psychiatric Symptoms in Opioid-Dependent Women: The Prevalence of Antenatal and Postnatal Depression

Background: Despite the high prevalence of psychiatric symptoms in substance-dependent women, little evidence is available on postpartum depression in this population. Objectives: To determine whether demographic variables and prenatal depression predict postpartum depression and select substance abuse treatment outcomes in a sample of pregnant women. Methods: A retrospective chart review was conducted on 125 pregnant women enrolled in a comprehensive substance abuse treatment program. Data on demographic variables, prenatal care attendance, urine drug screen (UDS) results, and psychiatric symptoms were abstracted from patient medical and substance abuse treatment charts. The Postpartum Depression Screening Scale (PDSS) was administered 6 weeks post-delivery. Multiple linear regression was conducted to identify predictors of prenatal care attendance and total PDSS scores at 6 weeks postpartum. Multiple logistic regression was used to examine predictors of positive UDS at delivery. Results: Nearly one-third (30.4%) of the sample screened positive for moderate or severe depression at treatment entry. Psychiatric symptoms did not predict either prenatal care compliance or UDS results at delivery. Almost half of the sample (43.7%) exhibited postpartum depression at 6 weeks post-delivery. No demographic variables correlated with incidence of postnatal depression. Only antenatal depression at treatment entry predicted PDSS scores. Conclusion: Prevalence of antenatal psychiatric disorders and postpartum depression was high in this sample of women seeking substance abuse treatment. Results support prior history of depression as a predictor of risk for developing postpartum depression. Scientific Significance: Routine screening for perinatal and postpartum depression is indicated for women diagnosed with substance abuse disorders.