Summary Background The perinatal period is a time of high risk for onset of depressive disorders and is associated with substantial morbidity and mortality, including maternal suicide. Perinatal depression comprises a heterogeneous group of clinical subtypes, and further refinement is needed to improve treatment outcomes. We sought to empirically identify and describe clinically relevant phenotypic subtypes of perinatal depression, and further characterise subtypes by time of symptom onset within pregnancy and three post-partum periods. Methods Data were assembled from a subset of seven of 19 international sites in the Postpartum Depression: Action Towards Causes and Treatment (PACT) Consortium. In this analysis, the cohort was restricted to women aged 19–40 years with information about onset of depressive symptoms in the perinatal period and complete prospective data for the ten-item Edinburgh postnatal depression scale (EPDS). Principal components and common factor analysis were used to identify symptom dimensions in the EPDS. The National Institute of Mental Health research domain criteria functional constructs of negative valence and arousal were applied to the EPDS dimensions that reflect states of depressed mood, anhedonia, and anxiety. We used k-means clustering to identify subtypes of women sharing symptom patterns. Univariate and bivariate statistics were used to describe the subtypes. Findings Data for 663 women were included in these analyses. We found evidence for three underlying dimensions measured by the EPDS: depressed mood, anxiety, and anhedonia. On the basis of these dimensions, we identified five distinct subtypes of perinatal depression: severe anxious depression, moderate anxious depression, anxious anhedonia, pure anhedonia, and resolved depression. These subtypes have clear differences in symptom quality and time of onset. Anxiety and anhedonia emerged as prominent symptom dimensions with post-partum onset and were notably severe. Interpretation Our findings show that there might be different types and severity of perinatal depression with varying time of onset throughout pregnancy and post partum. These findings support the need for tailored treatments that improve outcomes for women with perinatal depression. Funding Janssen Research & Development.

International audienceHuman newborns are cognitively and socially competent. Although they are sensitive to the presence of a social partner, little is known on the emergence of the ability to partake in social interaction. In this study we aimed to explore the roots of turn-taking in the neonatal period. We wished to highlight the way mothers' and newborns' vocalizations are organized in relation to each other in a face-to-face communication situation. We observed 15 mothers and their 2 to 4-day-old newborns while mothers were instructed to speak to them and infants were in a receptive behavioural state. We examined the temporal organization of maternal and newborn vocalization. Our results show that of all newborn vocalizations analysed, one third consisted of overlapping vocalizations with a maternal vocalization. Furthermore, among the 119 newborn vocalizations that followed a maternal vocalization, 68.9% occurred within the first second, and 26.9% were latched (occurring within the first 50\,ms). Indeed our study suggests that a 1-s window would be the correct window to appreciate social contingency in the neonatal period. Our study provides evidence that a turn-taking ability is already present at birth suggesting that turn taking, which depends on a tight coordination between interacting individuals, is a precocious human ability