Pregnant or depressed? The effect of overlap between symptoms of depression and somatic complaints of pregnancy on rates of major depression in the second trimester

This study investigated the relationship between symptoms of major depression that were attributed either to stress or to pregnancy among women in the second trimester and considered the effect of symptom overlap on diagnostic outcome. A sample of 570 obstetrical clinic patients were given the depression section of the Diagnostic Interview Schedule, with questions added about pregnancy as a cause of somatic symptoms. In this sample, some of the common symptoms of depression such as increased appetite and fatigue were attributed more frequently to pregnancy than to stress. When pregnancy‐related symptoms were included in the scoring for DSM‐III‐R major depression, the rate for the current pregnancy rose from 1.2 to 2.8 percent and the rate for lifetime major depression rose from 5.6 to 10.9%. Comparisons on measures of family history, self‐report depression, and personality between subjects with “pure” depression and those with “mixed” symptom pictures suggest that the latter may he a spectrum group. In the discussion we speculate that the overlap between symptoms of depression and complaints associated with pregnancy may bias estimates of depression in studies of women of childbearing age. Depression 2:308–314 (1994/1995).