Minor depressive disorder in the context of miscarriage

Background: Although minor depressive disorder is of considerable clinical and public health importance, it has received limited research attention re lative to major depressive disorder. This study examines the incidence rate and relative risk for minor depressive disorder following miscarriage. Met hods: Using a cohort design we tested whether miscarrying women are at incr eased risk for an episode of minor depression (diagnosed based on research criteria proposed in Appendix B of DSM-IV) in the 6 months following loss. The miscarriage cohort consisted of women attending a medical center for sp ontaneous abortion (n = 229): the comparison group was a population-based c ohort of women drawn from the community (n = 230). Results: Among miscarryi ng women, 5.2% experienced an episode of minor depression, compared with 1. 0% of community women. The overall relative risk for an episode of minor de pression for miscarrying women was 5.2 (95% confidence interval, 1.2-23.6). Relative risk did not vary by length of gestation at the time of loss or a ttitude toward the pregnancy. The majority of episodes in miscarrying women began within 1 month following loss. Limitations: Minor depression was rel atively rare in both study cohorts. The resulting limits on statistical pow er reduced our ability to identify factors, such as sociodemographic or rep roductive history variables that might moderate the effect of miscarriage o n risk for minor depression. Conclusions: These results, in the context of prior work showing increased risks of major depression and depressive sympt oms following miscarriage, lend some support to the conceptualization of mi nor depressive disorder as part of a continuum of symptom severity. Miscarr ying women should be evaluated for depression at their follow-up medical vi sits. (C) 2000 Elsevier Science B.V. All rights reserved.