Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-13T01:21:01.481Z Has data issue: false hasContentIssue false

Prevalence and risk factors for a high level of postnatal depression symptomatology in Italian women: A sample drawn from ante-natal classes

Published online by Cambridge University Press:  16 April 2020

Pietro Grussu*
Affiliation:
National Health Service, Azienda ULSS 17 Este, Consultorio Familiare Unit, Italy Department of Gynaecology and Human Reproduction Sciences, University of Padua, Italy
Rosa Maria Quatraro
Affiliation:
National Health Service, Azienda ULSS 6 Vicenza, Hospital Psychology Unit, Gynaecology and Obstetrics Section, Vicenza and Noventa Vicentina Hospital, Italy
*
*Corresponding author at: National Health Service, Azienda ULSS 17 Este, Consultorio Familiare Unit, Via Settabile n.39, I-35042 Este (PD), Italy. Tel./fax: +39 0429 618309. E-mail address: pgruss@tin.it (P. Grussu).
Get access

Abstract

Background

Depression after childbirth is a major problem affecting 10–22% of all mothers. In Italy, postnatal depression has not yet been systematically studied.

Methods

In this retrospective study we have sought to identify risk factors, assessed during pregnancy, and their importance for postnatal depression symptoms in a sample of 297 Italian women attending ante-natal classes organised by the local Consultorio Familiare Unit of the National Health Service, Italy. The Postpartum Depression Predictors Inventory – revised form (PDPI-Revised), was used to identify risk factors, 8–9 month of pregnancy. A double-test strategy using the Edinburgh Postnatal Depression Scale (EPDS) and 12-item General Health Questionnaire (GHQ12), was administered to screen women with a higher occurrence of symptoms of postnatal depression six–eight weeks after delivery. Women with high EPDS (<8) and high GHQ12 (<3) scores were compared with those who had scored below the EPDS and/or GHQ12 threshold scores.

Results

We found that 13% of the women studied showed high postnatal depressive symptomatology, which is very similar to rates of prevalence of postnatal depression in the first year after the birth of the child reported in other Western World studies. Feeling anxious during pregnancy is a strong predictor of high symptoms of depression at 6–8 weeks after delivery. However, University education and friends' support appear to be important protective factors.

Conclusion

These findings could be useful both for Italian health professionals and for researchers interested in the transcultural aspects of postnatal depression.

Type
Original article
Copyright
Copyright © Elsevier Masson SAS 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Affonso, D.D., De, A.K., Horowitz, J.A., Mayberry, L.J.An international study exploring levels of postpartum depressive symptomatology. J Psychosom Res 2000;49:207216.CrossRefGoogle Scholar
American Psychiatry Association Diagnostic and statistical manual of mental disorders 4th ed.Washington, DC: American Psychiatry Association; 1994.Google Scholar
Araya, R., Lewis, G., Rojas, G., Fritsch, R.Education and income: which is more important for mental health?. J Epidemiol Community Health 2003;57:501505.CrossRefGoogle ScholarPubMed
Areias, M.E., Kumar, R., Barros, H., Figuereo, E.Correlates of postnatal depression in mothers and fathers. Br J Psychiatry 1996;169:3641.CrossRefGoogle ScholarPubMed
Artazcoz, L., Borrell, C., Benach, J., Cortes, I., Rohlfs, I.Women, family demands and health: the importance of employment status and socio-economics position. Soc Sci Med 2004;59:263274.CrossRefGoogle Scholar
Baglio, G., Spinelli, A., Donati, S., Grandolfo, M.E., Osborn, J.Evaluation of the effects of antenatal classes and child health. Ann Ist Sup Sanita 2000;36:465478 [in Italian]Google Scholar
Beck, C.T.Predictors of postpartum depression. Nurs Res 2001;50:275285.CrossRefGoogle ScholarPubMed
Beck, C.T.Revision of the postpartum depression predictors inventory. J Obstet Gynecol Neonatal Nurs 2002;31:394402.CrossRefGoogle ScholarPubMed
Benvenuti, P., Ferrara, M., Niccolai, C., Valoriani, V., Cox, J.L.The Edinburgh postnatal depression scale: validation for an Italian sample. J Affect Disord 1999;53:137141.CrossRefGoogle ScholarPubMed
Bergant, A.M., Heim, K., Ulmer, H., Illmensee, K.Early postnatal depressive mood: associations with obstetrics and psychosocial factors. J Psychosom Res 1999;46:391394.CrossRefGoogle ScholarPubMed
BMDP 4F Biomedical Package 7.0 Statistical software Los Angeles, CA.: University of California Press, Department of Biomathematics, University of California; 1993.Google Scholar
Boath, E.H., Pryce, A.J., Cox, J.L.Postnatal depression: the impact on the family. J Reprod Infant Psychol 1998;16:199203.CrossRefGoogle Scholar
Born, L., Zinga, D., Steiner, M.Challenges in identifying and diagnosing postpartum disorders. Prim Psychiatr 2004;11:2936.Google Scholar
Brugha, T.S., Sharp, H.M., Cooper, S.-A., Weisender, C., Britto, D., Shinkwin, R.et al.The Leicester 500 Project. Social support and the development of postnatal depressive symptoms, a prospective cohort survey. Psychol Med 1998;28:6379.CrossRefGoogle ScholarPubMed
Brugha, T.S., Wheatley, S., Taub, N.A., Culverwell, A., Friedman, T., Kirwan, P.H.et al.Pragmatic randomized trial of antenatal intervention to prevent post-natal depression by reducing psychosocial risk factors. Psychol Med 2000;30:12731281.CrossRefGoogle ScholarPubMed
Burt, V.K., Stein, K.Epidemiology of depression throughout the female life cycle. J Clin Psychiatry 2002;63(Suppl. 7):s9s15.Google ScholarPubMed
Cooper, P.J., Murray, L.Prediction, detection, and treatment of postnatal depression. Arch Dis Child 1997;77:9799.CrossRefGoogle ScholarPubMed
Cooper, P.J., Murray, L., Hooper, R., West, A.The development and validation of a predictive index for postpartum depression. Psychol Med 1996;26:627634.CrossRefGoogle ScholarPubMed
Cox, J.L., Holden, J.M., Sagovski, R.Detection of postnatal depression – development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 1987;150:782786.CrossRefGoogle ScholarPubMed
Eberhard-Gran, M., Eskild, A., Tambs, K., Opjordsmoen, S., Samuelsen, S.O.Review of validation studies of the Edinburgh Postnatal Depression Scale. Acta Psychiatr Scand 2001;104:243249.CrossRefGoogle ScholarPubMed
Fiscella, K., Franks, P.Influence of patient education on profiles of physician practices. Ann Intern Med 1999;131:745751.CrossRefGoogle ScholarPubMed
Gale, S., Harlow, B.L.Postpartum mood disorders: a review of clinical and epidemiological factors. J Psychosom Obstet Gynaecol 2003;24:257266.CrossRefGoogle ScholarPubMed
Goldberg, D.P.The detection of psychiatric illness by questionnaire Maudsley Monograph No.21 London, UK: Oxford University Press; 1972.Google Scholar
Goldberg, D.P., Williams, P.A user's guide to the General Health Questionnaire London, UK: NFER-Nelson; 1978.Google Scholar
Grace, S.L., Evindar, A., Stewart, D.E.The effect of postpartum depression on child cognitive development and behaviour: a review and critical analysis of the literature. Arch Womens Ment Health 2003;6:263274.CrossRefGoogle ScholarPubMed
Grussu, P., Quatraro, R.M.Individuazione precoce delle donne a rischio di depressione postnatale Rovereto (TN): National Congress of the Italian Association of Psychology, Section of Clinical Psychology; 2006, September 15–17 Abstracts Book, page 109.Google Scholar
Hendrick, V.Treatment of postnatal depression. BMJ 2003;327:10031004.CrossRefGoogle ScholarPubMed
Horowitz, J.A., Damato, E., Solon, L., Von Metzsch, G., Gill, V.Postpartum depression: issues in clinical assessment. J Perinatol 1995;15:268280.Google ScholarPubMed
ISTAT Famiglia, abitazione e zona in cui si vive. Indagine multiscopo sulle famiglie. Aspetti della vita quotidiana Anno 2003 Roma, Italy: Istituto Nazionale di Statistica; 2005.Google Scholar
Jardri, R., Pelta, J., Maron, M., Thomas, P., Delion, P., Codaccioni, X.et al.Predictive validation study of the Edinburgh Postnatal Depression Scale in the first week after delivery and risk analysis for postnatal depression. J Affect Disord 2006;93:169176.CrossRefGoogle ScholarPubMed
Josefsson, A., Angelsioo, L., Berg, G., Ekstrom, C.M., Gunnervik, C., Nordin, C.et al.Obstetric, somatic, and demographic risk factors for postpartum depressive symptoms. Obstet Gynecol 2002;99:223228.Google ScholarPubMed
Lane, A., Keville, R., Morris, M., Kinsella, A., Turner, M., Barry, S.Postnatal depression and elation among mothers and their partners: prevalence and predictors. Br J Psychiatry 1997;171:550555.CrossRefGoogle ScholarPubMed
Lee, D.T.S., Yip, A.S.K., Chiu, H.F.K., Chung, T.K.H.Screening for postnatal depression using the double-test strategy. Psychosom Med 2000;62:258263.CrossRefGoogle ScholarPubMed
Lumley, J., Austin, M.-P.What interventions may reduce postpartum depression. Curr Opin Obstet Gynecol 2001;13:605611.CrossRefGoogle ScholarPubMed
Martell, L.K.Postpartum depression as a family problem. MCN Am J Matern Child Nurs 1990;15:9093.CrossRefGoogle ScholarPubMed
McNair, D., Lorr, M., Droppleman, L.F.Manual for the profile of mood states San Diego, USA: EdITS; 1981.Google Scholar
Murray, L., Cooper, P.J., Hipwell, A.Mental health of parents caring for infant. Arch Womens Ment Health 2003;6(Suppl. 2):s71s77.CrossRefGoogle Scholar
McCarthy, A.Postnatal depression: diagnosis and treatment. Ir Med J 1998;91:44Google ScholarPubMed
Nielsen Forman, D., Videbech, P., Hedegaard, M., Dalby Salvig, J., Secher, N.J.Postpartum depression: identification of women at risk. Br J Obstet Gynaecol 2000;107:12101217.CrossRefGoogle ScholarPubMed
O'Hara, M.W., Gorman, L.L.Can postpartum depression be predicted?. Prim Psychiatr 2004;11:4247.Google Scholar
O'Hara, M.W., Rehm, L.P., Campbell, S.B.Postpartum depression: a role for social network and life stress variables. J Nerv Ment Dis 1983;171:336341.CrossRefGoogle ScholarPubMed
O'Hara, M.W., Swain, A.M.Rates and risk of postpartum depression: a meta-analysis. Int Rev Psychiatry 1996;8:3754.CrossRefGoogle Scholar
Paykel, E.S., Emms, E.M., Fletcher, J., Rassaby, E.S.Life events and social support in puerperal depression. Br J Psychiatry 1980;136:339346.CrossRefGoogle ScholarPubMed
Piccinelli, M., Risoffi, G., Bon, M.G., Cunico, L., Tansella, M.Validity and test–retest reliability of the Italian version of the 12-Item general health questionnaire in general practice: a comparison between three scoring methods. Compr Psychiatry 1993;34:198205.CrossRefGoogle ScholarPubMed
Regione Veneto. Osservatorio Immigrazione Regionale. Censimento 2004.Google Scholar
Righetti-Veltema, M., Conne-Perreard, E., Bousquet, A., Manzano, J.Risk factors and predictive signs of postpartum depression. J Affect Disord 1998;49:167180.CrossRefGoogle ScholarPubMed
Robertson, E., Grace, S., Wallington, T., Stewart, D.E.Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry 2005;26:289295.CrossRefGoogle Scholar
Rubertsson, C., Wickberg, B., Gustavsson, P., Rådestad, I.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 2005;8:97104.CrossRefGoogle Scholar
Seguin, L., Potvin, L., St-Denis, M., Loiselle, J.Chronic stressors, social support, and depression during pregnancy. Obstet Gynecol 1995;85:583589.CrossRefGoogle ScholarPubMed
Seguin, L., Potvin, L., St-Denis, M., Loiselle, J.Socio-enviromental factors and postnatal depressive symptomatology: a longitudinal study. Women Health 1999;29:5772.CrossRefGoogle ScholarPubMed
Seimyr, L., Edhborg, M., Lundh, W., Sjogren, B.In the shadow of maternal depressed mood: experiences of parenthood during the first year after childbirth. J Psychosom Obstet Gynaecol 2004;25:2334.CrossRefGoogle ScholarPubMed
Singh-Manoux, A., Clarke, P., Marmot, M.Multiple measure of socio-economic position and psychosocial health: proximal and distal measures. Int J Epidemiol 2002;31:11921199.CrossRefGoogle ScholarPubMed
Spinelli, A., Baglio, G., Donati, S., Grandolfo, M., Osborn, J.Do antenatal classes benefit the mother and her baby?. J Matern Fetal Neonatal Med 2003;13:94101.CrossRefGoogle ScholarPubMed
SPSS 11.5. Chicago: SPSS Inc.; 2003. http://www.spss.com 15.11.2004Google Scholar
Stein, A., Cooper, P.J., Campbell, E.A., Day, A., Altham, P.M.E.Social adversity and perinatal complications: their relation to postnatal depression. BMJ 1989;298:10731074.CrossRefGoogle ScholarPubMed
Tammentie, T., Tarkka, M.T., Astedt-Kurki, P., Paavilainen, E.Sociodemographic factors of families related to postnatal depressive symptoms of mothers. Int J Nurs Pract 2002;8:240246.CrossRefGoogle ScholarPubMed
Verkerk, G.J., Pop, V.J., Van Son, M.J., Van Heck, G.L.Prediction of depression in the postpartum period: a longitudinal follow-up study in high-risk and low-risk women. J Affect Disord 2003;77:159166.CrossRefGoogle ScholarPubMed
Warner, R., Appleby, L., Whitton, A., Faragher, B.Demographic and obstetric risk factors for postnatal psychiatric morbidity. Br J Psychiatry 1996;168:607611.CrossRefGoogle ScholarPubMed
Wickberg, B., Hwang, C.P.Screening for postnatal depression in a population-based Swedish sample. Acta Psychiatr Scand 1997;95:6266.CrossRefGoogle Scholar
Zlotnick, C., Johnson, S.L., Miller, I.W., Pearlstein, T., Howard, M.Postpartum depression in women receiving public assistance: pilot study of an interpersonal therapy oriented group intervention. Am J Psychiatry 2001;158:638640.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.