Patterns of Presentation of Psychiatric Disorders During Pregnancy and Postpartum Period in a Tertiary Care Center- A 5 Years Retrospective Study

Introduction: Postpartum psychiatric disorders are a common cause of morbidity and distress affecting the lives of significant number of women. Materials And Methods: A five-year retrospective chart review was carried out in the psychiatry department of a tertiary care hospital in Northern Karnataka from 2014-2018 to determine the patterns of presentations of psychiatric disorders during pregnancy and postpartum period. The data was collected from the records available in the hospital. Information regarding demographic details, Obstetric details, Psychiatric diagnosis and treatment details was recorded. Results: During the study period, 74 women were evaluated during pregnancy and postpartum period in the Department of Psychiatry. All these patients were referred from the department of Obstetrics and Gynecology. The study found that Postpartum Depression was the most common diagnosis with 39% followed by Postpartum Psychosis being 28% and 3% patients presented with postpartum Baby Blues. About 9% women had exacerbation of their pre-existing mood disorder, 5.4% have been diagnosed with adjustment disorder and 4.1% women presented with Delirium. Due to infant death because of various reasons, 7% patients presented with a Grief reaction. More than half the women required inpatient care (51%),12 patients received ECTs. Treatment was predominantly with antipsychotics (51%), antidepressants (50%) and one woman received Lithium during the postpartum period due to the severity of presentation. It was noted that 13.5% women had recurrent mood episodes and 8% had schizophrenia in the next 5 years period. Conclusion: Postpartum depression and postpartum psychosis were the cause for psychiatric consultation during pregnancy and postpartum in general hospital setup. About 1/3rd women with postpartum onset psychiatric disorder did have further episodes in the next 5yrs. Therefore, we need to follow up these patients in the long-term to monitor for recurrent illness in the future.