postpartum Psychiatric disorders –A neglected Issue

Abstract

Postpartum period along with pregnancy are considered to be emotionally susceptible periods. The association between emotional or psychiatric disorders and postpartum period has been documented since Hippocratic times. Hormonal changes have been implicated, along with multiple factors in the development of depression associated with postpartum period. Moreover, maternal depression can have devastating effects on neonate as well. This study explores an important area to assess the magnitude of problem in our setup, so that appropriate evaluation of mental health status and up-to-date management can be planned. Objective: To find out psychiatric morbidity among females presenting during postpartum period at a tertiary care hospital in Lahore. Methods: A cross-sectional study was done in Department of Obstetrics and Gynaecology of Central Park Teaching Hospital, Lahore. One Hundred women presenting in peripartum period were included in the study, using purposive sampling technique. After an informed consent participant's bio data was recorded. A structured proforma was used for psychiatric evaluation of the cases, which contained social and demographic details along with questions from Edinburgh postnatal depression scale. Psychiatric diagnosis was made according to DSM-5. Severity of illness was assessed using Hamilton rating scale for depression and Hamilton anxiety rating scale. Results: Postpartum follow up of 100 females revealed that 18% developed psychiatric morbidity. 13 had major depressive disorder and 5 females had anxiety disorder. There was no case of puerperal psychosis in any of the females postpartum in this study. Psychiatric morbidity and age group between 18-25 years (20.6%) showed significant correlation. Similarly, higher incidence of psychiatric morbidity was observed in women living in nuclear household (24.1%). Conclusion: Psychiatric morbidities are common among females during postpartum period. Major depression is the commonest one. Therefore assessment for depression should be included in routine obstetric follow-ups. Key Words: psychiatric morbidity, major depression, anxiety disorder, puerperal psychosis, postpartum females.