Postpartum psychosis
| Subclass of | puerperal disorders, psychosis, mental disorder complicating pregnancy, childbirth, or the puerperium  |
|---|---|
| Facet give | women's health |
| Short name | PPP |
| Health specialty | psychiatry |
| ICD-9-CM | 648.44 |
Postpartum psychosis (PPP), dem sanso know as puerperal psychosis anaa peripartum psychosis, dey involve de abrupt onset of psychotic symptoms shortly dey follow childbirth, typically within two weeks of delivery buh less dan 4 weeks postpartum.[1] PPP be a condition currently represented under "Brief Psychotic Disorder" insyd de Diagnostic and Statistical Manual of Mental Disorders, Volume V (DSM-V).[2] Symptoms fi include delusions, hallucinations, disorganized speech (e.g., incoherent speech), den/anaa abnormal motor behavior (e.g., catatonia).[2] Oda symptoms wey frequently associate plus PPP dey include confusion, disorganized thought, severe difficulty sleeping, variations of mood disorders (wey dey include depression, agitation, mania, anaa a combination of de above), as well as cognitive features such as consciousness wey dey cam den dey go (waxing and waning) or disorientation.[1][3]
De cause of PPP currently be unknown, though growing evidence for de broad category of postpartum psychiatric disorders (e.g., postpartum depression) dey suggest hormonal den immune changes as potential factors wey dey contribute to dema onset,[4] as well as genetics and circadian rhythm disruption.[5] Der be no agreement insyd de evidence about risk factors, though na a number of studies suggest say sleep loss, first pregnancies (primiparity), den previous episodes of PPP fi play a role.[1] Na more recent reviews add to growing evidence say prior psychiatric diagnoses, especially bipolar disorder, insyd de individual anaa ein family fi raise de risk of a new-onset psychosis wey be triggered by childbirth.[1][5][6][7] Der currently be no screening anaa assessment tools available to diagnose PPP; a diagnosis for be made by de attending physician based on de patient ein presenting symptoms, wey be guided by diagnostic criteria insyd de DSM-V (see Diagnosis).[1][5]
While dem dey see PPP insyd 1 to 2 of every 1000 childbirths per,[1][3] de rapid development of psychotic symptoms, particularly those wey dey include delusions of misidentification anaa paranoia,[8] dey raise concerns give de safety of de patient den de infant; thus, PPP be considered a psychiatric emergency, usually dey require urgent hospitalization.[1][3][5] Treatment fi include medications such as benzodiazepines, lithium, den antipsychotics, as well as procedures such as electroconvulsive therapy (ECT).[1][3][5] Insyd sam cases wer na pregnant women know history of bipolar disorder anaa previous episodes of PPP, prophylactic use of medication (especially lithium) either thru out anaa immediately after delivery na dem demonstrate am to reduce de incidence of psychotic anaa bipolar episodes insyd de postpartum period.[1][3][5]
PPP no be an independently recognized diagnosis insyd de DSM-V; instead, de specifier "plus peripartum onset" be used give both "Brief psychotic disorder" den "Unspecified bipolar and related disorders."[2] Recent literature dey suggest say, more frequently, dis syndrome dey occur insyd de context of known anaa new-onset bipolar illness (spy Postpartum Bipolar Disorder).[5] Given de variety of symptoms wey be associated plus PPP, a thorough consideration of oda psychiatric den non-psychiatric (ana organic) causes for be ruled out thru a combination of diagnostic labwork den imaging, as well as clinical presentation - a non-exhaustive sample of dese oda causes be examined below (spy Organic postpartum psychoses den Other non-organic postpartum psychoses).[5]
Books dem wrep about postpartum psychosis den postpartum bipolar disorder
[edit | edit source]Na dem publish de following books about dese psychoses:
- Ripping, Dr (1877) Die Geistesstörungen der Schwangeren, Wöchnerinnen und Säugenden. Stuttgart, Enke.
- Knauer O (1897) Über Puerperale Psychose für practische Ärzte. Berlin, Karger.
- Twomey T (2009) Understanding Postpartum Psychosis: A Temporary Madness. Westport, Praeger.
- Harwood D (2017) Birth of a New Brain - Healing from Postpartum Bipolar Disorder. Brentwood, Post Hill Press.
References
[edit | edit source]- 1 2 3 4 5 6 7 8 9 Osborne LM (September 2018). "Recognizing and Managing Postpartum Psychosis: A Clinical Guide for Obstetric Providers". Obstetrics and Gynecology Clinics of North America. 45 (3): 455–468. doi:10.1016/j.ogc.2018.04.005. PMC 6174883. PMID 30092921.
- 1 2 3 American Psychiatric Association. DSM-5 Task Force (2017). Diagnostic and statistical manual of mental disorders: DSM-5 (Fifth ed.). New Delhi: American Psychiatric Association Publishing. ISBN 978-93-86217-96-7. OCLC 1030754444.
{{cite book}}: CS1 maint: numeric names: authors list (link) - 1 2 3 4 5 Rodriguez-Cabezas L, Clark C (September 2018). "Psychiatric Emergencies in Pregnancy and Postpartum". Clinical Obstetrics and Gynecology. 61 (3): 615–627. doi:10.1097/GRF.0000000000000377. PMC 6143388. PMID 29794819.
- ↑ Dye C, Lenz KM, Leuner B (2021). "Immune System Alterations and Postpartum Mental Illness: Evidence From Basic and Clinical Research". Frontiers in Global Women's Health. 2 758748. doi:10.3389/fgwh.2021.758748. PMC 8866762. PMID 35224544.
- 1 2 3 4 5 6 7 8 Hutner LA, Catapano LA, Nagle-Yang SM, Williams KE, Osborne LM, eds. (2021). Textbook of Women's Reproductive Mental Health. Washington, D.C.: American Psychiatric Association Publishing. ISBN 978-1-61537-386-4. OCLC 1289371393.
- ↑ Nguyen K, Mukona LT, Nalbandyan L, Yar N, St Fleur G, Mukona L, et al. (September 2022). "Peripartum Complications as Risk Factors for Postpartum Psychosis: A Systemic Review". Cureus. 14 (9) e29224. doi:10.7759/cureus.29224. PMC 9495292. PMID 36159350.
- ↑ Perry A, Gordon-Smith K, Jones L, Jones I (January 2021). "Phenomenology, Epidemiology and Aetiology of Postpartum Psychosis: A Review". Brain Sciences. 11 (1): 47. doi:10.3390/brainsci11010047. PMC 7824357. PMID 33406713.
- ↑ Lewis G, Blake L, Seneviratne G (September 2022). "Delusional Misidentification Syndromes in Postpartum Psychosis: A Systematic Review". Psychopathology. 56 (4): 285–294. doi:10.1159/000526129. PMID 36116435. S2CID 252341410.