Epidemiology and phenomenology of postpartum mood disorders

The overall prevalence rate of post-partum depression has been estimated to be 10% to 15% across cultures, similar to prevalence rates for nonchildbearing women during the same developmental period. The same diagnostic criteria are used to detect MDD in the postpartum period as at any other time point. However, women with PPD also commonly exhibit anxiety symptoms, especially involving intrusive thoughts about safety of their infant, as well feelings of guilt and inadequacy about mothering. The unique significance of PPD is based primarily on its documented association with poor maternal and child health and functioning outcomes. Perinatal depression, defined either diagnostically or symptomatically, may persist into the first postpartum year. There is a clear need to revise DSM diagnostic criteria for postpartum depression, given the evidence regarding both peak onset and duration of symptoms. Further study of strategies for detection is also needed, particularly research aimed at improving the precision of early detection by refining risk profiles. 45 Validation of screening instruments for women from diverse ethnic and cultural backgrounds is also needed to improve accuracy of detection and prevalence estimation.