Network Structure of Perinatal Depressive Symptoms in Latinas: Relationship to Stress and Reproductive Biomarkers.
Hudson Santos, Eiko I Fried, Josephine Asafu-Adjei and 1 others
PMID 28220506WHAT IT FOUND
In pregnant Latina women, perinatal depression symptoms clustered together.
Depressed mood, happiness, sadness, loneliness and feeling blue appeared most strongly linked to other symptoms. Stress and reproductive biomarkers showed only weak links.
Key findings
01The strongest positive links among CES-D symptoms were happy with joy (.54), unfriendly with dislike (.47), crying with sadness (.37), hope with feeling good (.31), and sadness with depressed mood (.28).
02Depressed mood, happiness, sadness, loneliness and feeling blue had the highest strength centrality, but the stability coefficient was .28, below the preferred .5, and the difference test did not always show them significantly more central.
03Stress and reproductive biomarkers had few and weak links to symptoms, and the depressed group's overall connection strength was 8.83, compared with 8.47 in the non-depressed group (P = .001), but the pattern of connections did not differ (P = .99).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was cross-sectional, so it cannot show that one symptom caused another or that treating a central symptom would help. Network models estimate many parameters, and the authors say the sample may not be large enough for firm clinical conclusions or stable networks. Missing data reduced the number of participants available for some analyses, and the secondary biomarker and group comparisons were described as proof-of-principle because they were likely underpowered. Several CES-D items overlap, such as sadness, lack of happiness, depressed mood and feeling blue, which may make those symptoms look more central than they truly are. Comparing non-depressed and depressed groups by a BDI-II cut point included many women near the cut point, and the analytic samples were reduced for the network comparison.
Declared interests
The authors declared no potential conflicts of interest.
The easy way to misread this
Do not treat the central symptoms as proven treatment targets. The study did not test an intervention, the centrality ranking was only moderately stable, and overlapping CES-D items may have made mood symptoms look more central than they are.