Patient compliance to psychiatric interventions and course of postpartum mood disorders

Abstract

Objective: Patient compliance to the psychiatric interventions may affect the outcomes of the mothers with postpartum mood disorders. The aim of this study was to assess the course of depressive symptoms of compliant and noncompliant mothers with postpartum mood disorders.

Method: One hundred-three mothers were followed with the Edinburgh Postnatal Depression Scale (EPDS) during 12-month follow-up period. Mothers with an EPDS score of 12 or higher were consulted with a psychiatrist. "Noncompliant patient" term was defined in this study for the patients who refused psychiatric consultation or treatment suggestions. Outcomes of the depressive symptoms were followed up according to the EPDS scores. Response rate based EPDS scoring was defined.

Results: A total of 35 (34%) mothers received a higher EPDS score; 28 (27.2%), who accepted the consultation, were diagnosed with postpartum mood disorder. Twenty-three mothers (10 mothers with major depressive disorder and 13 mothers with adjustment disorder) complied with treatment suggestions, and all of them responded to the treatment. EPDS scores was more likely to decrease in these compliant mothers (p = 0.010). However, of the noncompliant mothers (n = 12), only 50% responded to treatment; moreover, the drop out rate was quite high (58.3%).

Conclusions: This study reveals that noncompliance to psychiatric interventions may lead to a much less favorable course in depressive symptoms, and to a tendency in drop-outs from visits. Health professionals can give advice to the mothers about postpartum mood disorders and could assist them in getting better outcome.