ABSTRACT
Depression, anxiety and symptoms of distress during pregnancy and the first year postpartum (the perinatal period) are experienced by many women. Some common DSM diagnoses in perinatal women are described including major depressive disorder, other specified depressive disorder, unspecified depressive disorder and generalised anxiety disorder, as well as panic disorder, obsessive-compulsive disorder and post-traumatic stress disorder. Whether or not symptoms meet diagnostic criteria, they can nevertheless be disabling and can have a significant impact on women’s well-being and quality of life. Child behavioural, cognitive, social and emotional development is also impacted, as is the couple relationship and the mental health of depressed women’s partners. Various psychosocial factors may mediate or moderate the impacts of postnatal depression, including women’s cognitive and coping styles and the degree of social supports. A number of psychological and pharmacological treatments can be effective, but most women prefer a non-pharmacological approach due to concerns over medication passing to the fetus or to breastfeeding infants. Cognitive behavioural therapy (CBT) has the largest evidence base for psychological interventions and recently has been evaluated in online e-mental health programs. Treatment of depression may not be sufficient to improve dysfunctional mother-infant interactions, and a targeted approach to this is discussed.
