IMPACT OF POSTNATAL DEPRESSION ON PARTNERS

A PROFILE OF THE MENTAL HEALTH OF MEN WHOSE PARTNERS WERE EXPERIENCING POSTNATAL DISTRESS - A PILOT STUDY

Beverley Turner, Child & Family Services, Royal North Shore Hospital, NSW

It is well recognised that the early postpartum period is a time of elevated risk for depression in mothers. Much attention has focussed on mothers and their individual pathologies, then on the mother-infant dyad and the adverse consequences of postnatal depression for the infant. Clinicians and researchers working in this area have been aware of the associated psychopathology of partners of women experiencing postnatal depression. This has led to considering the impact of paternal psychopathology on the onset and duration of their partners' depression and the impact on their infants and children. Clearly, the partner's resilience, capacity for support and other available social networks can be of critical importance in the woman's recovery from depression. This presentation includes a brief overview of the literature concerned with the impact of PND on partners and observations of their mental health. Results of a pilot study of men whose partners were recruited from a population referred to a mothercraft facility because of postpartum adjustment difficulties will be presented. It is hoped that an increasing awareness of the problems men experience in such circumstances and an assessment of their strengths and weaknesses will assist in therapeutic intervention, not only for the mother and infant but for the family system.

POSTNATAL DEPRESSION AND THE EFFECT ON PARTNERS: EVALUATION OF AN EDUCATIONAL INTERVENTION FOR PARTNERS OF WOMEN WITH POSTNATAL DEPRESSION

Susan Roberts, Queens Medical Centre, University of Nottingham, UK

There is evidence in the current literature that supports the significant morbidity in spouses of women with postnatal depression. From a previous pilot study conducted at The Prince Charles Hospital, Brisbane, entitled "Postpartum Psychiatric Disorders - A Partner's Perspective", there appeared to be an association between psychological distress in partners and dissatisfaction regarding information provided to them. There have been a number of studies of patients with schizophrenia and affective disorder that show the effectiveness of family psychoeducation in helping to diminish family burden and change attitudes and behaviour towards the patient and therefore improve outcome. There are no studies that have been performed in the effectiveness of family psychoeducation in postpartum psychiatric illness.

The aim of this study was to study the knowledge base of partners of women with postnatal depression in another setting, the Motherhood and Mental Health Team at Queens Medical Centre in Nottingham , UK, and to evaluate the usefulness of a psychoeducational intervention.

Early results from a postal questionnaire to partners of patients of the Motherhood and Mental Health Team will be presented. This questionnaire includes questions on symptoms, aetiology and treatment of postpartum depression and asks partners what factors help them to cope with their wives' illness. It also asks them what information they would like on their wives' condition.

An evaluation of the UK pilot group psychoeducational intervention with partners will be presented together with results from the Brisbane study.

THE IMPACT OF POSTPARTUM DEPRESSION ON PARTNERS: PARTNERS TELL THEIR STORY

Jennie Barr, S Cook, Postnatal Disorders Support Group Assoc Inc, QLD

Literature that focuses on purely on the experiences of women suffering from postpartum depression is limiting as it does not recognise the influences of their partners and how they affect the mothers and their mothering (Sherr, 1995; Phoenix et al, 1991). The postpartum period is a time of tremendous change requiring parents to adapt to new roles, to renegotiate relationships and to adjust to lifestyle changes. This adaptation to childbirth is further compounded when the mother suffers from postpartum depression.

There is little argument that a man living with a woman, who is enduring postpartum depression, is also affected. Research has confirmed that following postpartum depression marital problems are common and also that a significant number of partners of postnatally depressed women also had a psychiatric disorder. The demands of parenting for a man may increase when a woman is suffering from depression. This may become a burden to the father as he continues to juggle his usual work commitments whilst caring for the baby and managing other home duties. This can result in marital tension further compounding the problems associated with postpartum depression.

Research has identified a relationship between social support and mental health. Social support in relation to postpartum depression has specifically been explored. Perceived support by the recipient is a significant feature of social support. However, it is well documented that women who are depressed do not always perceive the assistance offered by their partners as supportive nor does it always buffer the postpartum stress experienced by women (McClennan Reece, 1993). This has implications for both women and their partner.

It is clear that postpartum depression not only affects women but also their partners and yet the research has not extensively explored the impact upon the partners. Focus groups were organised involving partners of women who suffer from postpartum depression to discuss the impact that postpartum depression has on their lives. This information will be useful for health professionals who see women with postpartum depression. It will also identify areas for further research.

POSTNATAL DEPRESSION: MANAGING A SUBSEQUENT PREGNANCY AND BIRTH

Jenny Donovan, PO Box 328, Kew VIC

Research has not been uncovered describing a theory about basic social processes experienced by men where their female partners has experienced postnatal depression in a previous pregnancy. There is a dearth of information about the changes and adjustments men make as a result of postnatal depression and how they are affected by this condition in their partner (Lovestone & Kumar, 1993). This paper focuses on the preparation for a subsequent birth in families where postnatal depression was experienced after the birth of a previous baby. It aims to explain the core changes and responses experienced by men as well as the changes they make to assist their partner in the current pregnancy antenatally and postnatally. By using the grounded theory approach a substantive theory is developed to explain how men and women in partnerships manage this process. A discussion of the relationship of the theoretical schema to existing literature and theory follows.