Tom Cruise might not believe that postpartum depression exists, but there is a very real risk that first-time moms will develop serious mental illness -- such as schizophrenia, depression and bipolar disorder -- during the first three months after childbirth.
This study, published in today's issue of the Journal of the American Medical Association, is the largest ever to look at postpartum depression and the first to look at other kinds of serious postpartum mental illness, such as schizophrenia.
Danish researchers studied health and civic records collected over 32 years from 1 million first-time parents -- from the time their child was born until the child's first birthday. During those years, a total of 1,171 women and 658 men were admitted, with a mental disorder, to a psychiatric hospital during their first year of parenthood, says the study. So, new moms might be at risk for serious mental illness, but new dads aren't as vulnerable, researchers said.
First-time mothers were seven times more likely to be hospitalized for a severe mental illness than second-time moms who had given birth 11 to 12 months before, researchers say. These first-timers were so sick that they had to be hospitalized to treat their mental illness, and not just treated as outpatients. The greatest risk for mental illness was 10 to 19 days after childbirth, but the risk was still significant three months later.
Within that same early time period, women were nearly three times as likely to visit an outpatient facility for mental illness treatment compared with moms who had given birth a year ago.
Postpartum depression is a relatively common problem, estimated to affect one in seven new mothers, but researchers estimate postpartum depression isn't ever diagnosed in roughly 40 to 50 percent of cases, so the problem could be even more common.
Postpartum mental illness -- which affects one in 1,000 births -- can also be something more severe. Newspaper reports suggest postpartum psychosis likely played a role in the case of Andrea Yates, the mother who drowned her five children in a bathtub in Texas. Though Yates had not given birth shortly before she drowned her children, this story shows that mental illness can be devastating for a new mother, her newborn child and her family.
Since new mothers are especially vulnerable to mental illness inside of the first month of motherhood, doctors worry that new moms miss their best chance to be diagnosed and treated early because new moms are often at home and isolated from their doctors.
Usually, patients "come back [to the obstetrician] between two and six weeks, and that can be a little bit late," said Dr. Celia Dominguez, assistant professor of gynecology and obstetrics in the division of reproductive endocrinology and infertility at Emory University in Atlanta.
By the time the typical new mother sees her doctor again, she may have already fallen too far into a serious mental illness. "[By that time] we have totally missed the boat, " said Dominguez.
First-time dads, on the other hand, had no increased risk of being hospitalized with a psychiatric illness and were no more likely to need outpatient psychiatric therapy compared with men who had fathered children the year before.