Post Partum Depression: A Neglected Problem

Background

Postpartum depression (PPD) is a serious mental health condition that has severe acute and chronic manifestations on mothers, infants their families and society. In contrary to general reported prevalence of 10-20% in western countries, PPD has been shown to affect up to 60% of mothers in some communities. Despite having valid tools for screening, PPD is often under diagnosed, especially in developing countries. Purpose of the present study was to estimate the national prevalence of PPD in Sri Lanka.

Methods

A descriptive cross sectional study was conducted among mother of infants aging 2 weeks to 12 months. Data collection was carried out from 166 clusters in 18 districts of Sri Lanka representing eight provinces. The validated version of EPDS was used in this study with additional socio-demographic variables. Cut off points for PPD was taken as 10. Ethical clearance for the study was obtained from the Ethical Review Committee of Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka.

Results

Total of 1492 postpartum mother participated in the study. Mean age of the mothers was 28.4 years (SD 5.1years). Prevalence of EPDS among the study sample was 27.1% (n=404, 95% CI 24.9%- 29.4%). Thought of self harming (Question number 10 of EPDS) were reported (often or sometimes) by 2.9% (n=48) of the study participants. Primiparus mothers (191/623, 30.7%) and mothers with more than 3 pregnancies (31/75, 41.3%) reported higher level of PPD compared to mothers with two (126/529, 23.1%) or three (56/265, 21.8%) pregnancies (chi-square 19.35, p<.001). Prevalence of PPD according to the income quartile (from poorest to richest) was 32.6%, 30.6%, 23.5% and 22.4% respectively (Chi-square 13.77, p.003).

Conclusions

This study provides sufficient data to show evidence of higher prevalence of PPD in Sri Lanka, which need urgent attention.