Research Article| Volume 41, P74-80, December 2022

Factors affecting postpartum depression in Turkish women


      • Postpartum depression increases in mothers with cognitive emotion regulation difficulties.
      • The risk of developing postpartum depression increases in mothers with low emotional intelligence.
      • The incidence of postpartum depression increases in mothers who experience emotional violence.
      • Mothers not attending regular antenatal follow-ups are more susceptible to PPD symptoms.
      • Mothers having a psychological/emotional problem during pregnancy and postpartum period more susceptible to PPD symptoms.



      To assess the effects of cognitive emotion regulation, emotional intelligence status and related factors on postpartum depression (PPD) in postpartum women.

      Design and methods

      This descriptive and cross-sectional study was conducted in 268 mothers with babies aged 1–12 months. The study was carried out between 01 November 2021 and 01 February 2022 in the pediatric outpatient clinic of the Medical Faculty Hospital of a province in the Central Anatolian Region of Turkey. Data were collected using the sociodemographic and obstetric data collection form, Edinburgh Postnatal Depression Scale (EPDS), Cognitive Emotion Regulation Questionnaire–Short Form (CERQ), and Trait Emotional Intelligence Questionnaire–Short Form (TEIQue-SF).


      Seventy-one (26.5 %) mothers received scores above the cut-off point (>13) in the depression scale. Experiencing emotional violence, having cognitive emotion regulation difficulties, and low emotional intelligence characteristics affected the risk of developing postpartum depression by 16 % (F = 13.757, p < 0.001).


      Exposure to emotional violence, cognitive emotion regulation, and emotional intelligence status reveal that they are important in identifying women at risk of PPD. These findings highlight the need for nurses to develop comprehensive cognitive emotion regulation and emotional intelligence traits assessment programs, including depression screening.


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        • Abdollahpour S.
        • Keramat A.
        • Mousavi S.A.
        • Khosravi A.
        The effect of debriefing and brief cognitive-behavioral therapy on postpartum depression in traumatic childbirth: A randomized clinical trial.
        Journal of Midwifery and Reproductive Health. 2018; 6: 1122-1131
        • Ahmad N.A.
        • Silim U.A.
        • Rosman A.
        • Mohamed M.
        • Chan Y.Y.
        • Kasim N.M.
        • Aziz F.A.A.
        Postnatal depression and intimate partner violence: A nationwide clinic-based cross-sectional study in Malaysia.
        BMJ Open. 2018; 8e020649
        • Aldao A.
        • Nolen-Hoeksema S.
        Specificity of cognitive emotion regulation strategies: A transdiagnostic examination.
        Behaviour Research and Therapy. 2010; 48: 974-983
        • APA A.P.A.
        Diagnostic and statistical manual of mental disorders (DSM-5®).
        2013 (Retrieved from)
        • Cakmak A.F.
        • Cevik E.I.
        Cognitive emotion regulation questionnaire: Development of Turkish version of 18-item short form.
        African Journal of Business Management. 2010; 4: 2097-2102
        • Cherniss C.
        Emotional intelligence: What it is and why it matters (p. 15).
        Rutgers University, Graduate School of Applied and Professional Psychology, 2000
        • Coo S.
        • Garcia M.I.
        • Prieto F.
        • Medina F.
        The role of interpersonal emotional regulation on maternal mental health.
        Journal of Reproductive and Infant Psychology. 2020; 1–19
        • Cox J.L.
        • Holden J.M.
        • Sagovsky R.
        Detection of postnatal depression: Development of the 10-item Edinburgh postnatal depression scale.
        The British Journal of Psychiatry. 1987; 150: 782-786
        • Cuartero N.
        • Tur A.M.
        Emotional intelligence, resilience and personality traits neuroticism and extraversion: Predictive capacity in perceived academic efficacy.
        Nurse Education Today. 2021; 102104933
        • Cudzik M.
        • Soroka E.
        • Olajossy M.
        The impact of emotional intelligence level on the depression vulnerability. Current problems of.
        Psychiatry. 2019; 20
        • de Paula Eduardo J.A.F.
        • de Rezende M.G.
        • Menezes P.R.
        • Del-Ben C.M.
        Preterm birth as a risk factor for postpartum depression: A systematic review and meta-analysis.
        Journal of Affective Disorders. 2019; 259: 392-403
        • Deninotti J.
        • Denis A.
        • Berdoulat E.
        Emergency C-section, maternal satisfaction and emotion regulation strategies: Effects on PTSD and postpartum depression symptoms.
        Journal of Reproductive and Infant Psychology. 2020; 38: 421-435
        • Deniz M.E.
        • Özer E.
        • Işık E.
        Trait emotional intelligence questionnaire-short form: Validity and reliability studies.
        Education and Science. 2013; 38: 407-419
        • Dinni S.M.
        • Ardiyanti D.
        Predictors of postpartum depression: The role of emotion regulation, maternal self-confidence, and marital satisfaction on postpartum depression.
        Jurnal Psikologi. 2020; 47
        • Engindeniz N.
        • Küey L.
        • Kültür S.
        Edinburgh post-natal Depression Scale Turkish form validity and reliability study.
        in: Spring Symp. 1. 1996: 51-52
        • Faul F.
        • Erdfelder E.
        • Lang A.-G.
        • Buchner A.
        G* power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences.
        Behavior Research Methods. 2007; 39: 175-191
        • Fu W.
        • Wilhelm L.O.
        • Wei Y.
        • Zhou G.
        • Schwarzer R.
        Emotional intelligence and dyadic satisfaction buffer the negative effect of stress on prenatal anxiety and depressive symptoms in Chinese women who are pregnant with twins.
        Anxiety, Stress, and Coping. 2020; 33: 466-478
        • Garnefski N.
        • Kraaij V.
        Cognitive emotion regulation questionnaire – Development of a short 18-item version (CERQ-short).
        Personality and Individual Differences. 2006; 41: 1045-1053
        • Garnefski N.
        • Kraaij V.
        • Spinhoven P.
        Negative life events, cognitive emotion regulation and emotional problems.
        Personality and Individual Differences. 2001; 30: 1311-1327
        • Garnefski N.
        • Kraaij V.
        • Spinhoven P.
        Manual for the use of the Cognitive Emotion Regulation Questionnaire.
        DATEC, Leiderdorp, The Netherlands2002
        • Haga S.M.
        • Ulleberg P.
        • Slinning K.
        • Kraft P.
        • Steen T.B.
        • Staff A.
        A longitudinal study of postpartum depressive symptoms: Multilevel growth curve analyses of emotion regulation strategies, breastfeeding self-efficacy, and social support.
        Archives of Women's Mental Health. 2012; 15: 175-184
        • Jannati N.
        • Mazhari S.
        • Ahmadian L.
        • Mirzaee M.
        Effectiveness of an app-based cognitive behavioral therapy program for postpartum depression in primary care: A randomized controlled trial.
        International Journal of Medical Informatics. 2020; 141104145
        • Karacam Z.
        • Coban A.
        • Akbas B.
        • Karabulut E.
        Status of postpartum depression in Turkey: A meta-analysis.
        Health Care for Women International. 2018; 39: 821-841
        • Marques R.
        • Monteiro F.
        • Canavarro M.C.
        • Fonseca A.
        The role of emotion regulation difficulties in the relationship between attachment representations and depressive and anxiety symptoms in the postpartum period.
        Journal of Affective Disorders. 2018; 238: 39-46
        • Martin R.C.B.
        • Bridgett D.J.
        • Mayes L.C.
        • Rutherford H.J.V.
        Maternal working memory, emotion regulation, and responsivity to infant distress.
        Journal of Applied Developmental Psychology. 2020; 71
        • Mayer J.D.
        • Salovey P.
        • Caruso D.R.
        TARGET ARTICLES:" emotional intelligence: Theory, findings, and Implications".
        Psychological Inquiry. 2004; 15: 197-215
        • Midletton N.
        • Kouta C.
        • Raftopoulos V.
        The role of emotional intelligence and postpartum depression in predicting mothers’ satisfaction with quality of co-operation with obstetricians and midwives.
        International Journal of Caring Sciences. 2016; 9
        • Ntow K.O.
        • Krzeczkowski J.E.
        • Amani B.
        • Savoy C.D.
        • Schmidt L.A.
        • Van Lieshout R.J.
        Maternal and infant performance on the face-to-face still-face task following maternal cognitive behavioral therapy for postpartum depression.
        Journal of Affective Disorders. 2021; 278: 583-591
        • Ozcan N.K.
        • Boyacioglu N.E.
        • Dinc H.
        Postpartum depression prevalence and risk factors in Turkey: A systematic review and meta-analysis.
        Archives of Psychiatric Nursing. 2017; 31: 420-428
        • Palancı A.Ö.
        • Aktaş S.
        The effect of maternal functional and postpartum depression status on breastfeeding self-efficacy of the mothers: A cross-sectional study.
        Health Care for Women International. 2021; 1–15
        • Petrides K.V.
        • Furnham A.
        On the dimensional structure of emotional intelligence.
        Personality and Individual Differences. 2000; 29: 313-320
        • Petrides K.V.
        • Furnham A.
        Trait emotional intelligence: Psychometric investigation with reference to established trait taxonomies.
        European Journal of Personality. 2001; 15: 425-448
        • Poreddi V.
        • Thomas B.
        • Paulose B.
        • Jose B.
        • Daniel B.M.
        • Somagattu S.N.R.
        • B V.K.
        Knowledge and attitudes of family members towards postpartum depression.
        Arch Psychiatr Nurs. 2020; 34: 492-496
        • Rabbani F.
        The relationship between emotional intelligence and marital satisfaction with postpartum depression.
        Journal of Advanced Pharmacy Education & Research. 2020; 10 (Apr-Jun)
        • Riva Crugnola C.
        • Ierardi E.
        • Ferro V.
        • Gallucci M.
        • Parodi C.
        • Astengo M.
        Mother-infant emotion regulation at three months: The role of maternal anxiety, depression and parenting stress.
        Psychopathology. 2016; 49: 285-294
        • Rode J.L.
        The role of emotional intelligence in predicting postpartum depression.
        Western Journal of Nursing Research. 2016; 38: 427-440
        • Rogathi J.J.
        • Manongi R.
        • Mushi D.
        • Rasch V.
        • Sigalla G.N.
        • Gammeltoft T.
        • Meyrowitsch D.W.
        Postpartum depression among women who have experienced intimate partner violence: A prospective cohort study at Moshi, Tanzania.
        Journal of Affective Disorders. 2017; 218: 238-245
        • Ruiz-Aranda D.
        • Extremera N.
        • Pineda-Galan C.
        Emotional intelligence, life satisfaction and subjective happiness in female student health professionals: The mediating effect of perceived stress.
        Journal of Psychiatric and Mental Health Nursing. 2014; 21: 106-113
        • Salguero J.M.
        • Extremera N.
        • Fernández-Berrocal P.
        Emotional intelligence and depression: The moderator role of gender.
        Personality and Individual Differences. 2012; 53: 29-32
        • Shimao M.
        • Matsumura K.
        • Tsuchida A.
        • Kasamatsu H.
        • Hamazaki K.
        • Inadera H.
        • Children's Study G.
        Influence of infants' feeding patterns and duration on mothers' postpartum depression: A nationwide birth cohort -The Japan Environment and Children's Study (JECS).
        J Affect Disord. 2021; 285: 152-159
        • Shorey S.
        • Chee C.Y.I.
        • Ng E.D.
        • Chan Y.H.
        • Tam W.W.S.
        • Chong Y.S.
        Prevalence and incidence of postpartum depression among healthy mothers: A systematic review and meta-analysis.
        Journal of Psychiatric Research. 2018; 104: 235-248
        • Stickel S.
        • Eickhoff S.B.
        • Habel U.
        • Stickeler E.
        • Goecke T.W.
        • Lang J.
        • Chechko N.
        Endocrine stress response in pregnancy and 12 weeks postpartum - Exploring risk factors for postpartum depression.
        Psychoneuroendocrinology. 2021; 125105122
        • Tabachnick B.G.
        • Fidell L.S.
        Using multivariate statistics. Vol. 6. Pearson Boston, MA2013
        • Tasnim F.
        • Rahman M.
        • Islam M.M.
        • Hasan M.
        • Mostofa M.G.
        • Rahman M.M.
        Exposure to domestic violence and the risk of developing depression within 6 months postpartum in Bangladesh.
        Social Psychiatry and Psychiatric Epidemiology. 2021; 1–12
        • Tho Tran N.
        • Nguyen H.T.T.
        • Nguyen H.D.
        • Ngo T.V.
        • Gammeltoft T.
        • Rasch V.
        • Meyrowitsch D.W.
        Emotional violence exerted by intimate partners and postnatal depressive symptoms among women in Vietnam: A prospective cohort study.
        PloS one. 2018; 13e0207108
        • Üstgörül S.
        • Yanıkkerem E.
        Psychosocial health of women during pospartum period and affecting risk factors.
        JAREN/Journal of Academic Research in Nursing. 2017; 3: 61-68
        • van der Zee-van den Berg A.I.
        • Boere-Boonekamp M.M.
        • Groothuis-Oudshoorn C.G.M.
        • Reijneveld S.A.
        Postpartum depression and anxiety: a community-based study on risk factors before, during and after pregnancy.
        J Affect Disord. 2021; 286: 158-165
        • Wakamatsu M.
        • Nakamura M.
        • Douchi T.
        • Kasugai M.
        • Kodama S.
        • Sano A.
        • Kobayashi H.
        Predicting postpartum depression by evaluating temperament during pregnancy.
        Journal of Affective Disorders. 2021; 292: 720-724
        • Yücesoy H.
        • Erbi L.N.
        Relationship of premenstrual syndrome with postpartum depression and mother-infant bonding.
        Perspectives in Psychiatric Care. 2021;
        • Zhang S.
        • Wang L.
        • Yang T.
        • Chen L.
        • Qiu X.
        • Wang T.
        • Zheng Z.
        Maternal violence experiences and risk of postpartum depression: A meta-analysis of cohort studies.
        European Psychiatry. 2019; 55: 90-101
        • Zhao X.H.
        • Zhang Z.H.
        Risk factors for postpartum depression: An evidence-based systematic review of systematic reviews and meta-analyses.
        Asian Journal of Psychiatry. 2020; 53102353