Antenatal depression and its predictors in Lahore, Pakistan

Mental health is an important but neglected component of reproductive health. This study aimed to determine the prevalence and risk factors for antenatal depression among women attending for antenatal care at an urban tertiary care hospital in Lahore, Pakistan. In a cross-sectional study/ structured questionnaires were filled and screening for depression was done using the Edinburgh postnatal depression scale [EPDS]. Out of 506 antenatal attendees 126 [24.9%] had no depression [EPDS scores < 10], 53 [10.5%] scored 10-12 and 327 [64.6%] EPDS scores > 12. Depression scores [> 10] were more common in mothers aged < 20 years [93.7%] than those aged > 35 years [55.0%]. Fear of childbirth and separation from husband were identified as significant risk factors for development of antenatal depression, while family history of psychiatric illness was significant protective factor. Domestic violence, drug abuse, lack of support, previous miscarriage and personal history of previous psychiatric illness were not found to be significant risk factors

Violence by psychiatric inpatients

The case notes of all the inpatients [n=107] committing assaults during their stay at Government Hospital for Psychiatric Diseases, Lahore in the year 1992 were analyzed. The most common victims were ward attendants followed by other patients and doctors. More doctors were assaulted than nurses and other patients. The violent patients were more likely to be schizophrenics, deluded [persecutory], hallucinated and to have undergone repeated admissions. Violence tended to be repetitive, and the violent patients were usually identifiable from previous aggressive disturbed behaviour. These patients tended to be younger, psychotic and more seriously sick. They were particularly treated in a closed ward