HKMJ Vol 6 No 4 December 2000
Identifying women at risk of postnatal depression:
prospective longitudinal study
DTS Lee, ASK Yip, TYS Leung, TKH Chung
Department of Social Medicine, Harvard Medical School,
641 Huntington Avenue, Boston 02115, United States
DTS Lee, MRCPsych, FHKAM (Psychiatry)
The Chinese University of Hong Kong, Prince of Wales Hospital,
Shatin, Hong Kong:
Department of Psychiatry
TYS Leung, MPhil
Department of Obstetrics and Gynaecology
ASK Yip, FRACOG, FHKAM (Obstetrics and Gynaecology)
TKH Chung, MD, FHKAM (Obstetrics and Gynaecology
Objective. To identify psychosocial risk factors for postnatal depression among Hong Kong Chinese women.
Design. Prospective longitudinal study involving self-report questionnaires and face-to-face interviews.
Setting. University teaching hospital, Hong Kong.
Participants. Two hundred and twenty consecutive Chinese women who were admitted to the postnatal ward
of the Department of Obstetrics and Gynaecology from 6 November 1996 to 18 January 1997.
Main outcome measures. Psychiatric diagnoses were established using the clinician-administered Structured
Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders. Psychosocial risk factors
were ascertained by conducting face-to-face interviews and using psychometric rating scales.
Results. Of the 330 women who delivered during the study period, 220 (66.7%) agreed to participate in the study.
The 220 participants had a mean age of 29 years (range, 16-42 years). Postnatal depression was associated with
depression during pregnancy, elevated depression score at delivery, and prolonged postnatal ‘blues’. Other
correlates of postnatal depression were temporary housing accommodation, financial difficulties, two or more
induced abortions, past psychiatric disorders (including depression), and an elevated neuroticism score. Postnatal
depression was more likely if the spouse was disappointed with the gender of the newborn.
Conclusion. Some risk factors are similar to those found in the West, whereas others (spouse disappointment
and history of abortion) may be unique to the local population. To help identify women who are at particularly high
risk of developing postnatal depression, obstetricians and midwives in Hong Kong should consider codifying the
identified risk factors into a check-list.
Keywords Depression, postpartum; Female; Mass screening/methods; Pregnancy complications; Psychiatric status
rating scales
Corresponding : Dr DTS Lee.
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