DETERMINANTS AND PATTERN OF POSTPARTUM PSYCHOLOGICAL DISORDERS IN HAZARA DIVISION OF PAKISTAN

Authors

  • Naveed Irfan
  • Ahmed Badar

Abstract

Background: The risk of psychological disorders in women increases during the postpartum period. The major forms of these disorders are post partum psychoses and post partal depression. This study was designed to evaluate the presentation and sociodemographic characteristics of postpartal psychological disorders at Hazara division of Pakistan. Methods: This study was carried out over a period of three years at three major cities of Hazara, Pakistan. One psychiatry clinic in each of these cities was selected and record of all the psychiatric patients was kept. All the patients presenting with post partal disorders were included in the study. A proforma was used to collect information about a wide variety of sociodemographic variables and presentation of disease. Frequencies were calculated for different variables. Results: 8.66 % (1248) out of 14,400 patients of psychiatric disorders presented with post partal disorders. 60 % out of these 1248 had post partal psychoses while the rest had post partal depression. The majority of our patients with post partal depression were young (20-31years), illiterate (80%), having past history of psychoses/depression (70%), house wives (95%), from rural areas (65%), highly religious (60%), poor (90%), with husband away for job etc. (70%), primipara (80%) and with a live baby born (70%). A number of stressors were identified in 65 % of subjects. Conclusions: There is a predictable set of risk factors for post partal psychological disorders in the population of Hazara. Proper identification of these risk factors during antenatal period with collaboration of obstetrician and psychiatrist can reduce the morbidity associated with this group of disorders.Keywords: Post Partal Psychoses, Post Partal Depression, Postpartum psychological disorders,

References

Burt VK, Stein K. Epidemiology of depression throughout the female life cycle. J Clin Psychiatry 2002;63 Suppl 7:9-15.

Danaci AE, Dinc G, Deveci A, Sen FS, Icelli I. Postnatal depression in Turkey: epidemiological and cultural aspects. Soc Psychiatry Psychiatr Epidemiol 2002;37(3):125-9.

Yonkers KA, Ramin SM, Rush AJ, Navarrete CA, Carmody T, March D, et al. Onset and persistence of postpartum depression in an inner-city maternal health clinic system. Am J Psychiatry 2001;158(11):1856-63.

Seidman D: “Postpartum Psychiatric Illness: The Role of the Pediatrician,” Pediatrics in Review 1998;19:128-31.

Beck CT. Predictors of postpartum depression: an update. Nurs Res 2001;50(5):275-85.

Josefsson A, Berg G, Nordin C, Sydsjo G. Prevalence of depressive symptoms in late pregnancy and postpartum. Acta Obstet Gynecol Scand 2001;80(3):251-5.

Terp IM, Mortensen PB. Post-partum psychoses. Clinical diagnoses and relative risk of admission after parturition. Br J Psychiatry 1998;172:521-6.

Agrawal P, Bhatia MS, Malik SC. Post partum psychosis: a clinical study. Int J Soc Psychiatry 1997;43(3):217-22.

Chandran M, Tharyan P, Muliyil J, Abraham S. Post-partum depression in a cohort of women from a rural area of Tamil Nadu, India. Incidence and risk factors. Br J Psychiatry 2002;181:499-504.

Gross KH, Wells CS, Radigan-Garcia A, Dietz PM. Correlates of self-reports of being very depressed in the months after delivery: results from the Pregnancy Risk Assessment Monitoring System. Matern Child Health J 2002;6(4):247-53.

Chaaya M, Campbell OM, El Kak F, Shaar D, Harb H, Kaddour A. Postpartum depression: prevalence and determinants in Lebanon. Arch Women Ment Health 2002;5(2):65-72.

Sierra Manzano JM, Carro Garcia T, Ladron Moreno E. Variables associated with the risk of postpartum depression. Edinburgh Postnatal Depression Scale. Aten Primaria 2002;30(2):103-11.

Ndosi NK, Mtawali ML. The nature of puerperal psychosis at Muhimbili National Hospital: its physical co-morbidity, associated main obstetric and social factors. Afr J Reprod Health 2002;6(1):41-9.

Regmi S, Sligl W, Carter D, Grut W, Seear M. A controlled study of postpartum depression among Nepalese women: validation of the Edinburgh Postpartum Depression Scale in Kathmandu. Trop Med Int Health 2002;7(4):378-82.

Josefsson A, Angelsioo L, Berg G, Ekstrom CM, Gunnervik C, Nordin C, Sydsjo G. Obstetric, somatic, and demographic risk factors for postpartum depressive symptoms. Obstet Gynecol 2002;99(2):223-8.

Patel V, Rodrigues M, DeSouza N. Gender, poverty, and postnatal depression: a study of mothers in Goa, India. Am J Psychiatry 2002;159(1):43-7.

Johnstone SJ, Boyce PM, Hickey AR, Morris-Yatees AD, Harris MG. Obstetric risk factors for postnatal depression in urban and rural community samples. Aust N Z J Psychiatry 2001;35(1):69-74.

Lee DT, Yip AS, Leung TY, Chung TK. Identifying women at risk of postnatal depression: prospective longitudinal study. Hong Kong Med J 2000;6(4):349-54.

Webster J, Linnane JW, Dibley LM, Pritchard M. Improving antenatal recognition of women at risk for postnatal depression. Aust N Z J Obstet Gynaecol 2000;40(4):409-12.

Nielsen Forman D, Videbech P, Hedegaard M, Dalby Salvig J, Secher NJ. Postpartum depression: identification of women at risk. BJOG 2000;107(10):1210-7.

Glasser S, Barell V, Shoham A, Ziv A, Boyko V, Lusky A, et al. Prospective study of postpartum depression in an Israeli cohort: prevalence, incidence and demographic risk factors. J Psychosom Obstet Gynaecol 1998;19(3):155-64.

Glasser S, Barell V, Boyko V, Ziv A, Lusky A, Shoham A, et al. Postpartum depression in an Israeli cohort: demographic, psychosocial and medical risk factors. J Psychosom Obstet Gynaecol 2000;21(2):99-108.

Sebastian Romero E, Mas Lodo N, Martin Blazquez M, Raja Casillas MI, Izquierdo Zamarriego MJ, Valles Fernandez N, et al. Postpartum depression in the health area of Toledo. Aten Primaria 1999;24(4):215-9.

Vega-Dienstmaier JM, Mazzotti G, Stucchi-Portocarrero S, Campos M. Prevalence and risk factors for depression in postpartum women. Actas Esp Psiquiatr 1999;27(5):299-303.

Da-Silva VA, Moraes-Santos AR, Carvalho MS, Martins ML, Teixeira NA. Prenatal and postnatal depression among low income Brazilian women. Braz J Med Biol Res 1998;31(6):799-804.

Righetti-Veltema M, Conne-Perreard E, Bousquet A, Manzano J. Risk factors and predictive signs of postpartum depression. J Affect Disord 1998;49(3):167-80.

Tamaki R, Murata M, Okano T. Risk factors for postpartum depression in Japan. Psychiatry Clin Neurosci 1997;51(3):93-8.

Lee D, Yip A, Chiu H, Leung T, Chung T. A psychiatric epidemiological study of postpartum Chinese women. Am J Psychiatry 2001;158(2):220-6.

Most read articles by the same author(s)

1 2 3 > >>