Italian Psychopathology in the Perinatal Period: Beyond Postpartum Depression


Published: April 23, 2021
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Authors

  • Greta Petrilli PhD, Psychologist- Psychotherapist; Member of Area Perinatale-SIPRe Milano; Executive Psychologist at Psychiatry Unit- "Varenna" outpatient service for Perinatal Mental Heatlh, ASST Papa Giovanni XXIII, Bergamo, Italy.

Having a child has always been perceived as something natural, something simply written in the journey of the life of any couple. However, natural is not a synonym for easy, nor ordinary, and the diverse possible medical and psychological complications are proof that bearing children is actually quite an extraordinary event. Similar to other life events, the birth of a child can be an experience that is accompanied by suffering, that does not always find the right support or adequate clinical answers. In the perinatal period serious psychopathology can exist and can be of varying degrees of severity. In the complexity of becoming a parent and within this we can find useful tools for the comprehension of psychopathology. Having a respectful outlook about these complexities means understanding signs and symptoms of distress that can be of differing intensity. As clinicians we must open ourselves up to the deeper meanings of suffering and be able to respond to medical and psychiatric priority needs. It is an ethical burden for anyone who approaches perinatal psychology to have the adequate knowledge to do so. Clinical and research attention of the perinatal period has in time focused almost exclusively on the mother"s postpartum depression, creating an algorithm that has consolidated itself in time: perinatal psychopathology = postpartum depression, but this is reductionist and misleading. The objective of this article is to explore this paradigm and highlight the ordinary and extraordinary complexity that is inherent to "becoming parents".


Adler, A. (1956). The individual psychology of Alfred Adler. New York: Basic Books, Inc. [Transl. Ansbacher H.L., & Ansbacher R.R. (1997). La psicologia individuale di Alfred Adler, Psycho. Firenze. G. Martinelli and C.].

Ali, E. (2020). Women"s experiences with postpartum anxiety disorders: a narrative literature review. International Journal of Women"s Health, 10, 237-249. doi:10.2147/IJWH.S158621. DOI: https://doi.org/10.2147/IJWH.S158621

American Psychiatric Association (APA). (2016). Manuale diagnostico e statistico dei disturbi mentali - 5th ed. (DSM-5). Milano: Raffaello Cortina Editore.

Baldoni, F. (2016). I disturbi affettivi perinatali nei padri. In P. Grossu & A. Bramante (Eds.), Manuale di psicopatologia perinatale (pp. 443-485). Milano: Erickson.

Baldoni, F., & Giannotti, M. (2017). I disturbi affettivi perinatali paterni: valutazione, prevenzione e trattamento. In A. Imbasciati & L. Cena (Eds.), Psicologia clinica perinatale. Neuroscienze e psicoanalisi (pp. 218-239). Milano: Franco Angeli.

Bennett, H.A, Einarson, A., Taddio, A., Koren, G., & Einarson, T.R. (2004). Prevalence of depression during pregnancy: systematic review. Obstetric Gynecology, 103(4), 698-709. doi:10.1097/01.AOG.0000116689.75396.5f DOI: https://doi.org/10.1097/01.AOG.0000116689.75396.5f

Biaggi, A., Conroy, S., Pawlby, S., & Pariante, C.M. (2016). Identifying the women at risk of antenatal anxiety and depression: a systematic review. Journal of Affective Disorder, 191, 62-77. doi:10.1016/j.jad.2015.11.014 DOI: https://doi.org/10.1016/j.jad.2015.11.014

Byrness, L. (2018). Perinatal mood and anxiety disorder. The Journal of Nurse Pratictioners, 14(7), 507-513. doi:10.1016/j.nurpra.2018.03.010 DOI: https://doi.org/10.1016/j.nurpra.2018.03.010

Bortolotti, A. (2010). E se poi prende il vizio. Pregiudizi culturali e bisogni irrinunciabile dei nostri bambini. Torino: Il Leone Verde.

Cameron, E.E., Sedov, I.D., & Tomfohr-Madsen, L.M. (2016). Prevalence of paternal depression in pregnancy and the postpartum: an updated meta-analysis. Journal of Affective Disorder, 206, 189-203. doi:10.1016/j.jad.2016.07.044. DOI: https://doi.org/10.1016/j.jad.2016.07.044

Cox, E.Q., Sowa, N.A., Meltzer-Brody, S.E., & Gaynes, B.N. (2016). The perinatal depression treatment cascade: baby steps toward improving outcomes. Journal of Clinical Psychiatry, 77(9), 1189-1200. doi:10.4088/JCP.15r10174. DOI: https://doi.org/10.4088/JCP.15r10174

Florita, M. (2021). One Cannot Touch Without Being Touched: Why Psychoanalysis Needs to Draw from the Perinatal, and Vice Versa. Ricerca Psicoanalitica, 32(1), 9-23.

Galimberti, U. (2009). I miti del nostro tempo. Milano: Feltrinelli.

Glover, V. (2014). Maternal depression, anxiety and stress during pregnancy and child outcome; what needs to be done. Best practice & research. Clinical obstetrics & gynaecology, 28(1), 25-35. doi:10.1016/j.bpobgyn.2013.08.017. DOI: https://doi.org/10.1016/j.bpobgyn.2013.08.017

Glover, V. (2015) Prenatal stress and its effects on the fetus and the child: possible underlying biological mechanisms. In M. Antonelli (Ed.), Perinatal programming of neurodevelopment. advances in neurobiology, vol. 10 (pp. 269-283). New York, NY: Springer. DOI: https://doi.org/10.1007/978-1-4939-1372-5_13

Glover, V., & Capron, L. (2017). Prenatal parenting. Current Opinion in Psychology, 15, 66-70. doi:10.1016/j.copsyc.2017.02.007. DOI: https://doi.org/10.1016/j.copsyc.2017.02.007

Dunkel Schetter, C., & Tanner, L. (2012) Anxiety, depression and stress in pregnancy: implications for mothers, children, research, and practice. Current Opinion in Psychiatry, 25(2), 141-148. doi:10.1097/YCO.0b013e3283503680. DOI: https://doi.org/10.1097/YCO.0b013e3283503680

Hannigan, L.J., Eilertsen, E.M., Gjerde, L.C, Reichborn-Kjennerud, T., Eley, T.C., Rijsdijk, F.V., Ystrom, E., & McAdams, T.A. (2018). Maternal prenatal depressive symptoms and risk for early-life psychopathology in offspring: genetic analyses in the Norwegian Mother and Child Birth Cohort Study. Lancet Psychiatry, 5(10), 808-15, doi:10.1016/S22150366(18)30225-6.

Hipwell, A., Goossens, F., Melhuish, E., & Kumar, R. (2000). Severe maternal psychopathology and infant-mother attachment. Development and Psychopathology, 12(2), 157-175. doi:10.1017/S0954579400002030, DOI: https://doi.org/10.1017/S0954579400002030

Howard, L.M., Piot, P., & Stein, A. (2014). No health without perinatal mental health. The Lancet, 384(9956), 1723-1724. doi:10.1016/S0140-6736(14)62040-7. DOI: https://doi.org/10.1016/S0140-6736(14)62040-7

Howard, L.M, Molyneaux, E., Dennis, C.-L., Rochat, T. Stein, A., & Milgrom, J. (2014).

Non-psychotic mental disorders in the perinatal period. The Lancet, 384(9956), 1775-88. doi:10.1016/S0140-6736(14)61276-9. DOI: https://doi.org/10.1016/S0140-6736(14)61276-9

Jones, I., Chandra, P.S., Dazzan, P., & Howard, L.M. (2014). Bipolar disorder, affective psychosis, and schizophrenia in pregnancy and the post-partum period. The Lancet, 384(9956), 1789-9910. doi:1016/S0140-6736(14)61278-2.

Kennerley, H., & Gath, D. (1989). Maternity blues. I. Detection and measurement by questionnaire, British Journal of Psychiatry, 155, 356-62. doi:10.1192/bjp.155.3.356. DOI: https://doi.org/10.1192/bjp.155.3.356

Klein, M.H., & Essex, M.J. (1994). Pregnant or depressed? The effect of overlap between symptoms of depression and somatic complaints of pregnancy on rates of major depression in the second trimester. Depression, 2(6), 308-314. doi:10.1002/depr.3050020606. DOI: https://doi.org/10.1002/depr.3050020606

Krontira, A.C., Cruceanu, C., & Binder, E.B. (2020). Glucocorticoids as mediators of adverse outcome of prenatal stress. Trends in Neurosciences, 43(6), 394-405. doi:10.1016/j.tins.2020.03.008. DOI: https://doi.org/10.1016/j.tins.2020.03.008

Lamb, M. (1975). Fathers: forgotten contributors to child development. Human Development, 18(4), 245-66. doi:10.1159/000271493. DOI: https://doi.org/10.1159/000271493

Lautarescu, A, Craig, M.C., & Glover, V. (2019). Prenatal stress: effects on fetal and child brain development. International Review of Neurobiology, 150, 17-40. doi:10.1016/bs.irn.2019.11.002. DOI: https://doi.org/10.1016/bs.irn.2019.11.002

Lee, A.M., Lam, S.K., Sze Mun Lau, S.M., Chong, C.S., Chui, H.W., & Fong, D.Y. (2007) Prevalence, course, and risk factors for antenatal anxiety and depression. Obstetric Gynecology 110, 1102-1112. doi:1097/01.AOG.0000287065.59491.70. DOI: https://doi.org/10.1097/01.AOG.0000287065.59491.70

Merisio, A. (2017). Depressione postpartum. Una questione di famiglia. Roma: Alpes Italia Editore.

Minolli, M., & Coin R. (2007). Amarsi amando. Roma: Borla.

Minolli, M. (2009). Psicoanalisi della relazione. Milano: FrancoAngeli.

Molenaara, N.M., Tiemeierb, H., van Rossumd, E.F.C., Hillegersb, M.H.J, Bocktinge, C.L.H., Hoogendijka, W.J.G., van den Akkerf, E.L., Lambregtse-van den Berga, M.P., & El Marrounb, H. (2019). Prenatal maternal psychopathology and stress and offspring HPA axis function at 6 years. Psychoneuroendocrinology, 99, 120-127. doi:10.1016/j.psyneuen.2018.09.003. DOI: https://doi.org/10.1016/j.psyneuen.2018.09.003

Petrilli, G., Anniverno, R., Ferrari, V., & Mencacci, C. (2010). Stress e ansia in gravidanza: conseguenze e implicazioni. Facts, News & Views, 10(1), Feb. 2010.

Stein, A., Pearson, R.M., Goodman, S.H., Rapa, E., Rahman, A., McCallum, M., Howard,

L.M., & Pariante, C.M. (2014). Effects of perinatal mental disorders on the fetus and child. The Lancet, 384(9956), 1800-1819. doi:10.1016/S0140-6736(14)61277-0. DOI: https://doi.org/10.1016/S0140-6736(14)61277-0

Stirrat, L.I., Sengers, B.G., Norman, J.E., Homer, N.Z.M., Andrew, R., Rohan, M. Lewis, R.M., & Reynolds, R.M. (2018). Transfer and metabolism of cortisol by the isolated perfused human placenta. The Journal of Clinical Endocrinology & Metabolism, 103(2), 640-648. doi:10.1210/jc.2017-02140. DOI: https://doi.org/10.1210/jc.2017-02140

Sweeney, S., & McBeth, A. (2016). The effects of paternal depression on child and adolescent outcomes: a systematic review. Journal of Affective Disorder, 205, 44-59. doi:10.1016/j.jad.2016.05.073. DOI: https://doi.org/10.1016/j.jad.2016.05.073

Yalom, I. (1980). Existential psychotherapy - First Edition. New York, NY: Basic Books. [Transl. S. Prina. (2019). Psicoterapia esistenziale. Vicenza: Neri Pozza Editore].

Yonkers, K., Smith, M.V., Gotman, N., & Belanger, K. (2009). Typical somatic symptoms of pregnancy and their impact on a diagnosis of major depressive disorder. General Hospital Psychiatry, 31, 327-333. doi:10.1016/j.genhosppsych.2009.03.005. DOI: https://doi.org/10.1016/j.genhosppsych.2009.03.005

www.nichd.nih.gov/health/publication/postpartum-depression-facts/index.shtml

Petrilli, G. (2021). Italian Psychopathology in the Perinatal Period: Beyond Postpartum Depression. Ricerca Psicoanalitica, 32(1). https://doi.org/10.4081/rp.2021.352

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