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Psychiatric disorders in obstetrics.

L I Hatherley1, J E Breheny, F S Robinson

  • 1Mercy Maternity Hospital, Melbourne, Vic.

The Medical Journal of Australia
|October 20, 1979
PubMed
Summary
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Serious psychiatric illness affects 0.7% of pregnant and postpartum patients. Puerperal-onset cases show high institutionalization and recurrence rates, necessitating further research into predictive factors.

Area of Science:

  • Psychiatry
  • Obstetrics
  • Public Health

Background:

  • Serious psychiatric illness during pregnancy and the puerperium is a significant concern.
  • Understanding the incidence and characteristics of these disorders is crucial for maternal health.
  • Previous research has highlighted the need for identifying risk factors in obstetric patients.

Purpose of the Study:

  • To determine the incidence of serious psychiatric illness in a large cohort of pregnant and puerperal patients.
  • To analyze the characteristics of puerperal-onset psychiatric disorders, including institutionalization and recurrence rates.
  • To identify clinical, ethnic, and socioeconomic factors associated with impending psychiatric disorders in obstetric patients.

Main Methods:

  • Retrospective analysis of 27,376 patient records.

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  • Comparison of patients with psychiatric disorders against a control group.
  • Analysis of clinical, ethnic, and socioeconomic factors.

    • Main Results:

    • The overall incidence of serious psychiatric illness was 0.7% (1 in 138 patients).
    • Puerperal-onset cases accounted for 32% of all cases, with 22% requiring psychiatric hospitalization.
    • The recurrence rate for the puerperal-onset group in subsequent pregnancies was 45%.

    Conclusions:

    • Serious psychiatric illness is relatively uncommon but carries significant morbidity, particularly for puerperal-onset cases.
    • The high recurrence rate in subsequent pregnancies underscores the need for proactive management.
    • Further investigation into associated clinical, ethnic, and socioeconomic factors may aid in early identification and intervention.