UCLA

Post-partum depression (PPD) is a significant mental health problem for women during the reproductive years and is highly prevalent among Saudi women. Studies have shown, Saudi women experience higher rates of PPD (up to 38.5%) compared to 12% of new mothers in the United States. PPD is associated with cognitive impairment and the potential for deficits in social cognitive function, which is the ability to identify, perceive, interpret, and respond to social stimuli. Social cognition has several components, including emotion recognition, empathy, and theory of mind (ToM). Impaired social cognition can impact the mother’s ability to care for her infant, read infant cues, and can potentially affect the infant’s development. However, there is little research on Saudi women with PPD and its effect on social cognition. The aim of this study is to compare social cognitive performance in Saudi women with and without PPD, examine the relationship between biological, psychological, and social variables on social cognition, and identify predictors of social cognition. Participants were screened at 6 weeks postpartum for depressive symptoms and assigned to either PPD or without PPD group using the Edinburgh Postnatal Depression Scale (EPDS). Participants completed a demographic form and measures of social cognition including Emotion Recognition Task (ERT), Interpersonal reactivity Index (IRI), and Reading the Mind Test (RMET). In addition, participants completed the Multidimensional Scale of Perceived Social Support (MPSS), the Generalized Anxiety Disorder-7 (GAD-7), and the Perceived Stress Scale (PSS). Variables related to maternal characteristics (planned pregnancy, delivery mode) and infant characteristics (birth weight, gestational age) were extracted from medical records. Descriptive and inferential statistics were used to assess group differences, correlations, and predictors of social cognition. One hundred and twenty-five eligible women (60 with PPD and 65 without PPD) consented, enrolled, and completed all study measures. No significant differences were noted between groups based on age, income, education, and employment status. Women who had a C-section or an unplanned pregnancy or whose child was born less than 38 weeks gestation with a birth weight less than 3033 grams were more likely to screen positive for PPD. Women with PPD performed significantly worse on emotional recognition (58.6 vs. 70.3, p<.001), and better on the empathy (69 vs. 65.2, p<.001) and ToM (22.8 vs. 20.6, p<.001) compared to women without PPD. Stress and anxiety were higher and social support was lower in the PPD group compared to controls (p<.001). Stepwise linear regression showed that anxiety scores accounted for 17% of the variance of emotional recognition (F=13.54, p <.001), income and age accounted for 16% of the variance of empathy (F=6.79, p=.002), and stress and birth weight accounted for 17% of the variance of ToM (F=6.9, p=.002). Age, income, anxiety, stress, and child’s birth weight affected social cognition in this sample of Saudi women with PPD. This study highlights decreased ability among participants with PPD to recognize emotions, increased empathy, and heightened ability to interpret the mind of others through the eyes (ToM). This may reflect a maternal hypersensitivity to social stimuli due to their condition and/or a stressed or anxious state. Further research is needed to assess the functional impact of these findings on maternal health, mother-infant attachment, and development.