Network Structure of Perinatal Depressive Symptoms Among Women in Rural Bihar.

Background: Perinatal depression (PND) is a common mental disorder affecting women worldwide. Despite receiving considerable attention as a unitary construct, PND's inter-symptom interactions have received limited attention. The present study examined the network structure of perinatal depressive symptoms, their relative importance, and interconnectedness among women experiencing PND from rural Bihar. Methods: A community-based cross-sectional study screened women for PND using the Edinburgh Postnatal Depression Scale (EPDS) through door-to-door surveys by trained workers. Women scoring above the cutoff were recruited. Using Results: Data from 132 participants with elevated depressive symptom scores on the EPDS were analyzed. The most central item was "I have been so unhappy that I have been crying". The strongest association was between "laughing/seeing the funny side of things" and "looking forward with interest and pleasure." Results suggest that mood and interest/pleasure symptoms, such as crying, anticipating enjoyable activities, and feeling sad showed relatively higher strength centrality in this exploratory analysis. Conclusion: The present study advances efforts to uncover symptom-symptom interactions within PND networks in India, particularly in rural Bihar. Future research to establish the clinical and prognostic utility of these symptoms can pave the way for evidence-based interventions in rural Indian settings.