Postnatal depression or perinatal dysphoria? Findings from a longitudinal community-based study using the Edinburgh Postnatal Depression Scale

Abstract

Postnatal depression is a label which will quickly be applied to any unhappywoman who has recently had a baby. However, both of these terms: postnatal and depression, place constraints on the ways that we think about and research this phenomenon that may not, in fact, be helpful. The term postnatal, for example, implies that we are considering a phenomenon that develops after the birth. As a result the majority of studies have only recruited subjects postnatally, and have therefore reinforced this assumption by failing to observe that some women were already unhappy before delivery. However, studies have shown that rates of depression in pregnancy are at least as high as those typically reported afterwards. Depression is a concept that forces us into dichotomies, whereas women who are not clinically depressed span a continuum from the euphoric to the very miserable. Pre- and postnatal scores on the Edinburgh Postnatal Depression Scale (EPDS) are presented from 1272 women. These show, firstly, that valuable data is wasted by dichotomizing on the basis of EPDS scores and, secondly, that the EPDS, while not a direct measure of depression, has face validity as a continuous measure of emotional well-being both antenatally and postnatally.