Skip to main content

Advertisement

Log in

The course of maternal depressive symptomatology during the first 18 months postpartum in an Italian sample

  • Original Contribution
  • Published:
Archives of Women's Mental Health Aims and scope Submit manuscript

Abstract

Postnatal depression (PND) affects about 10–15% of women and can last more than a year in chronic cases. The Edinburgh Postnatal Depression Scale (EPDS) is a well-known questionnaire for screening PND symptomatology during the first weeks after birth, but its use in later periods is rare, reflecting a tendency to pay more attention to the onset of PND instead of its course. The study aimed to explore stability of PND symptomatology at 3, 9 and 18 months after birth, using the EPDS. Depression rate decreased from 3 to 18 months postpartum. Onset of symptoms was mainly within the first 3 months; 23.4% of 167 women showed an EPDS score ≥13 on at least one of the assessments, and 7.2% of women did so on at least two assessments. Over the 18-month period, the number of women who had recovered in the period from one assessment to the following was not significantly different from the number of women becoming depressed. Our findings underline the need to consider the existence of different courses of depressive symptomatology in research and clinical practice; women with persistent or recurrent depressive symptoms need forms of preventive intervention that cover at least the first postpartum year.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Asten P, Marks MN, Oates MR, TCS-PND Group (2004) Aims, measures, study sites and participant samples of the Transcultural Study of Postnatal Depression. B J Psych 184(Suppl. 46):3–9

    Article  Google Scholar 

  • Augusto A, Kumar R, Calheiros JM, Matos E, Figueiredo E (1996) Post-natal depression in an urban area of Portugal: comparison of childbearing women and matched controls. Psychol Med 26:135–141

    CAS  PubMed  Google Scholar 

  • Beck CT (1995) The effects of postpartum depression on maternal-infant interaction: a meta-analysis. Nurs Res 44:298–304

    Article  CAS  PubMed  Google Scholar 

  • Beeghly M, Weinberg MK, Olson KL, Kernan H, Riley J, Tronick E (2002) Stability and change in level of maternal depressive symptomatology during first postpartum year. J Affect Disord 71:169–180

    Article  PubMed  Google Scholar 

  • Benvenuti P, Ferrara M, Niccolai C, Valoriani V, Cox JL (1999) The Edinburgh Postnatal Depression Scale: validation for an Italian sample. J Affect Disord 53:137–141

    Article  CAS  PubMed  Google Scholar 

  • Boyd RC, Le HN, Somberg R (2005) Review of screening instruments for postpartum depression. Arch Womens Mental Health 8:141–153

    Article  CAS  Google Scholar 

  • Brazelton TB (2007) Caring for the pediatrician. Pediatr Ann 36(4):236–237

    PubMed  Google Scholar 

  • Brazelton TB, Greenspan SI (2000) The irreducible needs of children: what every child must have to grow, learn, and flourish. Perseus, New York

    Google Scholar 

  • Brazelton TB, Sparrow J (2005) Touchpoints: emotions and behavioral development, 2nd edn. Perseus, Cambridge

    Google Scholar 

  • Brennan PA, Hammen C, Andersen MJ, Bor W, Najman JM, Williams GM (2000) Chronicity, severity and timing of maternal depressive symptoms: relationships with child outcomes at age 5. Dev Psychol 36(6):759–766

    Article  CAS  PubMed  Google Scholar 

  • Buist A, Condon J, Brooks J, Craig Speelman C, Milgrom J, Hayes B, Ellwood D, Barnett B, Kowalenko N, Matthey S, Austin M-P, Bilszta J (2006) Acceptability of routine screening for perinatal depression. J Affect Disord 93(1–3):233–237

    Article  PubMed  Google Scholar 

  • Campbell SB, Cohn JF (1997) The timing and chronicity of postpartum depression: implications for infant development. In: Murray L, Cooper PJ (eds) Postpartum depression and child development. Guilford, New York, pp 165–197

    Google Scholar 

  • Campbell SB, Cohn JF, Meyers T (1995) Depression in first-time mothers: mother-infant interaction and depression chronicity. Dev Psychol 31(3):349–357

    Article  Google Scholar 

  • Chabrol H, Teissedre F (2004) Relation between the Edinburgh Postnatal Depression Scale (EPDS) scores at 2–3 days and 4–6 weeks postpartum. J Reprod Infant Psychol 22:33–39

    Article  Google Scholar 

  • Cohn JF, Campbell S, Matias R, Hopkins J (1990) Face-to-face interactions of postpartum depressed and non-depressed mother-infant pairs at two months. Dev Psychol 26:12–23

    Article  Google Scholar 

  • Cooper PJ, Campbell EA, Day A, Kennerley H, Bond A (1988) Non-psychotic psychiatric disorder after childbirth. A prospective study of prevalence, incidence, course and nature. Br J Psychiatry 152:799–806

    CAS  PubMed  Google Scholar 

  • Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression. Development of the 10-items Edinburgh Postnatal Depression Scale. Br J Psychiatry 150:782–786

    CAS  PubMed  Google Scholar 

  • Cox JL, Murray D, Chapman G (1993) A controlled study of onset, duration and prevalence of postnatal depression. Br J Psychiatry 163:27–31

    CAS  PubMed  Google Scholar 

  • Cramer B (1999) Que deviendront nos bébés. Editions Odile Jacob, Paris

    Google Scholar 

  • Cummings EM, Davies PT (1994) Maternal depression and child development. J Child Psychol Psychiatry 35(1):73–112

    Article  CAS  PubMed  Google Scholar 

  • Dennis CL (2004) Can we identify mothers at risk for postpartum depression in the immediate postpartum period using the Edinburgh Postnatal Depression Scale? J Affect Disord 78(2):163–169

    Article  PubMed  Google Scholar 

  • Dennis CL, Ross LE (2006) Depressive symptomatology in the immediate postnatal period: identifying maternal characteristics related to true- and false-positive screening scores. Can J Psychiatry 51(5):265–273

    PubMed  Google Scholar 

  • Eberhard-Gran M, Eskild A, Tambs K, Opjordsmoen S, Samuelsen SO (2001) Review of validation studies of the Edinburgh Postnatal Depression Scale. Acta Psychiatr Scand 104:243–249

    Article  CAS  PubMed  Google Scholar 

  • Eberhard-Gran M, Eskild A, Tambs K, Samuelsen SO, Opjordsmoen S (2002) Depression in postpartum and non-postpartum women: prevalence and risk factors. Acta Psychiatr Scand 104:426–433

    Article  Google Scholar 

  • Endicott J, Spitzer RL (1978) A diagnostic interview: the schedule for affective disorders and schizophrenia. Arch Gen Psychiatry 35:837–844

    CAS  PubMed  Google Scholar 

  • Evans J, Heron J, Francomb H, Oke S, Golding J (2001) Cohort study of depressed mood during pregnancy and after childbirth. BMJ 323:257–260

    Article  CAS  PubMed  Google Scholar 

  • Field T (1995) Infants of depressed mothers. Infant Behav Dev 18:1–13

    Article  Google Scholar 

  • Field T (2007) The amazing infant. Blackwell, Malden, MA, USA

    Google Scholar 

  • Field T, Healy B, Goldstein S, Guthertz M (1990) Behavior state matching and synchrony in mother-infant interactions of nondepressed versus depressed dyads. Dev Psychol 26:7–14

    Article  Google Scholar 

  • Georgiopoulos AM, Bryan TL, Wollan P, Yawn BP (2001) Routine screening for postpartum depression. J Fam Pract 50(2):117–122

    CAS  PubMed  Google Scholar 

  • Goldberg DP (1972) The detection of psychiatric illness by questionnaire. Oxford University Press, London

    Google Scholar 

  • Goodman JH (2003) Postpartum depression beyond the early postpartum period. J Obstet Gynecol Neonatal Nurs 33:410–420

    Article  Google Scholar 

  • Gorman LL, O’Hara MW, Figueiredo B, Hayes S, Jacquemain F, Kammerer MH, Klier CM, Rosi S, Seneviratne G, Sutter-Dallay AL, TCS-PND Group (2004) Adaptation of the structured clinical interview for DSM-IV disorders for assessing depression in women during pregnancy and post-partum across countries and cultures. Br J Psychiatry 184(suppl. 46):17–23

    Article  Google Scholar 

  • Gotlib IH, Goodman SH (1999) Children of parents with depression. In: Silverman WK, Ollendick TH (eds) Developmental issues in the clinical treatment of children and adolescents. Allyn & Bacon, New York, pp 415–432

    Google Scholar 

  • Guedeney N (1993) A propos des mères déprimées: l’impact de la dépression sur les interactions précoces in analyse des travaux anglo-saxons. Ann Pédiatr 40(8):496–502

    CAS  Google Scholar 

  • Guedeney N, Jeammet P (2001) Dépressions postnatales (DPN) et décisions d’orientation thérapeutique. Devenir 13(3):51–64

    Google Scholar 

  • Halligan S, Murray L, Martins C, Cooper PJ (2007) Maternal depression and psychiatric outcomes in adolescent offspring: a 13-year longitudinal study. J Affect Disord 97:145–154

    Article  PubMed  Google Scholar 

  • Hannah P, Adams D, Lee A, Glover V, Sandler M (1992) Links between early post-partum mood and postnatal depression. Br J Psychiatry 154:777–780

    Google Scholar 

  • Matthey S (2004) Calculating clinically significant change in postnatal depression studies the Edinburgh Postnatal Depression Scale. J Affect Disord 78:269–272

    Article  PubMed  Google Scholar 

  • Matthey S, Barnett B, Ungerer J, Waters B (2000) Paternal and maternal depressed mood during the transition to parenthood. J Affect Disord 60:75–85

    Article  CAS  PubMed  Google Scholar 

  • Montgomery SA, Asberg M (1979) A new depression scale designed to be sensitive to change. Br J Psychiatry 134:382–389

    CAS  PubMed  Google Scholar 

  • Murray L, Carothers AD (1990) The validation of the Edinburgh Post-natal Depression Scale on a community sample. Br J Psychiatry 157:288–290

    Article  CAS  PubMed  Google Scholar 

  • Murray L, Cooper P (2003) Intergenerational transmission of affective and cognitive processes associated with depression: infancy and the preschool years. In: Goodyer I (ed) Unipolar depression: a lifespan perspective. Oxford University Press, London, pp 17–46

    Google Scholar 

  • Murray L, Fiore-Cowley A, Hooper R, Cooper P (1996) The impact of postnatal depression and associated adversity on early mother-infant interactions and later infant outcome. Child Dev 67:2512–2526

    Article  CAS  PubMed  Google Scholar 

  • O’Hara MW, Swain A (1996) Rates and risk of postnatal depression. A meta-analysis. Int Rev Psychiatry 8:37–54

    Article  Google Scholar 

  • O’Hara MW, Zekoski EM, Philipps LH, Wright EJ (1990) Controlled prospective study of postpartum mood disorders: comparison of childbearing and nonchildbearing women. J Abnorm Psychol 99:3–15

    Article  CAS  PubMed  Google Scholar 

  • Radloff L (1977) The CES-D scale: a self-report depression scale for research in the general population. J Appl Psychol Meas 1:385–401

    Article  Google Scholar 

  • Righetti-Veltema M, Conne-Perreard E, Bousquet A, Manzano J (2002) Postpartum depression and mother-infant relationship at three months old. J Affect Disord 70:291–306

    Article  PubMed  Google Scholar 

  • Rubertsson C, Wickberg B, Gustavsson P, Radestad I (2005) Depressive symptoms in early pregnancy, two months and one year postpartum-prevalence and psychosocial risk factors in a national Swedish sample. Arch Womens Ment Health 8:97–104

    Article  CAS  PubMed  Google Scholar 

  • Shakespeare J, Blake F, Garcia J (2003) A qualitative study of the acceptability of routine screening of postnatal women using the Edinburgh Postnatal Depression Scale. Br J Gen Pract 53(493):614–619

    PubMed  Google Scholar 

  • Stewart DE, Robertson E, Tennis C, Grace S (2004) An evidence-based approach to post-partum depression. World Psychiatry 3(2):97–98

    PubMed  Google Scholar 

  • Teissèdre F, Chabrol H (2004) Detecting women at risk for postnatal depression using the Edinburgh Postnatal Depression Scale at 2 to 3 days postpartum. Can J Psychiatry 49(1):51–54

    PubMed  Google Scholar 

  • Tronick EZ (2005) La cronicità della depressione. Per la salute o la malattia, la co-creazione dell’unicità dello stare insieme. Infanzia e adolescenza 4(1):1–17

    Google Scholar 

  • Tronick EZ, Weinberg MK (1997) Depressed mothers and infants: failure to form dyadic states of consciousness. In: Murray L, Cooper PJ (eds) Postpartum depression and child development. Guilford, New York, pp 54–81

    Google Scholar 

  • Wing JK, Cooper JE, Sartorius N (1974) The measurement and classification of psychiatric symptoms. Cambridge University Press, Cambridge

    Google Scholar 

Download references

Acknowledgements

We are extremely grateful to all the mothers who took part in this study. We would like to thank the Cassa di Risparmio in Bologna Foundation for their financial contribution and all the interviewers and the students who collaborated in this project.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Francesca Agostini.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Monti, F., Agostini, F., Marano, G. et al. The course of maternal depressive symptomatology during the first 18 months postpartum in an Italian sample. Arch Womens Ment Health 11, 231–238 (2008). https://doi.org/10.1007/s00737-008-0017-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00737-008-0017-6

Keywords

Navigation