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Until today postpartum depression (PPD) remains too often banalised or misknown by the population who is frequently badly informed. Actually it is an important public health problem because it concerns more than one new mother out of ten without this pathology being diagnosed nor treated. The consequences of this depression can be serious both for the mother and for the child with latter developmental difficulties. Since several years, a Genevian team of child psychiatrists has been working on this problem and developed a screening questionnaire to identify women at risk to develop PPD. A preventive method of dynamic psychotherapy is presently being developed and implemented to the at-risk women with the collaboration of the Genevian gynaecologists.

Background: This paper is part of a prospective, epidemiologic study concerning postpartum depression (PPD). The women were first examined during pregnancy; after delivery they were seen with their infants at 3 and 18 months. The present study focuses on the 3-months-postpartum results., Methods: A sample of 570 women and their infants were examined 3 months after delivery. Using the EPDS (Edinburgh Postnatal Depression Scale; Cox et al., 1987. Br. J. Psychiatry 150:782-786), 10.2% of these new mothers presented PPD. The focus of the study concerned the effects of this neurotic disorder on the mother, the infant and on the mother-infant relationship., Results: The deleterious effects concerning the infant were functional disorders such as eating or sleeping difficulties. The 'depressed' dyads presented less vocal and visual communications, less corporal interactions and less smiling. Conditions surrounding delivery and tiredness at 3 months are linked to difficulties in mother-infant relationship for the non-depressed mothers. Logistic models showed that primiparous PPD mothers have difficulties bathing their infants, whereas multiparous PPD mothers are more tired., Limitation: This study did not take into account either protective factors or the effects of the infant himself., Clinical Relevance: Knowledge of the mothers' and infants' difficulties may help caregivers to detect these at-risk dyads and initiate therapeutic measures., (Copright 2002 Elsevier Science BV.)

Background: Depressed new mothers usually do not seek and therefore do not receive any psychiatric help., Methods: In order to assess predictive signs of postpartum depression (PPD), an unselected sample of 570 women were seen by midwives during their pregnancy, using a questionnaire elaborated by ourselves and Derogatis' Hopkins Symptom Checklist. Three months after delivery each new mother was examined again by the same midwife using Cox' Edinburgh Postnatal Depression Scale. The medical files were also examined., Results: Of the new mothers, 58 (10.2%) suffered from PPD. Most significant factors were socio-professional difficulties, multiparity, deleterious life events, depressive mood prior to delivery, early mother-child separation and negative birth experience. The coping abilities of the depressed mother were decreased and her vulnerability to new stress factors increased., Conclusion: It is possible to detect women at risk for PPD already during pregnancy. We therefore elaborated a very simple, short predictive scale which is in the process of validation., Limitation: Protective factors still have to be studied., Clinical Relevance: Knowledge of these factors should help all caregivers to recognize, during pregnancy, women at risk for PPD, in order to initiate preventive and/or therapeutic measures.

Swiss legislation doesn't provide any maternity leave for pregnant women before the day of delivery. A retrospective study of 550 women who had just delivered, showed that in the absence of such provisions, 48.9% of women who worked during their pregnancy had been given temporary sick leaves by their physician on one or more occasion. The decision of giving such sick leave depends primarily on whether or not the woman presents obstetrical risks and is not systematic. The frequency of sick leaves increases also with job load. Finally, the attitude of each woman, related to her personal characteristics, her degree of satisfaction at work and her job security, are other deciding factors for prescribing sick leave.