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Background: Perinatal depression (PND) is often under-treated and under-recognized. It has a negative impact on infant development and mother-child interactions. This study aims to estimate the prevalence of PND during pregnancy and in the postpartum period and the effect of sociodemographic factors, psychosocial stressors, and obstetric and neonatal factors on PND. Methods: 166 antenatal mothers attending tertiary center, who completed the 1st-trimester, were evaluated on baseline sociodemographic, psychosocial, obstetric, neonatal, and post neonatal factors by using a semi-structured questionnaire. Periodic prospective assessments were done using Hamilton depression rating scale (HAMD) at the end of the second and third trimesters and first and sixth weeks of the postpartum period. Results: Prevalence of PND was 21.7%, 32.2%, 35%, 30.4%, and 30.6%, at the end of the first trimester, during second, and third trimesters, and first and sixth week postpartum, respectively. Factors significantly associated with depressive symptoms included history of previous children with illness (P: 0.013, OR-5.16, CI-1.3-19.5) and preterm birth (P: 0.037, OR-3.73, CI-1.1- 13.2) at the time of recruitment; history of abuse (P: 0.044, OR-3.26, CI-1.1-10.8) and marital conflicts (P: 0.003, OR-3.2, CI-1.4-6.9) by the end of second trimester; history of miscarriages (P: 0.012, OR-2.58, CI-1.2-5.4) by the end of third trimester; lower SES (P: 0.001, OR-3.48, CI-1.64-7.37), unsatisfied living conditions (P: 0.004, OR-2.9, CI-1.4-6.04), alcohol use in husband (P: 0.049, OR-2.01, CI-1.1-4.11), history of depressive episodes (P: 0.049, OR-2.09, CI-1.1-4.46), history of high-risk pregnancy (P: 0.008, OR-2.7, CI-1.29-5.64), history of miscarriages (P: 0.049, OR-2.04, CI-1.1-4.2), stressful events in the postpartum period (P: 0.043, OR-2.58, CI-1.01-6.59), IUD (P: 0.002), preterm birth (P: 0.001), congenital malformations (P: 0.001), dissatisfaction with the sex of the child (P: 0.005, OR-3.75, CI-1.42-9.91), poor family support (P: 0.001), and low birth weight (P: 0.001, OR-16.78, CI-6.32-44.53) in the postpartum period. These analyses are purely exploratory. Conclusions: PND is highly prevalent from the early antenatal period onwards; this warrants periodic assessment of depression among high-risk mothers, using a validated tool, for early diagnosis and management.
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BACKGROUND: Insight is awareness of one's symptoms, illness, and need for treatment. In bipolar disorder, insight is better in bipolar depression and nonpsychotic depression when compared with mania and psychotic depression. Insight impacts on medication adherence. In our study, we measured and compared with various clinical parameters of insight. The aim of this study is to assess various dimensions of insight recovery prospectively in bipolar affective disorder patients with treatment and drug compliance. MATERIALS AND METHODS: Patient's insight was assessed using Mood Disorder Insight Scale (MDIS) at baseline, 1st, 3rd, and 6th months. Their insight was then compared with various sociodemographic profiles and correlated with number of mood episodes, family history of mental illness, and 6-month MDIS scores. RESULTS: Depression patients scored better in insight components (P = 0.001). The good compliance group attributed their symptoms to their illness than the poor compliance group (P = 0.013). The MDIS scores were gradually improving from baseline to 6 months (P ≤ 0.001). There was no relationship between insight and the number of episodes (P = 0.788). CONCLUSION: Depressive episode patients had better insight during the baseline, which improved during 6 months follow-up compared with manic patients. Among various components of insight, insight on the attribution of symptoms was a predictor of good compliance. Progression of insight was steady and proportionate to the duration of treatment in depressive episode patients.