Psychiatric Morbidity, Cultural Factors, and Health-Seeking Behaviour in Perinatal Women: A Cross-Sectional Study from a Tertiary Care Centre of North India

BACKGROUND: Poor mental health of the mother affects her physical health and the neonate's health and development. Studies from Southern India place different estimates of perinatal mental ill-health. Cultural variables affect health-seeking behaviour and are thus important to study in perinatal women with psychiatric morbidity. METHODS: A total of 281 perinatal women were screened on Edinburgh Postnatal Depression Scale (EPDS), Perinatal Anxiety Screening Scale (PASS) and Mini International Neuropsychiatric Interview version 6.0 (MINI), assisted with a clinical interview to identify psychiatric illnesses. The cultural formulation interview (CFI) of DSM-5 was applied on perinatal women having psychiatric illnesses and their caregivers. RESULTS: A psychiatric diagnosis was present in 10.3% of perinatal women. Depression and anxiety disorders were seen in 7.12% and 1.41%, respectively. Marital discord (P < 0.0001), psychosocial stressors (P < 0.0001), and past history of psychiatric disorder (P < 0.001) were significantly higher in perinatal women with a current psychiatric diagnosis. On CFI work-related stress, the gender of the infant, low education and conflict across generations were identified as the negative aspects of the culture associated with psychiatric illness during and after pregnancy. Religion and social support were the major coping strategies, while stigma and financial problems were the major barriers to help-seeking. CONCLUSION: The high prevalence of psychiatric disorders and the strikingly low help-seeking are noteworthy. These findings can help in planning treatment and prevention programs for timely detection and intervention for perinatal psychiatric disorders.