Objectives
This is a pilot study on the relationship between a personality structure called “melancholic type” (typus melancholicus, TM) and postpartum depression. We tested the following hypotheses: 1) the main features of TM (orderliness, conscientiousness, hyper/heteronomia and intolerance of ambiguity) portray the personality structure of a group of mothers prone to a kind of postpartum depression whose clinical features are characterized by psychomotor retardation, depression and guilt feelings/ ideas (“melancholia” sensu Tellenbach); 2) the features of the puerperal crisis taking place during the early phases of motherhood in these women bears deep analogies with the kind of existential pathogenic situation (“pre-melancholic situation” sensu Tellenbach) characterized by “includence”, “remanence” and “despair” which (according to phenomenological literature) leads to “melancholic” depression.
Methods
We analyzed 31 cases of postpartum depression. To assess personality features we adopted the Criteria for Typus Melancholicus (CTM). To characterize the puerperal crisis we adopted the Pre-Melancholic Situation Criteria (PMSC). These instruments operationalize the main features of melancholic type of personality and the pre-melancholic situation. To assess clinical features, the AMDP system was used. Diagnosis was established according to DSM-IV-TR criteria for “major depression”.
Results
14 of 31 women showed clinical features of “melancholia”, as well as the personality traits of the TM kind of personality. These women also showed, in the period following delivery, a critical state characterized by conflicting roles leading to a phase of disorganized behaviour and confusion that paved the way to the melancholic decomposition. Thus, both our hypotheses were consistent and encouraged us to proceed with large scale quantitative studies.
Conclusions
TM personality structure may represent a valid model for the early diagnosis of a group of women at risk to develop episodes of postpartum depression, even in those cases in which an anamnesis of mood disorder or symptoms before and during pregnancy cannot be established. The TM structure can also enhance our capacity to understand the interplay between personality traits, the characteristics of the life-event “motherhood” and the presentation of depressive symptoms.