Chapter 205 Depression: Postpartum
INTRODUCTION
Description: Postpartum depression is a cluster of symptoms characterized by disturbance of mood; a loss of sense of control; intense mental, emotional, and physical anguish; and a loss of self-esteem associated with childbirth.
Prevalence: Eight percent to ten percent of delivering women, true psychosis—1 to 2 of 1000 deliveries.
ETIOLOGY AND PATHOGENESIS
Risk Factors: History of major depression, premenstrual syndrome, prior postpartum depression, perinatal loss, early childhood loss (parent, sibling), physical or sexual abuse, socioeconomic deprivation, family predisposition, lifestyle stress, preterm delivery, unplanned pregnancy. There is a 50% recurrence rate for subsequent pregnancies.
CLINICAL CHARACTERISTICS
Signs and Symptoms
• Five of the following must be present—depressive mood most of the time; diminished interest in normal or pleasurable activities; significant involuntary change in weight; insomnia or hypersomnia; psychomotor agitation or retardation; fatigue or loss of energy; feelings of worthlessness or guilt; diminished ability to think or concentrate; recurrent thoughts of death
