Postpartum depression: do we still need this diagnostic term?

The diagnostic term 'postpartum depression' is still widely used. This paper attempts to discuss if this is still justified in the light of recent research.

Comprehensive review of literature.

Postpartum depression is not a specific entity in terms of having a specific aetiology. Rather, giving birth to a child with all its biological and psychosocial consequences seems to act as a major stressor, which - within a general vulnerability-stress model - can trigger the outbreak of the disease in predisposed women. Nevertheless, it might still be justified to continue the use of this diagnostic term, as depression in early motherhood confronts us with specific needs. Thus, help-seeking is often delayed due to shame and stigma, and diagnosis is often missed due to misinterpretation of symptoms. Services often do not meet these women's needs adequately, as they do not take into account their specific situation, problems and fears. Untreated, postpartum depression can have especially severe long-term consequences, not only for the mother but also for the child and the whole family. Therefore, special attention and special treatment is necessary. This necessitates modifications of our pharmacological, non-pharmacological and psychotherapeutic treatment and also provision of new low-threshold mother-infant services.

Although postpartum depression is not a specific entity from an aetiological point of view, the diagnostic term [as 'specifier', as in the Diagnostic and Statistical Manual (DSM)-IV)] should not be abandoned, as depression in the postpartum period confronts us with specific needs for care.