Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Feb 19, 2023; 13(2): 50-59
Published online Feb 19, 2023. doi: 10.5498/wjp.v13.i2.50
Relationship between family cohesion/adaptability and postpartum depressive symptoms: A single-center retrospective study
Guo-Rong Zhang, Peng-Sheng Li, Yan-Bin Jia
Guo-Rong Zhang, Yan-Bin Jia, Department of Psychiatry, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou 510630, Guangdong Province, China
Peng-Sheng Li, Department of Women’s Healthcare, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan 528000, Guangdong Province, China
Author contributions: Zhang GR contributed to the study conception and design, drafting manuscript, data analysis and interpretation; Li PS contributed to the study conception, critical revision of article for important intellectual content; Jia YB contributed to the study conception and design, critical revision of article for important intellectual content.
Supported by Foundation of Bureau of Science and Technology of Foshan City, No. 2020001005566.
Institutional review board statement: This study was approved by the Institutional Review Board of the Affiliated Maternal & Child Health Hospital of Foshan, Southern Medical University (Approval No. FSFY-MEC-2021-029).
Informed consent statement: This is a retrospective study that used anonymous clinical data. According to institutional policies, informed consent was not required from patients in this study.
Conflict-of-interest statement: All authors declare no conflicts of interest.
Data sharing statement: The data for this study can be obtained from the corresponding author upon request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan-Bin Jia, MD, Chief Doctor, Department of Psychiatry, The First Affiliated Hospital of Jinan University, Jinan University, No. 613 Huangpu Avenue West, Tianhe District, Guangzhou 510630, Guangdong Province, China. jiayanbin1985@163.com
Received: November 28, 2022
Peer-review started: November 28, 2022
First decision: December 20, 2022
Revised: December 30, 2022
Accepted: January 19, 2023
Article in press: January 19, 2023
Published online: February 19, 2023
Processing time: 81 Days and 0.2 Hours
Abstract
BACKGROUND

Depression is the most common mental illness in postpartum mothers, and the etiology of postpartum depression remains poorly understood. Over the past several decades, studies have reported that postpartum depression is caused by multiple factors, such as genetic, psychological, pregnancy, and environmental factors, with the family environment being an important environmental factor. The theory of family cohesion and adaptability put forward by Olson is a classic model that describes the level of family function. However, to date, this model has not been examined regarding its applicability to patients with postpartum depression.

AIM

To investigate the relationship between family cohesion and adaptability and the risk of postpartum depressive symptoms.

METHODS

We retrospectively analyzed 1446 patients admitted to the postpartum healthcare clinic of the Affiliated Foshan Maternity and Child Healthcare Hospital from April 2021 to December 2021. Patients were grouped according to whether postpartum depression symptoms were reported (symptoms, n = 454; no symptoms, n = 992). All patients completed the Edinburgh Postpartum Depression Scale and the Chinese version of the Family Cohesion and Adapt-ability Assessment Scale II. Baseline and clinical data were compared between groups. Univariate regression analysis was used to investigate the association between different types of family cohesion and postpartum depressive symptoms and the association between different family adaptability types and postpartum depressive symptoms.

RESULTS

After adjusting for age, education, occupation, gravidity, parity, and mode of delivery, disengaged [adjusted odds ratio (AOR) = 3.36, 95%CI: 1.91–5.91], and separated (AOR = 1.97, 95%CI: 1.34–2.90) family cohesion types showed a higher risk of postpartum depression than the connection type, whereas the enmeshed type (AOR = 0.38, 95%CI: 0.28–0.51) protected against postpartum depressive symptoms. Rigid (AOR = 4.41, 95%CI: 3.02–6.43) and structured families (AOR = 1.88, 95%CI: 1.34–2.63) had a higher risk of postpartum depressive symptoms than flexible families, whereas chaotic families (AOR = 0.35, 95%CI: 0.24–0.51) protected against postpartum depressive symptoms.

CONCLUSION

Family cohesion and adaptability are influencing factors for postpartum depressive symptoms, with higher family cohesion and adaptability being associated with a lower risk of postpartum depressive symptoms.

Keywords: Family cohesion, Adaptability, Postpartum depressive symptoms, Cross-sectional study

Core Tip: Postpartum depression is the most common mental illness in postpartum mothers; studies have reported that postpartum depression is caused by multiple factors. This study analyzed the family environments of 1446 postnatal women, showing that high family cohesion and adaptability prevented the development of postpartum depressive symptoms. Further, we observed a linear relationship between family cohesion, adaptability, and postpartum depressive symptoms, where higher family cohesion and adaptability scores were associated with a risk of postpartum depressive symptoms.