Archives of Women's Mental Health

, Volume 13, Issue 1, pp 5–10 | Cite as

Women’s mental health: A “wish-list” for the DSM V

  • John CondonEmail author


This article highlights four areas of mental health affecting women in the reproductive age group which, in the author’s opinion, are poorly dealt with in the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM IV) (American Psychiatric Association 1994). These are depression occurring during pregnancy; childbirth-related post-traumatic stress disorder; disorders of parent-to-infant attachment and perinatal bereavement. It is suggested that, if these could be better addressed in the forthcoming DSM V, this would provide a very significant impetus for improved education of health professionals, as well as better recognition and earlier intervention in these disorders. As these are relatively common disorders, a very large number of women and their families would potentially benefit.


DSM Diagnosis Perinatal Pregnancy 


Conflict of interest

The author declares that he has no conflict of interest.


  1. Ainsworth MDS (1964) Patterns of attachment behaviour shown by the infant in interaction with his mother. Merril Palmer Q 10:51–58Google Scholar
  2. Alder J, Fink N, Bitzer J, Hosli I, Holzgreve W (2007) Depression and anxiety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. J Matern-Fetal Neonatal Med 20:189–209CrossRefPubMedGoogle Scholar
  3. Alder J, Stadlmayr W, Tschudin S, Bitzer J (2006) Post-traumatic symptoms after childbirth: what should we offer? J Psychosom Obstet Gynecol 27:107–112CrossRefGoogle Scholar
  4. American Psychiatric Association (1994) Diagnostic and statistics manual of mental disorders, 4th edn. APA, Washington DCGoogle Scholar
  5. Ayers S (2007) Thoughts and emotions during traumatic birth: a qualitative study. Birth 34:253–263CrossRefPubMedGoogle Scholar
  6. Badenhorst W, Hughes P (2007) Psychological aspects of perinatal loss. Best Pract Res Clin Obstet Gynaecol 21:249–259CrossRefPubMedGoogle Scholar
  7. Barr P (2006) Relation between grief and subsequent pregnancy status 13 months after perinatal bereavement. J Perinat Med 34:207–211CrossRefPubMedGoogle Scholar
  8. Beck CT (2006) The anniversary of birth trauma: failure to rescue. Nurs Res 55:381–390CrossRefPubMedGoogle Scholar
  9. Bonari L, Pinto N, Ahn E, Einarson A, Steiner M, Koren G (2004) Perinatal risks of untreated depression during pregnancy. Can J Psychiatry 49:726–735PubMedGoogle Scholar
  10. Boyce P, Condon J (2000) Traumatic childbirth and the role of debriefing. In: Raphael B, Wilson JP (eds) Psychological debriefing. Cambridge University Press, Cambridge, pp 272–280Google Scholar
  11. Boyce PM, Condon JT (2004) Mood disorders in pregnancy and the puerperium. In: Joyce PR, Mitchell PB (eds) Mood disorders: recognition and treatment. University of NSW Press, SydneyGoogle Scholar
  12. Boyce PM, Condon JT, Ellwood D (2002) Pregnancy loss: a major life event that effects emotional health and well-being. Med J Aust 176:250–251PubMedGoogle Scholar
  13. Cacciatore J, Radestead I, Frederik Froen J (2008) Effects of contact with stillborn babies on maternal anxiety and depression. Birth 35:313–320CrossRefPubMedGoogle Scholar
  14. Callahan JL, Borja SE, Hynan MT (2006) Modification of the perinatal PTSD questionnaire to enhance clinical utility. J Perinatol 26:533–539CrossRefPubMedGoogle Scholar
  15. Cigoli V, Gilli G, Saita E (2006) Relational factors in psychopathological responses to childbirth. J Psychosom Obstet Gynecol 27:91–97CrossRefGoogle Scholar
  16. Condon JT (1986a) Management of established pathological grief reactions after stillbirth. Am J Psychiatry 143:987–992PubMedGoogle Scholar
  17. Condon JT (1986b) Psychological disability in women who relinquish a baby for adoption. Med J Aust 144:117–119PubMedGoogle Scholar
  18. Condon JT (1986c) The spectrum of foetal abuse in pregnant women. J Nerv Ment Dis 174:509–516CrossRefPubMedGoogle Scholar
  19. Condon JT (1987) “The battered foetus syndrome” preliminary data on the incidence of the urge to physically abuse the unborn child. J Nerv Ment Dis 175:495–497Google Scholar
  20. Condon JT (1990) The psychology of human reproduction: old and new. In: Kosky RJ, Eshkevari HS, Carr VJ (eds) Mental health and illness: a textbook for austalasian health science students. Butterworths, MelbourneGoogle Scholar
  21. Condon JT (1993) The assessment of antenatal attachment: development of a questionnaire instrument. Br J Med Psychol 66:167–183PubMedGoogle Scholar
  22. Condon JT (2000) Pregnancy loss. In: Steiner M, Yonkers KA, Eriksson E (eds) Mood disorders in women. Martin Dunitz, London, pp 353–369Google Scholar
  23. Condon JT (2006) “What about dad?” Psychosocial and mental health issues for new fathers. Aust Fam Physician 35:690–692PubMedGoogle Scholar
  24. Condon JT, Dunn DJ (1988) Nature and determinants of parent-to-infant attachment in the early postnatal period. J Am Acad Child Adolesc Psychiatry 27:293–299CrossRefPubMedGoogle Scholar
  25. Condon JT, Corkindale CJ (1997) The correlates of antenatal attachment in pregnant women. Br J Med Psychol 70:359–372PubMedGoogle Scholar
  26. Condon JT, Corkindale CJ (1998) The assessment of parent-to-infant attachment: development of a self-report questionnaire instrument. J Reprod Infant Psychol 16:57–76CrossRefGoogle Scholar
  27. Condon JT, Boyce P, Corkindale CJ (2004) The first-time fathers study: a prospective study of male mental health and well-being during the transition to parenthood. Aust NZ J Psychiatry 38:56–64CrossRefGoogle Scholar
  28. Condon JT, Corkindale CJ, Boyce P (2007) Assessment of postnatal paternal-infant attachment: development of a questionnaire instrument. J Reprod Infant Psychol 26:195–210CrossRefGoogle Scholar
  29. De Wolff MS, Ijzendoorn MH (1997) Sensitivity and attachment: a meta analysis on parental antecedents of infant attachment. Child Dev 68:571–591CrossRefPubMedGoogle Scholar
  30. Engelhard IM, van den Hout MA, Schouten EG (2006) Neuroticism and low educational level predict the risk of posttraumatic stress disorder in women after miscarriage or stillbirth. Gen Hosp Psychiatry 28:414–417CrossRefPubMedGoogle Scholar
  31. Evans J, Heron J, Francomb H, Oke S, Golding J (2001) Cohort study of depressed mood during pregnancy and after childbirth. Br Med J 323:257–260CrossRefGoogle Scholar
  32. Frost M, Condon JT (1996) Psychological reactions to miscarriage: a critical review of the literature. Aust New Zeal J Psychiatr 30:54–62CrossRefGoogle Scholar
  33. Gold KJ, Dalton VK, Schwenk TL (2007) Hospital care for parents after perinnatal death. Obstet Gynecol 109:1156–1166PubMedGoogle Scholar
  34. Hobel CJ, Goldstein A, Barrett ES (2008) Psychosocial stress and pregnancy outcome. Clin Obstet Gynecol 51:333–348CrossRefPubMedGoogle Scholar
  35. Koubovec D, Geerts L, Odendaal HJ, Stein DJ, Vythilingum B (2005) Effects of psychologic stress on fetal development and pregnancy outcome. Curr Psychiatr Rep 7:274–280CrossRefGoogle Scholar
  36. Lusskin Sl, Pundiak TM, Habib SM (2007) Perinatal depression: hiding in plain sight. Can J Psychiatry 52:479–488PubMedGoogle Scholar
  37. Marcus SM (2009) Depression during pregnancy: rates, risks and consequences –Motherisk update 2008. Can J Clin Pharmacol/Journal canadien de Pharmacologie Clinique 16:315–322Google Scholar
  38. Olde E, van der Hart O, Kleber RJ, van Son MJ, Wijnen HA (2005) Peritraumatic dissociation and emotions as predictors of PTSD symptoms following childbirth. Journal of Trauma & Dissociation 6:125–142CrossRefGoogle Scholar
  39. Pederson DR, Gleason KE, Morgan G, Bento S (1998) Maternal attachment representation, maternal sensitivity and infant-mother attachment relationships. Dev Psychol 34:925–993CrossRefPubMedGoogle Scholar
  40. Psychotropic Expert Group (2008) Therapeutic Guidelines: Psychotropic. Version 6, Therapeutic Guidelines Limited, MelbourneGoogle Scholar
  41. Saflund K, Wredling R (2006) Differences within couples’ experience of their hospital care and well-being three months after experiencing a stillbirth. Acta Obstet Gynecol Scand 85:1193–1199CrossRefPubMedGoogle Scholar
  42. Smith PB, Pederson DR (1988) Maternal sensitivity and patterns of infant-mother attachment. Child Dev 59:1097–1101CrossRefPubMedGoogle Scholar
  43. Soderquist J, Wijma B, Wijma K (2006) The longitudinal course of post-traumatic stress after childbirth. J Psychosom Obstet Gynecol 27:113–119CrossRefGoogle Scholar
  44. Stanton C, Lawn JE, Rahman H, Wilczynska-Ketende K, Hill K (2006) Stillbirth rates: delivering estimates in 190 countries. Lancet 367:1487–1494CrossRefPubMedGoogle Scholar
  45. Surkan PJ, Radestad I, Cnattingius S et al (2008) Events after stillbirth in relation to maternal depressive symptoms: a brief report. Birth 35:153–157CrossRefPubMedGoogle Scholar
  46. Talge NM, Neal C, Glover V, Early Stress, Translational Research and Prevention Science Network: Fetal and Neonatal Experience on Child and Adolescent Mental Health (2007) Antenatal maternal stress and long-term effects on child neurodevelopment: how and why? J Child Psychol Psychiatry & Allied Disciplines 48:254–261Google Scholar
  47. Toedter LJ, Lasker JN, Alhadeff JM (1988) The perinatal grief scale: development and initial validation. Am J Orthopsychiatry 58:435–449PubMedCrossRefGoogle Scholar
  48. Turton P, Badenhorst W, Hughes P, Ward J et al (2006) Psychological impact of stillbirth on fathers in the subsequent pregnancy and puerperium. Br J Psychiatry 188:165–172CrossRefPubMedGoogle Scholar
  49. Vaillant GE (1985) Loss as a metaphor for attachment. Am J Psychiatry 45:59–67Google Scholar
  50. Velderman MK, Bakermans-Kranenburg MJ et al (2006) Effects of attachment-based interventions on maternal sensitivity and infant attachment: differential susceptibility of highly reactive infants. J Fam Psychol 20:266–274CrossRefPubMedGoogle Scholar
  51. Wisborg K, Barklin A, Hedegaard M, Henriksen TB (2008) Psychological stress during pregnancy and stillbirth: prospective study. BJOG 115:882–885CrossRefPubMedGoogle Scholar
  52. Zaers S, Waschke M, Ehlert U (2008) Depressive symptoms and symptoms of post-traumatic stress disorder in women after childbirth. J Psychosom Obstet Gynecol 29:61–71CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  1. 1.Flinders UniversityBedford ParkAustralia

Personalised recommendations