Pregnancy is associated with psychiatric symptoms in a low-income countryside community of Brazil

Fernando MV Dias^1–3, Claudio SD Junior⁴, Glaura C Franco⁵, Antônio L Teixeira³, Angela M Ribeiro^2
1Department of Medicine and Nursing, Federal University of Viçosa, Viçosa; ²Graduate Program in Neurosciences, Laboratory of Molecular and Behavioral Neuroscience (LaNeC); ³Graduate Program in Neurosciences, Neuropsychiatric Branch Research; ⁴Department of Sociology and Anthropology; ⁵Department of Statistics, Federal University of Minas Gerais, Belo Horrizonte, Brazil

Background: Psychiatric symptoms during pregnancy induce an increase in morbidity and also in the mortality levels among women and children. However, the real association between pregnancy and psychiatric disorders and the peculiarities of the phenomenology of symptoms in underprivileged countryside communities remain uncertain.
Objective: To verify the association between psychiatric disorder, symptoms, and pregnancy among women from a low-income countryside community and to determine the specific cutoff points for major depression diagnosis according to Beck Depression Inventory for the different trimesters of pregnancy in this population.
Methods: Ninety-four pregnant women and 38 healthy women from the Conceição do Mato Dentro health service, a rural low-income community in Brazil, participated in the present study. Psychiatric examination included a structured clinical interview for psychiatric disorders according to Mini International Neuropsychiatric Interview and psychometric scales such as the Yale–Brown Obsessive Scale, the Beck Depression Inventory, and the Hamilton Anxiety Scale. The cutoff points for Beck Depression Inventory were determined through the application of receiver operating characteristic curves considering the diagnosis of major depression according to Mini International Neuropsychiatric Interview.
Results: The pregnant women had a higher frequency of psychiatric disorders and depression and anxiety symptoms. All cutoff points of Beck Depression Inventory were equal or higher than 12 with high sensitivity and specificity. Although the modified cutoff was selected based on both high sensitivity and high specificity, they were lower than when the cutoff was applied to nonpregnant women.
Conclusion: Pregnancy was associated with the occurrence of psychiatric disorders and depressive and anxiety symptoms. In comparison to the literature, the present results indicate that there are different cutoff points in the Beck Depression Inventory for pregnant women from different cultures and in different pregnancy trimesters.

Keywords: pregnancy, psychiatric symptoms, low-income countryside communities