Background. A prospective epidemiology study evaluated the
role of specific social and psychological
variables in the prediction of depressive symptomatology and
disorders following childbirth in a
community sample. Measures of social support used previously in
clinically depressed populations facilitated further comparison.
Methods. Nulliparous pregnant women (N=507)
were interviewed during pregnancy with the
Interview Measure of Social Relationships (IMSR) and a contextual
assessment of pregnancy-related support and adversity and 427 were
followed up at 3 months postpartum with the 30-item
GHQ, including six depression items. To establish the clinical
representativeness of the GHQ, high
GHQ scorers and a random subsample of low scorers were interviewed
using the SCAN. Regression
models were developed using the GHQ Depression scale (GHQ-D), the
IMSR and other risk factor data.
Results. GHQ-D after childbirth was predicted by lack of
perceived support from members of the
woman's primary group and lack of support in relation to the
event becoming pregnant; this held
even after controlling for antenatal depression, neuroticism, family
and personal psychiatric history
and adversity. Informant-rated deficits in provision of social
support also predicted later depression.
The size of the primary social network group previously found to
be related to depression in women,
did not predict depressive symptom development.
Conclusion. Predictors of depressive symptom development
differ from predictors of recovery from
clinical depression in women. Interventions should be designed to
reduce specific deficits in social
support observed in particular study populations.