Postpartum psychosis

Postpartum psychosis

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Postpartum psychosis
Classification and external resources
Incidence of psychoses among Swedish first-time mothers
ICD10 F53.0f50
ICD9 Template:ICD9648.4

Postpartum psychosis (or puerperal psychosis) is a term that covers a group of mental illnesses with the sudden onset of psychotic symptoms following childbirth.

A typical example is for a woman to become irritable, have extreme mood swings and hallucinations, and possibly need psychiatric hospitalization. Often, out of fear of stigma or misunderstanding, women hide their condition.[1]

In this group there are at least a dozen organic psychoses, which are described under another heading “organic pre- and postpartum psychoses“.[2] The relatively common non-organic form, still prevalent in Europe, North America and throughout the world, is sometimes called puerperal bipolar disorder, because of its close link with manic depressive (bipolar) disorder;[3] but some of these mothers have atypical symptoms (see below), which come under the heading of acute polymorphic (cycloid) psychosis (schizophreniform in the US).[4] Puerperal mania was first clearly described by the German obstetrician Osiander in 1797,[5] and a literature of over 2,000 works has accumulated since then. These psychoses are endogenous, heritable illnesses with acute onset, benign episodic course and response to mood-normalizing and mood-stabilizing treatments. The inclusion of severe postpartum depression under postpartum psychosis is controversial: many clinicians would allow this only if depression was accompanied by psychotic features (see below).

The onset is abrupt, and symptoms rapidly reach a climax of severity. Manic and acute polymorphic forms almost always start within the first 14 days, but depressive psychosis may develop somewhat later.

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