Title
A review of postpartum psychosis
UMMS Affiliation
Department of Psychiatry
Publication Date
2006-05-27
Document Type
Article
Subjects
Adult; Antipsychotic Agents; Depression, Postpartum; Diagnosis, Differential; Female; Humans; Personality Disorders; Postnatal Care; Self Concept; Social Support; *Women's Health
Disciplines
Psychiatry
Abstract
OBJECTIVE: The objective is to provide an overview of the clinical features, prognosis, differential diagnosis, evaluation, and treatment of postpartum psychosis.
METHODS: The authors searched Medline (1966-2005), PsycInfo (1974-2005), Toxnet, and PubMed databases using the key words postpartum psychosis, depression, bipolar disorder, schizophrenia, organic psychosis, pharmacotherapy, psychotherapy, and electroconvulsive therapy. A clinical case is used to facilitate the discussion.
RESULTS: The onset of puerperal psychosis occurs in the first 1-4 weeks after childbirth. The data suggest that postpartum psychosis is an overt presentation of bipolar disorder that is timed to coincide with tremendous hormonal shifts after delivery. The patient develops frank psychosis, cognitive impairment, and grossly disorganized behavior that represent a complete change from previous functioning. These perturbations, in combination with lapsed insight into her illness and symptoms, can lead to devastating consequences in which the safety and well-being of the affected mother and her offspring are jeopardized. Therefore, careful and repeated assessment of the mothers' symptoms, safety, and functional capacity is imperative. Treatment is dictated by the underlying diagnosis, bipolar disorder, and guided by the symptom acuity, patient's response to past treatments, drug tolerability, and breastfeeding preference. The somatic therapies include antimanic agents, atypical antipsychotic medications, and ECT. Estrogen prophylaxis remains purely investigational.
CONCLUSIONS: The rapid and accurate diagnosis of postpartum psychosis is essential to expedite appropriate treatment and to allow for quick, full recovery, prevention of future episodes, and reduction of risk to the mother and her children and family.
DOI of Published Version
10.1089/jwh.2006.15.352
Source
J Womens Health (Larchmt). 2006 May;15(4):352-68. Link to article on publisher's site
Journal/Book/Conference Title
Journal of women's health (2002)
Related Resources
PubMed ID
16724884
Repository Citation
Sit, Dorothy; Rothschild, Anthony J.; and Wisner, Katherine L., "A review of postpartum psychosis" (2006). Psychiatry Publications and Presentations. 61.
https://escholarship.umassmed.edu/psych_pp/61
