The happiest time in your life

Postnatal depression deserves our attention for many reasons. What is often expected to be “the happiest time in your life» is certainly not always so. The wide disparity between expectation and actuality may raise the threshold at which women report disorders and symptoms. There is scarcely any period in a woman’s life when the need for good caring ability is greater than after childbirth. With depression, particularly if it is severe, the failure to function can have an effect on her ability to care for the child, disrupt the communication between mother and child and affect the whole family. Studies have shown that fewer than one in three cases of postnatal depression are identified (1). An article in this issue of the Journal of the Norwegian Medical Association describes experience with a screening instrument for postnatal depression (2). The Edinburgh Postnatal Depression Scale (EPDS) was developed in the UK in the 1980s and has since been translated into numerous languages and introduced into clinical use in many parts of the world. There has also been experience of using this tool in Norway. The article emphasises interpretation, when the screening should be undertaken, and limitations compared with a clinical diagnostic interview. Key points include the risk of false positive results and the risk of overlooking a depressive condition, depending on where the threshold value is set.