Psychiatric disorders of the puerperium in South African women of Nguni origin. A pilot study.

The clinical impression gained from symptoms exhibited by Zulu and Xhosa obstetric patients referred to the Department of Psychiatry, King Edward VIII Hospital, Durban, was that certain of the psychiatric disorders presented in a different form to those observed in hospitals serving other population groups. Opinions differ as to the aetiology and relationship of disorders of the puerperium to other psychiatric syndromes with controversial hypotheses referring to both the aetiology and the symptomatology. Firstly, the disorders are considered to be a reaction to specific psychological or biological stresses of pregnancy. Secondly, in contradistinction, it is postulated that the illness is incidental to ongoing personality disintegration, which is manifested by premorbid personality disturbances, a family history of mental illness, a past history of psychiatric disorder and nonspecific stresses common to all other psychiatric illnesses. This pilot study indicates that cultural phenomena contributed to the symptoms of the majority of the 31 severely disturbed Black women displaying psychiatric features in the puerperium studies. While confirming the findings of a number of other authors, we have also detected a high incidence of transient situational disturbances of short duration. The findings indicate the need for more detailed research in this area among Black patients.