noticed that women with an avoidant, dependent, or obsessive-compulsive personality disease had greater chances of postpartum depressive onset Uguz et al. The tendency of these mothers to experience a state of growing anxiety, along with a predisposition to face intimate relationships with an attitude of hyperresponsibility, can transform the engagement in child care into an emotional burden that can overwhelm these patients, leading to a depressive condition. They are often associated with the tendency to experience feelings of guilt and inadequacy, low self-esteem, and lack of autonomy, along with brooding, lack of assertiveness, and hypersensitivity toward refusal. This is also the case for women with borderline personality organization, who may have specific difficulties in dealing with developmental challenges typical of the transition to parenthood.Ī specific bond between obsessive-compulsive/dependent personality traits and depressive perinatal risk can be found among the features related to these profiles. The studies conducted so far suggest that women with obsessive-compulsive, avoidant, or dependent personality disorders have greater risks of developing a major depressive episode during pregnancy. Although the relation between major depressive diseases and personality diseases has been deeply investigated, the number of works concerning personality organization as a factor of vulnerability in perinatal depression has been limited in the psychiatric literature. Personality structure is considered a significant source of vulnerability for the onset, development, and treatment of various psychiatric conditions and it is likely to play a role in perinatal depression. These personality structures, in which intrapsychic and relational functioning are already problematic, may become maladaptive during the delicate transition from being a daughter to being a mother.
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In this transitional phase, women with a complex personality structure can develop affective symptoms. Indeed, maternity is known as an interval of vulnerability, in which the physical, psychological, and relational transformations imply a deep reorganization of the inner and outer reality, a sort of “identity crisis” that allows the mother to arrange in her mind a new place to grow a new representation of the incoming baby and of herself as a parent. Many have written about pregnancy and maternity, focusing on the hard task that women have to deal with in this peculiar phase of their life cycle. In clinical practice, it is very common that the depressive symptoms seem to be an epiphenomenon of a deeper disease, which has its roots in issues concerning both the area of the integration of identity and the affective modulation. Therefore, the observation and analysis of these features have led researchers to wonder about the existence of several etiopathogenetic pathways and specific risk factors in relation to different clinical conditions.
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Perinatal mood disorders include a variety of clinical entities, which differ with regard to the period of onset, the severity of the illness, and psychopathological features. Characteristics of personality have a key role in clinical manifestations of perinatal depression it is important to detect them to identify mothers at risk and to plan targeted therapeutic interventions. The first cluster (39.5%) collects structures of personality with prevalent obsessive or dependent functioning tending to develop a “psychasthenic” depression the third cluster (13.95%) includes women with prevalent borderline functioning tending to develop “dysphoric” depression the second cluster (46.5%) shows a normal profile with a “defensive” attitude, probably due to the presence of defense mechanisms or to the fear of stigma. The analysis identified three clusters of personality profile: two “clinical” clusters (1 and 3) and an “apparently common” one (cluster 2). A clinical group of subjects with perinatal depression (PND, 55 subjects) was selected clinical and validity scales of MMPI-2 were used as predictors in hierarchical cluster analysis carried out.
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The study started with a screening of a sample of 453 women in their third trimester of pregnancy, to which was administered a survey data form, the Edinburgh Postnatal Depression Scale (EPDS) and the Minnesota Multiphasic Personality Inventory 2 (MMPI-2). To assess personality characteristics of women who develop perinatal depression.