Alan J Flisher CPMH Seminar: Trajectories of perinatal depressive symptoms in South Africa.

The CPMH’s seminar programme is an opportunity to share on-going work and invite broader participation in the Centre.

On 6 July 2021 the Alan J Flisher Centre for Public Mental Health hosted a seminar by Dr. Emily Garman. She is a senior researcher in the field of public mental health.


Perinatal depression is prevalent in South Africa, and associated with greater risk of birth complications, poorer health outcomes and greater risk of suicide behaviours for the mother, and with poorer physical, cognitive, socio-emotional and behavioural development for her child. There is preliminary evidence using growth curve mixture modelling, that the course of perinatal depression is heterogeneous, and that each course is associated with a range of risk factors and child outcomes. A systematic review of the literature revealed that the most commonly reported trajectories are (i) a ‘low-risk’ trajectory, characterised by chronically low levels of depressive symptoms throughout the perinatal period, (ii) a ‘high-risk’ trajectory, characterised by chronically severe levels of depressive symptoms, and (iii) an ‘antenatal’ trajectory, with greater levels of symptoms antenatally, which naturally abate before or just after birth. All the evidence was generated in high-income countries, however. Little is known about the course of perinatal depression in low-income settings, where women are more likely to experience social and economic adversity, and where the patterns of risk among mothers and their children are likely to differ. The overall aim of this research was to identify the trajectories of perinatal depressive symptoms among low-income women in South Africa, and investigate whether these were associated with specific psychosocial and economic risk factors, child outcomes and suicidal risk over time. Given the limited mental health resources available at primary care level in South Africa, findings could contribute to developing efficient methods to identify, refer and manage perinatal women who may need more intensive mental health care.

The presentation in PDF form can be downloaded here:

Kevin Ernstzen