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. 2023 Mar 15:325:231-239.
doi: 10.1016/j.jad.2022.12.111. Epub 2023 Jan 4.

The structure of mood and anxiety disorder symptoms in the perinatal period

Michelle L Miller  1 , Michael W O'Hara  2
Affiliations

The structure of mood and anxiety disorder symptoms in the perinatal period

Michelle L Miller et al. J Affect Disord. .

Abstract

Background: The perinatal period is increasingly recognized as a vulnerable time for the development and exacerbation of psychiatric symptoms. Research has often focused on perinatal depression, with much less information on perinatal anxiety. This study examined the psychometric structure of all internalizing (anxiety and mood disorder symptoms) in the perinatal period.

Methods: Participants were primarily community adults receiving prenatal care from an academic medical center (N = 246). Participants completed a structured clinical interview using the Interview for Mood and Anxiety Symptoms (IMAS) during pregnancy (28-32 weeks gestation) and the postpartum (6-8 weeks). Clinical interviews dimensionally assessed all current anxiety, mood, and obsessive-compulsive symptoms as well as lifetime psychiatric diagnoses.

Results: Confirmatory factor analyses identified three latent factors onto which psychiatric symptoms loaded: Distress (depression, generalized anxiety, irritability, and panic symptoms), Fear (social anxiety, agoraphobia, specific phobia, and obsessive-compulsive symptoms), and Bipolar (mania and obsessive-compulsive symptoms) in both pregnancy and the postpartum. The fit statistics of the models indicated adequate to good fit in both models.

Limitations: The IMAS is validated against the DSM-IV-TR rather than the DSM-5 and assessments of psychiatric symptoms were focused only on the current pregnancy.

Conclusions: A three-factor model consisting of Distress, Fear and Bipolar latent factors was the best-fitting model in pregnancy and the postpartum period and showed stability across time. The structure of internalizing symptoms has important implications for future perinatal research and can be utilized to guide treatment by highlighting which psychiatric symptoms may be most similar during the perinatal period.

Keywords: Anxiety symptoms; Confirmatory factor analysis; Mood disorders; Postpartum; Pregnancy; Structure.

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Conflict of interest statement

Conflict of interest All authors declare that they have no conflicts of interest.

Figures

Figure 1.
Figure 1.. 3-Factor Model Confirmatory Factor Analysis in Pregnancy
Note. Higher order exploratory factor analysis results in nine components clustered into three factors, with obsessive-compulsive subfactor cross-loaded on Fear and Bipolar. Path coefficients are standardized estimates. Full exploratory factor analysis results are presented in Table 4. N = 251.
Figure 2.
Figure 2.. 3-Factor Model Confirmatory Factor Analysis in Postpartum
Note. Higher order exploratory factor analysis results in nine components clustered into three factors, with obsessive-compulsive subfactor cross-loaded on Fear and Bipolar. Path coefficients are standardized estimates. Full exploratory factor analysis results are presented in Table 4. N = 206.
See this image and copyright information in PMC

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