Thirteen percent of women experience depression during the first 12 months postpartum, which adversely impacts key aspects of maternal role functioning, i.e. maternal-infant interaction, infant caretaking, gratification in the maternal role, and use of preventive health services for the infant (immunizations and well-child visits). Antidepressants, such as Selective Serotonin Reuptake Inhibitors (SSRIs) improve depression symptoms and social functioning, but their impact upon maternal role functioning has not been determined. The purpose of this naturalistic, longitudinal supplement is to investigate the impact of SSRI treatment on maternal role functioning in women during the first postpartum year. In addition, we will determine if self-efficacy is higher in depressed women who are treated with SSRIs, and we will test if a model of self-efficacy, depression, SSRI use, and social support predicts maternal role functioning. The sample (N=270) will consist of 3 groups of postpartum women (depressed, treated with SSRIs; depressed and not treated; not depressed, not treated) who are evaluated 4 times. The study is a supplement to an NIMH funded investigation, Antidepressant Use During Pregnancy (5 R01 MH60335-02, Katherine L. Wisner, M.D. PI), which addresses the effects of both depression and drug intervention during pregnancy and the postpartum period on mothers and infants. In this study, data on many aspects of the psychosocial environment of pregnant and parenting women are collected in order to isolate developmental and other effects of prenatal drug exposure on the infant. Using much of the same data, the supplement enhances and extends research currently funded by NIMH to Dr. Wisner by asking an additional question that is a national health priority: Does treatment of PPD with antidepressants improve a woman's ability to fulfill key aspects of functioning in the maternal role? Results of the study will inform women and their health care providers on outcomes of the use of SSRIs in depressed, postpartum women, assisting with decision-making on the treatment of postpartum depression. ? ?
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