Psychotic disorders after childbirth in Nigerian women

Fifty-seven consecutive cases of psychotic disorders arising within one year of childbirth and presenting over a two-year-period were studied prospectively. There was a preponderance of primigravidae. In 18% a family history of psychiatric disorders was obtained; 39% had suffered from previous psychotic episodes; 35% had suffered from obstetric complications; in 9% there was poor psychological adjustment to pregnancy. The majority (65%) was schizophrenic. Onset of symptoms in half the cases was within one month of delivery. The majority of cases (60%) presented in hospital within one month of onset of symptoms; there was a significant association between delay in arrival in hospital and prior treatment by religious or traditional healers. The immediate prognosis in terms of clinical recovery of the women was good. However, 53% ceased breast-feeding; seven of the children died, while another seven became physically ill. Eleven husbands left their wives. The implications of these findings are discussed.