[Why is it essential to diagnose and prevent postpartum depression?]. / Pourquoi est-il essentiel de dépister et de prévenir la dépression postpartum?

Until today postpartum depression (PPD) remains too often banalised or misknown by the population who is frequently badly informed. Actually it is an important public health problem because it concerns more than one new mother out of ten without this pathology being diagnosed nor treated. The consequences of this depression can be serious both for the mother and for the child with latter developmental difficulties. Since several years, a Genevian team of child psychiatrists has been working on this problem and developed a screening questionnaire to identify women at risk to develop PPD. A preventive method of dynamic psychotherapy is presently being developed and implemented to the at-risk women with the collaboration of the Genevian gynaecologists.

Postpartum depression and mother-infant relationship at 3 months old.

BACKGROUND: This paper is part of a prospective, epidemiologic study concerning postpartum depression (PPD). The women were first examined during pregnancy; after delivery they were seen with their infants at 3 and 18 months. The present study focuses on the 3-months-postpartum results. METHODS: A sample of 570 women and their infants were examined 3 months after delivery. Using the EPDS (Edinburgh Postnatal Depression Scale; Cox et al., 1987. Br. J. Psychiatry 150:782-786), 10.2% of these new mothers presented PPD. The focus of the study concerned the effects of this neurotic disorder on the mother, the infant and on the mother-infant relationship. RESULTS: The deleterious effects concerning the infant were functional disorders such as eating or sleeping difficulties. The 'depressed' dyads presented less vocal and visual communications, less corporal interactions and less smiling. Conditions surrounding delivery and tiredness at 3 months are linked to difficulties in mother-infant relationship for the non-depressed mothers. Logistic models showed that primiparous PPD mothers have difficulties bathing their infants, whereas multiparous PPD mothers are more tired. LIMITATION: This study did not take into account either protective factors or the effects of the infant himself. CLINICAL RELEVANCE: Knowledge of the mothers' and infants' difficulties may help caregivers to detect these at-risk dyads and initiate therapeutic measures.