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Postnatal depression across countries and cultures: a qualitative study

Division of Psychiatry, University of Nottingham

John L. Cox, DM, FRCPsych

Academic Suite, Keele University, UK

Stella Neema, PhD

Makerere Institute of Social Research Kampala, Uganda

Paul Asten, MHSc

Section of Perinatal Psychiatry, Institute of Psychiatry, London, UK

Nine Glangeaud-Freudenthal, PhD

Research Unit 149, INSERM, Villejuf, France

Barbara Figueiredo, PhD

Department of Psychology, University of Minho, Braga, Portugal

Laura L. Gorman, PhD

Department of Psychology, University of Iowa, USA

Sue Hacking, PhD

Department of Psychiatry, Keele University, UK

Emma Hirst

School of Psychiatry and Behavioural Sciences, University of Manchester, UK

Martin H. Kammerer, Dr med

Child and Adolescent Psychiatry, University of Zurich, Switzerland

Claudia M. Klier, MD

Department of Psychiatry, University of Vienna, Austria

Gertrude Seneviratne, MRCPsych

Section of Perinatal Psychiatry, Institute of Psychiatry, London, UK

Mary Smith

Trinity College, Dublin, Ireland

Anne-Laure Sutter-Dallay, MD

University Department of Psychiatry, Centre Hospitalier Charles Perrens, Bordeaux, France

Vania Valoriani, PhD

Department of Neurologic and Psychiatric Sciences, University of Florence, Italy

Birgitta Wickberg, PhD

Department of Psychology, University of Göteborg, Sweden

Keiko Yoshida, MD

Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan

TCS–PND Group^*

Correspondence: Dr Margaret Oates, Division of Psychiatry, A Floor South Block, Queen's Medical Centre, Nottingham NH7 2UH, UK. E-mail: margaret.oates{at}nottingham.ac.uk

Declaration of interest None.

^* TCS–PND Group membership and funding detailed in Acknowledgements, p. iv, this supplement.

Background Postnatal depression seems to be a universal condition with similar rates in different countries. However, anthropologists question the cross-cultural equivalence of depression, particularly at a life stage so influenced by cultural factors.

Aims To develop a qualitative method to explore whether postnatal depression is universally recognised, attributed and described and to enquire into people's perceptions of remedies and services for morbid states of unhappiness within the context of local services.

Method The study took place in 15 centres in 11 countries and drew on three groups of informants: focus groups with new mothers, interviews with fathers and grandmothers, and interviews with health professionals. Textual analysis of these three groups was conducted separately in each centre and emergent themes compared across centres.

Results All centres described morbid unhappiness after childbirth comparable to postnatal depression but not all saw this as an illness remediable by health interventions.

Conclusions Although the findings of this study support the universality of a morbid state of unhappiness following childbirth, they also support concerns about the cross-cultural equivalence of postnatal depression as an illness requiring the intervention of health professionals; this has implications for future research.

This article has been cited by other articles:

				P. Asten, M. N. Marks, and M. R. Oates Aims, measures, study sites and participant samples of the Transcultural Study of Postnatal Depression The British Journal of Psychiatry, February 1, 2004; 184 (46): s3 - s9. [Abstract] [Full Text] [PDF]