Postpartum depression: A critical review.

Abstract

The available literature on postpartum depression has failed to distinguish among the maternity blues, postpartum affective psychoses, and mild to moderate postpartum depression. Mild to moderate postpartum depression, which is similar to an untreated nonpostpartum clinical depression, merits further study for two reasons. First, it is a relatively common disorder, affecting as many as 20% of new mothers, and it has clear ramifications for the well-being of women and their infants. Second, the study of postpartum depression offers a unique opportunity to clarify the relation between a specific stressor (the birth of a child) and the development of psychiatric illness. Previous research on postpartum depression is reviewed and critically evaluated. Methodological and conceptual shortcomings of existing studies have resulted in inconsistent findings, which in turn have prevented the development of a coherent theoretical framework for understanding the etiology, course, and treatment of this disorder. Because recent data indicate a relation between stress and depression, one promising area for further research is the contribution of psychosocial factors, specifically life events and social support, to postpartum depression. Recommendations that may lead to the development of a comprehensive theoretical model of this disorder are proposed for future research.