Postpartum Depression

Epidemiological studies of postpartum samples have consistently revealed that approximately 10 percent of women experience a non-psychotic major depressive disorder in the early weeks following delivery (O'Hara 1997). Although this does not represent an increase over the non-postpartum rate (Cooper et al. 1988; O'Hara et al. 1990), the inception rate for depression in the first three months postpartum does appear to be elevated compared to the succeeding nine months. The duration of postpartum depression is similar to that of depressions arising at other times; in other words, episodes typically remit spontaneously within two to six months. Some residual depressive symptoms are, however, not uncommon, and can persist up to a year following delivery (O'Hara et al. 1990; Cooper et al. 1988). Some cultural variation in the rate of postpartum depression is apparent. Thus, although a rate similar to that found in Western groups has been reported for a Chinese sample (Lee et al. 2001) and for a Nigerian sample (Aderbrigbe, Gureje, and Omigbodun 1993), a substantially lower rate has been found in a Malaysian sample (Grace et al. 2001), and in an indigent urban South African postpartum sample the rate was found to be as high as 34 percent (Cooper et al. 1999). The high prevalence in the latter sample probably reflects a response to the endemic levels of extreme socioeconomic adversity.