Screening for perceived stress among pregnant women availing antenatal care at a tertiary care teaching institution in Kerala, India

Background: Stress during pregnancy can have serious adverse outcomes on the mother, the foetus and the new-born. It can lead to low-birth-weight, preterm births and neuro-psychological effects such as anxiety and depression during pregnancy and puerperium. This cross-sectional research aims to assess the severity of stress among postnatal women in Kerala. This study analysed socio-demographic, obstetric, family dynamics, neonatal characteristics and psychiatric determinants of postpartum stress using perceived stress scale (PSS) among postnatal women in a tertiary hospital in Kerala state, India.Methods: 119 women between 2 to 6 weeks of postpartum period were subjected to a pre-tested pre-structured standard questionnaire. Terminal illness, still birth delivery and comorbid psychiatric illness was excluded. Screening and diagnosis of postpartum stress was done based on perceived stress scale (PSS) and graded as mild 0-13, moderate 14-26, severe 27-40.Results: Study findings indicated a statistically significant association between postpartum stress and risk factors such as unplanned/unwanted pregnancy. The mean age of women was 27±4.8 years. Support from spouse and in-laws was a negative predictor of developing both postnatal stress and depression. Family income, education of couple and husbands’ occupations were non-determinant factors (p>0.05) in this study. Psychiatric illness in the family and past history of psychiatric illness also contributed to postnatal stress. The most important variable which influenced perceived stress during pregnancy was lengthier NICU stay. Even breastfeeding problems and associated neonatal issues worsened the stress scales significantly in the immediate postnatal period.Conclusions: This research concluded that stress detection and timely counselling along with mental and physical support will mitigate stress and postpartum depression.

A preliminary study on identifying specific risk factors of post-partum depression

Background: Pregnancy and childbirth are important events in the life of a woman and also highly vulnerable period of various physiological and psychological illnesses. Several literatures propound that 22% young Indian mothers are showing depressive symptoms after delivery. The consequence of maternal depression is adverse both for mother and development of the child. Objective of this study was to examine the social and obstetric factors contributing post-partum depression.Methods: Women, 18-35 years of age, having four days to one-year postpartum period was taken from the tertiary care hospital settings. Terminal illness, still birth delivery and comorbid psychiatric illness was excluded. Screening and diagnosis of postpartum depression done based on international classification of diseases (ICD 10) using Edinburgh post-natal depression scale (EPDS). A comparative approach by the means of descriptive statistics was implied for data analysis where mothers with depressive symptoms are experimental group and non-depressed mothers were acted as the controls.Results: Study findings indicated a statistically significant association between postpartum depression and risk factors such as occupation and average social economic class, first time delivery.Conclusions: It is a preliminary study in a restricted geographical area, not covering the neurobiological risk factors of postpartum depression. Hence, the future study will focus on the large sample size in a multi areal population for assuring the accuracy of the result.

Utilization of Edinburgh Post Natal Depression Scale (EPDS) as Screening Tool for Predicting Life Events related to Anxiety & Depression during Perinatal Period: An Implication of Preventive Psychiatry

Background: Postpartum depression (PPD) is depression that occurs after having a child. Feelings ofpostpartum depression are more intense and last longer than those of “baby blues,” a term used to describethe worry, sadness, and tiredness many women experience after having a child. This study was undertakenwith the objective to assess the magnitude of risk of Post-Partum Depression in mothers admitted forinstitutional delivery in JK HospitalMethods: It is a cross sectional analytical study. Study was conducted in outpatient department ofPsychiatry of JK Hospital, Kolar, Bhopal which is a tertiary care institution. Study was conducted for 6months amongst the population of mothers who were referred to Psychiatry OPD and who delivered in aweek before period. Convenience sampling method was adopted to conduct the study. The EPDS was themain scale used in the study.Results: Out of 8 variables of study only education level of mothers was found to be insignificant statistically.Rest of the other variables were calculated as statistically significant in our study. Edinburg PostnatalDepression Scale rating was adopted with a cut off of 8, which revealed that about 51.61% of mothers werefalling outside the risk boundary of postpartum depression.Conclusions: The EDPS is useful scale for screening for post natal depression in mothers that have recentlyundergone a delivery though further studies are needed to validate these findings.

Encontros e desencontros: do nascimento à constituição do psiquismo / Success and failure: from birth to psychic constitution / Encuentros y desencuentros: del nascimiento a la constitución de la psique

Este artigo tem como objetivo discutir aspectos relacionados ao encontro mãe-bebê no pós-parto. O nascimento e a recepção do bebê que chega são, em geral, descritos pela mãe como um momento de profunda alegria e sensação de completude. Partindo do princípio de que raramente as dificuldades vividas aparecem no discurso materno, temos como proposta discutir o que está por trás da negação da dor e das dificuldades, que também se fazem presentes nesse momento. Assim, pretende-se retomar aspectos do pensamento psicanalítico relacionados à constituição e à organização do psiquismo do bebê, no intuito de compreender mais profundamente a complexidade presente no nascimento, tanto do ponto de vista da mãe quanto do bebê.

This article aims to discuss aspects related to the encounter mother-baby in the post-delivery moments. The birth and the reception of the new baby are, in general, described by the mother as a moment of joy and the feeling of completeness. Considering that we hardly observe that the difficulties of this period comes up in the mother's speech, our proposal is to discuss what is behind the difficulties of the mothers in communicating the pain and the difficulties that are also part of this moment. Therefore, we intend to look at the psychoanalytical aspects related to the psychological organization of the baby's mind, in order to understand the complexity present at birth, in the mother's point of view, as well as the baby's. In order to do that, we intend to locate at the Freudian works, the moments when the author presents, in his theory, the importance of the mother - unique and essential, responsible for receiving the baby and offering her own ego to the newborn. We also intend to observe the development of these thoughts in the post-Freudian authors.

Este texto tiene como objetivo discutir aspectos relacionados con el posparto y el encuentro madre-bebé. El nacimiento y la recepción del bebé que llega son descritos generalmente por su madre como un momento de profunda alegría y el sentimiento de plenitud. Suponiendo que las dificultades vividas difícilmente surgen en el discurso materno, hemos propuesto discutir lo que está detrás de la negación del dolor y de las dificultades, que también están presentes en este momento. Nuestra intención es reanudar aspectos del pensamiento psicoanalítico en relación con la constitución y la organización de la psique del bebé con el fin de comprender más la complejidad presente en el nacimiento, del punto de vista del bebé y también de la madre. Por lo tanto, tenemos la intención de reanudar el texto freudiano, los momentos en los que el autor presenta la importancia de la figura materna -figura única y esencial, responsable del cuidado y también de ofrecerle su ego al hijo que llega. Por otra parte, se reanudaron de autores posfreudianos avances psicoanalíticos en esta área.

Depression in Women with Recurrent Miscarriages - an Exploratory Study / Depressão em mulheres com perdas gestacionais recorrentes - um estudo investigativo

ABSTRACT Objective: To assess depression, domestic violence and the use of substances in women with recurrent miscarriages. Methods: The Abuse Assessment Screen (AAS), the Edinburgh Postnatal Depression Scale (EPDS) and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were used to assess violence, depression and the use of substances among women with recurrent miscarriages. The population corresponded to patients receiv-ing prenatal care from June to August 2014. Multiple logistic regression was used to assess the multivariable relationship between depression and sociodemographic, psychosocial and medical characteristics (p < 0,10). Results: The prevalence of depression was of 41.3% (95% confidence interval [CI] 1/4 28.3-55.7%). One third of the pregnant women (32.6%) reported emotional or physical violence, and 13% were classified as abusing or addicted to tobacco according to ASSIST. History of psychiatric diseases was associated with depression (p 1/4 0.005). Violence during life demonstrated a modest association (p 1/4 0.073) with depression, as well as the number of miscarriages (p 1/4 0.071). Conclusion: Depression is a frequent disease among pregnant women with recurrent miscarriages. The results of this investigation suggest that a systematic assessment of depression and its associated conditions, such as domestic violence and the use of substances, should be part of the prenatal follow-up visits for women with recurrent miscarriages.

RESUMO Objetivo: Avaliar a presença de depressão, violência doméstica e uso de substâncias em gestantes com história de perdas gestacionais de repetição. Métodos: Foram utilizados os instrumentos: Edinburgh Postnatal Depression Scale (EPDS), Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), Abuse Assessment Screen (AAS), além de um questionário com dados sociodemográficos e clínicos elaborado pelos investigadores. As variáveis que apresentaram associação com depressão na análise bivariada (p < 0,10), tais como número de abortos e violência durante a vida, entraram no modelo de regressão logística. Resultados: Foram entrevistadas 46 pacientes, sendo encontrada uma prevalência de depressão de 41,3% (intervalo de confiança [IC] de 95% 1/4 28,3-55,7%). Com relação à violência contra a mulher, um terço das gestantes (32,6%) foi vítima de violência emocional ou física pelo seu parceiro ou por alguém próximo a elas. O abuso e/ou dependência de tabaco estava presente em 13% das gestantes, segundo o ASSIST. Na análise bivariada, observou-se uma associação significativa entre histórico de doença psiquiátrica e depressão em mulheres com abortamento de repetição (p 1/4 0,005). Observamos também uma tendência de associação entre depressão, número de abortos (p 1/4 0,071) e histórico de violência durante a vida (p 1/4 0,073) . Conclusão: Depressão é uma doença frequente entre as gestantes com abortamento de repetição. A sobreposição entre depressão, violência doméstica e uso de substâncias aponta para a necessidade do rastreio sistemático dessas condições no pré-natal de gestantes com perdas gestacionais de repetição.

Depressão e maternidade à luz da psicanálise: uma revisão sistemática da literatura / Depression and maternity in the light of psychoanalysis: a systematic review of literature / La depresión y la maternidad desde la perspectiva psicoanalítica: una revisión sistemática de la literatura

Este artigo realizou uma revisão sistemática da produção científica nacional sobre depressão e maternidade na perspectiva psicanalítica. Os descritores empregados foram depressão pós-parto OR depressão materna OR depressão puerperal AND psicanálise, sendo incluídos artigos, dissertações ou teses publicados entre 2004 e 2014, disponibilizados na íntegra, advindos da psicologia, psicanálise e psiquiatria ou multidisciplinares. Foram encontrados 37 trabalhos, sendo a maioria derivada da psicologia. Observou-se uma carência de estudos empíricos e, entre os encontrados, destacaram-se trabalhos qualitativos, com estudos de caso, tendo como participantes mães, duplas mãe-bebê, tríades pai-mãe-bebê e pediatras. Os principais resultados encontrados foram: a importância da detecção precoce de sinais de risco, o impacto da depressão na interação mãe-bebê e no desenvolvimento infantil, a etiologia multifatorial do transtorno, a vulnerabilidade do contexto familiar a psicopatologias e algumas hipóteses acerca dos aspectos psicodinâmicos da depressão. Por fim, considerando o funcionamento psicodinâmico próprio à maternidade nos dois primeiros anos após o parto, defende-se a conceituação desse transtorno como depressão materna e a elaboração de um constructo diferenciado.

This article has performed a systematic review of the scientific national research about depression and maternity on the psychoanalytical perspective. The descriptors employed were post-partum depression OR maternal depression OR puerperal depression AND Psychoanalysis; including articles, dissertations or theses published between 2004 and 2014, available in full, from Psychology, Psychoanalysis and Psychiatry or multidisciplinary fields. There were 37 papers, the majority being from Psychology. We could observe a scarcity of empirical studies and, among these, include the qualitative studies, such as case studies having as participants mothers, pairs: mother-baby, triad: father-mother, baby and pediatricians. The main results found were: the importance of the early detection of risk signs, the impact of depression in the interaction of mother-baby and in the child development, the multifactorial etiology of the disorder, the vulnerability of the familiar context and psycopathologies and some hypotheses on the psychodynamic aspects of depression. Finally, considering the psychodynamic functioning of maternity itself in the next two years after birth, it is defended the conceptualization of this disorder as maternal depression and the elaboration of a differentiated construct.

En este artículo se realizó una revisión sistemática de la producción científica sobre la depresión y la maternidad en la perspectiva psicoanalítica. Los descriptores fueron depresión posparto materna OR la depresión OR la depresión posparto AND el psicoanálisis, y se incluyeron artículos, disertaciones o tesis publicados entre 2004 y 2014, disponibles en su totalidad, que surge de la psicología, el psicoanálisis y la psiquiatría o multidisciplinar. Fueron encontrados 37 obras, en su mayoría derivados de la psicología. Hubo una falta de estudios empíricos y entre las que se encuentraran, se destacó el trabajo cualitativo, con estudios de casos, teniendo como participantes las madres, las parejas madre-hijo, las tríadas padre-madre-bebé, y los pediatras. Los principales resultados fueron: la importancia de la detección temprana de signos de riesgo, el impacto de la depresión en la interacción madre-hijo y en el desarrollo infantil, la etiología multifactorial de la enfermedad, la vulnerabilidad del contexto familiar de la psicopatología y algunas hipótesis sobre los aspectos psicodinámicos de la depresión. Por último, teniendo en cuenta el funcionamiento psicodinámico propio de la maternidad en los dos primeros años después del nacimiento, se defiende nombrar este trastorno como la depresión materna y o desarrollar de una construcción diferenciada para definirla.

Depressão pós-parto materna e o envolvimento paterno no primeiro ano do bebê / Maternal postpartum depression and father involvement in the first year of the child

O presente estudo investigou o envolvimento do pai no primeiro ano do bebê no contexto da depressão pós-parto materna (DPP). Foram entrevistados 11 pais (23 a 44 anos), cujas mães apresentavam indicadores de DPP. As entrevistas foram realizadas através de uma análise de conteúdo baseada nas três dimensões do conceito de envolvimento paterno: interação, acessibilidade e responsabilidade. Os resultados revelaram que as interações pai-bebê perpassavam as situações de brincadeira e cuidado. Contudo, os cuidados do bebê eram realizados mais eventualmente e somente com a solicitação da mãe. Também apareceram sentimentos de incompetência e insegurança frente aos cuidados, preocupação com o estado emocional da mãe e com a sua sobrecarga. Os pais também relataram limitações de tempo para auxiliar a mãe nos cuidados com a criança, atribuindo a ela a maior responsabilidade pelo filho. Os resultados sugerem que no contexto da DPP o pai pode também estar fragilizado e pode apresentar dificuldades em suprir as demandas maternas de apoio emocional e instrumental, assim como para se envolver com o bebê.

The present study investigated father's involvement in infant's first year in the context of the maternal postpartum depression (PPD). Eleven fathers from 23 to 44 years participated in this study, whose wives presented PPD symptoms were interviewed. The interviews were examined through content analyzes, based on three dimensions of father involvement: interaction, accessibility and responsibility. Results showed that interactions between father-infant pervaded situations of playing and care giving. However, the latter were less often and most commonly were done upon the request of the mother. Feelings of incompetence and insecurity about the care concern for the emotional state of the mother and her overhead also were reported. Father also showed problems regarding time to assist the mother in care giving for the child, pointing for the mother the greatest responsibility for the child. The results suggest that in the context of DDD the father may be so weakened as the mother and thus he may have difficulties in coping with the demands of emotional and instrumental maternal support, as well as to engage with the child.

Acceptability and barriers to treatment for perinatal depression: An exploratory study in Mexican women / Aceptación y barreras al tratamiento para depresión perinatal: Estudio exploratorio en mexicanas

Background Depression is frequently experienced during the perinatal period. In Mexico, it has received very little attention from researchers and health service providers. It is well known that untreated depression is one of the leading causes of disability in women. Objective This study seeks to explore: 1. the recognition of perinatal depression among pregnant and postpartum women; 2. the acceptance of various modalities of treatment for depression, and 3. the perception of the barriers to receive treatment. Material and methods For this descriptive, exploratory study, 41 women in the third trimester of pregnancy and 30 women between the fourth and sixth postpartum weeks were interviewed. The study was conducted at a health center and a general hospital. The interview included demographic and obstetric data; depressive symptomatology (PHQ-2); open questions on the recognition of perinatal depression and scales relating to the acceptance of treatment modalities and barriers to access health services. Results Almost all the women had heard of the term postpartum depression, while one quarter did not know the causes of this disorder, which was attributed to an inability to face new challenges, emotional and hormonal changes, and lack of social support. The majority considered that it is not easy to speak about their unhappiness or discomfort, and that people would not understand if pre- or post-partum women felt sad or depressed in this period. Individual psychotherapy was the treatment with the highest level of acceptance, while medication, during pregnancy or breastfeeding, was the least accepted. The main barriers to treatment were: lack of time; institutional procedures; being unable to afford care and not having anyone to look after the children. Conclusions These results constitute a preliminary approach to the care needs for depression during the perinatal period. Women's awareness that help is required may not suffice to encourage them to seek assistance due to instrumental barriers and attitudes to treatment. In order to ensure effective care, it is necessary for the official norms regulating the health care for women and babies in this period to include treatment for mental disorders.

Antecedentes La depresión es un estado frecuente en el periodo perinatal. En México ha recibido muy poca atención por parte de investigadores y prestadores de servicios. Se sabe que la depresión no tratada es una de las causas más importantes de discapacidad en las mujeres. Objetivo Explorar: 1. el reconocimiento de la depresión perinatal en embarazadas y puérperas, 2. la aceptación de diferentes modalidades de atención para la depresión y 3. la percepción de las barreras para asistir a tratamiento. Material y métodos En este estudio descriptivo y exploratorio se entrevistó a 41 mujeres en el tercer trimestre del embarazo y a 30 entre la cuarta y sexta semanas del posparto. El estudio se llevó a cabo en un centro de salud y en un hospital general. La entrevista incluyó: datos demográficos y obstétricos; sintomatología depresiva (PHQ-2); preguntas abiertas sobre el reconocimiento de la depresión perinatal y escalas relativas a la aceptación de diversas modalidades de tratamiento y barreras para acudir a servicios de salud. Resultados Casi todas habían escuchado el término depresión posparto; una cuarta parte desconocía las causas de este trastorno, el cual fue atribuido a no saber enfrentar los nuevos retos, cambios emocionales, cambios hormonales y falta de apoyo social. La mayoría consideró que no es fácil hablar de tristeza o malestar en este periodo y que la gente tampoco lo entendería. La psicoterapia individual fue el tratamiento con mayor aceptación; los medicamentos, durante el embarazo o lactancia, los menos aceptados. Las principales barreras al tratamiento fueron: la falta de tiempo, los trámites institucionales, la imposibilidad de pagarlo y la carencia de cuidado para los hijos. Conclusiones Estos resultados constituyen una primera aproximación a los requisitos de atención de la depresión en el periodo perinatal. El reconocimiento de la necesidad de ayuda por parte de las mujeres puede no ser motivo suficiente para que acudan a buscarla debido a las barreras instrumentales y las actitudes hacia el tratamiento. Para poder brindar una atención efectiva es necesario que las normas oficiales, que regulan el cuidado de la salud de mujeres e infantes en este periodo, incluyan una atención a los trastornos mentales.

Produção de enfermagem sobre depressão pós-parto / Nursing production on post-partum depression / Producción de enfermería acerca de la depresión posparto

Revisão narrativa com objetivo de caracterizar estudos elaborados por enfermeiros sobre depressão pós-parto. A busca das publicações ocorreu em duas bases de dados internacionais, utilizando-se os descritores depression, postpartum e nursing; a amostra do estudo constituiu-se de 15 artigos. Um dos interesses centrais dos enfermeiros está na detecção precoce de mulheres com sinais preditivos de depressão; esse é destacado como um profissional que, pelo contato frequente com puérperas, teria maior facilidade para realizar a triagem e oferecer aconselhamento acerca da depressão. Percebe-se que os enfermeiros vêm se envolvendo com a produção de conhecimento sobre essa temática e que a maioria dos estudos tem abordagem quantitativa. O conhecimento produzido tem se voltado, em especial, para a detecção precoce da depressão, o que evidencia preocupação com questões da recuperação da saúde da mulher e promoção do desenvolvimento adequado da criança.

This is a narrative review aiming to characterize studies undertaken by nurses on post-partum depression. The search for publications occurred in two international databases, using the descriptors depression, postpartum and nursing; the study sample was made up of 15 articles. One of the nurses' central interests is in the early detection of women with signs which are predictive of depression; this is emphasized as a professional who, through the frequent contact with puerperas, has greater facility in undertaking triage and offering counselling regarding depression. It is noted that the nurses become involved with the production of knowledge on this issue and that the majority of the studies have a quantitative approach. The knowledge produced is directed, in particular, to the early detection of the depression, which evidences preoccupations with questions of the recovery of the woman's health and promotion of the appropriate development of the child.

Revisión narrativa con el objetivo de caracterizar estudios elaborados por enfermeros sobre depresión pos parto. La búsqueda de las publicaciones ocurrió en dos bases de datos internacionales, utilizándose los descriptores depression, postpartum y nursing; la muestra del estudio se constituye de 15 artículos. Uno de los intereses centrales de los enfermeros está en la detección precoz de mujeres con indicios de depresión; ese es destacado como un profesional que, por el contacto frecuente con puérperas, tendría más facilidad para realizar la selección y ofrecer consejos acerca de la depresión. Se percibe que los enfermeros vienen involucrándose con la producción de conocimiento sobre esa temática y que la mayoría de los estudios tiene abordaje cuantitativo. El conocimiento producido se vuelve, en especial, para la detección precoz de la depresión, lo que evidencia preocupación con cuestiones de la recuperación de la salud de la mujer y promoción del desarrollo adecuado del niño.

A cross- sectional study to assess the prevalence & certain associated risk factors for postpartum depression in women in a tertiary care hospital.

Background: Postpartum depression (PPD) is the most common complication after delivery and may lead mothers to be inconsistent with childcare and may even progress to negative events. If diagnosed early it can be treated with support, medication etc. & prevented by screening for depression. The study was carried out to find the prevalence of postpartum depression in women and to identify & establish the associated risk factors involved. Methods: Cross sectional study on women in first week of postpartum period. Data was obtained by interviewing the mothers using a structured questionnaire, which included socio-demographic details. Edinburgh Postnatal Depression Scale (EPDS) was used to identify patients at risk for PPD. Questions were translated into Konkani according to local needs & validated by pilot study. Results: Study revealed 18.25% prevalence of PPD and significantly associated with relationship with In-laws, outcome of immediate previous & present delivery, neonatal complications in immediate previous pregnancy, which could be identified as potential risk factors. Conclusion: As postpartum depression can put the mother and child to certain risks, it is important that women are screened for PPD. Social support and interventions including counseling, various supportive interactions during the pregnancy can help in preventing PPD. This is an essential area of research that needs to be further developed in order to guide policy and clinical practice.

O sofrimento psíquico no puerpério: um estudo psicossociológico / Post partum psychic suffering: a psychosocial study

Este estudo baseou-se na Teoria das Representações Sociais, buscando apreender o senso comum acerca da depressão pós-parto e da experiência materna, elaborado pelas puérperas com sintomatologia depressiva. Trata-se de uma pesquisa descritiva, realizada em um serviço público de saúde da cidade de João Pessoa, na Paraíba. A amostra foi constituída por 20 mães com sintomatologia depressiva, avaliada pela Escala de Edinburgh, instrumento para rastreamento da depressão pós-parto. As participantes submeteram-se a uma entrevista em profundidade, cujos registros, após gravados e transcritos, foram tratados pela Análise de Conteúdo Temático. As mães ancoraram as representações sociais da depressão puerperal nos seus fatores desencadeantes, objetivados nas adversidades socioeconômicas e nas conflituosas relações sociais familiares e amorosas. A maternidade foi ancorada nas experiências vivenciadas no puerpério, objetivadas na ambivalência psicoafetiva, na sobrecarga advinda com o cuidar do bebê e da família, nas mudanças na identidade feminina e nas expectativas futuras em relação à vida familiar. Encarado sob um ponto de vista psicossociológico, este estudo possibilitou a compreensão de como a mãe puérpera deprimida se sente em relação a si e como pensa a respeito dos eventos da vida cotidiana, da sua experiência materna e do seu ambiente social. Os resultados sugerem a necessidade de elaboração de programas diferenciados de políticas públicas de saúde coletiva voltados para a comunidade feminina durante sua fase reprodutiva, de modo a dar visibilidade e tratamento ao sofrimento psíquico presente no ciclo gravídico-puerperal.

This study was anchored in the Theory of the Social Representations, searching to recognize the common denominator concerning post partum depression and the maternal experience elaborated by post partum mothers with depressive symptomology. This descriptive research was administered in a public health service in João Pessoa, Paraíba. The sample was constituted of 20 mothers with depressive symptomology, evaluated by the Edinburgh Scale, an instrument for tracking post partum depression. The participants went through an in depth interview and after the information was recorded and transcribed, it was treated by the Analysis of Thematic Content. The mothers anchored the social representations of port partum depression in its triggering factors, objectified in the social-economic adversities, conflicting family and amorous relationships. Maternity was anchored in the experiences lived deeply in the post partum, objectified in the psychoaffective ambivalence, being overwhelmed by taking care of a baby and the family, in the changes in the feminine identity and the future expectations in relation to family life. This study, under the psycho-sociologic viewpoint, allowed us to understand how a post partum depressed mother feels in relation to herself, the events of her daily life, about the maternal experience and her social environment. The results suggest the necessity of the elaboration of public politics differentiated programs in collective health system directed toward the feminine community during her reproductive phase, in order to give visibility and treatment to the present psychic suffering in the gravid-puerperal cycle.

The Influences Caused by Life Events,Social Support,Personality Agent and Antepartum Mental Stale on the Post Partum Depression / 中国慢性病预防与控制

Objective To explore the influence of psychosocial factor on post partum depression,to offer the theoretical support for intervention on the occurrence of post partum depression. Methods 45 women with the post partum depression as the case group and 84 health women as the control were investigated by using the gravida general situation questionnaire,the Edinburgh Postnatal Depression Scale (EPDS),life event scale (LES),Type A Behavior pattern questionnaire (TABQ),Eysenck Personality Questionnaire (EPQ),Social Support Rating Scale (SSRS),symptom check list-90 (SCL-90),Trait Anxiety Inventory (T-AI) and State Anxiety Inventory (S-AI). Results The education time of the case group was fewer than those of the control(9.8?3.0 vs 11.6?3.5 yrs,P