Background: Childbirth is accompanied by a lot of biological, psychological and social changes, resulting in a considerable proportion of mothers showing postpar-tum maladjustment and emotional distress. Early identification of mothers at risk enables the provision of timely psychosocial support and the focusing psychosocial resources on those who need it most.Aim: to investigate the prevalence of depressive symptoms during early postpar-tum period in a rural Greek sample and identify associated risk factors.Objectives:1. To review screening tools for postnatal depressive symptomatology and choose, translate and validate in Greek language a self-reported psycho-metric scale for screening mothers for postnatal depression.2. To translate and validate in Greek language screening tools for psychoso-cial predictors of postnatal depressive symptomatology.3. To describe, explore and test a self – constructed conceptual framework that is helpful to understand the relative impact of psychosocial factors on levels of depressive symptoms during early postpartum period.4. To identify and explore associated risk factors of depressive symptoms during early postpartum period.5. To investigate the prevalence of depressive symptoms during early post-partum period in a rural Cretan sample.Methods: Target population was new mothers of rural areas of Crete. Data collec-tion was complete in four phases. During phase 1, Edinburgh Postnatal Depression Scale (EPDS) was translated and validated in Greek language (130 mothers). During phase 2, Women Abuse Screening Tool (WAST) was translated and validated in Greek language (579 mothers). During phase 3, MAMA was translated and validated in Greek language (347 mothers). During phase 4, demographic questionnaire and the translated, culturally adapted Greek versions of EPDS, WAST, MAMA and SOC were administered to mothers that delivered their babies from June 2008 to August 2008 (174 mothers) to all the Maternity Hospitals of Heraklion. Risk factors (marital relationship, maternal attitudes/roles and cognitive influences) for depressive symp-toms were measured by validated self-report questionnaires. Mothers completed the Edinburgh Postnatal Depression Scale (EPDS), the Sense of Coherence (SOC), the Maternal Adjustment and Maternal Attitudes (MAMA) and the Women Abuse Screening Tool (WAST) within the first week postpartum. Surveys were administered in random order from June 2009 to August 2009. Statistical analysis was performed using IBM SPSS version 19 and LISREL. The statistical measurements that were per-formed included: two independent samples t-tests, reliability coefficients, hierarchi-cal multivariate linear regression, x2, exploratory, confirmatory factor analysis, structural equation modeling, Pearson’s correlation coefficient (r), Cronbach’s alpha, Guttman split-half, Receiver Operating Characteristic (ROC), Structural Equation Modeling (SEM).Results: Depressive symptomatology (EPDS scores) correlated well with those on the WAST, MAMA, SOC; High rates of postnatal depression were reported. Hierar-chical multivariate linear regression showed the psychosocial factors as an entity accounted for a significant proportion of variance (82.5%) for depressive sympto-matology (R Square= 0,681; Adjusted R Square= 0,530; Std. Error of the Esti-mate=3,206; Durbin-Watson=1,758; Bias -0,188; CI 95% 1,081-2142). The strongest predictors of psychological distress were general psychosocial characteristics: SOC (sense of security), MAMA (postpartum maternal adjustment), WAST (psychological abuse), past psychiatric history, unwanted pregnancy, recent life events, economic status, mode of delivery, education, insomnia, miscarriages, abortion, gravida, gynaecological problems, pregnancy problems and age of gestation. There was no significantly higher rates of depressive symptomatology among rural and urban mothers (23.6% vs 17.2%).Conclusion: Our data demonstrated that psychosocial characteristics, specifically marital relationship, maternal attitudes/roles and cognitive influences, are impor-tant in predicting the variability in depressive symptoms during postpartum period. Results of this study have implications for the prevention and intervention of post-natal depression symptoms both of which need to be intensified in order to minim-ize the psychosocial effects of postnatal adjustment difficulties in early postpartum period in a rural population.