Here's another expert weighing in onthe new language about postpartum depression in the DSM-V: Susan Stone, LCSW. Susan ischair of the President's Advisory Council of Postpartum Support International.

It takes years (generally) for clinical observation to find representation in the DSM. The basis for making such change requires compelling research, clinical oversight and the agreement of multiple committee members, each with his own perspective and experience. It is a necessarily lengthy and thoughtful process. While the gap between clinical reality and DSM validation may be frustrating at times, the extension of the postpartum onset specifier [to 6 months] is highly significant.

If included, this could help increase access to insurance coverage to mental health services in pregnancy and the postpartum. Liability issues resulting from denial of benefits becomes a more strongly mitigating factor in coverage decisions when the DSM acknowledges and validates the proposed extension. In addition, extending the specifier justifies the research community's ever-widening investigation of perinatal mood disorder incidence and initiation, encouraging funding. These are major gifts which will pave the way for future DSM modifications.

In reading through the language [of Dr. Ian Jones], I did not feel that the writer was denying the existence of pregnancy-related disorders, butcalling for further research. Because the incidence of depression among women is close to the statistics for antenatal and postpartum depression, specific determination of the biopsychosocial characteristics unique to perinatal mood disturbances is needed to justify its entry as a separate group of disorders. Research focused on these determinations will help inform prevention and treatment!

Great insight Susan! Thanks!