Postpartum psychiatric episodes increase women's risk for subsequent divorce, separation

Women who experienced postpartum psychiatric episodes were at increased risk for subsequent divorce or separation, according to results of a population-based cohort study published in Journal of Clinical Psychiatry.

“Earlier studies on [postpartum psychiatric episodes] have described increased marital dissatisfaction among mothers following varying degrees of postpartum depression and postpartum psychosis,” Benedicte M. W. Johannsen, MD, of the National Centre for Register-based Research at Aarhus University in Denmark, and colleagues wrote. “However, to our knowledge, no previous study has systematically investigated the probability of divorce or separation among couples affected by the broad spectrum of [postpartum psychiatric episodes]. Therefore, this study aimed to investigate and quantify the probability of subsequent divorce or separation among women suffering from either mild/moderate or severe [postpartum psychiatric episode] compared with new mothers without [postpartum psychiatric episode].”

The researchers analyzed data from national Danish registers that included all cohabitating, primiparous women with no prior psychiatric history who gave birth between 1996 and 2014 (n = 266,771). They evaluated each woman’s postpartum psychiatric episode status at 6 months postpartum and categorized them as mild/moderate (n = 4,442) if they had a psychotropic medication prescription; severe (n = 1,141) if they received psychiatric inpatient or outpatient treatment; or as none, which was the reference group. They evaluated cohabitation status up to five times.

Results showed a significantly increased risk for later divorce (adjusted HR = 1.23; 95% CI, 1.15-1.31) for women with mild/moderate postpartum psychiatric episode compared with those without it. Those categorized as severe had an even greater probability (adjusted HR = 1.64; 95% CI, 1.45-1.85).

“Within the present study, we are not able to report specific reasons for the divorces observed in the two groups of women with [postpartum psychiatric episode], and the recommendation of specific interventions is therefore not supported by our results,” Johannsen and colleagues wrote. “However, the vulnerability of the relationships affected by [postpartum psychiatric episode], demonstrated in this study, suggests that both treatment and follow-up of women with [postpartum psychiatric episode] should include a focus on the well-being of the entire family and potentially offer appropriate, unbiased information and guidance for women experiencing difficulties in their relationships following [postpartum psychiatric episode].”