Maria Plotnikova

Trajectories of maternal depression: a 27-year population-based prospective study.

AIMS To identify distinct trajectories of depression experienced by a population-based sample of women over a 27-year period and to assess the validity of the derived trajectories. METHOD The Mater University of Queensland Study of Pregnancy is a birth cohort study which commenced in 1981. Women (N = 6753) were interviewed at their first clinic visit, at 6 months, then 5, 14, 21 and 27 years after the birth of their child, using the Delusions Symptoms - States Inventory. Some 3561 (52.7%) women were followed up at 27 years, with 3337 (49.4%) of the sample completing the Composite International Diagnostic Interview (CIDI). Depression trajectories over a 27-year period were identified using Latent Class Growth Modelling (LCGM). LCGM was used to identify respondents with similar patterns of depression over a 27-year period. At the 27-year follow-up women who completed the CIDI, were stratified according to their trajectory group membership. RESULTS Three trajectory groups, each with different life-course patterns of depression were identified. The low/no symptoms of depression trajectory group comprised 48.4% of women. The mid-depression group (41.7%) had a consistent pattern of occasional symptoms of depression. The high/escalating trajectory group comprised 9.9% of the women in the study. We then examined each trajectory group based on their completion of the CIDI at the 27-year follow-up. Using the CIDI, 27.0% of women in the study had met the DSM-IV criteria for lifetime ever depression by their mean age of 46.5 years. The responses to the CIDI differed greatly for each of the trajectory groups, suggesting that the trajectories validly reflect different life histories of depression. The high/escalating trajectory group had an earlier age of first onset, more frequent episodes, longer duration of each episode of depression and experienced higher levels of impairment for their episodes of depression. For the high symptoms trajectory group, clinically significant depression is estimated to be experienced by women almost one in every 6 days of their life. CONCLUSION While symptoms of depression are commonly experienced in a large community-based sample of women, a minority of women experience many episodes of depression in their lifetime. It is this group of women who are most impaired and should be of most concern, and who should be the main target of prevention and treatment initiatives.

Cannabis Use and Quality of Life of Adolescents and Young Adults: Findings from an Australian Birth Cohort

Abstract Cannabis is generally used to enhance mood (quality of life), but it is not known whether it has this effect in the medium to longer term. Little is currently known about the temporal sequence between cannabis use and the quality of life (QOL). Data are taken from a prospective longitudinal study of pregnant women recruited at their first antenatal visit in Brisbane, Australia. Offspring data from the follow-ups with 14-year-olds and 21-year-olds are used here. Indicators of QOL, happiness, and satisfaction at 14 years are considered as predictors of subsequent cannabis use. The association between cannabis use and QOL at 21 years, adjusting for prior QOL (14 years), is also examined. Socio-demographic characteristics were included as potential confounders relevant to QOL assessments. In this cohort, lower QOL in the early teenage years predicted subsequent onset of cannabis use in young adulthood. After adjustment for socio-demographic characteristics and for QOL pre-cannabis use, participants who used cannabis more frequently had a lower QOL at the 21-years follow-up. Frequent use of cannabis does not appear to enhance the user’s QOL and appears to be associated with a reduced QOL into young adulthood.

Quality of life, age of onset of alcohol use and alcohol use disorders in adolescence and young adulthood: Findings from an Australian birth cohort

INTRODUCTION AND AIMS Alcohol consumption among adolescents and young adults is a persistent community concern. Little is known about the short-term effects on the young adult drinkers quality of life (QOL), particularly prior to the first use of alcohol and the effect of alcohol consumption on subsequent QOL assessments. There is a need to know more about the QOL of those who decide to use alcohol in adolescence and the effect of alcohol consumption on young adult QOL. DESIGN AND METHODS This is a prospective longitudinal study of a birth cohort. Data were taken from the 14- and 21-year follow ups. At both time points, QOL was indicated by a measure of happiness and satisfaction. Alcohol use was also measured at 14- and 21-year follow ups. At the 21-year follow up, alcohol use disorder (AUD) was assessed using the Composite International Diagnostic Interview. RESULTS At the 14-year follow up, there was a strong association between QOL and quantity of alcohol consumed. QOL at 14 years also predicted more frequent alcohol use at 21 years of age. Poor QOL at 14 years was a strong predictor of earlier age of onset of an AUD. However, when age of onset of AUD was used to predict subsequent QOL, the associations were weak and inconsistent. DISCUSSION AND CONCLUSION Poor QOL was associated with the early age of onset of alcohol use and AUDs. Addressing adolescent and young adult QOL may reduce the early onset of alcohol use and its potential for harm.

Social adversity in pregnancy and trajectories of women’s depressive symptoms: A longitudinal study

BACKGROUND Sound evidence has linked the experience of adversity with depression. Less is known about this association over time. AIM The aim of this study is to determine whether or not social adversity experienced by pregnant women is associated with their patterns of depressive symptoms over their reproductive life course. METHODS Data were obtained from a cohort of women collected at their first obstetrical clinic visit of an index pregnancy (time-point 1) and at a further six time-points to 27 years following the birth. Latent Class Growth Modelling was used to estimate trajectories of womens depressive symptoms over this time period. Logistic regression modelling determined the prospective association between measures of adversity in pregnancy and 27-year postpartum depression trajectories, controlling for potential confounders. FINDINGS Experiencing financial problems, housing problems, serious disagreements with partners and with others, and experiencing serious health problems in pregnancy were associated with membership of high and middle depression trajectories over the 27 years. Having someone close die or have a serious illness was associated with the high depression trajectory only. Younger maternal age and low family-income at first clinic visit were also associated with an increased risk of womens membership of both high and middle depression trajectories. CONCLUSIONS Experiencing adversity during pregnancy predicts subsequent patterns of maternal depression over an extended period of womens reproductive life course. It is not clear whether womens experiences of adversity during pregnancy were causally associated with subsequent depression or whether there are other explanations of the observed association.

Maternal depression and family adversity: linked pathways to offspring depression?

There is conflicting evidence about the contribution of maternal depression and family adversity to depression experienced by offspring. Because maternal depression and family adversity are related, there is a need to determine how they independently contribute to offspring depression. Data are from a long-running prospective birth cohort study (Mater-University of Queensland Study of Pregnancy and its outcomes - MUSP). For this study some 2200 offspring were followed up at 30 years of age. We first examine the association between maternal depression and family adversity over the period from the pregnancy to the child reaching adulthood. Then we consider the extent to which maternal depression and family adversity trajectories over this period predict CIDI/DSM-IV episodes of depression in the offspring of these mothers at 30 years of age. We find a strong bi-directional association between maternal depression and family experiences of adverse life events over the entire period the child is at home. After adjustment, children reared in a family experiencing high levels of adverse life events are more likely to experience a lifetime ever DSM-IV diagnosis of depression, are more likely to have experienced multiple episodes of lifetime ever depression, and are more likely to report their first episode of depression was at a younger age. The findings suggest the association between maternal depression and offspring depression appears to be partly attributable to the higher levels of family adversity characteristic of depressed mothers.