Non-psychotic psychiatric disorders after childbirth: prevalence and comorbidity in a community sample.
BACKGROUND
Postnatal psychiatric morbidity is a frequent and serious complication of childbirth. The aim of the present study was to determine the prevalence and co-occurrence of DSM-IV psychiatric disorders in a community sample of postpartum Spanish mothers.


METHODS
A two-phase cross-sectional study was conducted in which all consecutive women attending the routine 6-week postnatal control visit at the Department of Obstetric and Gynecology of a university-affiliated hospital over a one year period were included. In the first phase, 1453 women were screened with the Edinburgh Postnatal Depression Scale (EPDS). In the second phase, 428 participants stratified according to employment status and EPDS outcomes were randomly selected within each stratum for clinical psychiatric evaluation using the Structured Clinical Interview for DSM-IV. Weighted prevalence estimates were obtained for DSM-IV disorders with or without comorbidity.


RESULTS
The overall 6-week prevalence rate for postpartum psychiatric disorders was 18.1% (95% CI 15.0-21.8) and 2.0% (95% CI 1.2-2.9) of postpartum women met criteria for more than one disorder. Mood disorders was the most prevalent group (9.8%; 95% CI 7.9-12.1) followed by adjustment disorders (4.3%; 95% CI 3.0-6.3), and anxiety disorders (4%; 95% CI 3.0-6.3). Comorbidity was associated to major depressive disorder.


CONCLUSIONS
Underestimation of some disorders due to the cross-sectional design and the use of a screening instrument with good psychometric characteristics restricted to depression, anxiety, and adjustment disorders.


CONCLUSIONS
In the context of a 6-week postnatal visit, a high prevalence and heterogeneity of postnatal psychiatric morbidity in a community sample of Spanish women was found.
Navarro
Purificación
P
Unit of Perinatal Psychiatry and Gender Research, Hospital Clínic Universitari de Barcelona, Barcelona, Spain. purinavarrogar@yahoo.es
García-Esteve
Lluïsa
L
Ascaso
Carlos
C
Aguado
Jaume
J
Gelabert
Estel
E
Martín-Santos
Rocío
R
D000328:Adult; D000379:Agoraphobia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008403:Mass Screening; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D016584:Panic Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D036801:Parturition; D010698:Phobic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D011644:Puerperal Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D012111:Residence Characteristics; D013030:Spain / Q000453:epidemiology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology