A recent study published by the Public Library of Science in December 2017 reveals that perinatal depression (depression in pregnancy and postpartum) is linked with higher rates of Attention Deficit Hyperactivity Disorder (ADHD) symptoms in children at ages three and six years highlighting an "urgent" need for perinatal depression screening.
Even though other studies have linked perinatal depression to ADHD in children, what this recent study examined was whether it matters if depression at a certain point in time in pregnancy or postpartum has any effect on whether or not a child develops ADHD.
Approximately 1 in 4 women experience a mental health disorder in pregnancy and an average of 15 to 20 per cent of women experience postpartum depression.
According to the National Institute of Mental Health, symptoms of perinatal depression include feeling sad, hopeless, empty, or overwhelmed, crying more often than usual or for no apparent reason, worrying or feeling overly anxious, feeling moody, irritable, or restless, oversleeping, or being unable to sleep even when her baby is asleep, having trouble concentrating, remembering details and making decisions, experiencing anger or rage, losing interest in activities that are usually enjoyable, suffering from physical aches and pains including frequent headaches, stomach problems, and muscle pain, eating too little or too much, withdrawing from or avoiding friends and family, having trouble bonding or forming an emotional attachment with her baby, persistently doubting her ability to care for her baby, and thinking about harming herself or her baby.
Treatment for perinatal depression includes medication and therapy depending on each individual case. Some women may benefit from medication while others may be helped solely through therapy or a combination of both depending on the severity. There are also risk factors to consider in taking medication while pregnant.
ADHD affects 5.9 to 7.1 per cent of children and is considered the most common neurodevelopmental disorder in childhood. There are three sub-types of ADHD: Inattentive; Hyperactive; and Combination Inattentive-Hyperactive.
According to the Centre for ADHD Awareness Canada, symptoms of ADHD can include difficulty regulating, switching and prioritizing attention, over-focusing on stimulating activities, being easily distracted, daydreaming, being unable to remember verbal instructions, misinterpreting instructions, inability to pay attention to details, difficulty with organization, fidgeting, talking excessively and at inappropriate times, running and climbing, standing instead of sitting at the table, acting or reacting before considering consequences, and inattention.
Studies show a multi-modal approach to treatment is best for children with ADHD. This includes a combination of medication and therapy. It’s not about curing ADHD, but decreasing symptoms and helping children and adults with ADHD learn strategies to navigate their environment.
Rates of ADHD have increased by 30 per cent over recent years and researchers aren’t sure why. Theories have pointed to increased awareness and reporting rates, however, researchers in this study wanted to identify whether it was also related to perinatal depression. So far, science has linked obesity and diabetes in pregnancy as well as preterm birth and low birthweight to an increased risk of ADHD. There were a couple of previous studies that have shown higher prevalence rates of ADHD in children from mothers who were depressed a year before their child’s birth and mothers who were depressed at 20 weeks of pregnancy had children with higher rates of ADHD at three years of age. Previous studies also showed that mothers who were depressed at 18 and 32 weeks of pregnancy had children with higher rates of ADHD at four and 11 years of age. However, researchers of the current study suggest that these previous studies were limited because they didn’t cover the entire woman’s pregnancy, they didn’t account for obesity and diabetes during pregnancy, and they didn’t test whether postpartum depression also had an affect on their child’s diagnosis of ADHD.
A total of 1779 Finnish women participated in the recent study. They were recruited from ten hospitals in Southern and Eastern Finland during their first ultrasound at 12 weeks of pregnancy. Mothers had to complete the Center of Epidemiological Studies Depression Scale biweekly from 12 weeks on during pregnancy and the Beck Depression Inventory-II and the Conners’ Hyperactivity Index for their children at ages three and six years. Results showed that mothers with consistent high depression symptoms throughout pregnancy resulted in high ADHD symptoms in their children, about 2.8 times higher. Results also showed that postpartum depression symptoms add to the effects of ADHD in children.
Though researchers did not find a link between a specific period of depression during pregnancy and postpartum with children with ADHD, they did find that women with higher levels of perinatal depression resulted in higher numbers of children with ADHD: “The proportion and odds of children with clinically significant ASDHD symptoms were the highest among those women with clinically significant depressive symptoms both during and after pregnancy.”
Public Library of Science, (December 2017), Maternal derpessive symptoms during and after pregnancy are associated with attention-deficit/hyperactivity disorder symptoms in their 3-6 year old children, http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0190248
Centre for ADHD Awareness Canada, http://caddac.ca/adhd/understanding-adhd/in-general/treatment/
National Institute of Mental Health, https://www.nimh.nih.gov/health/publications/postpartum-depression-facts/index.shtml
The British Journal of Psychiatry, (January 2018), Accuracy of the Whooley questions and the Edinburgh Postnatal Depression Scale in identifying depression and other mental disorders in early pregnancy, https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/accuracy-of-the-whooley-questions-and-the-edinburgh-postnatal-depression-scale-in-identifying-depression-and-other-mental-disorders-in-early-pregnancy/A317DC7FBD645FB34FF8A1D2E2762A5F/core-reader