Microbiological analysis of skin lesions of cod (Gadus morhua) from the southern part of the Baltic Sea.

Introduction: Since the middle of the 1980s, severe skin disorders have been observed in Baltic cod (Gadus morhua) each year. Available data on the spectrum of bacteria isolated from the clinical cases being limited, and evaluation of the microbial background of fish skin lesions being useful, a bacteriological examination has been undertaken. Material and Methods: A total of 1,381 cod were caught during two voyages of the Baltica research vessel in the Polish exclusive economic zone of the southern Baltic Sea. After an examination which found lesions in 164 of the fish, a microbiological analysis was performed to isolate bacteria from them. The collected strains were phenotyped and genotyped, and their antimicrobial resistance was analysed by minimum inhibitory concentration (MIC) techniques. Results: Bacteriological examinations provided 850 isolates. The dominant microorganisms were mesophilic Aeromonas spp., Pseudomonas spp. and Shewanella baltica. Opportunistic bacteria potentially hazardous to human health were also isolated, e.g. Alcaligenes faecalis, Staphylococcus epidermidis, Stenotrophomonas maltophilia and Vibrio sp. The MIC analysis determined the highest number of bacteria to resist sulphamethoxazole and amoxicillin and clavulanic acid. Conclusion: Most of the collected bacteria were opportunistic pathogens for fish, widespread in the aquatic environment, and potentially threatening to humans.

Phylogenetic analysis of Shewanella spp. isolated from fish.

Different species of Shewanella spp. widely inhabit freshwater and marine environments. Some of them are opportunistic fish pathogens. The application of high-throughput sequencing enabled the characterization and taxonomic reclassification of many Shewanella spp. species. Still, some strains collected from fish need to be better recognized. The aim of the present study was to classify and determine the phylogenetic relationships of Shewanella spp. collected from fish. The complete genomes of 94 strains of Shewanella spp. from different fish species were sequenced using Illumina platform (MiSeq). The 16S rRNA gene, genomic features and whole-genome relationships of those bacteria were comprehensively analysed in comparison to reference strains. Whole-genome analysis showed that the tested Shewanella spp. strains were clustered into six groups similar to reference strains of S. xiamenensis, S. oneidensis, S. glacialipiscicola, S. hafniensis, S. baltica and S. oncorhynchi. Our study indicates that the whole-genome sequence analysis enabled taxonomic classification and assessment of the diversity of the Shewanella spp. strains, as opposed to recently the gold standard method of 16S rRNA amplicon sequencing. The high genetic diversity and low similarity to the reference genome of S. oneidensis indicate that the group of strains may be a subspecies or even new species. Furthermore, we showed that the most frequent Shewanella spp. species occurring in freshwater fish in our study is the recently described species S. oncorhynchi.

Drug efficacy on zoonotic nematodes of the Anisakidae family: new metabolic data.

In the Anisakidae family, there are nematodes, most of which are parasitic for important commercial fish species. Both public health risks and socio-economic problems are attributed to these parasites. Despite these concerns, knowledge of the metabolism of these parasites remains unknown. Therefore, the main objective of this study was to investigate the receptors of drugs and oxidative metabolic status of two Anisakidae species, Pseudoterranova decipiens (s. s.) and Contracaecum osculatum (s. s.), under the influence of anthelminthic drugs, ivermectin (IVM) and pyrantel (PYR), at different concentrations: 1.56, 3.125 and 6.25 µg mL−1 of culture medium for 3, 6, 9, 12 and 72 h. The mRNA expressions of the γ-aminobutyric acid receptor, acetylcholine receptor subunits, adenosine triphosphate-binding cassette transporters and antioxidative enzymes were determined. The total antioxidant capacity and glutathione S-transferase activity were also examined. To the best of the authors' knowledge, this is the first time that IVM and PYR have been tested against these parasitic nematodes.

Effect of freezing on the metabolic status of L3 larvae of Anisakis simplex s. s.

The fish-borne parasite, Anisakis simplex s. s., triggers a disease called anisakiasis, that is associated with a gastrointestinal infection. The Anisakis is also associated with allergic response which may lead to anaphylactic shock. The A. simplex s. s. L3 larvae may be freeze tolerant despite when the nematodes will be cooled rapidly to -20 °C according to the sanitary authorities of the USA and the EU. The aim of this work was to study the metabolic status of A. simplex s. s. L3 larvae when frozen in terms of viability, expression of genes involved in the nematodes' survival of freezing, as well content of carbohydrates which play a cryoprotective role in thermal stress and are the main source of energy. The levels of trehalose were significantly higher after slow freezing treatment (p < .0001), than the fast freezing (p < .002). The lower temperatures induce changes, especially in trehalose synthesis gene expression, genes responsible for oxidative metabolism, and chaperone proteins, but we cannot state clearly whether these changes occur during freezing, or because they are already prevalent during cold acclimation. The induction of mentioned genes seems to be a common trait of both cold- and dehydration tolerance.

First evidence of the presence of Anisakis simplex in Crangon crangon and Contracaecum osculatum in Gammarus sp. by in situ examination of the stomach contents of cod (Gadus morhua) from the southern Baltic Sea.

Cod (Gadus morhua), an important fish species in the Baltic Sea, is the paratenic host for many parasite species, including the zoonotic nematodes, Anisakis sp. and Contracaecum osculatum. We aimed to identify which invertebrate species (found in situ in the fish stomach) are responsible for infection of cod with zoonotic nematodes. We found that Crangon crangon and Gammarus sp., both invertebrate prey species of cod, were infected with Anisakis simplex and C. osculatum, respectively. These host-parasite systems are reported here for the first time, implicating C. crangon and Gammarus sp. as sources of infection of Baltic cod with zoonotic nematodes.

How effective is freezing at killing Anisakis simplex, Pseudoterranova krabbei, and P. decipiens larvae? An experimental evaluation of time-temperature conditions.

The consumption of raw or inadequately cooked marine fish can lead to several disorders caused by the ingestion of viable anisakid nematodes. Although anisakid larvae can be killed by subzero temperatures, making freezing an important control measure for this potential health hazard, these parasites can survive freezing under some conditions. Therefore, the aim of the present study was to experimentally evaluate the time-temperature conditions needed to kill Anisakis simplex and Pseudoterranova spp. The effectiveness of freezing was tested on two species of fish: cod, Gadus morhua from the North Atlantic, and herring, Clupea harengus membras from the southern Baltic Sea. Samples, which comprised skinless fillets of cod (n = 40) with visible parasites and whole herring (n = 240), were separately frozen at - 15, - 18, or - 20 °C for 24 h, or at - 20 °C for 48 h in the single-compressor freezer and at - 20, - 25, or - 35 °C for 24 h in the double-compressor freezer. After thawing, parasites were stained with malachite green and examined under the microscope for viability. All A. simplex and Pseudoterranova spp. larvae in cod fillets died at a temperature of - 15 °C or lower. However, freezing did not kill all the A. simplex larvae in whole herring: spontaneous movement of these parasites was observed in samples stored in the single-compressor freezer at - 15, - 18, and - 20 °C over 24 h. Our results demonstrate that the freezing procedure must consider both the capability of the freezing device and the nature of the fish product to ensure consumer safety.

Mitochondrial Phylogenomics yields Strongly Supported Hypotheses for Ascaridomorph Nematodes.

Ascaridomorph nematodes threaten the health of humans and other animals worldwide. Despite their medical, veterinary and economic importance, the identification of species lineages and establishing their phylogenetic relationships have proved difficult in some cases. Many working hypotheses regarding the phylogeny of ascaridomorphs have been based on single-locus data, most typically nuclear ribosomal RNA. Such single-locus hypotheses lack independent corroboration, and for nuclear rRNA typically lack resolution for deep relationships. As an alternative approach, we analyzed the mitochondrial (mt) genomes of anisakids (~14 kb) from different fish hosts in multiple countries, in combination with those of other ascaridomorphs available in the GenBank database. The circular mt genomes range from 13,948-14,019 bp in size and encode 12 protein-coding genes, 2 ribosomal RNAs and 22 transfer RNA genes. Our analysis showed that the Pseudoterranova decipiens complex consists of at least six cryptic species. In contrast, the hypothesis that Contracaecum ogmorhini represents a complex of cryptic species is not supported by mt genome data. Our analysis recovered several fundamental and uncontroversial ascaridomorph clades, including the monophyly of superfamilies and families, except for Ascaridiidae, which was consistent with the results based on nuclear rRNA analysis. In conclusion, mt genome analysis provided new insights into the phylogeny and taxonomy of ascaridomorph nematodes.

Types of reactions to malignant disease in view of V.E. Frankl philosophy.

PURPOSE: The purpose of this work was to find out whether there is interdependence between the patients- assessments of biological, psychological, psychosocial and spiritual levels. METHODS: 590 subjects, both ill and healthy, were examined by appropriate means and asked to consider their level of fear, depression (Hospital Anxiety and Depression Scale - Modification), aggression, quality of life (EORTC QLQ-C30 questionnaire), and the purpose and meaning of life (The "PURPOSE in Life Test" - PIL questionnaire). RESULTS: Three groups of patients were established with the help of statistical procedures. The first group encompassed the healthy subjects, whereas the second and third included those that were ill. Although the subjects estimated their level of physical fitness and general quality of life similarly, there were some essential differences in their disease-associated reactions (i.e. the groups adjusted differently - the second group poorly and the third well). The majority of people suffering from cancer were well adapted to the early stages of the disease. As cancer progressed the percentage of those that adjusted poorly rose. However, even in the terminal stage some of the patients, about 1/3, still belonged to the group of those that were quite well adjusted. Established meaning of life, system of values, and personal religion were factors that helped to adapt. CONCLUSIONS: There was no connection between the patients' assessments of their biological level and other (psychological, psychosocial, spiritual) levels. We can distinguish groups of patients that judge their physical condition similarly and still vary in the assessment of their emotional state or meaning of life.

Acetylcholinesterase secreted by Anisakis simplex larvae (Nematoda: Anisakidae) parasitizing herring, Clupea harengus: an inverse relationship of enzyme activity in the host-parasite system.

Acetylcholinesterase (AChE) is a key enzyme involved in nerve impulse transmission in both vertebrates and invertebrates. In addition to neuromuscular AChE, many parasitic nematodes synthesize AChE in secretory glands and release the enzyme into their external environment. In this study, we evaluate the activities of both somatic and secreted AChE from larvae (L3) of the parasitic nematode Anisakis simplex, and compare these to the AChE activity in its host, herring, Clupea harengus. A. simplex larvae were obtained from a herring sampled in three areas of the southern Baltic. Enzyme kinetics were determined for excretory/secretory (E/S) products and somatic extracts of larvae as well as for herring muscle tissue. The results reveal that mean AChE activity is approximately fourfold higher in E/S products and eightfold higher in somatic extracts of post-secretory A. simplex larvae than in host muscle tissue. The level of AChE activity in nematodes is inversely related to the enzyme activity in their hosts, i.e. reduced AChE activity in herring was accompanied by increased enzyme activity in its parasites. The physiological function of AChE secreted by parasitic nematodes has been widely discussed in the literature, and numerous roles for this form of enzyme have been suggested. The results of our investigation indicate that AChE secretion by A. simplex larvae may constitute an adaptive mechanism that promotes survival under adverse environmental conditions. Larvae probably increase secretion of AChE in response to a direct and/or indirect effect of neurotoxic compounds. This is the first report of such a phenomenon in A. simplex.

Mitochondrial genomes of Anisakis simplex and Contracaecum osculatum (sensu stricto)--comparisons with selected nematodes.

Anisakid nematodes parasitize mainly fish, marine mammals and/or fish-eating birds, and can be transmitted to a range of fish-eating mammals, including humans, where they can cause gastrointestinal disease linked to larval infection or allergic responses. In spite of the animal and human health significance of these parasites, there are still gaps in our understanding of the systematics, biology, epidemiology and ecology of anisakids. Mitochondrial (mt) DNA provides useful genetic markers for investigations in these areas, but complete mt genomic data have been lacking for most anisakids. In the present study, the mt genomes of Anisakis simplex sensu stricto and Contracaecum osculatum sensu stricto were amplified from genomic DNA by long-range polymerase chain reaction and sequenced using 454 technology. The circular mt genomes of these species were 13,926 and 13,823 bp, respectively, and each of them contained 12 protein-coding, 22 transfer RNA, and 2 ribosomal RNA genes consistent for members of the Ascaridida, Oxyurida, Spirurida, Rhabditida and Strongylida. These mt genomes provide a stepping-stone for future comparative analyses of a range of anisakids and a basis for reinvestigating their genetic relationships. In addition, these markers might be used in prospecting for cryptic species and exploring host affiliations.

[Real self and ideal self of pregnant and postpartum women with symptoms of perinatal depression]. / Ja realne i ja idealne u kobiet ciezarnych i poloznic z objawami depresji okoloporodowej.

AIMS: To assess real self and ideal self in pregnant and postpartum women with symptoms of perinatal depression in the area of psychological needs and topical scales. METHODS: The study involved 239 pregnant women whose gestational age ranged between 32 and 40 weeks, and 105 postpartum women (2 to 5 days after childbirth). The Edinburgh Postnatal Depression Scale questionnaire was used as a screening test for antenatal and postnatal depressive symptoms. Personality profiles were assessed using the Adjective Check List test. RESULTS: Pregnant and postpartum women with symptoms of perinatal depression varied in their self-assessment of a number of their real psychological needs, while they presented similar scores with respect to their ideal (expected) self. The differences between pregnant and postpartum women correspond to changes in roles and activities related to pregnancy and the postpartum period; women presenting more passive attitudes in pregnancy become more active in the postpartum period. Apositive change in the real self-image related to motherhood in the postpartum period occurs despite depressive disorders. CONCLUSION: Numerous significant differences between the ideal and real self in both pregnant and postpartum women with perinatal depressive symptoms demonstrate their lack of self-acceptance, which requires individualised psychological intervention.

[Quality of Life in Depression Scale (QLDS)--development of the scale and Polish adaptation]. / Kwestionariusz Jakosci Zycia w Depresji (QLDS)--powstanie narzedzia oraz adaptacja do warunków polskich.

AIM: The aim of this study was to adapt the Quality of Life in Depression Scale to Polish conditions. The scale determines the quality of life, defined in terms of the concept of needs, and focuses on patients with depressive disorders. Since its basic version has been developed, the tool was adapted in many countries, also outside Europe. METHOD: The adaptation procedure included the translation of the original version into Polish, followed by the English retranslation, and was performed by four independent, qualified translators. The final Polish version was verified during a pilot study. RESULTS: This pilot study confirmed high reliability of the Polish version of Quality of Life in Depression Scale. CONCLUSION: The Quality of Life in Depression Scale (QLDS) can be considered an interesting tool in view of its broad theoretical background, and a simple procedure to complete during a clinical evaluation. The use of a specialist translation procedure, and the results of our pilot study suggest that the QLDS can be used in further research, both when evaluating a clinical population and when dealing with individual patients.

[Personality traits and the feeling of loneliness of women treated for infertility]. / Cechy osobowosciowe a poczucie osamotnienia kobiet leczonych z powodu nieplodnosci.

OBJECTIVES: Assessing the feeling of loneliness of women treated because of infertility compared to women without any procreation problems, and verifying, whether there is a correlation with the presented personality traits. MATERIAL AND METHODS: 26 women treated for infertility (in accordance with the officially recognized criteria) in the Obstetrics and Women Health Clinic at the Medical University in Gdansk, and 25 women not experiencing any procreation problems, were included into the study The research tools included a self-constructed sociodemographic questionnaire, the Minnesota Multiphasic Personality Inventory (MMPI) and the UCLA Loneliness Scale by D. Russell, L. Peplau, C. Cytron. RESULTS: There are significant differences among the investigated groups in terms of the following personality dimensions: Masculinity - Femininity Paranoia, Psychasthenia, Schizophrenia and the Social Introversion Scale. Women treated because of infertility scored higher in all these scales, their results remained within the norm though. The studied groups demonstrated different relations between the MMPI scales and the UCLA scales results. CONCLUSIONS: Women treated due to infertility have a personality profile similar to women without any procreation problems. Only the group whose profiles exhibited some pathological features demonstrated symptoms of worse adaptation to life, a tendency to experience a higher psychological discomfort and higher psychological stress, higher level of anxiety related to being assessed by others, and greater difficulties in accepting the role of a female. As far as the sense of loneliness was concerned women treated due to infertility did not differ significantly from the ones without procreation problems.

Infertility as a psychological problem.

Recently there has been enormous progress in couple infertility treatment and diagnostics. Some couples cannot conceive despite the fact that there seems to be no objective somatic or immunologic reasons. In such situations gynaecologists are helpless and couples may be overwhelmed by a sense of defeat and hopelessness. Thus, consulting a psychologist or therapist on how to cope better with the problem may be a good solution. The objective of the following paper is to discuss the dilemmas of couples undergoing infertility treatment, related psychological problems, and to determine the need for psychological and therapeutic support. The study demonstrates numerous infertility causes and concludes that there is no universal method of dealing with them. Very frequently psychological and somatic problems overlap. Psychological causes are often the primary factors, but sometimes they are secondary derivatives of the therapeutic process. A wide scope of factors must be considered to attempt psychological analysis of patients treated for infertility including the influence of the family and relations within, reaction to the diagnosis and suggested treatment, the influence of religion on the treatment, the evaluation of the relations in the family of procreation, sexual life assessment, the sense of a woman's self-esteem and self-acceptance. Basing on empirical analysis it was concluded that all women treated for infertility want to create a full family. They have problems in coping with emotional liability during treatment and a sense of fear and failure. Understanding the psychological mechanisms observed in patients treated for infertility might help to diagnose the causes of their problems with facing the new, extremely difficult situation.

Personality traits assessed by the NEO Five-Factor Inventory (NEO-FFI) as part of the perinatal depression screening program.

BACKGROUND: As pre- and postnatal depression is a multifactorial disorder, the screening programmes which are currently in use in obstetric clinics remain problematic due to their inadequate standardization and limited efficacy. The evaluation of core risk factors for perinatal depression in the screening process, in addition to routine questionnaire-based tools such as the Edinburgh Postnatal Depression Scale (EPDS), might improve the diagnosis and early treatment of women affected by depression. This study was undertaken to analyze the relationship between personality traits and the risk of perinatal depression in pregnant and postpartum women. MATERIAL/METHODS: For the study, 229 patients (pregnant and postpartum women) admitted to an obstetric hospital in Poland were recruited. Two self-report questionnaires were used: the Edinburgh Postnatal Depression Scale (EPDS) as a screening tool for depressive symptoms and the NEO Five-Factor Inventory (NEO-FFI) for the evaluation of five personality traits in the studied patients. RESULTS: Neuroticism significantly increased the risk of perinatal depressive symptoms in both pregnant and postpartum women (OR=1.23 and OR=1.11, respectively). Personality traits related to a lower risk of perinatal depression in the group of pregnant women included extraversion, openness to experience, high degree of agreeableness and conscientiousness (OR=0.90, OR=0.92, OR=0.90 and OR=0.91, respectively). However, among at-risk postpartum women no additional factors, except neuroticism, affected the prevalence of depressive symptoms. CONCLUSIONS: Personality trait like neuroticism as measured by the NEO-FFI is associated with a greater risk of perinatal depression. The NEO-FFI is a useful tool, potentially adding significant value to the program of perinatal depression screening.

[Marital status and the severity of perinatal depression among pregnant women]. / Stan cywilny a nasilenie objawów depresji okoloporodowej wsród kobiet ciezarnych.

INTRODUCTION: Cohabitation existing for ages in all human cultures is becoming more common since the 1960s due to complex changes in postmodern societies. These societies have made the phenomenon of cohabitation the object of adequate theoretical reflection. The aim of this work was to determine whether the marital status of pregnant women affects the severity of perinatal depression. MATERIAL AND METHODS: We enrolled 117 gravida hospitalized in 2006 and 2007 at the Department of Maternal-Fetal Medicine, Pomeranian Medical University. The gestational age ranged from week 32 to 40. The clinical condition of each gravida was assessed during routine obstetric history taking. The Edinburgh Postnatal Depression Scale by Cox, Holden, and Sagovski was used as the screening test for perinatal depression. CONCLUSIONS: 1. The marital status of the gravida with emphasis on cohabitation is a significant correlate of perinatal depression and its risk. 2. Clinical examination should concentrate not only on the physical and medical condition but also on the psychosocial status of the patient as the predictor of perinatal depression. 3. All pregnant women living in informal partnerships should be offered psychological support.

[Anisakis simplex larvae from the Baltic herring as tag organisms in biological and fisheries research. I. Baltic herring and A. simplex nematodes: the models of parasitic infection and fish migration tags]. / Larwy Anisakis simplex w sledziach baltyckich jako organizmy wskaznikowe w badaniach biologicznych i rybackich. I. Sledz baltycki i nicienie A. Simplex: modele infekcji pasozytniczej i wskazniki migracji ryb.

Models relating infection intensity with Anisakis simplex larvae to the fish length and weight were developed and applied to estimate the asymptotic size of herring. Generalized linear models (GLM) were used to analyse the prevalence and intensity of infection as dependent on time and area of sampling and the biological parameters of fish. For the characterization of herring populations in the southern Baltic, two complementary approaches were used: morphometric and meristic analyses to quantify the body shape of herring and the presence of parasites as fish migration tags.

[Anisakis simplex larvae from the Baltic herring as tag organisms in biological and fisheries research. II. Host and parasite acetylcholinesterases]. / Larwy Anisakis simplex w sledziach baltyckich jako organizmy wskaznikowe w badaniach biologicznych i rybackich. II. Acetylocholinesterazy zywiciela i pasozyta.

Acetylcholinesterase (AChE) activity in the tissues of host and the parasite and the impact of carbofuran, a carbamate pesticide on the AChE activity in A. simplex larvae was investigated. Generalized linear models (GLM) were used for modeling enzymatic activity in herring and A. simplex nematodes.

Biomarker responses in flounder Platichthys flesus from the Polish coastal area of the Baltic Sea and applications in biomonitoring.

The objective of this study was to investigate the pattern of enzymatic activities, environmental genotoxicity and cytotoxicity in flounder, Platichthys flesus, from the Polish coastal area of the Baltic Sea. Fish were sampled in different contaminated sites in the Gulf of Gdansk and in a reference area outside the gulf. The activities of acetylcholinesterase (AChE), glutathione S: -transferase (GST), catalase (CAT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase (CK), lactate dehydrogenase (LDH), were studied, as well as the frequency of micronuclei, nuclear buds and fragmented-apoptotic cells. A higher mean activity level of muscular AChE and a lower activity level of hepatic GST were evident in samples taken from the reference site, relative to those found in the gulf. Modeled CAT activity (in both liver and gill tissue), blood plasma LDH and CK activities were all significantly higher in flounder collected at locations within the Gulf of Gdansk than at the reference site. No statistically significant alterations were observed in the activities of ALT and AST in the blood plasma of flounder in this study. Fish collected from a location at the mouth of the Vistula River showed the highest hepatic GST and CAT, the highest gill CAT activity, and the highest frequency of blood micronuclei, nuclear buds and fragmented-apoptotic cell inductions, as well as the lowest level of blood plasma CK. The present study confirms that compared to fish from the reference area, flounder from the Gulf of Gdansk clearly demonstrate a different enzyme activity, genotoxicity and cytotoxicity biomarker response pattern.

[Cohabitation as a strong predicting factor of perinatal depression]. / Kohabitacja jako silny czynnik predykcyjny depresji okoloporodowej.

OBJECTIVES: The aim of this study was to assess if the marital status, especially cohabitation, of pregnant and postpartum women, has any influence on the incidence of perinatal depression symptoms. MATERIAL AND METHODS: 117 pregnant women (at 32-40 weeks of gestation) and 105 postpartum patients (2-5 days after the delivery) were included in the study. The Edinburgh Postnatal Depression Scale (EPDS) was used as a screening test for symptoms of pre- and postnatal depression. The risk of appearance of depressive symptoms was assessed in three groups of pregnant and postpartum patients - married, unpartnered and cohabitating. RESULTS: By means of the EPDS test, symptoms of perinatal depression were found in 17% of pregnant and 10% of postpartum women. In comparison to married women, the risk of appearance of depressive symptoms in unpartnered pregnant patients was almost 10-times higher (OR=9.34; 95% CI 1.42, 201.77), and several hundred times higher in cohabitating pregnant women (OR=975.86; 95% CI 116.73, 19502.00); the risk of depressive symptoms in postpartum unpartnered women was more than 2 times higher (OR=2.4; 95% CI 0.59, 9.72) and more than 20 times higher in cohabitating postpartum mothers (OR=23.2; 95% CI 5.89, 91.51). CONCLUSIONS: 1. the marital status of pregnant and postpartum women has a substantial influence on the risk of the development of perinatal depressive symptoms; this risk is highly increased in a group of cohabitating women compared to patients remaining in a formal partnership as well as women who live unpartnered, 2. clinical evaluation of women in the perinatal period should include the assessment of their psychosocial status, which can constitute a predicting factor of perinatal depression, 3. pregnant women living in informal partnership should be put under strict psychological surveillance.