Men's and Women's Perceptions of Women's Postpartum Depression Symptoms Catherine Habel MSc, MSc(A)(c), Nancy Feeley RN, PhD, Barbara Hayton MD, Linda Bell RN, PhD, Phyllis Zelkowitz EdD International Marcé Society for perinatal mental health biennial scientific conference September 10 th 2014
Introduction What is postpartum depression (PPD)?
Introduction What is postpartum depression (PPD)? Presence of impairing symptoms during the postpartum period Some of the most reported symptoms include recurrent and impairing feelings of dysphoria, tearfulness, hopelessness, agitation and anxiety, guilt or fatigue
Introduction Why study PPD?
Introduction Why study PPD?
Introduction Why study PPD?
Introduction Why study PPD?
Introduction Why study PPD? It can have long-term negative implications for mothers and their family members Very little is currently known regarding how mothers perceive their PPD symptoms compared to how their partners do
Introduction Our study examined two questions: 1. What are men s and women s perceptions of women s PPD symptoms? 2. What are the similarities and the differences between partners perceptions of women s PPD symptoms?
Methods Design: Qualitative descriptive study using indepth semi-structured interviews of 30 heterosexual couples Recruitment: Purposive sampling from a primary study comparing care refusers and care acceptors Setting: Home visits in 2 urban areas
Results Society expects too much from women Fatigue Hormones Pain Biophysical issues Societal pressure Transition to parenthood Being a good parent Identity change C-sections Premature births Unmet birth expectations PPD SYMPTOMS Social connectedness and support Isolation Lack of support Financial issues Pile-up of events Other life stressors Pressure to breastfeed Unanswered questions Unmet care needs Child's health and temperament Personality and past psych. Hx Difficult babies Sick babies That s how I am Previous mental health issues Reported causes of women s PPD symptoms. Pink represents causes identified by women and blue causes that were identified by men.
Discussion/Conclusion PPD is seen as having multiple causes by both men and women Other than for societal pressure, all causes were identified by men and women The perceived causes are concordant with the current literature on risk factors
Discussion/Conclusion The gender-based results are in opposition with current literature Extended paternal leaves could explain why men and women identify the same causes Also possible that recruitment method explains why men and women have similar perceptions
Future directions Analyze data in terms of couples as dyads (intra-couple agreement vs disagreement) Impact on women s EPDS scores? Need to find a way to quantify levels of agreement Look at the impact of the length of paternal leaves Increases intra-couple agreement?
Thank you! Questions?
References American Psychiatric Association., & American Psychiatric Association. Task Force on DSM-IV. (2000). Diagnostic and statistical manual of mental disorders : DSM-IV-TR (4th ed.). Washington, DC: American Psychiatric Association. Cox, J. L. (1987). Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. British journal of psychiatry, 150, 782-786. Munk Olsen, T. (2006). New parents and mental disorders. Journal of the American Medical Association, 296(21), 2582 Miller, L. J. (2002). Postpartum depression. Journal of the American Medical Association, 287(6), 762-765. doi: 10.1001/jama.287.6.762 O'Hara, M. W. (1996). Rates and risk of postpartum depression-a meta-analysis. International review of psychiatry, 8(1), 37 Robertson, E., Grace, S., Wallington, T., & Stewart, D. E. (2004). Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry, 26(4), 289-295. doi: 10.1016/j.genhosppsych.2004.02.006 World Health Organization. (1992). The ICD-10 Classification of Mental and Behavioural Disorders.
Methods Women % Men % Age 32.5 (5.6) 35.0 (7.4) Initial EPDS score 14.8 (2.7) n.a. EPDS score at interview 9.6 (4.9) 6.8 (4.5) Children 1.6 (0.9) 1.7 (1.0) First child 19 63.3 19 63.3 Canadian-born 20 66.7 15 50.0 University degree 18 60.0 13 44.8 History of mental illness 6 20.0 2 6.7 Note: Numbers in the Women and Men columns are given as means (standard deviations) or as absolute numbers of participants.
Methods Inclusion criteria: Both partners agreed to participate in the study Birth in the last 12 months before the interview Woman had 12 on the EPDS 12 months after birth Ability to communicate in English or French Living in accessible locations
Methods Exclusion criterion: Diagnosis of postpartum psychosis