Perinatality and Childbirth as a Factor of Decompensation of Mental Illness: The Case of Depressive States in Newly Delivered Cameroonian Women

Abstract

Decompensation in psychiatry refers to the process by which a previously stable patient or predisposed individual may suddenly manifest symptoms or experience exacerbation of a sickness. This is prompted by factors which may be physiological, pathological, endogenous or exogenous, being responsible for psychic disequilibrium. Perinatality is characterized by multiple hormone variation and stress, which may constitute a risk for mental imbalances. The baby blues is a precocious and transient depressive state of the postpartum, which may occur as a borderline, signalling psychic decompensation. This study aims to investigate the phenomenon in women predisposed to mental disorders, having manifested the baby blues during immediate postpartum. In a case control study conducted in 2015 in two teaching hospitals of Yaoundé, Cameroon over four months, the Kennerley and Gath blues screening permitted to separate the group of “cases” from that of “controls”. After various analyses, women with psychological and psychiatric risk factors including: past history of depression (OR=6.8; p<0.001), past history of postpartum blues (OR=2.3; p=0.002), past history of other psychiatric illnesses (OR=10.21; p<0.01), family history of depression (OR=3.58; p<0.001), family history of other psychiatric illnesses (OR=4.39; p<0.001), current chronic diseases (OR=2.33, p-value<0.001), sickness or complication during pregnancy (OR=2.53, p-value<0.0211) were more susceptible to manifest the baby blues during immediate postpartum. Therefore, women with psychological predispositions, stand a risk of decompensation during the perinatal period including psychiatric disorders of postpartum. Preventive measures such as counselling, keen monitoring and treatment adjustment may help to prevent this phenomenon.