Scottish Longitudinal Study
Development & Support Unit
Post-partum psychiatric illness in Scotland 1991-2001
Rosaline S. Barbour (University of Dundee)
Approved on 22-01-2008
There have been four previous studies looking at hospital admissions due to post-partum mental illness. The most relevant of these is Kendell et al (1987) which used admissions to the Royal Edinburgh Hospital over an eight year period. Some limited social data were available from the hospital records. The rates of mental illness admissions in the relevant categories increased sharply in the 90 days post partum to more than 20 times the rates for those for the same women when they were not in the post-partum period. Unsupported, single or divorced, women were at much higher risk.
Another two studies have used data from population registers in Denmark and in Sweden. The Swedish study has shown a strong association with neighbourhood deprivation. The Danish study has found interesting evidence of reduced REadmission rates for certain categories of mental illness after childbirth. All studies have suggested a reduced rate of admissions DURING pregnancy, but at a much lower rate than the subsequent increases, so that the net effect is an increase in all admissions from the pre-pregnancy rate.
This study would bring the Kendell et al analyses up to date and present results for the whole of Scotland, rather than just one hospital. By using the hospital admissions over time for all SLS mothers with PPP admissions in pregancy, they can act as their own controls as was done in reference 1. Comparisons with other SLS mothers will provide another type of control that will identify the type of woman who is vulnerable to episode(s) of PPP . The census data on the SLS members will allow a much wider range of background data to be examined compared to the other studies.
By linking the SLS members data to psychiatric admissions we will be able to compare the relation of PPP to social factors and compare this with other psychiatric admissions, not linked to pregnancies occurring in all SLS mothers, including those who have not given birth in the period.
The study would scope the incidence and variation by locality and individual characteristics of serious mental illness (i.e. illness requiring psychatric hospital admission) in young women of childbearing age in relation to birth events. The major focus will be on post-partum mental illness, but the study will identify admissions for all women of childbearing age to provide control data. Admissions before and after pregnancy will allow additional analyses of the relationship of admissions to the timing of pregnancy. The 1991 census data for the women will allow the rates of admission to be studied in relation to individual and household characteristics.
Kendall RE, Rennie D, Clarke JA Dean C 1981 The social and obstetric correlates of psychiatric admission in the puerperum. Psychological Medicine 11, 341-350.
Kendell RE, Chalmers JC, Platz C. Epidemiology of puerperal psychoses. Br J Psychiatry. 1987;150:662-673.
Terp IM, Mortensen PB. Post-partum psychoses: clinical diagnoses and relative risk of admission after parturition. Br J Psychiatry. 1999;172:521-526.
Nager, L, Johansson, M. & Sundquist, K. (2006) 'Neighbourhood socioeconomic environment and risk of postpartum psychosis', Arch. Womens Mental Health, 9: 81-86.