Hostname: page-component-7c8c6479df-7qhmt Total loading time: 0 Render date: 2024-03-28T13:28:23.325Z Has data issue: false hasContentIssue false

Life Events and Social Support in Puerperal Depression

Published online by Cambridge University Press:  29 January 2018

E. S. Paykel
Affiliation:
St George's Hospital Medical School, London SW17
E. M. Emms
Affiliation:
St George's Hospital Medical School, London SW17
J. Fletcher
Affiliation:
St George's Hospital Medical School, London SW17
E. S. Rassaby
Affiliation:
St George's Hospital Medical School, London SW17

Summary

A 20 per cent prevalence of mild clinical depression was found in 120 women assessed at about six weeks postpartum. The strongest associated factor was occurrence of recent stressful life events. Previous history of psychiatric disorder, younger age, early postpartum blues, and a group of variables reflecting poor marital relationship and absence of social support were also notable. Poor marital support acted as a vulnerability factor, only producing an effect in presence of stressful life events. Previous psychiatric history produced a strong independent effect, both with and without life events. Postpartum blues were only associated with depression in the absence of life events, suggesting a small hormonal sub-group. Overall the findings indicate the importance of social stress in puerperal depression.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1980 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andrews, G., Tennant, C., Hewson, D. & Vaillant, G. E. (1978) Life event stress, social support, coping style and risk of psychological impairment. Journal of Nervous and Mental Disease, 166, 307–16.CrossRefGoogle ScholarPubMed
Ballinger, C. B., Buckley, D. E., Naylor, G. J. & Stansfield, D. A. (1979) Emotional disturbance following childbirth: clinical findings and urinary excretion of cyclic AMP (adenosine 3’ 5’ cyclic monophosphate). Psychological Medicine, 9, 293300.CrossRefGoogle ScholarPubMed
Brown, G. W. & Harris, T. (1978) Social Origins of Depression. London: Tavistock Publications.Google ScholarPubMed
Brown, G. W., Sklair, F., Harris, T. & Birley, J. L. T. (1973) Life events and psychiatric disorders. Part I: Some methodological issues. Psychological Medicine, 3, 7487.CrossRefGoogle Scholar
Covi, L., Lipman, R. S., Derogatis, L. R., Smith, J. E. & Pattison, J. H. (1974) Drugs and group psychotherapy in neurotic depression. American Journal of Psychiatry, 131, 191–8.CrossRefGoogle ScholarPubMed
Friedman, A. S. (1975) Interaction of drug therapy with marital therapy in depressive patients. Archives of General Psychiatry, 32, 619–37.CrossRefGoogle ScholarPubMed
Gordon, R. E. & Gordon, K. K. (1959) Social factors in the prediction and treatment of emotional disorders of pregnancy. American Journal of Obstetrics and Gynaecology, 77, 1074–83.CrossRefGoogle ScholarPubMed
Handley, S. L., Dunn, T. L., Baker, J. M., Cockshott, C. & Gould, S. (1977) Mood changes in puerperium, and plasma tryptophan and Cortisol concentrations. British Medical Journal, iii, 1820.CrossRefGoogle Scholar
Jacobs, S. C., Prusoff, B. A. & Paykel, E. S. (1974) Recent life events in schizophrenia and depression. Psychological Medicine, 4, 444–53.Google Scholar
Jacobson, L., Kaij, L. & Nilsson, A. (1965) Postpartum mental disorders in an unselected sample: frequency of symptoms and predisposing factors. British Medical Journal, i, 1640–3.Google Scholar
Klerman, G. L., Dimascio, A., Weissman, M. M., Prusoff, B. A. & Paykel, E. S. (1974) Treatment of depression by drugs and psychotherapy. American Journal of Psychiatry, 131, 186–91.CrossRefGoogle ScholarPubMed
Kumar, R. & Robson, K. (1978) Neurotic disturbance during pregnancy and the puerperium: preliminary report of a prospective survey of 119 primiparae. In: Mental Illness in Pregnancy and the Puerperium. (ed. Sandler, M.). Oxford: Oxford University Press.Google Scholar
Miller, P. McC., Ingham, J. G. & Davidson, S. (1976) Life events, symptoms and social support. Journal of Psychosomatic Research, 20, 515–22.CrossRefGoogle ScholarPubMed
Nilsson, A. (1970) Para-natal emotional adjustment. Part I: A general account of background variables, attitudes towards childbirth, and an appreciation of psychiatric morbidity. Acta Psychiatrica Scandinavica, Supplement 220.Google Scholar
Paykel, E. S., Myers, K. J., Dienelt, M. N., Klerman, G. L., Lindenthal, J. J. & Pepper, M. P. (1969) Life events and depression: a controlled study. Archives of General Psychiatry, 21, 753–60.CrossRefGoogle ScholarPubMed
Paykel, E. S., Klerman, G. L. & Prusoff, B. A. (1970) Treatment setting and clinical depression. Archives of General Psychiatry, 22, 1121.Google Scholar
Paykel, E. S. (1974) Recent life events and clinical depression. In: Life Stress and Illness. (eds. Gunderson, E. K. and Rahe, R. H.). Springfield, Illinois: Charles C. Thomas.Google Scholar
Paykel, E. S., Prusoff, B. A. & Myers, J. K. (1975) Suicide attempts and recent life events: a controlled study. Archives of General Psychiatry, 32, 327–33.CrossRefGoogle Scholar
Paykel, E. S., McGuiness, B. & Gomez, J. (1976) An Anglo-American comparison of the scaling of life events. British Journal of Medical Psychology, 49, 237–47.CrossRefGoogle ScholarPubMed
Paykel, E. S. & Tanner, J. (1976) Life events, depressive relapse and maintenance treatment. Psychological Medicine, 6, 481–5.CrossRefGoogle ScholarPubMed
Paykel, E. S., Parker, R. R., Penrose, R. J. J. & Rassaby, E. (1979) Depressive classification and prediction of response to phenelzine. British Journal of Psychiatry, 134, 572–81.CrossRefGoogle ScholarPubMed
Pitt, B. (1968) ‘Atypical’ depression following childbirth. British Journal of Psychiatry, 114, 1325–35.CrossRefGoogle ScholarPubMed
Raskin, A., Schulterbrandt, J., Reatig, N. & McKeon, J. (1970) Differential response to chlorpromazine, imipramine and placebo. A study of sub-groups of hospitalized depressed patients. Archives of General Psychiatry, 23, 164–73.CrossRefGoogle Scholar
Robin, A. (1962) Psychological changes of normal parturition. Psychiatric Quarterly, 36, 129–50.CrossRefGoogle ScholarPubMed
Ryle, A. (1961) The psychological disturbances associated with 345 pregnancies in 137 women. Journal of Mental Science, 107, 279–86.CrossRefGoogle ScholarPubMed
Stein, G., Milton, F., Bebbington, P., Wood, K. & Coppen, A. (1976) Relationship between mood disturbances and free and total plasma tryptophan in postpartum women. British Medical Journal, ii, 457.CrossRefGoogle Scholar
Tennant, C. & Bebbington, P. (1978) The social causation of depression: a critique of the work of Brown and his colleagues. Psychological Medicine, 8, 565–75.CrossRefGoogle Scholar
Tod, E. D. M. (1964) Puerperal depression. A prospective epidemiological study. The Lancet, ii, 1264–6.Google Scholar
Weissman, M. M., Lieb, J., Prusoff, B. A. & Bothwell, S. (1975) A double-blind trial of maprotiline (Ludiomil) and amitriptyline in depressed out-patients. Acta Psychiatrica Scandinavica, 52, 225–36.CrossRefGoogle Scholar
Yalom, I. D., Lunde, D. T., Moos, R. H. & Hamburg, D. A. (1968) ‘Postpartum blues’ syndrome. A description and related variables. Archives of General Psychiatry, 18, 1627.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.