Post-partum mental disorder in an unselected sample. The psychiatric history

Women with nonorganic psychosis: factors associated with pregnancy's effect on mental health

Pregnancy's effect on mental health during pregnancy was studied in relation to 17 variables representing the pregnant woman's demographic, social, material, physical and attitudinal characteristics, in an attempt to explain the highly varied effect of pregnancy on mental health which had been observed both among 88 index women with a history of nonorganic psychosis and among 104 demographically similar pregnant control women. Little explanation or predictability was found for the varied effect of pregnancy. Among index cases, only maternal age and the experienced effect of pregnancy on physical health were significantly related to its effect on mental health. In controls, the presence of material-situational problems and a negative/ambivalent initial reaction to pregnancy were each related to increased change in mental health, i.e. to both improvement and worsening in mental health associated with pregnancy.

Women with nonorganic psychosis: pregnancy's effect on mental health during pregnancy

The effect of pregnancy on women's mental health during pregnancy was studied by interview with 88 pregnant index cases with a history of nonorganic psychosis and 104 demographically similar pregnant controls, and by psychiatric records for the subsample of index cases with relevant information. Controls generally reported experiencing no change or only a slight worsening of mental health due to pregnancy, while index differentially reported improved or considerably worsened health. In total, worsening was more common than improvement in the index cases, and especially in those with a history of Schizophrenic, Psychogenic, Postpartum and Other Psychoses. Psychiatric record information suggested predominantly more improvement in the subsample with information, but this bore little systematic relation to the same women's reports at interview during pregnancy.

Patients at a paediatric out-patient clinic. A study with particular reference to psychological and social background factors. II. Earlier contacts with the health service, social background, parents' morbidity, general discussion and recommendations

Psychological factors were considered by the examining physicians to play an important part in 5.2% of approximately 4 000 initial visits to a paediatric clinic. These cases are compared with a matched control group representing the cases where the physicians judged that psychological factors were not involved. As compared with the controls, then a considerably larger proportion of the patients with symptoms associated with psychological factors had a previous history of contacts with child psychiatrists or attendence at the paediatric clinic for problems of a psychological nature. Their parents, the mothers in particular, had a higher frequency of registered sickness for mental-nervous disorders and their families had more frequently been the subject of special social inquiries or assistance. To a large extent the examining paediatrician was unaware of these background conditions. With a better case history and proper follow-up one could probably reduce the number of X-ray examinations, consultations and laboratory tests. Further training and better contacts would be facilitated if members of a children's psychiatric team were stationed within the paediatric clinic.

The longitudinal course of para-natal emotional disturbance

Ninety-five nulliparous women were interviewed during pregnancy and 4 months post partum. The possibility of predicting mental disturbance post partum from that during pregnancy was studied. When the woman was mentally disturbed during pregnancy, the prognosis was better in the case of a poor social situation at the time of the pregnancy than in the case of a good social situation. Negative attitude towards further pregnancies and repudiation of the own mother, however, implied unfavourable prognosis. In the case of a woman without mental symptoms during pregnancy, denial of the pregnancy and sensations connected with it suggested poor adaptation post partum.