Editorials

Preventing and treating postnatal depression

BMJ 2009; 338 doi: https://doi.org/10.1136/bmj.a2975 (Published 16 January 2009) Cite this as: BMJ 2009;338:a2975
  1. Cindy-Lee Dennis, associate professor and Canada research chair in perinatal community health
  1. 1University of Toronto, Lawrence S Bloomberg Faculty of Nursing and Faculty of Medicine, Department of Psychiatry, Toronto, ON, Canada M5T 1P8 cindylee.dennis@utoronto.ca

    Comprehensive screening programmes and better organisation of care are key

    Two linked studies assess different approaches for preventing and treating postnatal depression.1 2 This condition is a common form of maternal morbidity that affects about one in eight women from diverse cultures.3 It is also a leading cause of maternal mortality. The UK Confidential Enquiry into maternal deaths found that psychiatric disorders contributed to 12% of all maternal deaths, with suicide being identified as the leading cause of maternal mortality in the United Kingdom.4 Postnatal depression can also have serious consequences for the health and wellbeing of the family. Infants and children are particularly vulnerable—impaired maternal-infant interactions can affect their cognitive, emotional, social, and behavioural development. Clearly, postnatal depression is a substantial public health problem that requires attention.

    Given the diversity in causes and severity of symptoms, researchers have evaluated various treatments. Although antidepressants are effective many women are reluctant to take medication, especially when breast feeding. A recent systematic review indicates that psychosocial and psychological interventions may provide an alternative to pharmacological treatment.5 In the linked randomised controlled trial (doi:10.1136/bmj.a3045), Morrell and …

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