The British Journal of Psychiatry (2008) 193: 383-388. doi: 10.1192/bjp.bp.107.045427
© 2008 The Royal College of Psychiatrists
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Mood changes after delivery: role of the serotonin transporter gene

J. Sanjuan, MD, PhD

Hospital Clínico, UV, CIBER Enfermedades Mentales (CIBERSAM), Valencia, Spain

R. Martin-Santos, MD, PhD and L. Garcia-Esteve, MD, PhD

IMIM-Hospital del Mar and Hospital Clínico, Barcelona, Spain

J. M. Carot, PhD, PhD

Departamento de Estadística e Investigación Operativa, UPV, Valencia, Spain

R. Guillamat, MD, PhD

Corporación Sanitaria Parc Tauli, Sabadell, Spain

A. Gutierrez-Zotes, PhD

Hospital Psiquiátrico, Instituto Pere Mata, URV Reus, Spain

I. Gornemann, MD, PhD

Fundación IMABIS, Hospital Carlos Haya, Málaga, Spain

F. Canellas, MD, PhD

Hospital Son Dureta (IUNICS), Palma de Mallorca, Spain

E. Baca-Garcia, MD, PhD

Fundación Jiménez Díaz, UAM, CIBERSAM, Madrid, Spain

M. Jover

Hospital Clínico, UV, CIBERSAM, Valencia, Spain

R. Navines, MD, PhD

IMIM-Hospital del Mar and Hospital Clínico, Barcelona, Spain

V. Valles

Corporación Sanitaria Parc Tauli, Sabadell, Spain

E. Vilella, PhD

Hospital Psiquiátrico, Instituto Pere Mata, URV Reus, Spain

Y. de Diego, PhD

Fundación IMABIS, Hospital Carlos Haya, Málaga, Spain

J. A. Castro, PhD

Hospital Son Dureta (IUNICS), Palma de Mallorca, Spain

J. L. Ivorra

Hospital Clínico, UV, CIBERSAM, Valencia, Spain

E. Gelabert

IMIM-Hospital del Mar and Hospital Clínico, Barcelona, Spain

M. Guitart, MD, PhD

Corporación Sanitaria Parc Tauli, Sabadell, Spain

A. Labad, MD, PhD

Hospital Psiquiátrico, Instituto Pere Mata, URV Reus, Spain

F. Mayoral, MD, PhD

Hospital Son Dureta (IUNICS), Palma de Mallorca, Spain

M. Roca, MD, PhD

Hospital Son Dureta (IUNICS), Palma de Mallorca, Spain

M. Gratacos, PhD

CIBER en Epidemiología y Salud Pública (CIBERESP) (CRG), Barcelona, Spain

J. Costas, PhD

SERGAS Hospital Clínico Universitario, Santiago de Compostela, Spain

J. van Os, MD, PhD

Department of Psychiatry and Neuropsychology, Maastricht University, Netherlands and Division of Psychological Medicine, Institute of Psychiatry, London, UK

R. de Frutos, PhD

Hospital Clínico, UV, CIBERSAM, Valencia, Spain

Correspondence: Julio Sanjuán, Unidad de Psiquiatría, Facultad de Medicina Valencia, Universidad de Valencia, Blasco Ibáñez 15, 46010 Valencia, Spain. Email: julio.sanjuan{at}uv.es

Declaration of Interest

None. Funding detailed in Acknowledgements.

Background

Polymorphic variations in the serotonin transporter gene (5-HTT) moderate the depressogenic effects of tryptophan depletion. After childbirth there is a sharp reduction in brain tryptophan availability, thus polymorphic variations in 5-HTT may play a similar role in the post-partum period.

Aims

To study the role of 5-HTT polymorphic variations in mood changes after delivery.

Method

One thousand, eight hundred and four depression-free Spanish women were studied post-partum. We evaluated depressive symptoms at 2–3 days, 8 weeks and 32 weeks post-partum. We used diagnostic interview to confirm major depression for all probable cases. Based on two polymorphisms of 5-HTT (5-HTTLPR and STin2 VNTR), three genotype combinations were created to reflect different levels of 5-HTT expression.

Results

One hundred and seventy-three women (12.7%) experienced major depression during the 32-week post-partum period. Depressive symptoms were associated with the high-expression 5-HTT genotypes in a dose–response fashion at 8 weeks post-partum, but not at 32 weeks.

Conclusions

High-expression 5-HTT genotypes may render women more vulnerable to depressive symptoms after childbirth.