. 2025 Feb;28(1):55-65.

doi: 10.1007/s00737-024-01510-9. Epub 2024 Aug 31.

Neuropsychological performance in women at risk of postpartum depression and postpartum psychosis

Giulia Cattarinussi^#^{1

2}, Giulia Segre^#¹, Alessandra Biaggi^{1

3}, Katie Hazelgrove¹, Fabio Sambataro², Manuela Russo⁴, Andrew Lawrence^{1

5}, Montserrat Fusté¹, Mitul A Mehta^{5

6}, Gertrude Seneviratne⁷, Michael C Craig⁸, Maddalena Miele⁹, Susan Pawlby¹, Susan Conroy¹, Carmine M Pariante^{1

5}, Paola Dazzan^{10

11}

Affiliations

¹ Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
² Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy.
³ Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy.
⁴ Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁵ National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK.
⁶ Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁷ South London and Maudsley NHS Foundation Trust Channi Kumar Mother and Baby Unit, Bethlem Royal Hospital, London, UK.
⁸ National Female Hormone Clinic, Maudsley Hospital, SLaM NHS Foundation Trust, and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁹ Perinatal Mental Health Service, St Mary's Hospital, Imperial College London and Central North West London NHS Foundation Trust, London, UK.
¹⁰ Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. paola.dazzan@kcl.ac.uk.
¹¹ National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK. paola.dazzan@kcl.ac.uk.

^# Contributed equally.

PMID: 39214910
PMCID: PMC11762223
DOI: 10.1007/s00737-024-01510-9

Neuropsychological performance in women at risk of postpartum depression and postpartum psychosis

Giulia Cattarinussi et al. Arch Womens Ment Health. 2025 Feb.

. 2025 Feb;28(1):55-65.

doi: 10.1007/s00737-024-01510-9. Epub 2024 Aug 31.

Authors

Affiliations

¹ Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
² Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy.
³ Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy.
⁴ Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁵ National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK.
⁶ Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁷ South London and Maudsley NHS Foundation Trust Channi Kumar Mother and Baby Unit, Bethlem Royal Hospital, London, UK.
⁸ National Female Hormone Clinic, Maudsley Hospital, SLaM NHS Foundation Trust, and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁹ Perinatal Mental Health Service, St Mary's Hospital, Imperial College London and Central North West London NHS Foundation Trust, London, UK.
¹⁰ Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. paola.dazzan@kcl.ac.uk.
¹¹ National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK. paola.dazzan@kcl.ac.uk.

^# Contributed equally.

PMID: 39214910
PMCID: PMC11762223
DOI: 10.1007/s00737-024-01510-9

Abstract

Purpose: While neuropsychological deficits are commonly observed in affective and psychotic disorders, this remains unexplored in these disorders when they occur during pregnancy and the postpartum period.

Methods: A neuropsychological test battery was administered to women defined at risk of postpartum depression (PD, N = 53) because having either a current or past diagnosis of major depressive disorder, women at risk of postpartum psychosis (PP, N = 43) because of a diagnosis of bipolar disorder or schizoaffective disorder and/or a previous episode of PP and women not at risk (NR, N = 48) in the third trimester of pregnancy. Generalized and specific cognitive abilities were compared between groups.

Results: Women at risk of PP presented worse executive functions and processing speed compared to NR and worse performance compared to women at risk of PD across all cognitive domains. In addition, women at risk of PP who developed a psychiatric relapse in the first four weeks post-partum showed worse verbal learning and memory, visual memory, executive functions and processing speed in pregnancy compared to NR, whereas women at risk of PP who remained well presented neuropsychological performance that was intermediate between that of the women NR and those at risk of PP who developed symptoms. There were no differences in performance between women at risk of PD and the NR women, even if 31 women at risk of PD presented depressive symptoms at the time of cognitive assessment.

Conclusions: Our findings in women at risk of PP align with neuropsychological findings in individuals with, or at risk of psychosis unrelated to pregnancy. In addition, initial evidence that women at risk of PP who develop a psychiatric relapse in the postpartum show a particularly poor neuropsychological performance in pregnancy suggests that this could be considered part of a phenotype for the disease and help guiding future preventive strategies in this clinical population. In women at risk of PD, the presence of depressive symptoms did not influence cognitive performance.

Keywords: Antenatal depression; Childbirth; Cognitive function; Postpartum depression; Postpartum psychosis.

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Conflict of interest statement

Declarations. Conflict of interest: The authors report no competing interests.

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Neuropsychological performance in women at risk of postpartum depression and postpartum psychosis

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Neuropsychological performance in women at risk of postpartum depression and postpartum psychosis

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