Ethnicity, psychosocial risk, and perinatal depression--a comparative study among inner-city women in the United Kingdom.

摘要

OBJECTIVE: The objective of this study was to explore the relationships between psychosocial risk, ethnicity, and prevalence of depressive symptoms in the perinatal period. A comparative study among a cohort of Black Caribbean and White British women was undertaken. METHODS: A predominantly inner-city sample (N=301) was recruited at a large teaching hospital and at community antenatal clinics in the north of England. Women were screened for depressive symptoms in the last trimester of their pregnancy and 6 weeks their delivery with the Edinburgh Postnatal Depression Scale (EPDS). RESULTS: Black Caribbean women reported higher levels of psychosocial risk for perinatal depression compared with their White British counterparts. They were more socially and socioeconomically deprived. To elaborate, the Black Caribbean women were more likely to live in the most deprived areas of the city (P=.002), to live on benefits (P=.014), and to be lone parents (P<.0001). However, despite higher levels of deprivation and other known risks for perinatal depression, Black Caribbeans were not more likely than White British women to score above the threshold on the EPDS (cutoff point, 12/13). CONCLUSIONS: During and after pregnancy, approximately a quarter of the Black Caribbean women in this study recorded symptom scores suggestive of clinically significant morbidity. These findings are not reflected in clinical practice, suggesting that there may be substantial levels of undetected and untreated perinatal depression among this ethnic group. This has potentially serious implications not only for the mental health and well-being of individual women but also for their families.