Can the Development of Mood and Anxiety Disorders During Pregnancy and the Postpartum Period Be Anticipated in Women With Epilepsy?

Depression and anxiety disorders are the 2 most frequent psychiatric comorbidities in epilepsy.1 Higher prevalence rates of symptoms of depression and anxiety have also been reported more frequently during pregnancy and the postpartum period in pregnant women with epilepsy (PWWE) than pregnant nonepileptic women.2 Using data from the Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs study, and applying a robust methodology, Meador et al.3 compared the type and prevalence of mood and anxiety disorders during pregnancy and the postpartum periods among PWWE, nonpregnant WWE, and healthy pregnant women and the epilepsy and psychiatric variables associated with their occurrence, and they report their findings in this issue of Neurology®. They are the first investigators to demonstrate a pleomorphic manifestation of mood disorders in this setting: in some women, mood disorders present as a major depressive episode (MDE), in others, as subsyndromic depressive episodes.4 Although the prevalence of MDE did not differ among pregnant and nonpregnant WWE and healthy pregnant women, subsyndromic depressive episodes were identified more frequently among PWWE during pregnancy and the postpartum period.