Marital problems and other factors associated with postpartum psychiatric disorder

Abstract

To study the association between postpartum psychiatric disorder and demographic and psychosocial, pre- and perinatal factors. All families having 4-month-old infants in Vila Jardim, a district of Porto Alegre, Brazil, born at a public hospital from November 1998 through December 1999 were assessed. The Self-Report Questionnaire (SRQ-20) and semi-structured interviews were used for the psychiatric assessment that included a possible diagnosis using Diagnostic and Statistical Manual of Mental Disorders IV (DSM- IV) criteria. Relational functioning between couples, the relationship with mother's family of origin and social network were assessed using the DSM-IV Global Assessment of Relational Functioning Scale (GARF). A total of 148 mothers and 116 cohabiting fathers were assessed. According to the SRQ, 34.4% of the mothers and 25.4% of the fathers had a suspicion of psychiatric disorder. Clinical assessments using DSM-IV criteria detected larger numbers. In the analysis of the whole group of women, low family income (OR = 0.8; p < 0.05) and presence of previous maternal disorder (OR = 2.2; p < 0.05) were associated. When only women living with partners were assessed (n = 116), there was an exclusive association with quality of marital relationship (OR = 7.3; p < 0.05). This study reinforces the need of investigating the presence of maternal psychiatric disorder during prenatal care, introduces data about the father, and especially, the importance of routine assessment of the marital relationship.