Confinement and other psychosocial factors in perinatal depression: A transcultural study in Singapore

• Published in: Journal of affective disorders Vol. 89; no. 1; pp. 157 - 166
• Main Authors: Chee, Cornelia Y.I., Lee, Dominic T.S., Chong, Y.S., Tan, L.K., Ng, T.P., Fones, Calvin S.L.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 01.12.2005; Elsevier
• Subjects: Adult; Adult and adolescent clinical studies; Biological and medical sciences; Confinement; Conflict (Psychology); Cross-Sectional Studies; Depression; Depression, Postpartum - diagnosis; Depression, Postpartum - epidemiology; Depression, Postpartum - psychology; Family - psychology; Female; Humans; Infant, Newborn; Labor, Obstetric - psychology; Male; Marriage - psychology; Medical sciences; Mood disorders; Perinatal; Pregnancy; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Regression Analysis; Risk Factors; Singapore; Social Support; Socioeconomic Factors; Asia; Singapore; Perinatal; Depression; Confinement; Singapore; Social support; Mood disorder; Human; Postnatal; Female; Psychosocial factor
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2005.09.004

To investigate the prevalence, socio-cultural and psychosocial risk factors for perinatal depression in Singaporean women. 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. 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. 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. Perinatal depression in Singaporean women is common. Contrary to expectations, a negative ‘confinement’ 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.