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Contextual Assessment of the Maternity Experience: development of an instrument for cross-cultural research

Department of Psychiatry, Montreal, Canada

Sue Conroy, MSc, Maureen N. Marks, DPhil and Kathryn A. Siddle

RMN, Section of Perinatal Psychiatry, Institute of Psychiatry, London, UK

Nicole Guedeney, MD

Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France

Antonia Bifulco, PhD

Royal Holloway, University of London

Paul Asten, MHSc

Section of Perinatal Psychiatry, Institute of Psychiatry, London, UK

Barbara Figueiredo, PhD

Department of Psychology, University of Minho, Braga, Portugal

Laura L. Gorman, PhD

Iowa Depression and Clinical Research Center, University of Iowa, USA

Simona Bellini, MD

Department of Neurologic and Psychiatric Sciences, University of Florence, Italy

Elisabeth Glatigny-Dallay

University Department of Psychiatry, Centre Hospitalier Charles Perrens, Bordeaux, France

Sandra Hayes, MPsychSc

Department of Psychology, University College Dublin, Ireland

Claudia M. Klier, MD

Department of Psychiatry, University of Vienna, Austria

Martin H. Kammerer, Dr med

Child and Adolescent Psychiatry, University of Zurich, Switzerland

Carol A. Henshaw, MD, MRCPsych

School of Postgraduate Medicine, Keele University, UK

TCS–PND Group^*

Correspondence: Dr Odette Bernazzani, Pavillon Rosemont, Département de Psychiatrie, 5689 Boulevard Rosemont, Montréal, Québec, Canada H1T 2H1. E-mail:o.bernazzani{at}umontreal.ca

Declaration of interest None.

^* TCS–PND Group membership and funding detailed in Acknowledgements, p. iv, this supplement.

Background There is evidence that stressors may trigger the onset of a depressive episode in vulnerable women. A new UK interview measure, the Contextual Assessment of the Maternity Experience (CAME), was designed to assess major risk factors for emotional disturbances, especially depression, during pregnancy and post-partum.

Aims With in the context of a cross-cultural study, to establish the usefulness of the CAME, and to test expected associations of the measure with characteristics of the social context and with major or minor depression.

Method The CAME was administered antenatally and postnatally in ten study sites, respectively to 296 and 249 women. Affective disorder throughout pregnancy and up to 6 months postnatally was assessed by means of the Structured Clinical Interview for DSM–IVAxis I Disorders.

Results Adversity, poor relationship with either apartner or a confidant, and negative feelings about the pregnancy all predicted onset of depression during the perinatal period.

Conclusions The CAME was able to assess major domains relevant to the psychosocial context of the maternity experience in different cultures. Overall, the instrument showed acceptable psychometric properties in its first use in different cultural settings.

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