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Perinatal Depression in Neurological Disease and Disability

Women and men with neurological disease more often suffer from depression in relation to pregnancy and delivery than other parents. Perinatal depression may harm the parent-child relationship as well as the health of the child. Postnatal psychosis, suicide, and infanticide are rare but severe consequences of the disorder. Symptoms of perinatal depression may overlap with symptoms of neurological disease. Both disorders may aggravate each other. Side effects from neurological treatment could mimic symptoms of depression, and antidepressive drugs could worsen neurological symptoms and interact with other treatment. Neurological patients should be evaluated for risk factors for perinatal depression before delivery. These include previous psychiatric disease, sexual or psychical abuse, sleep problems, high neurological disease activity, and low social support. Pregnant women with previous psychotic episodes or bipolar disease should be referred for psychiatric evaluation before delivery. All patients should be screened for depressive symptoms during follow-up using a 3-step method.