A perinatal psychiatric service audit in New Zealand: patient characteristics and outcomes

As part of a clinical audit, data were collected on all patients assessed and offered treatment by the Christchurch 'Mothers and Babies' Service between 1-7-98 and 30-6-2000. At assessment and discharge a comprehensive psychiatric interview and the Marcé Checklist were completed by clinicians and self-rating questionnaires were completed by the patient. Univariate analysis and logistic regression were performed on the variables collected. A significant proportion of women suffered from chronic recurrent psychiatric disorders. Pure 'postnatal depression' was uncommon. Thirty-eight percent of women were pregnant at assessment. Risk factors for poor maternal outcomes included history of chronic illness, high symptomatic scores at assessment, the presence of more than one Axis I diagnosis (excluding nicotine dependence) or an Axis II diagnosis, and poor interpersonal relationships. Perinatal psychiatric services need resources to treat women with a range of severe and chronic disorders and should pay attention to interpersonal issues in treatment.