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Journal articles on the topic 'Mental illness in Zimbabwe'

Author: Grafiati

Published: 4 June 2021

Last updated: 10 February 2022

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1

Patel, V., F. Gwanzura, E. Simunyu, K. Lloyd, and A. Mann. "The phenomenology and explanatory models of common mental disorder: a study in primary care in Harare, Zimbabwe." Psychological Medicine 25, no. 6 (November 1995): 1191–99. http://dx.doi.org/10.1017/s003329170003316x.

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synopsisIn order to describe the explanatory models and the etic and emic phenomena of common mental disorder in Harare, Zimbabwe, 110 subjects were selected by general nurses in three clinics and by four traditional healers from their current clients. The subjects were interviewed using the Explanatory Model Interview and the Revised Clinical Interview Schedule.Mental disorder most commonly presented with somatic symptoms, but few patients denied that their mind or soul was the source of illness. Spiritual factors were frequently cited as causes of mental illness. Subjects who were selected by traditional healer, reported a greater duration of illness and were more likely to provide a spiritual explanation for their illness.The majority of subjects were classified as ‘cases’ by the etic criteria of the CISR. Most patients, however, showed a mixture of psychiatric symptoms that did not fall clearly into a single diagnostic group. Patients from a subgroup with a spiritual model of illness were less likely to conform to etic criteria of ‘caseness’ and they may represent a unique category of psychological distress in Zimbabwe. A wide variety of emic phenomena were elicited that have been incorporated in an indigenous measure of non-psychotic mental disorder. Kufungisisa, or thinking too much, seemed to be the Shona term closest to the Euro-American concept of neurotic illness.

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2

Chawla, S., T. Buchan, and N. Galen. "Capgras Syndrome: a Case Report from Zimbabwe." British Journal of Psychiatry 151, no. 2 (August 1987): 254–56. http://dx.doi.org/10.1192/bjp.151.2.254.

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A case of Capgras syndrome in a black Zimbabwean patient is described. The syndrome occurs in the setting of a schizophrenic illness, but psychodynamic factors are readily identified despite the patient's different cultural background.

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3

Patel, V., T. Musara, T. Butau, P. Maramba, and S. Fuyane. "Concepts of mental illness and medical pluralism in Harare." Psychological Medicine 25, no. 3 (May 1995): 485–93. http://dx.doi.org/10.1017/s0033291700033407.

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SYNOPSISThe Focus Group Discussions (FGD) described in this paper are the first step of a study aiming to develop an ‘emic’ case-finding instrument. In keeping with the realities of primary care in Zimbabwe, nine FGD were held with 76 care providers including 30 village community workers, 22 traditional and faith healers (collectively referred to as traditional healers in this paper), 15 relatives of patients and 9 community psychiatric nurses. In addition to the general facets of concepts of mental illness, three ‘etic’ case vignettes were also presented.A change in behaviour or ability to care for oneself emerged as the central definition of mental illness. Both the head and the heart were regarded as playing an important role in the mediation of emotions. The types of mental illness described were intimately related to beliefs about spiritual causation. Angered ancestral spirits, evil spirits and witchcraft were seen as potent causes of mental illness. Families not only bore the burden of caring for the patient and all financial expenses involved, but were also ostracized and isolated. Both biomedical and traditional healers could help mentally ill persons by resolving different issues relating to the same illness episode. All case vignettes were recognized by the care providers in their communities though many felt that the descriptions did not reflect ‘illnesses’ but social problems and that accordingly, the treatment for these was social, rather than medical.The data enabled us to develop screening criteria for mental illness to be used by traditional healers and primary care nurses in the next stage of the study in which patients selected by these care providers on the grounds of suspicion of suffering from mental illness will be interviewed to elicit their explanatory models of illness and phenomenology.

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Patel, Vikram, Charles Todd, Mark Winston, Essie Simunyu, Fungisai Gwanzura, Wilson Acuda, and Anthony Mann. "Outcome of common mental disorders in Harare, Zimbabwe." British Journal of Psychiatry 172, no. 1 (January 1998): 53–57. http://dx.doi.org/10.1192/bjp.172.1.53.

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BackgroundLittle is known about the outcome of common mental disorders (CMD) in primary care attenders in low income countries.MethodTwo and 12 month (T1 and T2) follow-up of a cohort of cases of CMD (n=199) recruited from primary health, traditional medical practitioner, and general practitioner clinics in Harare, Zimbabwe. The Shona Symptom Questionnaire (SSQ) was the measure of caseness.ResultsThe persistence of case level morbidity was recorded in 41% of subjects at 12 months. Of the 134 subjects interviewed at both follow-up points, 49% had recovered by T1 and remained well at T2 while 28% were persistent cases at both T1 and T2. Higher SSQ scores, a psychological illness model, bereavement and disability predicted a poor outcome at both times. Poorer outcome at T1 only was associated with a causal model of witch-craft and an unhappy childhood. Caseness at follow-up was associated with disability and economic deprivation.ConclusionsA quarter of cases of CMD were likely to be ill throughout the 12 month follow-up period. Targeting risk groups for poor outcome for interventions and policy interventions to reduce the impact of economic deprivation may provide a way of tackling CMD in primary care in low income countries.

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Booysen, Marthina, Theodora Mildred Chikwanha, Vasco Chikwasha, and James January. "Knowledge and conceptualisation of mental illness among the Muslim population in Harare, Zimbabwe." Mental Health, Religion & Culture 19, no. 10 (November 25, 2016): 1086–93. http://dx.doi.org/10.1080/13674676.2017.1318120.

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6

Patel, V. "Spiritual distress: an indigenous model of nonpsychotic mental illness in primary care in Harare, Zimbabwe." Acta Psychiatrica Scandinavica 92, no. 2 (August 1995): 103–7. http://dx.doi.org/10.1111/j.1600-0447.1995.tb09551.x.

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7

Patel, Vikram. "A view from the road: experiences in four continents." Psychiatric Bulletin 18, no. 8 (August 1994): 500–502. http://dx.doi.org/10.1192/pb.18.8.500.

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Since graduating from medical school eight years ago, I have had the chance of experiencing clinical psychiatry in four countries on four continents; Bombay and Goa, India, my home, where I trained in medicine and began my psychiatric training; Oxford and London, United Kingdom, where I acquired a taste for academic psychiatry and completed my clinical training; Sydney, Australia, where I worked in a liaison unit in a large general hospital and a community mental health centre; and now, Harare, Zimbabwe, where I am conducting a two year study on traditional concepts of mental illness and the role of traditional healers and other care providers in primary mental health care.

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8

Patel, Vikram, Charles Todd, Mark Winston, Fungisai Gwanzura, Essie Simunyu, Wilson Acuda, and Anthony Mann. "Common mental disorders in primary care in Harare, Zimbabwe: Associations and risk factors." British Journal of Psychiatry 171, no. 1 (July 1997): 60–64. http://dx.doi.org/10.1192/bjp.171.1.60.

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BackgroundThis study aimed to investigate the associations for common mental disorders (CMD) among primary care attenders in Harare.MethodThis was an unmatched case-control study of attenders at primary health clinics, general practitioner surgeries and traditional medical practitioner clinics; 199 cases with CMD as identified by an indigenously developed case-finding questionnaire, and 197 controls (non-cases), were interviewed using measures of sociodemographic data, disability, care-giver diagnoses and treatment, explanatory models, life events and alcohol use.ResultsCMD was associated with female gender (.=0.04) and older age (.=0.02). After adjustment for age, gender and site of recruitment, CMD was significantly associated with chronicity of illness; number of presenting complaints; beliefs in “thinking too much” and witchcraft as a causal model; economic impoverishment; infertility; recent unemployment; an unhappy childhood for females; disability; and consultations with traditional medical practitioners and religious priests.ConclusionsMental disorders are associated with female gender, disability, economic deprivation, and indigenous labels of distress states.

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9

TODD, C., V. PATEL, E. SIMUNYU, F. GWANZURA, W. ACUDA, M. WINSTON, and A. MANN. "The onset of common mental disorders in primary care attenders in Harare, Zimbabwe." Psychological Medicine 29, no. 1 (January 1999): 97–104. http://dx.doi.org/10.1017/s0033291798007661.

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Background. This study aimed to investigate the onset and predictors of common mental disorders (CMD) in primary-care attenders in Harare, Zimbabwe.Method. Two (T1) and 12-month (T2) follow-up of a cohort of primary-care attenders without a common mental disorder (N=197) as defined by the Shona Symposium Questionnaire (SSQ), recruited from primary health care clinics, traditional medical practitioner clinics and general practitioner surgeries. Outcome measure was caseness as determined by scores on the SSQ at follow-up.Results. Follow-up rate was 86% at 2 months and 75% at 12 months. Onset of CMD was recorded in 16% at T1 and T2. Higher psychological morbidity scores at recruitment, death of a first-degree relative and disability predicted the presence of a CMD at both follow-up points. While female gender and economic difficulties predicted onset only in the short-term, belief in supernatural causation was strongly predictive of CMD at T2. Caseness at both follow-up points was associated with economic problems and disability at those follow-up points.Conclusions. Policy initiatives to reduce economic deprivation and targeting interventions to primary-care attenders who are subclinical cases and those who have been bereaved or who are disabled may reduce the onset of new cases of CMD. Closer collaboration between biomedical and traditional medical practitioners may provide avenues for developing methods of intervention for persons with supernatural illness models.

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Chidarikire, Sherphard, Merylin Cross, Isabelle Skinner, and Michelle Cleary. "Navigating Nuances of Language and Meaning: Challenges of Cross-Language Ethnography Involving Shona Speakers Living With Schizophrenia." Qualitative Health Research 28, no. 6 (February 22, 2018): 927–38. http://dx.doi.org/10.1177/1049732318758645.

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For people living with schizophrenia, their experience is personal and culturally bound. Focused ethnography enables researchers to understand people’s experiences in-context, a prerequisite to providing person-centered care. Data are gathered through observational fieldwork and in-depth interviews with cultural informants. Regardless of the culture, ethnographic research involves resolving issues of language, communication, and meaning. This article discusses the challenges faced by a bilingual, primary mental health nurse researcher when investigating the experiences of people living with schizophrenia in Zimbabwe. Bilingual understanding influenced the research questions, translation of a validated survey instrument and interview transcripts, analysis of the nuances of dialect and local idioms, and confirmation of cultural understanding. When the researcher is a bilingual cultural insider, the insights gained can be more nuanced and culturally enriched. In cross-language research, translation issues are especially challenging when it involves people with a mental illness and requires researcher experience, ethical sensitivity, and cultural awareness.

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LLOYD, K. R., K. S. JACOB, V. PATEL, L. St. LOUIS, D. BHUGRA, and A. H. MANN. "The development of the Short Explanatory Model Interview (SEMI) and its use among primary-care attenders with common mental disorders." Psychological Medicine 28, no. 5 (September 1998): 1231–37. http://dx.doi.org/10.1017/s0033291798007065.

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Background. Recent anthropological studies have documented the importance of understanding the relation of culture to the experience of mental illness. The use of interviews that elicit explanatory models has facilitated such research, but currently available interviews are lengthy and impractical for epidemiological studies. This paper is a preliminary report on the development of a brief instrument to elicit explanatory models for use in field work.Method. The development of the SEMI, a short interview to elicit explanatory models is described. The interview explores the subject's cultural background, nature of presenting problem, help-seeking behaviour, interaction with physician/healer and beliefs related to mental illness.Results. The SEMI was employed to study the explanatory models of subjects with common mental disorders among Whites, African-Caribbean and Asians living in London and was also used in Harare, Zimbabwe. Data from its use in four different ethnic groups is presented with the aim of demonstrating its capacity to show up differences in these varied settings.Conclusions. The simplicity and brevity of the SEMI allow for its use in field studies in different cultures, data can be used to provide variables for use in quantitative analysis and provide qualitative descriptions.

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12

Chigiji, Handrick, Deborah Fry, Tinashe Enock Mwadiwa, Aldo Elizalde, Noriko Izumi, Line Baago-Rasmussen, and Mary Catherine Maternowska. "Risk factors and health consequences of physical and emotional violence against children in Zimbabwe: a nationally representative survey." BMJ Global Health 3, no. 3 (June 2018): e000533. http://dx.doi.org/10.1136/bmjgh-2017-000533.

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IntroductionThis study provides, for the first time, comparable national population-based estimates that describe the nature and magnitude of physical and emotional violence during childhood in Zimbabwe.MethodsFrom August to September 2011, we conducted a national population-based survey of 2410 respondents aged 13–24 years, using a two-stage cluster sampling. Regression models were adjusted for relevant demographics to estimate the ORs for associations between violence, risk factors and various health-related outcomes.ResultsRespondents aged 18–24 years report a lifetime prevalence (before the age of 18) of 63.9% (among girls) to 76% (among boys) for physical violence by a parent or adult relative, 12.6% (girls) to 26.4% (boys) for humiliation in front of others, and 17.3% (girls) to 17.5% (boys) for feeling unwanted. Almost 50% of either sex aged 13–17 years experienced physical violence in the 12 months preceding the survey. Significant risk factors for experiencing physical violence for girls are ever experiencing emotional abuse prior to age 13, adult illness in the home, socioeconomic status and age. Boys’ risk factors include peer relationships and socioeconomic status, while caring teachers and trusted community members are protective factors. Risk factors for emotional abuse vary, including family relationships, teacher and school-level variables, socioeconomic status, and community trust and security. Emotional abuse is associated with increased suicide attempts for both boys and girls, among other health outcomes.ConclusionPhysical and emotional violence often work in tandem causing poor mental and physical health outcomes. Understanding risk factors for violence within the peer or family context is essential for improved violence prevention.

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13

Kaplan, Robert. "The Clinicide Phenomenon: An Exploration Of Medical Murder." Australasian Psychiatry 15, no. 4 (August 2007): 299–304. http://dx.doi.org/10.1080/10398560701383236.

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Objective: The aim of this paper is to explore the phenomenon of clinicide. Conclusions: The study of medical killers is barely in its infancy. Clinicide is the unnatural death of multiple patients in the course of treatment by a doctor. Serial medical killing is a relatively new phenomenon. The role model is Dr Marcel Petiot, the worst serial killer in French history. More recently, Dr Harold Shipman was Britain's worst serial killer and in the United States and Zimbabwe, Dr Michael Swango killed 60 patients. A number of doctors have such high patient death rates that it cannot be ignored. At some level, these doctors have an awareness of what they are doing, countered by an overweening refusal to acknowledge the implications or desist from further treatment. Treatment killer offences usually occur on the basis of serial mental illness, but may include the contentious area of euthanasia killing. Doctors have frequently been accomplices in state repression, brutality and genocide in direct contravention to their sanctioned role to relieve suffering and save life. They have become mass murderers on an exponential scale, making any comparison with a doctor killing his own patients almost risible. Many clinicidal doctors have extreme narcissistic personalities, a grandiose view of their own capability and inability to accept that they could be criticized or need assistance from other doctors. Such doctors develop a God-complex, getting a vicarious thrill out of ending suffering and by determining when a person dies.

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14

Mazwi, Nicola, Bongani Seremani, Tsungai Kaseke, and Clemencia Lungu. "PSYCHO-SOCIAL EXPERIENCES OF YOUTHS DURING THE COVID-19 LOCKDOWN: INSIGHTS FROM HARARE, ZIMBABWE." Business Excellence and Management S.I., no. 1 (October 15, 2020): 46–59. http://dx.doi.org/10.24818/beman/2020.s.i.1-04.

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The COVID-19 pandemic that started in Wuhan, Hubei province in China in December 2019 has brought about varied psycho-social experiences to youths during the COVID-19 lockdown period. World Health Organisation warned that the coronavirus and the restrictive measures around it would have negative effects on people’s mental health and well-being. Current scientific literature reveals that in China, UK and Spain COVID-19 outbreak resulted in symptoms leading to psychological disorders while in Africa the 2014 Ebola outbreak resulted in social and economic breakdowns in people’s livelihoods. This qualitative study made use of document analysis as a research design. WhatsApp messages were analysed using thematic analysis. The study sought to explore how youths in Harare, Zimbabwe responded to the lockdown and ways in which the lives of the youths were psychologically and socially affected. Research questions were on; how youths in Harare responded to the lockdown; how the lockdown affected the youths; in what ways the lockdown affected psychological lives of the youths and what can be done in future in order to improve the lives of youths during pandemics. The study revealed that some youths of Harare presented psychological conditions leading to PTSD symptoms such as stress, confusion, anger, anxiety and depression while some embraced COVID-19 Lockdown as it improved family and social ties. It was also noted that youths should be able to access psychological services during epidemics in order to avert surges in mental health illnesses emanating from national lockdowns.

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15

Broadhead, Jeremy, and Melanie Abas. "Depressive Illness — Zimbabwe." Tropical Doctor 24, no. 1 (January 1994): 27–30. http://dx.doi.org/10.1177/004947559402400113.

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Depression is common in the developing world and accounts for 10–20% of attendances at primary care clinics. It is a condition associated with considerable morbidity. This paper considers the characteristics of depressive illness in Zimbabwe and discusses ways to improve detection and management.

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16

Hollander, D. "Zimbabwe: MENTAL HEALTH." Lancet 328, no. 8500 (July 1986): 212–13. http://dx.doi.org/10.1016/s0140-6736(86)92504-3.

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17

Anonymous. "Mental illness = Treatable illness." Journal of Psychosocial Nursing and Mental Health Services 35, no. 5 (May 1997): 9. http://dx.doi.org/10.3928/0279-3695-19970501-03.

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18

Mangezi, Walter, and Dixon Chibanda. "Mental health in Zimbabwe." International Psychiatry 7, no. 4 (October 2010): 93–94. http://dx.doi.org/10.1192/s1749367600006032.

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Zimbabwe is a landlocked country which has recently emerged from some marked political and socio-economic challenges. Against this background, mental health has fallen down the priority list, as matters such as food shortages and the AIDS scourge have taken prece dence. Zimbabwe is in southern Africa; Zambia and Botswana lie to the north, Namibia to the west, South Africa to the south and Mozambique to the east. Its population is 11.4 million. The capital city is Harare, which has a population of 1.6 million.

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19

Wilbanks, Sandy, and Sandra Wilbanks. "Mental Illness." Journal for Nurse Practitioners 5, no. 7 (July 2009): 552. http://dx.doi.org/10.1016/j.nurpra.2009.05.011.

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20

Wilbanks, Sandy, and Sandra Wilbanks. "Mental Illness." Journal for Nurse Practitioners 5, no. 8 (September 2009): 631. http://dx.doi.org/10.1016/j.nurpra.2009.07.010.

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21

Sandison, Ronald. "Mental illness." Lancet 357, no. 9265 (April 2001): 1361. http://dx.doi.org/10.1016/s0140-6736(00)04480-9.

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22

Hyman, Steven E. "Mental Illness." Neuron 28, no. 2 (November 2000): 321–23. http://dx.doi.org/10.1016/s0896-6273(00)00110-0.

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23

Rees, Neil. "Mental Illness." International Journal of Mental Health 22, no. 4 (December 1993): 23–38. http://dx.doi.org/10.1080/00207411.1993.11449266.

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24

Lewis, Catherine F. "Mental Illness." JAMA 297, no. 1 (January 3, 2007): 94. http://dx.doi.org/10.1001/jama.297.1.94.

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25

Amerongen, Denae I., and Linda H. Cook. "Mental Illness." Journal of Christian Nursing 27, no. 2 (April 2010): 86–90. http://dx.doi.org/10.1097/cnj.0b013e3181d26050.

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26

YUKER, H. E. "Mental Illness." Science 233, no. 4766 (August 22, 1986): 830. http://dx.doi.org/10.1126/science.233.4766.830.

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27

Mlambo, Tecla, Nyaradzai Munambah, Clement Nhunzvi, and Ignicious Murambidzi. "Mental Health Services in Zimbabwe – a case of Zimbabwe National Association of Mental Health." World Federation of Occupational Therapists Bulletin 70, no. 1 (November 1, 2014): 18–21. http://dx.doi.org/10.1179/otb.2014.70.1.006.

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Ferrand, R. A., A. J. V. Maunganidze, and N. M. Mgodi. "Cryptococcal peritonitis as the first AIDS-defining illness in Zimbabwe." Tropical Doctor 36, no. 4 (October 2006): 249–50. http://dx.doi.org/10.1258/004947506778604931.

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Chapman, A. H., and Marta A. dos Reis. "Creating mental illness." Arquivos de Neuro-Psiquiatria 63, no. 1 (March 2005): 190–91. http://dx.doi.org/10.1590/s0004-282x2005000100042.

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30

Patton, Declan. "Creating Mental Illness." Journal of Advanced Nursing 51, no. 2 (July 2005): 200. http://dx.doi.org/10.1111/j.1365-2648.2005.03497_3.x.

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31

FOX, JEANNE C. "Chronic Mental Illness." Annual Review of Nursing Research 10, no. 1 (September 1992): 95–112. http://dx.doi.org/10.1891/0739-6686.10.1.95.

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32

Wirth-Cauchon, Janet, and Allan V. Horwitz. "Creating Mental Illness." Contemporary Sociology 31, no. 6 (November 2002): 785. http://dx.doi.org/10.2307/3089999.

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33

Davis, Carla. "Mental Illness Myths." AJN, American Journal of Nursing 114, no. 6 (June 2014): 10. http://dx.doi.org/10.1097/01.naj.0000450407.57067.1b.

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Subramanian, Roma. "Covering Mental Illness." Journalism Practice 8, no. 6 (January 8, 2014): 809–25. http://dx.doi.org/10.1080/17512786.2013.874723.

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Fischetti, Mark. "Mental Illness Overlap." Scientific American 319, no. 1 (June 19, 2018): 76. http://dx.doi.org/10.1038/scientificamerican0718-76.

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Martin, Andrés. "Creating Mental Illness." Journal of the American Academy of Child & Adolescent Psychiatry 42, no. 7 (July 2003): 877–78. http://dx.doi.org/10.1097/01.chi.0000046879.27264.5b.

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&NA;, &NA;. "MENTAL ILLNESS VIDEOTAPE." Family & Community Health 19, no. 3 (October 1996): 86. http://dx.doi.org/10.1097/00003727-199610000-00019.

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Angell, Beth. "Creating Mental Illness." Journal of Health Politics, Policy and Law 30, no. 3 (June 2005): 523–29. http://dx.doi.org/10.1215/03616878-30-3-523.

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Elbogen, Eric B., Paul A. Dennis, and Sally C. Johnson. "Beyond Mental Illness." Clinical Psychological Science 4, no. 5 (June 21, 2016): 747–59. http://dx.doi.org/10.1177/2167702615619363.

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Jabr, Ferris. "Redefining Mental Illness." Scientific American Mind 23, no. 2 (April 16, 2012): 28–35. http://dx.doi.org/10.1038/scientificamericanmind0512-28.

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Ericson, Karl. "Preventing Mental Illness." Journal of Humanistic Psychology 26, no. 1 (January 1986): 61–71. http://dx.doi.org/10.1177/0022167886261004.

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Kozhimannil, K. B., and H. Kim. "Maternal mental illness." Science 345, no. 6198 (August 14, 2014): 755. http://dx.doi.org/10.1126/science.1259614.

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Barratt, Ernest S., and Laura Slaughter. "Mental illness violence." Current Opinion in Psychiatry 9, no. 6 (November 1996): 393–97. http://dx.doi.org/10.1097/00001504-199611000-00005.

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Wetzler, S., and Jeanne B. Funk. "Measuring Mental Illness." Journal of Developmental & Behavioral Pediatrics 11, no. 4 (August 1990): 219???222. http://dx.doi.org/10.1097/00004703-199008000-00012.

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45

Chaiklin, Harris. "Preventing Mental Illness." Journal of Nervous and Mental Disease 179, no. 11 (November 1991): 707. http://dx.doi.org/10.1097/00005053-199111000-00020.

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46

Hensley, M. A. "Mental Illness Stigma." Social Work 51, no. 2 (April 1, 2006): 188. http://dx.doi.org/10.1093/sw/51.2.188.

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47

Plank, Richard E., and Duncan G. Labay. "Chronic Mental Illness." Journal of Nonprofit & Public Sector Marketing 1, no. 2-3 (February 24, 1993): 15–33. http://dx.doi.org/10.1300/j054v01n02_03.

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48

Horwitz, Allen V., and DIANE HAMILTON. "Creating Mental Illness." Nursing History Review 12, no. 1 (January 2004): 243–45. http://dx.doi.org/10.1891/1062-8061.12.1.243.

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TIBBITS, JOHN C. N. "MENTAL ILLNESS UNITS." Journal of the British Institute of Mental Handicap (APEX) 10, no. 2 (August 26, 2009): 56. http://dx.doi.org/10.1111/j.1468-3156.1982.tb00031.x.

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Ladd, Carrie, Nathalie A. Rodriguez McCullough, and Claudia Carmaciu. "Perinatal mental illness." InnovAiT: Education and inspiration for general practice 10, no. 11 (September 1, 2017): 653–58. http://dx.doi.org/10.1177/1755738017722171.

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Mental illness is the most common medical complication of pregnancy. The impact and prevalence are often underestimated. Depression and anxiety can occur, as at other times of life, but conditions such as postnatal psychosis and tokophobia (fear of childbirth) are specific to mental health in pregnancy and the first year after birth. In this article, we discuss the wide range of perinatal mental illness, using case histories to illustrate different presentations and evidence-based management. We also discuss the wider impact of perinatal mental illness.

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