Post-natal psychosis

Question 1

Puerperal psychosis - def

Answer 1

Describes a range of mood and psychotic conditions presenting in the immediate postnatal period

• Most cases are bipolar affective disorder
• Also can have severe unipolar depression, schizophrenia

Question 2

Puerperal psychosis - epi

Answer 2

0.1%

Question 3

Puerperal psychosis - RF

Answer 3

1. Personal hx bipolar affective disorder
2. Previous episode puerperal psychosis
3. 1st degree relative with bipolar affective disorder
4. 1st degree relative with hx puerperal psychosis
5. First pregnancy

Question 4

Puerperal psychosis - mx (3)

Answer 4

1. Urgent psychiatric assessment and treatment needed
2. Admission bc risks to both mother and baby (neglect as well as direct harm) - ideally admitted to specialist mother and baby unit
3. Tx according to dx (may involve antidepressant/antipsychotic medication, mood stabilisers or ECT)