Research Report Pregnancy and post-partum depression and anxiety in a longitudinal general population cohort: The effect of eating disorders and past depression Nadia Micali a, ⁎, Emily Simonoff a , Janet Treasure b a King's College London, Child and Adolescent Psychiatry Department, Institute of Psychiatry, London, UK b King's College London, Eating Disorders Research Unit, Department of Academic Psychiatry (Guy's Hospital), London, UK article info abstract Article history: Received 29 June 2010 Received in revised form 28 September 2010 Accepted 28 September 2010 Available online 10 December 2010 Background: This study investigated the effect of past depression, past and current eating disorders (ED) on perinatal anxiety and depression in a large general population cohort of pregnant women, the Avon Longitudinal Study of Parents and Children (ALSPAC). Methods: Anxiety and depression were measured during and after pregnancy in 10,887 women using the Crown-Crisp Experiential Inventory and Edinburgh Postnatal Depression Scale. Women were grouped according to depression and ED history: past ED with (n = 123) and without past depression (n = 50), pregnancy ED symptoms with (n = 77) and without past depression (n = 159), past depression only (n = 818) and controls (n = 9,660). We compared the course of depression and anxiety with linear mixed-effect regression models; and probable depressive and anxiety disorders using logistic regression. Results: Women with both past depression and past/current ED had high anxiety and depression across time perinatally; this was most marked in the group with pregnancy ED symptoms and past depression (b coefficient:5.1 (95% CI: 4.1–6.1), p b 0.0001), especially at 8 months post-partum. At 18 weeks in pregnancy all women (apart from those with past ED only) had a higher risk for a probable depressive and anxiety disorder compared to controls. At 8 months post-partum pregnancy ED symptoms and/or past depression conferred the highest risk for a probable depressive and anxiety disorder. Limitations: Data were based on self-report. There was some selective attrition. Conclusions: Pregnancy ED symptoms and past depression have an additive effect in increasing the risk for depression and anxiety perinatally. Screening at risk women for anxiety and depression in the perinatal period might be beneficial. © 2010 Elsevier B.V. All rights reserved. Keywords: Anxiety Depression Eating disorders Pregnancy Post-partum ALSPAC 1. Introduction Child-birth is associated with an increase in maternal psychiatric illness (Brockington, 1996). Epidemiological studies across different countries have reported 10–20% of women experience an episode of depression in the first few months after delivery (Cooper et al., 1988; O'Keane & Marsh, 2007; Josefsson et al., 2001), and between 7% and 15% in late pregnancy (Dietz et al., 2007; Evans et al., 2001). Research has consistently highlighted previous depressive disorders as increasing the risk for perinatal affective disorders (Milgrom et al., 2008). Although anxiety during pregnancy and the post-partum has been less studied its prevalence in the antenatal period has been estimated at 11.4%; with a drop to 8% in the post-partum (Andersson et al., 2001; Ross & McLean, 2006). There is also evidence of a relationship between perinatal depression and anxiety (Austin, 2004); in particular a bidirectional effect of Journal of Affective Disorders 131 (2011) 150–157 ⁎ Corresponding author. Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, P085, De Crespigny Park, London, SE5 8AF, UK. Tel.: +44 207 848 0468; fax: +44 207 708 5800. E-mail address: nadia.micali@kcl.ac.uk (N. Micali). 0165-0327/$ – see front matter © 2010 Elsevier B.V. All rights reserved. doi:10.1016/j.jad.2010.09.034 Contents lists available at ScienceDirect Journal of Affective Disorders journal homepage: www.elsevier.com/locate/jad