Postnatal Depression Recurrence Risk — MRCPsych Paper B MCQ

Correct answer: A — 40%

The correct answer is A, approximately 40%. In a prospective cohort of women who were non-depressed during pregnancy but had previously experienced postpartum-onset major depression, 21 of 51 developed recurrent major depression within one year of another birth: a recurrence rate of 41%. A later cohort found a comparable figure of 37.2% among women with subsequent childbirths. Thus, about two in five is the best estimate, although individual risk varies with illness severity, non-perinatal depressive history, current symptoms, psychosocial adversity and preventive treatment. Ten per cent is closer to the population prevalence of postnatal depression rather than recurrence in a high-risk group. Estimates of 60–80% are too high for the general recurrence evidence, whereas 2% markedly underestimates the risk.

Reference: Wisner KL et al. Timing of depression recurrence in the first year after birth. Journal of Affective Disorders. 2004;78(3):249–252. https://pubmed.ncbi.nlm.nih.gov/15013250/