Puerperium psychosis

Question 1

What is postpartum (puerperal) psychosis?

Answer 1

Severe mental illness which develops acutely in the early postnatal period, usually within first month following delivery

Question 2

How common is puerperal psychosis?

Answer 2

Occurs in 1 in 1000 births

Question 3

When does puerperal psychosis usually present?

Answer 3

Between 2-4 weeks postpartum

Question 4

What are the risk factors for puerperal psychosis?

Answer 4

Previous thyroid disorder

Previous episode

Family history

Being unmarried

First pregnancy

C-section

Perinatal death

Question 5

Women with history of mental illness do not have an increased risk. True/false?

Answer 5

False

Women with history of mental illness have increased risk however 50% of patients have no previous history

Question 6

Clinical features of puerperium psychosis?

Answer 6

Acute sudden onset of psychotic symptoms

Manic symptoms/disinhibition

Confusion

Question 7

Management of puerperium psychosis?

Answer 7

Regarded as psychiatric emergency due to safeguarding risk - requires urgent assessment, referral and usually admission, ideally to specialist mother and baby unit.

Medication usually involves an antipsychotic and/or mood stabiliser.