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Network Structure of Perinatal Depressive Symptoms Among Women in Rural India

Bibliographic Data

ID22414367
AuthorsSanjna Shukla (0000-0002-2442-6482, Schizophrenia Research Foundation, Chennai, Tamil Nadu, India.), Jothilakshmi Durairaj (0000-0003-3971-6818, Schizophrenia Research Foundation, Chennai, Tamil Nadu, India.), Homam A Khan (0000-0002-0534-0640, Innovators in Health (India) Nagar Panchayat, Dalsinghsarai, Samastipur, Bihar, India.), Uttara Seshu (0000-0002-5915-1191, Innovators in Health (India) Nagar Panchayat, Dalsinghsarai, Samastipur, Bihar, India.), Manish Bhardwaj (0000-0001-9615-5741, Innovators in Health (India) Nagar Panchayat, Dalsinghsarai, Samastipur, Bihar, India.), Vijaya Raghavan (0000-0001-5517-6175, Schizophrenia Research Foundation, Chennai, Tamil Nadu, India., corresponding author)
Year2026
Pages02537176261444526-02537176261444526
Publication date2026-05-16
Open AccessYes
TypeARTICLE
VenueIndian Journal of Psychological Medicine (JOURNAL)
Journal identifiersISSN: 0253-7176 • E-ISSN: 0975-1564
PublisherSAGE Publications (PUBLISHER • US)
DOI10.1177/02537176261444526
PMID42153100
OpenAlexW7161450035
LanguageEN
References cited62

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: 4.0.3 and the qgraph package, the network structure was estimated to visualize symptom relationships. Centrality indices highlighted the connectivity of each symptom within the network. Accuracy and stability analyses assessed the robustness of the results. 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.

Centrality · Depressive symptoms · Edinburgh Postnatal Depression Scale · Feeling · Mental health · Mood · Psychological intervention · Maternal Mental Health During Pregnancy and Postpartum · Mental Health Research Topics · Treatment of Major Depression

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