Application of the PRECEDE Model to Understanding Postnatal Depression

In the Diagnostic and Statistical Manual – Fourth Edition (SM-IV-TR) postnatal depression (PND) is not currently recognized as a separate diagnosis. Instead, the DSM-IV-TR recognizes mood problems during the postnatal period using a " with postnatal onset " specifier to several mood disorders including, major depressive, manic or mixed episode of major depressive disorder, bipolar i disorder, bipolar ii disorder and brief psychotic disorder (1). Postnatal depression, that is depression occurs in a mother within 6 weeks of her giving birth, can have profound effects upon the health and well-being of the mother, her baby and the family (2) characterized by a number of symptoms including core symptoms of depressed mood and/or loss of pleasure, together with additional symptoms, including changes in weight or sleep, fatigue or loss of energy, feelings of worth lessens or guiltiness, concentration difficulties, and suicidal ideation (3). Therefore, PND is a multifactorial disorder with biological, psychological, and sociological aspects interacting with woman's risk individually. In addition to the considerable negative personal impact that PND has on women, PND also negatively affects marital relationships (1). Mothers are fully active in their role, when they feel healthy, and the society considers them healthy. While, PND can be explained by clinical criteria and physical symptoms , social recognition is also effective in this area. PND may also detrimentally affect mother-infant attachment, and infant social and cognitive development. Depressed mothers are less emotionally sensitive and less attuned to their infant's emotional state. These serious implications make PND an important mental illness to study because of the tremendous impact it has on the mother and support system, including child's development and familial relationships (1). The ability of a woman to adjust to these changes affects herself, her infant , other children she may have, and her partner (3). Healthy People 2010 listed improve-ement of the health and well-being of women, infants, children , and families as goal (3). The first step in designing an educational program is selecting a health education model which starts the program on the right way and guides it to the evaluation phase. One of the frequently used models in health education and promotion is the PRECEDE model. We assessed the effectiveness of application of PRECEDE model on pregnant women for preventing PND. We hypothesized that predisposing, enabling and reinforcing would