User:Mr. Ibrahem/Postpartum psychosis
Medical condition / From Wikipedia, the free encyclopedia
Postpartum psychosis (PPP) involves the abrupt onset of psychotic symptoms shortly following childbirth, typically within two weeks of delivery but less than 4 weeks.[3][4] Symptoms may include seeing or smelling things that are not there (hallucinations), thoughts that are unlikely to be true (delusions), abnormally elevated mood (mania), depression, anxiety, or confusion.[1] Other symptoms may include disorganized thoughts, difficulty sleeping, and variable mood and consciousness.[3][4] There is generally little understanding of the severity of the condition by the person themselves.[4] Over half of those affected are later diagnosed with bipolar.[4]
Postpartum psychosis | |
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Other names | Puerperal psychosis, peripartum psychosis |
Rate and timing of onset of psychoses among Swedish first-time mothers | |
Specialty | Obstetrics, psychiatry |
Symptoms | Hallucinations, delusions, mood swings, confusion, restlessness, personality changes[1] |
Complications | Suicide, infanticide[2] |
Usual onset | Within 2 weeks of delivery[3] |
Duration | 1 to 12 months[2] |
Causes | Unclear[1] |
Risk factors | First pregnancies, older age, loss of sleep, personal or family history of the condition or bipolar disorder[4][3] |
Diagnostic method | Based on symptoms after ruling out other potential causes[2] |
Differential diagnosis | Normal adjustment after birth, postpartum depression, post partum bleeding, endometritis, drug intoxication, drug withdrawal, autoimmune thyroiditis, autoimmune encephalitis, postpartum obsessive-compulsive disorder[3][4] |
Treatment | Anti-psychotics, lithium, benzodiazepines, electroconvulsive therapy (ECT)[3][4] |
Frequency | 1 to 2 per 1000 childbirths[3][4] |
The cause is unknown, though may relate to hormone changes, immune system problems, and genetics.[1][4][3] Risk factors include first pregnancies, older age, loss of sleep, and a personal or family history of PPP or bipolar disorder.[4][3] Life stress does not appear to play a role, nor is evidence clear around complications of pregnancy.[2] There are no screening or assessment tools for diagnosis;[3] which is made based on the presenting symptoms, guided by criteria in the DSM-V after ruling out other potential causes.[2] In the Diagnostic and Statistical Manual of Mental Disorders, Volume V (DSM-V TR) it is under brief psychotic disorder with the specifier "peripartum onset", rather then as a separate entity.[5][2]
It is considered a psychiatric emergency requiring urgent hospitalization.[3] Treatment may include medications such as lithium, benzodiazepines, and antipsychotics, as well as the procedure electroconvulsive therapy (ECT).[3][4] In cases where a women has previously been effected lithium may be started preventatively immediately after delivery.[4] Psychotic symptoms, particularly those that include delusions of misidentification, cause safety concerns for the baby and mother;[6] with the condition resulting in the child's death in 4% of cases and a risk of suicide by the mother.[4] Divorce occurs in up to 20%.[2]
Postpartum psychosis occurs in 1 to 2 per 1000 childbirths.[3][4] Rates appear similar in different cultures and social classes.[2] More frequently, it occurs in the context of known or new-onset bipolar, known as postpartum bipolar disorder.[2] The condition has been described since 400 BC by Hippocrates.[3]