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A STATEMENT CONCERNING POSTNATAL DEPRESSION

Wide variations of the prevalence of postnatal depression are reported in the literature (1.2). Many studies reporting prevalence estimates have used opportunistic or convenience samples taken in hospitals or community postnatal clinics. Furthermore, some of the estimates have been based on sample size that may be too small to provide accurate estimates. One recent population study using an adequate sample size conducted in New Zealand estimated the prevalence of postnatal depression at 20% ( 3 ) . Given the importance of the problem it is essential that more precise estimates are provided (2). Using the 1993 South Australian Health Omnibus Survey which is a unique, large, representative population survey (n=3,004), it has been possible for the first time, to estimate the self-reported prevalence of severe postnatal depression (4). One thousand five hundred and thirty seven females over the age of 15 were personally interviewed and 1,102 (71.7%) had delivered at least 1 full term pregnancy. Almost 1 respondent in 5 (18.5%) indicated that they had experienced serious depression for more than 1 month after the birth of I or more of their children. Only 49.1% of those who felt seriously depressed had sought help for their depression. Help was most commonly sought from their general practitioner (28.4%), hospital doctors (4.6%), nurses or midwives (3.8%), social workers (2.1 %). self-help support groups (1.4%) and others, including friends and relatives. Although self-diagnosis and retrospective selfreporting does not necessarily fully correlate with psychometric testing during the first postnatal year, the prevalence reported is likely to be an underestimation because of possible nonself-recognition or admission of depression (3) . This study estimated the overall prevalence of postnatal depression rather than the prevalence per pregnancy and this may also have underestimated the actual prevalence. This large population study suggests a higher prevalence of postnatal depression than often reported and supports the New Zealand population estimate of a postnatal depression prevalence of 20% (3). These data support the need for the development of appropriate intervention strategies. They also reinforce the need for vigilance on the part of general practitioners and other health professionals when dealing with postnatal women.