Evolutionary approaches to postpartum depression

rdf:langString Evolutionary approaches to postpartum depression

rdf:langString Evolutionary approaches to postpartum depression examine the syndrome from the framework of evolutionary theory. Postpartum (or postnatal) depression refers to major and minor episodes of depression within the first 12 months after delivery. Depression during pregnancy is referred to as prenatal (or antenatal) depression. Symptoms of postpartum depression include sad or depressed mood, feelings of worry, anxiety, guilt, or worthlessness, hypersomnia or insomnia, difficulty concentrating, anhedonia, somatic pain, changes in appetite, weight loss or weight gain, moodiness, irritability, restlessness, and fatigue. Women may also have doubts about their ability to care for a new infant, difficulty bonding with the infant, or thoughts of harming themselves or their infants. In the DSM-V, diagnosis is made under major depressive disorder, with the added specifier “With peripartum onset” if the episode occurs during pregnancy or the first four weeks postpartum. Postpartum depression is not to be conflated with postpartum psychosis, which is qualitatively different. A meta-analysis found that up to 12.7% of pregnant women experience an episode of major depression, while as many as 18.4% experience depression at some point in their pregnancy. However, they did not find a significant difference between these and rates of depression in women at nonchildbearing times. Similarly, one meta-analysis found rates of depression of up to 12.9% within the first year postpartum, and other studies have found similar rates. There is also growing evidence that PPD is under-reported and under-diagnosed, raising concerns that a number of women suffer untreated. Cross-cultural research is often difficult to replicate and synthesize. For instance, one meta-analysis found rates of PPD from 0% to 60% across 40 countries. It is likely that a number of cultural factors likely lead to under- and over-diagnosis in some countries.