Diagnostic features

Baby blues:

• Emotional lability, crying, irritatability, tiredness, feelings of inadequacy.

Postnatal depression:

• tearfulness, which may be worse at particular times of the day
• irritability, agitation, poor concentration
• anxiety (the mother may be afraid to be alone with the baby)
• sleep difficulties (even if baby is sleeping)
• appetite disturbance
• guilt
• ambivalence about the baby
• low self-esteem, indecisiveness
• exhaustion and general inability to cope
• thoughts of self-harm and suicide
• vague physical symptoms.

Risk factors include a previous history of depression or postnatal depression, poor relationship with partner, adverse social circumstances, an unplanned pregnancy, perinatal death.

Puerperal psychosis:

• pronounced disturbance of mood - either consistently low or high, or fluctuating unpredictably between the two, and sometimes interspersed with periods of normal mental state
• extreme irritatability
• delusions (often taking the form of irrational preoccupations concerning the baby) and hallucinations
• onset within the first few weeks after birth.

Risk factors include a previous or family history of psychosis, and young age.

In different cultures, pregnancy and childbirth are associated with widely differing traditions and rituals, as well as differences in the concept of depression.

Last edited: 2/2/2004

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