‘Postnatal depression’ is the term applied to depression in the postnatal year (Elliott, 2000). Prevalence studies suggest that up to 30% of postnatal women have symptoms of depression and between 10% and 15% fulfil diagnostic criteria for depressive disorder (O'Hara & Swain, 1996). These figures do not include the ‘blues’ (emotional lability for a day or two around days 3 to 5) or puerperal psychosis (severe, but rare, disorders with onset typically within 14 days and usually requiring hospitalization). There is no space to address postnatal depression in men (Matthey et al., 2000). The text also relates only to English-speaking women in cultures similar to the indigenous population of the UK. Whilst there have been a few studies in other cultures (e.g. Clifford et al., 1999) and countries (e.g. Cooper et al., 2002), the transcultural approach to the study of perinatal mental health is still in the early stages (Marks et al., 2004).

Experience and consequences

Controlled studies have demonstrated marked differences in prevalence between postnatal women and appropriate controls for both blues and puerperal psychoses but not for postnatal depression. However, postnatal women do report higher levels of depressive symptoms and social maladjustment, particularly marital adjustment (O'Hara et al., 1990). Research is therefore consistent with clinical experience that postnatal depression has a greater psychosocial impact than depression at other times. Many women are very distressed about the depression itself when it occurs at this critical time in their life and relationships.