Research Letter: is neuroticism a risk factor for postpartum depression?

Although the relationship between personality and depressive illness is complex (Shea, 2005), there is empirical evidence that some personality features such as neuroticism, harm avoidance, introversion, dependency, self-criticism or perfectionism are related to depressive illness risk (Gunderson et al. 1999). Moreover, personality traits, especially neuroticism, may explain the increased prevalence of depression among females (Goodwin & Gotlib, 2004). Few studies have explored neuroticism, extraversion and psychoticism as risk factors for depression after an event as stressful as childbirth. Pitt (1968) was the first author to report high scores on neuroticism and low scores on extraversion among postpartum depressed women. Similar results were found in a comparison of mothers with and without postpartum depressive symptoms (Dudley et al. 2001; Podolska et al. 2010). A case-control study comparing women with recurrent major depression with and without a history of postpartum depression found no personality trait differences between them; however, those with a history of postpartum depression showed higher neuroticism and psychoticism and lower extraversion than controls. These results suggested that these traits did not confer a specific risk for the postnatal onset episodes (Jones et al. 2010). Prospective studies have also studied the link between personality and postpartum depression; however, these data are not conclusive due to methodological limitations, such as sample size (Kumar & Robson, 1984; Watson et al. 1984; Areias et al. 1991; Boyce et al. 1991; Matthey et al. 2000), selection bias (Kumar & Robson, 1984; Areias et al. 1991; Boyce et al. 1991; Matthey et al. 2000), or depression assessment (self-report measures versus clinical diagnosis: Boyce et al. 1991; Matthey et al. 2000; Dudley et al. 2001; Saisto et al. 2001; Van Bussel et al. 2009) or because the authors did not take into account confounding factors such as stressful life events or social support (Watson et al. 1984; Kumar & Robson, 1984; Boyce et al. 1991; Matthey et al. 2000; Saisto et al. 2001; Verkerk et al. 2005; Van Bussel et al. 2009). (See Supplementary material, Table S1.)The aim of this paper was to extend the previous knowledge of the role of neuroticism, extroversion and psychoticism as risk factors for postpartum depression (depression symptomatology and clinical diagnosis) considering psychosocial variables in a large cohort of women from the general population.Peer Reviewe