Hostname: page-component-54dcc4c588-54gsr Total loading time: 0 Render date: 2025-10-11T18:58:32.594Z Has data issue: false hasContentIssue false

Postnatal depression and bonding disorder: A tautology or two overlaping phenomena?

Published online by Cambridge University Press:  26 August 2025

G. Hernández-Santillán*
Affiliation:
Psychiatry, Hospital Universitario La Paz, Madrid
M. Gurpegui
Affiliation:
Granada Centre for Psychiatric Studies, Granada
M. Alcamí-Pertejo
Affiliation:
Psychiatry, Hospital Universitario La Paz, Madrid
G. Lahera
Affiliation:
Psychiatry, Hospital Universitario Príncipe de Asturias Psychiatry, Universidad de Alcalá, Madrid, Spain
M. F. Bravo-Ortiz
Affiliation:
Psychiatry, Hospital Universitario La Paz, Madrid
*
*Corresponding author.

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Introduction

Perinatal disorders occur in 25% of childbearing women. Postnatal depressive symptoms (PDS) have been widely studied, whilst PDS usually overshadows bonding disorder (BD) in clinical practice and research. BD includes mild disorders, such as delay, ambivalence or loss of maternal emotional response, and severe disorders, such as pathological anger or rejection of the child (Brockington et al., Arch Womens Ment Health 2006; 9(5) 243-251).

Objectives

To estimate the prevalences of PDS and BD in mothers during the six months after birth.

Methods

Women and their male partners aged ≥ 18, without delivery and neonatal complications, were recruited at the Maternity Ward in a public hospital in Madrid, during 2021-2022. Data was collected at immediate puerperium (T0), sixth week (T1), fourth month (T2), and sixth month (T3). The last observation carried forward (LOCF) was used. An Ad hoc Socio-Demographic questionnaire was used. To determine the presence of PDS and BD, respectively, there were used the Edinburgh Postnatal Depression Scale (EPDS), cut off ≥ 11 (Ascaso-Terrén et al., Med Clin (Barc) 2003; 120(9) 326-329) and Postpartum Bonding Questionnaire (PBQ), cut off ≥ 13 for BD, and ≥ 18 for severe BD (Torres-Giménez et al., Span J Psychol. 2021; 24, e47, 1-9).

Results

1502 couples were recruited at T0. The main characteristics of female participants were: mean age 34.1 years, 53.9% married, 54.1% primiparous, 27.8% migrants, 67.3% university degree or higher, 83.2% employed, 14.8% financial difficulties, 4.9% smoking during pregnancy and, 21.7% c-section. At T0, the prevalences of PDS were 13.0% of mothers, 10.5% of fathers, and 3.5% of both parents. Applying LOCF, 874 women responded to the questionnaires at some timing during the follow-up. The results were divided into two groups (see Table 1 and Table 2) depending on whether they presented PDS at T0. In mothers with PDS at T0, PDS and BD rates eventually decrease at T3. In the other group, while BD rates decrease at T3, a slight increase in PDS presentation at T3 is observed.Table 1.

LOCF of mothers with PDS at T0

NFollow-upNo-PDSBDSevere BD
106T153/87 (60.9%)49/87 (53.3%)32/87 (36.78%)
PDS at T0T247/74 (63.5%)33/74 (44.6%)19/74 (25.7%)
T344/73 (60.3%)30/73 (41.1%)14/73 (19.2%)
Table 2.

LOCF of mothers without PDS at T0

NFollow-upPDSBDSevere BD
768T146/638 (7.2%)225/638 (35.3%)106/638 (16.6%)
No-PDS at T0T247/575 (8.2%)147/575 (25.6%)66/575 (11.5%)
T345/525 (8.6%)122/525 (23.2%)57/525 (10.9%)

Conclusions

Depressive symptoms and impaired bonding could have different severity and timing during the postnatal period. More research on bonding disorder is needed to clarify more accurately the psychopathological features that distinguish it from postnatal depression to provide more targeted treatment that will also reduce the associated stigma of childbearing difficulties.

Disclosure of Interest

None Declared

Information

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of European Psychiatric Association
Submit a response

Comments

No Comments have been published for this article.