Maternal and infant health policies, a priority in low-income countries, must integrate maternal depression as a disorder of public health significance. Interventions should target mothers in the antenatal period and incorporate a strong gender-based component.

Background: Postnatal depression is a recognised cause of delayed cognitive development in infants in developed countries. Being underweight is common in South Asia. Aims: To determine whether postnatal depression contributes to poor growth and development outcomes in Goa, India. Methods: Cohort study for growth outcomes with nested case-control study for developmental outcomes. A total of 171 babies were weighed and measured at 6-8 weeks following birth. The following measures were used: Edinburgh Postnatal Depression Scale for maternal mood, and sociodemographic and infant health variables. Outcome measures were: weight (<5th centile), length (<5th centile), and Developmental Assessment Scale for Indian Infants scores at six months. Results: Postnatal depression was a strong, and independent, predictor of low weight and length and was significantly associated with adverse mental development quotient scores. Conclusions: This study provides evidence for the first time that postnatal depression, a potentially treatable disorder, is a cause of poor growth and development in South Asia.

There is little qualitative research on depression in motherhood from non-Western societies. The objective of the study described in this paper was to use qualitative methods to investigate the cultural validity of the construct of postnatal depression (PND) and its social and cultural contexts. The study was nested in a cohort of mothers recruited to study the risk factors and outcome of PND in Goa, India. In-depth interviews were carried out with 39 mothers (19 of whom were found to be suffering from PND as defined by a cut-off score on the Edinburgh PND scale) and their husbands purposively recruited from the cohort. An illness narrative was conducted with mothers who were categorized as suffering from PND and their husbands to elicit their explanatory models. The two groups (PND and non-PND) of mothers were comparable in terms of socio-demographic characteristics. PND mothers had lower levels of practical help and emotional support. The symptoms reported by PND mothers were similar to those recorded in studies with women in other cultures suggesting a universal clinical presentation of PND. Causal attributions for the experience of depression focused on economic difficulties and poor marital relationship. All mothers expressed the need for more practical help and support during the period after childbirth; husbands in both groups were often disengaged from baby care or supporting the mother. The study provides validity for the construct of PND in an Indian setting, but also shows that the emotional distress is interpreted from the context of social adversity, poor marital relationships and cultural attitudes towards gender rather than a biomedical psychiatric category. Contrary to the assumption that sociocultural contexts associated with childbirth in non-Western societies protect mothers from depression, factors unique to the culture such as gender preference and the low involvement of husbands in child-care are major causes of stress to mothers. r

Psychosocial factors have the strongest association with the complaint of vaginal discharge. Syndromic management algorithms need refinement so that women with complaints that are non-infectious in aetiology are offered psychosocial interventions.

This report is concerned with the prevalence of symptoms of specific personality disorders in a representative community sample and draws attention to the importance of different sources of diagnostic information. We recruited a sample of 1,630 people between the ages of 55 and 64 to participate in a study regarding personality and health. Using careful recruitment methods, our participation rate was 43 %. Participants completed the SIDP-IV interview as well as a questionnaire (self-report MAPP). Informants completed the same questionnaire (informant MAPP), describing the participant’s maladaptive personality characteristics. According to the diagnostic interview, 7 % of participants met criteria for exactly one PD, 1 % met criteria for 2 or 3 PDs, and 2 % met criteria for PD NOS (defined as 10 or more miscellaneous criteria). Avoidant and obsessive compulsive PDs were the most common types. Correlations between the three sources of information indicated significant agreement among these measurement methods, but they are not redundant. In comparison to interview and self-report data, informants reported more symptoms of personality pathology (except for avoidant PD). Symptoms of personality pathology are continuously distributed, and subthreshold features may have an important impact on health and social adjustment. In this community sample, rates of co-morbidity among PDs and the proportion of PDNOS diagnoses are substantially lower than reported from clinical samples. Future research must evaluate the validity of diagnostic thresholds and competing sources of diagnostic information in relation to important life outcomes.

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