Not much is known about the interaction between these characteristics and disorders, Dr. Suzanne E. Masseo, from Virginia Commonwealth University in Richmond, and colleagues note. What little is known is limited by relatively small samples drawn exclusively from clinics.
Their own study, reported in the International Journal of Eating Disorders for April, included 1119 women who reported a mean of 2.5 pregnancies each. They had undergone four evaluations between 1988 and 1997. A self-report questionnaire assessed the incidence of anorexia nervosa, bulimia nervosa, and binge eating disorder.
Lifetime incidence of major depressive disorder and depression during pregnancy were determined, and subjects with evidence of postnatal depression completed the Edinburgh Postnatal Depression Scale questionnaire.
Three subscales of the Multidimensional Perfectionism Scale were used to evaluate concern over tendencies to interpret mistakes as failures, doubts about one's ability to accomplish tasks, and personal standards.
The authors observed that symptoms of depression during pregnancy, "baby blues," and postpartum depression were higher among women with eating disorders. Specifically bulimia nervosa (odds ratio 3.5) and binge-eating disorder (OR 2.8) were strongly associated with postpartum depression.
In fact, "women with eating disorders appear to be at as much, if not greater, risk for developing depression during pregnancy or postpartum as are women with a history of major depressive disorder."
They also found that, after correcting for lifetime major depression, postpartum depression scores correlated with concern over mistakes and doubts about one's abilities.
"These findings suggest that, among individuals who reported symptoms of postpartum depression...the severity of these symptoms may be accounted for by specific aspects of perfectionism, primarily concern over making mistakes."
Dr. Masseo's team advises physicians to ask pregnant patients about their histories of eating disorders and assess the features of perfectionism, since these traits help "to identify at-risk individuals, and facilitate primary prevention of postpartum depression."
They conclude: "Given the significant impact that postpartum depression can have on the health of both mothers and their offspring, as well as the effectiveness of treatment, early detection and treatment appear invalu