Journal of Affective Disorders 89 (2005) 157–166 Confinement and other psychosocial factors in perinatal depression: A transcultural study in Singapore Cornelia Y.I. Chee a,*, Dominic T.S. Lee b,c, Y.S. Chong d, L.K. Tan e, T.P. Ng e, Calvin S.L. Fones Department of Psychological Medicine, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074 b Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong c Department of Social Medicine, Harvard Medical School, United States d Department of Obstetrics and Gynaecology, National University of Singapore, Singapore e Department of Psychological Medicine, National University of Singapore, Singapore Received 1 April 2005; received in revised form 16 September 2005; accepted 16 September 2005 Available online 28 October 2005 Abstract Background: To investigate the prevalence, socio-cultural and psychosocial risk factors for perinatal depression in Singaporean women. Method: A prospective cohort of 559 women was interviewed antenatally and at six weeks’ postpartum at a tertiary hospital. Women were interviewed for diagnosis of depression using a two-stage design, with a screening questionnaire and diagnostic interview. Results: Postnatally, a negative confinement experience was associated with depression. Other independent factors included poor emotional support, a past history of depression, unplanned pregnancy and perceived potential conflicts with relatives over childcare antenatally and dissatisfaction, poor instrumental support postnatally. The prevalence of depression antenatally and postnatally was 12.2% and 6.8%, respectively. Limitations: Measures of satisfaction with social support were based on self-report; there were high dropout rates at six weeks’ postpartum; and other modulating social factors such as pre-existing interpersonal conflicts were not studied. Conclusions: Perinatal depression in Singaporean women is common. Contrary to expectations, a negative dconfinementT experience is a significant risk factor for postnatal depression, and is not universally welcomed by women. Depression is modulated by dissimilar sets of psychosocial factors antenatally and postnatally. © 2005 Elsevier B.V. All rights reserved. Keywords Perinatal; Depression; Singapore; Confinement; Social support Corresponding author. Tel.: +65 6772 4512; fax: +65 6777 2191. E-mail address: pcmcheec@nus.edu.sg (C.Y.I. Chee). 4 5 6 7 8 9 10 11 12 13 ...