title: A history of mental health problems may predict maternal distress in women postpartum.
abstract: OBJECTIVE
  to elucidate the effects of prior mental disorders on newly delivered women's mental health and to compare the outcome of different instruments to screen for maternal distress and depression after childbirth. The sample of 232 Stockholm women responded to a questionnaire on background data and three questionnaires, Beck Depression Inventory (BDI), Edinburgh Postnatal Depression Scale (EPDS) and Postpartum Depression Symptoms Rating Scale (PPDS) at 4-6 weeks and 10-12 weeks after childbirth.
  
  
  RESULTS
  show that maternal distress was experienced by 20% of the women as assessed by the BDI and the EPDS at 4-6 weeks postpartum, and by 13-16% of the women at 10-12 weeks after childbirth. A regression analysis showed that a history of mental health problems influenced maternal self-assessment at both points-in-time. The following background data showed a small but significant impact on maternal self-assessment; younger age, lower educational level, and a short-term partner relationship. The most important emotional responses were sadness, guilt and self-blame across all three instruments at both points in time. Loss of pleasure, self-accusations, irritability, anger, worry and somatic symptoms such as muscular tension, headaches and stomach cramps also occurred.
  
  
  CONCLUSIONS
  women with prior mental health problems are more vulnerable for maternal distress and midwives at the antenatal health clinics should encourage pregnant women to express emotional issues during their transition to motherhood in order to offer appropriate professional support and care.
authors.affiliation: Department of Women's and Children's Health, Karolinska Institutet, Retzius väg 13A-B, Stockholm, Sweden. Louise.Seimyr@ki.se
authors.forename: Louise
authors.initials: L
authors.lastname: Seimyr
authors.forename: Barbara
authors.initials: B
authors.lastname: Welles-Nyström
authors.forename: Eva
authors.initials: E
authors.lastname: Nissen
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000342:Affective Symptoms; D019052:Depression, Postpartum / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008603:Mental Health; D008880:Midwifery / Q000379:methods; D036801:Parturition / Q000523:psychology; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012307:Risk Factors; D012647:Self-Assessment; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology