Post-partum mental disorders: pattern and problems of management in Wesley Guild Hospital, Ilesa, Nigeria

Sixty-seven consecutive women who presented with postpartum mental disorder within 1 year after delivery over a 5-year period in a teaching hospital serving rural and semi-urban communities were evaluated. All patients were followed-up until they defaulted or for a maximum period of 1 year after presentation. There were more primiparous women (43.3%) than women of other parities. In 16.4%, a previous history of mental disorder was elicited. Family history of mental disorder was present in 13.4%. Premorbidly, marital disharmony was present in 23.9%, obstetric complications in 22.4%, neonate/infant mortality in 19.4% and unwanted pregnancy in 16.4%. Onset of illness occurred during the peurperium in majority of cases (58.2%). Schizophrenia topped the list of clinical types. Short-term prognosis was good but defaulting rate was high. Breastfeeding was stopped permanently by nine patients and two babies died. Ten husbands deserted their wives. The pattern of postpartum mental disorders has remained stable in the past two decades. Although the cause and effect relationship is difficult to establish in our study, the relative stability of some sociocultural factors suggests their usefulness in planning preventive strategies. A multidisciplinary approach is essential.