Factors invoved in onset and recovery from postnatal depression

Abstract

Background: A wide variety of psychosocial variables have been implicated in the onset and recovery from postnatal depression. A number of these factors were examined on a representative sample of pregnant Maltese women attending St Luke's Hospital. Method: A random sample of 239 pregnant women were interviewed at booking using a detailed sociodemographic history, the Revised Version of the Clinical Interview Schedule (CIS-R) and Maltese translation of the Edinburgh Postnatal Depression Scale (EPDS). The CIS-R was again administered over the phone at 36 weeks and the EPDS sent by post. At eight weeks postpartum, the CIS-R, modified version of the Social Maladjustment Schedule and the EPDS were again administered to 95.8% of women. Results: Onset of depression in the postpartum was not predicted by depressive symptomatology during pregnancy, marital status, level of education, planning of pregnancy, woman's, partner's or family's reaction to pregnancy and marital adjustment. However being primiparous and employed during pregnancy were significantly associated with postnatal depression. In contrast, depressed women who remained depressed postnatally had a past personal psychiatry history and significantly higher scores on the CISR recorded at 36 weeks gestation. Limitation: The number of women examined in the study yielded a small number of depressed women, for which the results are limited in value. The sample is that of Maltese women booking in at the antenatal clinic, thus excluding women who present late, close to delivery date. The follow up period was limited to eight weeks postpartum only, excluding those who develop depressive episodes after 8 weeks. Conclusions: Some cases of postpartum depression may be traced back to pregnancy while others do not seem to be predictable during pregnancy further contributing evidence to the view that the prenatal period may be a separate entity from the postnatal period with regards to depressive illness.