title: Postnatal depression across countries and cultures: a qualitative study.
abstract: 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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Division of Psychiatry, University of Nottingham, UK. margaret.oates@nottingham.ac.uk
authors.forename: M R
authors.initials: MR
authors.lastname: Oates
authors.forename: J L
authors.initials: JL
authors.lastname: Cox
authors.forename: S
authors.initials: S
authors.lastname: Neema
authors.forename: P
authors.initials: P
authors.lastname: Asten
authors.forename: N
authors.initials: N
authors.lastname: Glangeaud-Freudenthal
authors.forename: B
authors.initials: B
authors.lastname: Figueiredo
authors.forename: L L
authors.initials: LL
authors.lastname: Gorman
authors.forename: S
authors.initials: S
authors.lastname: Hacking
authors.forename: E
authors.initials: E
authors.lastname: Hirst
authors.forename: M H
authors.initials: MH
authors.lastname: Kammerer
authors.forename: C M
authors.initials: CM
authors.lastname: Klier
authors.forename: G
authors.initials: G
authors.lastname: Seneviratne
authors.forename: M
authors.initials: M
authors.lastname: Smith
authors.forename: A-L
authors.initials: AL
authors.lastname: Sutter-Dallay
authors.forename: V
authors.initials: V
authors.lastname: Valoriani
authors.forename: B
authors.initials: B
authors.lastname: Wickberg
authors.forename: K
authors.initials: K
authors.lastname: Yoshida
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003431:Cross-Cultural Comparison; D019052:Depression, Postpartum / Q000208:ethnology* / Q000523:psychology / Q000628:therapy; D004812:Epidemiologic Methods; D005190:Family / Q000523:psychology; D005260:Female; D006240:Happiness; D006801:Humans; D009034:Mother-Child Relations