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contributory f ac t or to the occurrence of psych iatric disorder .
of even greater impo rtance is the fact that these diseases may
ma s k an d/or a lso he ma s ked by the psychiatric d isorder theroby
interfering wi t h t he treatment of both disorders . In tile
Ibadan s t udy , a number of pa t i e nt s had de l a ye d psychiatric
referrals because they had other severe puerpera l c a mpI ic­
atians such as sepsis, anaemia a nd pyrex i a , which are known
causes of functiona l organic psychosis by themselves [2 43 J .
Cultural practices a re i mpo r t a nt modifiers i n the
occurrence and presentat ion of psychiatric d i seases in
ge neraL In developing world societies whe r e c hild birth is
often marked by elaborate ceremonies the traditiona l practices
coul d be i mportan t factors in the epidemiology of t he
puerpe r a l psychiatric d isorders. In t he No r the r n Nigerian
study, for i nstance , the autho rs r e mar ked on the part icularly
young ages of t heir pa t i e nt s and attributed this to t he
yo unger age - at marri age and chil d be a ring in the region.
These young fema les who were less well- pr ep a r ed to cope with
t he str e s s es of ch ild be a r ing were probabl y therefore at
h i ghe r risk for puerperal psychiatric disorders (244) . Tho
stUdy , als o noted that the dramatic behaviourial changes were
often r e l a t ed t o the elaborate child na mi ng ceremonies
performed on t he seventh postpartum da y (2 44 ] .
In South Af r i ca ( 2 381, 80% of the puerperal psychiatric
pati ents as compared with 30% of controls, we r e concerned