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Mood Disorders
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Madeleine A. Becker, Tal E. Weinberger, Leigh J. Ocker
Onset of symptoms in women with postpartum psychosis is often sudden. The peak prevalence of symptom onset is between postpartum days 1 to 3 [33]. In a large retrospective study, 94% of episodes of mania or psychotic depression occurring in women with BAD I occurred within the first 4 weeks after delivery, while the onset of nonpsychotic depression was later in the postpartum period [39]. Women with bipolar disorder have a 23-fold greater risk of psychiatric admission within 30 days of delivery compared to non-postpartum women with bipolar disorder [40]. Approximately 50% of episodes of postpartum psychosis are the first manifestation of bipolar disorder; with sudden onset and precipitous worsening of symptoms [35].
Pregnancy, Delivery and Postpartum
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Zahra Ameen, Katy Kuhrt, Kopal Singhal Agarwal, Chawan Baran, Rebecca Best, Maria Garcia de Frutos, Miranda Geddes-Barton, Laura Bridle, Black Benjamin
A woman suffering from postpartum psychosis is a medical emergency and needs to be transferred to a specialist unit for medication and psychological support where possible. There is a paucity of research exploring effective treatment for this acute emergency, but expert opinion on the treatment of schizophrenia in low-resource settings states that to ensure mental wellbeing, family need to be involved in ensuring medication is taken regularly and safely; more employment, retention and education of mental health specialists needs to be encouraged; and continued efforts are needed to make medication and treatment affordable and available to all.34
Mental health issues
Published in Sheila Broderick, Ruth Cochrane, Trauma and Birth, 2020
Sheila Broderick, Ruth Cochrane
Postpartum psychosis occurs in approximately 1 in 1,000 births in the UK. It is more likely to affect woman with bipolar disorder, especially bipolar 1 disorder, characterised by having had at least one manic episode lasting a week or more. There is also a higher incidence in women who have previously had postpartum psychosis. Having said that, for many women it happens out of the blue.
Reproductive planning, vitamin knowledge and use, and lifestyle risks of women attending pregnancy care with a severe mental illness
Published in Scandinavian Journal of Primary Health Care, 2021
Jacqueline Frayne, Yvonne Hauck, Thinh Nguyen, Helena Liira, Vera A. Morgan
General Practitioners (GPs) are integral to patient management and are ideally placed within the health care system to provide reproductive planning to those with existing or new mental health diagnoses. Women of reproductive age with an established SMI diagnosis appear to have satisfactory engagement with GPs in primary care [3]. Additionally, new diagnoses can be made in the peripartum period with research suggesting that women who develop postpartum psychosis visit the GP more frequently than healthy controls [4]. Ideally reproductive planning should be undertaken early, either prior to a pregnancy or in the postpartum period for subsequent pregnancies. Not only are women with SMI at increased psychiatric risk, requiring liaison with the treating psychiatric team, they have higher rates of medical and lifestyle comorbidities than those without mental illnesses, and their care is complicated by the use of psychotropic medications in pregnancy [5,6].
Postpartum Depression in a Cohort of Post-9/11 Women Veterans: The Role of Military Stress and Trauma
Published in Military Behavioral Health, 2020
Joan L. Combellick, Allison E. Gaffey, Mary A. Driscoll, Teresa Foley, Silvia Ronzitti, James Dziura, Lori A. Bastian, Laurie C. Zephyrin, Kristin M. Mattocks, Sally G. Haskell
Depression is one of the most common disorders that women experience during the postpartum period (Gavin et al., 2005). Defined as a depressive illness following childbirth (American Psychiatric Association, 2013) postpartum depression is distinct from the rare, severe event of postpartum psychosis (Sit et al., 2006), and the more common, mild, and transient “baby blues” (Buttner et al., 2012). Prevalence estimates of postpartum depression vary due to lack of standardization in diagnostic criteria and reporting methods, however two large meta-analyses reported prevalence estimates of 13% to 19% in the U.S. general population (O'Hara & McCabe, 2013; O'Hara & Swain, 1996; Gavin et al., 2015). A systematic review of postpartum depression worldwide reported U.S. rates between 9% and 37%, depending on demographic and psychosocial characteristics (Norhayati et al., 2015; United States Preventive Services Task Force, 2018). Postpartum depression may be diagnosed within the first four weeks or up to 12 months after birth (American Psychiatric Association, 2013; Stewart & Vigod, 2016). The condition can lead to negative health consequences for both mother and baby including maternal suffering and dysfunction, marital conflict, impaired mother-baby bonding, decreased infant growth, impaired emotional, social, or cognitive development in the child, and child abuse (McLearn et al., 2006; Surkan et al., 2012; Stein et al., 2014). In rare cases, postpartum depression can lead to suicide or infanticide (Esscher et al., 2016).
Burdened parents sharing their concerns for their children with the doctor. The impact of trust in general practice: a qualitative study
Published in Scandinavian Journal of Primary Health Care, 2019
Marit Hafting, Frøydis Gullbrå, Norman Anderssen, Guri Rørtveit, Tone Smith-Sivertsen, Kirsti Malterud
An illustration of this point is a case a male GP described where the mother suffered from postpartum psychosis following the births of all of her four children. In his opinion, both parents had sparse intellectual resources. During their work with the family, the local child welfare services (CWS) sent the GP questionnaires to fill in. However, there were many questions that he was unable to answer:‘I see the children only when they have runny noses. Then the parents tell [me] how well functioning the children are. I have been there on [a] home visit once and saw that the children were jumping around like rabbits long after bedtime. The parents said this was a special situation. I cannot take any action, as far as I can see.’