First lifetime psychiatric admission in the postpartum period: A population-based comparison to women with prior psychiatric admission

Objectives: To better understand women with a first lifetime psychiatric hospitalization in the postpartum period. Methods: We included all 1071 postpartum women in Ontario, Canada, with a psychiatric admission in the 1-year postpartum (2007-2012). We compared women with their first lifetime psychiatric admission to those with any prior psychiatric admission on demographic and clinical characteristics and on mental health physician visits, psychiatric emergency department (ED) revisits and psychiatric readmission within 1-year postdischarge. Results: Compared to women with prior admission, women with a first lifetime admission (n=537, 59%) were less likely to have psychotic disorders (14% vs. 25%) and had shorter lengths of stay (13.6+/-12.7 vs. 18.9+/-27.8 days). Women with prior admission were at higher risk for ED revisits (44% vs. 32%, odds ratio=1.63, 95% confidence interval=1.26-2.09) and readmissions (32% vs. 24%, odds ratio=1.82, 95% confidence interval=1.39-2.38) by 1-year postdischarge versus women with first lifetime admission; differences were explained by clinical factors. Conclusions: Although women with a first lifetime psychiatric admission postpartum have a favorable clinical course up to 1 year after index admission versus women with any prior admission, 25% are readmitted with 1-year postdischarge, underscoring need for attention to this group. (C) 2016 Elsevier Inc. All rights reserved.