Prevalence of depression and anxiety in antenatal women attending a tertiary care hospital in semi urban area of North coastal Andhra Pradesh – A cross sectional study

Abstract

Introduction: The research into the psychological issues related to woman still remains in infancy. The exact incidence and prevalence of psychiatric disorders in women or those seen exclusively in them is unknown[2]. Women mental health hardly forms a component in the training of postgraduates in the departments of psychiatry or gynecology and obstetrics. There is little consultation liaison between the two departments and thus, no integrated teaching of common problems related to women mental health. Materials and methods: Cross sectional study in patients attending the OPD of The Department of Obstetrics and Gynecology, Maharajah"s Institute of Medical Sciences (MIMS), Vizianagaram. The sample of this study was the population that included all antenatal women registered in the Obstetrics OPD at MIMS from Feb 2020 to December 2020. They are screened for Common mental disorders across three Trimesters at a point of time during their Antenatal visits. Inclusion criteria include Antenatal cases attending in Obstetrics OPD, Maharajah"s Institute of Medical Sciences (MIMS), Vizianagaram. Age between 16-50 yrs. Exclusion criteria Patients suffering from Comorbid Systemic illnesses and Past H/o Mental Illness. The study participants were briefed about the study, and informed written consents were obtained. Results: 165 patients were included in the study. Patients were assessed for Anxiety and depression behavior by using Semi Structured Interview Tool, Hospital Anxiety and Depression Scale (HADS). In rural areas, moderate anxiety, normal, severe anxiety as follows 19 (14.4%), 86 (65.2%) and 27 (20.5%) respectively. In Urban areas, moderate anxiety, normal, severe anxiety as follows 0 %), 33 (100%) and 0% respectively. In first trimester, moderate Anxiety were 12 (16.2%), severe anxiety 8 (10.8%). In second trimester, moderate Anxiety were 7(13.5%), severe anxiety 19 (36.5%). In Third trimester, moderate Anxiety was 0%, severe anxiety 0%. In rural areas, moderate depression, normal, severe depression as follows 26 (19.7%), 79 (59.8%) and 27 (20.5%) respectively. In Urban areas, moderate depression, normal, severe depression as follows 0 %, 33 (100%) and 0% respectively. In first trimester, moderate depression were 6 (8.1%), severe depression 14 (18.9%). In second trimester, moderate depression were 13(25%), severe anxiety 13 (25%). In Third trimester, moderate depression were 7 (17.9%), severe Depression 39 (100%). Conclusion: Our results are important for practicing clinicians as they identify risk factors during routine obstetric care. The providers should consider the possibility of antenatal patients developing depression and anxiety symptoms in the presence of risk factors. This window of opportunity should be our best bet in reducing postnatal depression. The antenatal records should have remainder boxes for history of CMD and intimate partner violence. Future research should focus on capturing this data and evaluate how to use these risk factors to improve our screening accuracy and clinical assessments.