Psychiatric morbidities in postpartum females: a prospective follow-up during puerperium

Aims and objectives: Postpartum psychiatric disturbances pose a significant mental health problem in community because of their impact on parent-infant and couple relationship. This study was carried out with the aim to find out psychiatric morbidities in postpartum females during puerperium so that a proper assessment of mental health and comprehensive management can be planned. Methodology: Hundred females who had delivered in maternity ward of obstetrics and gynaecology department of Sir Sunderlal Hospital, Institute of Medical Sciences, Banaras Hindu University, Varanasi were evaluated for mental status on day one (i.e. day of delivery), and followed-up till four weeks postpartum period. Psychiatric evaluation was done on the basis of structured proforma containing socio-demographic details and the text revision of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) diagnostic criteria for diagnosis. Brief Psychiatric Rating Scale (BPRS), Hamilton Anxiety Rating Scale (HARS), and Hamilton Rating Scale for Depression (HDRS) were used to assess the severity of the respective conditions. Result: Psychiatric evaluation during postpartum puerperal stage revealed that 16 (16%) females had developed psychiatric morbidity. Twelve (12%) cases fulfilled the criteria for major depressive disorder and four (four per cent) patients had features of anxiety disorder. In 84 (84%) cases, postpartum period was uneventful and no psychiatric disturbance was found.Seventy five per cent females had joint family and good family support. Conclusion: Major depressive disorder is the most common psychiatric morbidity observed in postpartum females during puerperium. The careful observation of females during postpartum puerperal stage may help in identification and proper management of mental state of such females, and also proper care of newborn.perspective