Pictorial phenomena expressing maternal representations of first time expectant mothers demonstrating signs of depression

A analysis was undertaken of pictorial phenomena manifested in an art-based evaluation of women in the third trimester of their first pregnancy who presented with depressive symptoms. Forty-five women in their third trimester created a mother-infant relationship drawing, filled in a questionnaire assessing their level of depressive symptoms during pregnancy (EPDS), and took part in a semi-structured in-depth interview. The drawings of the 11 women who scored above the minimum cut-off (≥10) on the questionnaire were subjected to further phenomenological analysis, along with a higher order grounded theory analysis including their semi-structured interview data. Four pictorial phenomena were identified: (1) Limited use of color and a combination of blue and yellow shades, (2) Selection of rectangular format, (3) Lack of environment and details in the drawing and (4) The expression of a connection between the objects in the drawing. Three recurring themes emerged: feelings of reduction, a possible conflict between positive and negative feelings, and the idea of mother-infant separation. The findings may assist clinicians in better understanding the content in the drawings of expectant women demonstrating signs of depression.