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i ncreased occu rrenC:2 of psychiatric disorders in e a r ly a nd
l ate pre gn ancy ha s a lso been noted [236,237 ). Th e ma j ority o f
mor bidit ies h owever occur a f t e r child birth.
Predisposing and t r i g gering f actors wh i ch h av e b e en
ide ntified include pri miparity , unstable family b ackground,
l a c k of s uppor t, a p o s i t i ve fami l y history and past histor y of
psychiatric disorder , ob stetric comp lications an d loss o f the
infant [224-226]. Puerperal psychosis is recurrent i n a bout
15 % o f cases ( 2 2 3 , 2 2 5 ] .
As noted with the o ther puerperal conditions , less
i nfo rmation is also availabl e on p uerperal p s y c h i atric
disorders in t he d ev eloping world and especiall y in Af r i c a .
The e s timat e d i nc ide nc e of puerpel'al psychosis f r om h ospl tal­
based s t udies i n South Af ric a and Tan z a nia we r e 0 .7 pe r 1000
a nd 0 . 4 per 10 00 births r espectively [.!38 ,239} . I n Za ria [8] ,
4 0 cases we r e see n among 2 2 .774 del i veries Wh i c h gives a n
inci dence o f 1 . 8 p er 1000. Th i s i s s i mila r t o t h e rat es in
Europe [ 2 2 3J .
In t he Assir r eg ion of Sa"di Ar abi a, the r epor t e d
incide nce of p ue r per al p s yc h osis is 3 p e r 10 00 ( 2 4 0 ] a r a t e
Which is s lightly high e r t han t h o s e reported i n the western
world and s ub-sahara n Af r i c a. The inc i dence o f pu e r p e ral
depressive i llnesses i n Uga n da wa s f o u nd by J .L . Co x t o be
10%, a figu r e s imilar t o rates observed i n t he developed veea e
[241].
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