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Differential effects of ethnic density on the risk of postnatal depression and personality dysfunction

  • Andrea Du Preez (a1), Susan Conroy (a1), Susan Pawlby (a1), Paul Moran (a2) and Carmine M. Pariante (a3)...

The relationship between ethnic density and psychiatric disorder in postnatal women in the UK is unclear.


To examine the effect of own and overall ethnic density on postnatal depression (PND) and personality dysfunction.


Multilevel analysis of ethnically mixed community-level data gathered from a sample of 2262 mothers screened at 6 weeks postpartum for PND and personality dysfunction.


Living in areas of higher own ethnic density was protective against screening positive for PND in White women (z =–3.18, P = 0.001), even after adjusting for area level deprivation, maternal age, relationship status, screening positive for personality dysfunction, parity and geographical clustering (odds ratio (OR) 0.98 (95% CI 0.96–0.99); P = 0.002), whereas the effect on personality dysfunction (z =–2.42, P = 0.016) was no longer present once the effect of PND was taken into account (OR = 0.99 (95% CI 0.90–1.0); P = 0.13). No overall ethnic density effect was found for women screening positive for PND or personality dysfunction.


In White women, living in areas of higher own ethnic density was protective against developing PND.

Corresponding author
Carmine M. Pariante, MD, FRCPsych, PhD, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Room 2-055, The James Black Centre, 125 Coldharbour Lane, London SE5 9NU, UK. Email:
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These authors contributed equally to this work.

The study was funded by the Foundation for the Study of Infant Deaths. C.M.P. and P.M. are supported by the National Institute of Health Research (NIHR) Biomedical Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and King's College London.

Declaration of interest


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Differential effects of ethnic density on the risk of postnatal depression and personality dysfunction

  • Andrea Du Preez (a1), Susan Conroy (a1), Susan Pawlby (a1), Paul Moran (a2) and Carmine M. Pariante (a3)...
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Differential effects of ethnic density on the risk of postnatal depression and personality dysfunction

Woody Caan, Editor, Journal of Public Mental Health, RSPH
04 January 2016

The subtle relationship between depression, gender and life events (such as motherhood) creates a global challenge to the United Nations’ Sustainable Development Goals.1 Du Preez and colleagues make a fascinating contribution to the epidemiology of postnatal depression.2 However, as someone interested in family and household effects on mental health 3 I wonder if she missed a key ‘protective’ aspect of having ‘higher own ethnic density’ in a mother’s locality?2 My own observation on British White mothers in a mixed community with marked deprivation and high levels of postnatal depression 4 was that nearby, close relatives (like the baby’s grandmother) made for a healthier new mum. Close relatives tend to belong to the same Ethnic group, as do those ‘good neighbours’ who maintain frequent visits. The local risk of developing depression seems to be influenced by very short-range social networks of close relatives and neighbours.5 In that poor community with so much postnatal depression,4 it transpired that many mothers had no relatives in the area and did not see any friends among their neighbours.

1.Caan W. The global crisis of depression: the low of the 21st century? Perspectives in Public Health 2015; 135: 62.

2.Du Preez A, Conroy S, Pawlby S, Moran P, Pariante CM. Differential effects of ethnic density on the risk of postnatal depression and personality dysfunction. British Journal of Psychiatry 2016; 208: 49-55.

3.Caan W. How family friendly is the UK? BMJ 2011; 343: 331-332.

4.Northrop M, Pittam G, Caan W. The expectations of families and patterns of participation in a trailblazer sure start. Community Practitioner 2008; 81 (2): 24-28.

5.Christakis NA, Fowler JH. Social contagion theory: examining dynamic social networks and human behaviour. Statistics in Medicine 2013; 32: 556-577.

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