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Background: Postnatal depression (PND) follows 10-15% of deliveries. Postnatal blues occur in the first postpartum week and are thought to have little significance. Studies report links between them, PND and premenstrual symptomatology but are methodologically flawed. Hypotheses: Women with severe blues are more likely to become depressed in the 6 months after delivery and more likely to experience premenstrual symptomatology when menstruation resumes. Subjects: First-time mothers who were literate, English speaking, had a singleton pregnancy, no current severe mental illness and whose fetus was healthy. Method: Written informed consent was obtained in late pregnancy. Baseline data include the Eysenck Personality Questionnaire, Edinburgh Postnatal Depression Scale (EPDS), sociodemographic and obstetric details. The Blues Questionnaire was completed on postpartum days 3 & 5. Obstetric data were recorded. Subjects (scores >/75^th centile on the Blues Questionnaire) and controls (\<25^th centile) were matched for age, marital status and social class. All participants completed monthly postal EPDS. When menstruation returned, daily Menstrual Distress Questionnaires and visual analogue scales for premenstrual symptoms were completed for 2 cycles. At 6 months all women with EPDS scores >/9 at any time postpartum were interviewed using the Schedule for Affective Disorder and Schizophrenia (Lifetime version). Research Diagnostic Criteria diagnoses were made for current or past psychiatric disorder. 1 in 5 women with EPDS scores <9 were interviewed to exclude false negatives. Results: Women with severe blues were 3.8 times more likely to become depressed and to have a major rather than minor illness. Their depressions began sooner after delivery and lasted longer than those with no blues. They were more likely to experience premenstrual symptoms. Discussion: Results support the idea that these conditions are variants of affective disorder, severe blues acting as a marker of affective vulnerability. Clinical applications of the results and areas for further research are explored.

<p>Postnatal depression (PND) is a condition which affects about 8-15% of recent parents. The cause of PND is unknown but several underlying factors have been purposed through different studies. This descriptive literature review aims to illuminate the parent’s situation when the mother is affected with PND. In search of literature, the databases Medline (via PubMed), Academic Search Elite, Cinahl, PsycINFO, PsycARTICLES and SweMed+ were used. Fourteen articles were finally included in this study. The result of the chosen articles, both from the woman’s and the men’s perspective, could be divided into three categories; thoughts and feelings about the own situation, thoughts and feelings surrounding the partner and the baby and thoughts and feelings about the perception of support. The women felt that the expectations they had of motherhood, before the baby was born, was not matched by later experiences and they perceived themselves as bad mothers. They also found it hard to talk about their feelings with both their partner and with people outside the family, thinking that no one would understand. The men felt as though they, due to their partner’s condition, had lost control of life and that there, for them, was no organized help or support available.</p> / <p>Postnatal depression (PND) är ett tillstånd som drabbar ca 8-15% av nyblivna föräldrar. Orsaken till PND är inte känd men flera troliga bakomliggande faktorer har föreslagits genom olika studier. Föreliggande beskrivande litteraturstudie syftar till att belysa föräldrarnas situation när modern drabbats av PND. Vid sökning av litteratur användes databaserna Medline (via Pubmed), Academic Search Elite, Cinahl, PsycINFO, PsycARTICLES och SweMed+. Fjorton artiklar inkluderades slutligen i studien. Resultatet av valda artiklar kunde, både ur kvinnans och ur mannens perspektiv, delas in i tre kategorier; tankar och känslor om sin egen situation, tankar och känslor omkring partnern och barnet samt tankar och känslor om upplevelsen av stöd. Kvinnorna upplevde att de förväntningar de haft på moderskapet före barnets födelse inte överensstämde med den senare erfarenheten och de uppfattade sig själva som dåliga mammor. De upplevde det även svårt att tala om sina känslor, både med partnern och med personer utanför familjen, i tron att ingen skulle förstå. Männen upplevde att de, i och med partnerns tillstånd, förlorade kontrollen över livet och att det, för dem, inte fanns organiserad hjälp eller stöd att få.</p>

Postnatal depression (PND) is a condition which affects about 8-15% of recent parents. The cause of PND is unknown but several underlying factors have been purposed through different studies. This descriptive literature review aims to illuminate the parent’s situation when the mother is affected with PND. In search of literature, the databases Medline (via PubMed), Academic Search Elite, Cinahl, PsycINFO, PsycARTICLES and SweMed+ were used. Fourteen articles were finally included in this study. The result of the chosen articles, both from the woman’s and the men’s perspective, could be divided into three categories; thoughts and feelings about the own situation, thoughts and feelings surrounding the partner and the baby and thoughts and feelings about the perception of support. The women felt that the expectations they had of motherhood, before the baby was born, was not matched by later experiences and they perceived themselves as bad mothers. They also found it hard to talk about their feelings with both their partner and with people outside the family, thinking that no one would understand. The men felt as though they, due to their partner’s condition, had lost control of life and that there, for them, was no organized help or support available. / Postnatal depression (PND) är ett tillstånd som drabbar ca 8-15% av nyblivna föräldrar. Orsaken till PND är inte känd men flera troliga bakomliggande faktorer har föreslagits genom olika studier. Föreliggande beskrivande litteraturstudie syftar till att belysa föräldrarnas situation när modern drabbats av PND. Vid sökning av litteratur användes databaserna Medline (via Pubmed), Academic Search Elite, Cinahl, PsycINFO, PsycARTICLES och SweMed+. Fjorton artiklar inkluderades slutligen i studien. Resultatet av valda artiklar kunde, både ur kvinnans och ur mannens perspektiv, delas in i tre kategorier; tankar och känslor om sin egen situation, tankar och känslor omkring partnern och barnet samt tankar och känslor om upplevelsen av stöd. Kvinnorna upplevde att de förväntningar de haft på moderskapet före barnets födelse inte överensstämde med den senare erfarenheten och de uppfattade sig själva som dåliga mammor. De upplevde det även svårt att tala om sina känslor, både med partnern och med personer utanför familjen, i tron att ingen skulle förstå. Männen upplevde att de, i och med partnerns tillstånd, förlorade kontrollen över livet och att det, för dem, inte fanns organiserad hjälp eller stöd att få.

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Syftet med föreliggande enkätstudie var att undersöka om distriktssköterskorna upplever att de har tillräckligt med kunskap och stöd för att genomföra stödsamtal med deprimerade mammor, samt att se hur handläggningen ser ut då mammor visar tecken på postnatal depression. Urvalet bestod i distriktssköterskor som genomgått utbildning i Postnatal depression och svarsfrekvensen i enkätstudien var 66 %. Samtliga respondenter upplever att utbildningen i Postnatal depression är användbar i deras arbete. Mest nytta har de av att veta hur en bra screening ska gå till. Majoriteten av respondenterna har tillgång till handledning med psykolog 1 gång/mån eller 2-3 gånger/halvår. Något mindre än hälften upplever att handledningen de får inte är tillräcklig. Samtliga respondenter använder The Edinburgh Postnatal Depression Scale (EPDS) i sitt arbete och remitterar alla mammor med mer än 16 poäng till psykolog. Mer än hälften genomför i genomsnitt 1-3 stödsamtal med varje deprimerad mamma. Knappt hälften av respondenterna upplever att de träffar för få deprimerade mammor för att känna sig trygga och säkra i situationen med stödsamtal. Slutsats Postnatal depressions utbildningen är användbar i arbetet som distriktssköterska. Tillgången till handledning är för de flesta god men otillräcklig. Många upplever att de träffar för få deprimerade mammor för att känna sig trygga och säkra med att genomföra stödsamtal. / The aim of this study was to investigate if the child health care nurses feel they have enough knowledge and support to operate counselling with mothers that feel depressed postpartum, further the aim also was to see how the child health care nurses handle mothers with signs of depression. The sample consists of child health care nurses who had taken the training-course in Postnatal depression, 66 % answered the questionnaire. All respondents experience that the training in Postnatal depression is useful in their work. Most useful to know is how a god screening is attended. The majority of respondents have access to supervision with psychologist once a month or 2-3 times over six months. Barely half feel they don’t get enough supervision. All respondents use The Edinburgh Postnatal Depression Scale (EPDS) in their work and also refer mothers with EPDS score 16 or more to psychologist. More than half of the respondents operate 1-3 counselling with each depressed mother. Almost half feel that they meet too few depressed mothers to feel secure with counselling. Conclusion: The training-course in Postnatal depression is useful in the work of child health care nurses. Supervision with psychologist is for the most child health care nurses adequate, but not enough. Many of the respondents experience that they meet too few depressed mothers to feel secure and to find a routine in counselling.

Background: Maternal postnatal depression (MPND) has been associated with child emotional, behavioural and cognitive problems, placing them at greater risk for later psychopathology. Therefore research into mechanisms of risk transmission is important. This longitudinal study considers the emotional quality of the mother-child relationship, using a measure of Expressed Emotion (EE), as a potential mechanism explaining the link between MPND and child emotional and behavioural problems in the postnatal period. It was predicted mothers with higher depressive symptoms at 3-months would show more negative EE and their child would have more internalising and externalising problems at 2-years, with maternal EE acting as a mediator. Methods: Data from the longitudinal Oxford Father’s Project for 130 (of 192 originally recruited) mother-child dyads was used. Mother’s depressive symptoms were measured using the Edinburgh Postnatal Depression Scale at 3-months. Maternal EE, specifically critical and positive comments, was coded from the Preschool Five Minute Speech Sample measured at 2-years. Maternal, paternal and independently rated child outcomes were measured at 2-years using the Child Behaviour Checklist for ages 1.5-5. Results: Mothers, fathers and “others” rated child problems similarly. EE-positive comments showed stability from 1-2 years. Mothers with more depressive symptoms at 3-months showed more EE-criticism at 2-years especially towards boys and rated their children higher in internalising and externalising problems. Maternal EE-criticism predicted child internalising and externalising problems at 2-years. EE was not a significant mediator between maternal depressive symptoms and child problems. Conclusions: Children of mothers with more depressive symptoms 3-months post-birth experience more maternal EE-criticism and show more internalising and externalising problems aged 2-years. Given the long-term consequences of early childhood problems, postnatal depression should be screened and treated early to reduce EE-criticism and negative child outcomes. Research should consider why mothers experiencing postnatal depression may be more critical of male children and how this may impact on development.