A group of first-time mothers (119) were interviewed repeatedly at fixed intervals during their pregnancies and until their babies were a year old; they were then followed up at four years. A similar investigation was carried out on 38 other primiparae and 39 multiparae, but only postnatally. The incidence of depressive neurosis rose significantly in early pregnancy and in the first three months after delivery (10 per cent and 14 per cent of the main sample respectively). Subjects mainly suffered either from antenatal or postnatal depression, not both. Marital conflict and severe doubts about having the baby were associated with depression at either time. Bereavement and preterm birth were the only life events to relate with the onset of depression and bereavement had a greater impact during pregnancy. Depressed mothers were more likely to express negative or mixed feelings about their three-month-old babies. Many who had become depressed for the first time in their lives continued to experience psychological problems for up to four years after childbirth.

Ninety four women and their first born children took part in a longitudinal study of maternal mental health during pregnancy and after delivery. The children's cognitive functioning was assessed at age 4 using the McCarthy scales, without knowledge of the mothers' psychiatric history or current health. As expected girls performed slightly better than boys and children from middle class and professional families did better than children from working class homes, as did children whose mothers had achieved at least one A level at school. Significant intellectual deficits were found in the children whose mothers had suffered with depression, but only when this depression occurred in the first year of the child's life. Marital conflict and a history of paternal psychiatric problems were independently linked with lower cognitive test scores; together with a working class home background these were the only factors that contributed to the deleterious effect of maternal postnatal depression.

A follow-up study was carried out to investigate the children of 204 mothers who had previously participated in a study of their mental health during pregnancy and the first postnatal year. One hundred and seventy two children, 170 mothers, and 99 fathers were assessed when the children were 3 years 10 months. Boys of mothers depressed in the first year postpartum scored approximately 1 standard deviation lower on standardised tests of intellectual attainment than boys whose mothers were well that year. The difference was reliable even when behaviour during the test was controlled for, and general behavioural problems, birth weight, parental IQ measures of the family climate and home environment, mother-child interaction, and breast-feeding during infancy were taken into account.

Prevention and early treatment of depression in fathers may benefit not only themselves but also their spouses and their children.

Comparisons of EPDS and SADS ratings showed that the translated EPDS was a valid instrument for women but it was less satisfactory when applied to men.