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Learning Objectives
How common is it?
It occurs in every 0.89-2.6 per 1000 births (Madora et al., 2023)
When is it typically seen?
Difference between Postpartum Psychosis and Depression
What is Postpartum Psychosis?
- Mania
- Psychosis
- Psychotic Depression
- Mixed affective state
-(Madora et al., 2023)
Bio
Psycho
post burth
Social
Symptoms
Depressive Symptoms
Manic Symptoms
Kleiman, K. (2022). Therapy and the Postpartum Woman: Notes on Healing Postpartum Depression for Clinicians and the Women Who Seek their Help (1st ed.). Routledge. https://doi.org/10.4324/9781003248477
Nall, R. (2018). Depressive psychosis: Causes, symptoms, and diagnosis. Healthline.https://www.healthline.com/health/depression/major-depression-with-psychotic-features
Important Considerations
Diagnosis
Criteria for
Diagnosis
(American Psychiatric Association, 2013)
1. Mania/mixed episodes with or without
psychotic symptoms
2. Depression with psychotic features
3. Psychosis without mood symptoms
Lab Work
Bergink et al., 2016)
Family usually 1st to notice changes
(Timms, 2018)
(Timms, 2018)
Doula
Treatment Options
Pharmacotherapy
ECT
Early Psychosis Intevention
Services they provide:
Role of the Nurse
At EPI
Assessment
Client/family education
Group
Support
Case
Management
Medication
Management
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Bergink, V., Rasgon, N., & Wisner, K. L. (2016). Postpartum psychosis: Madness, mania, and melancholia in motherhood. American Journal of Psychiatry, 173(12), 1179–1188. https://doi.org/10.1176/appi.ajp.2016.16040454
Doucet, S., Dennis, C. L., Letourneau, N. & Blackmore, E. R. (2009). Differentiation and clinical implications of postpartum depression and postpartum psychosis. Journal of Obstetrics, Gynecology, & Neonatal Nursing, 38(3), 269-279. https://doi.org/10.1111/j.1552-6909.2009.01019.x.
Edinoff, A. N., Sathivadivel, N., McNeil, S. E., Ly, A. I., Kweon, J., Kelkar, N., Cornett, E. M., Kaye, A. M., & Kaye, A. D. (2022). Antipsychotic Use in Pregnancy: Patient Mental Health Challenges, Teratogenicity, Pregnancy Complications, and Postnatal Risks. Neurology international, 14(1), 62–74. https://doi.org/10.3390/neurolint14010005
Friedman, S. H., Reed, E., & Ross, N. E. (2023). Postpartum psychosis. Current Psychiatry Reports, 25(2), 65–72. https://doi.org/10.1007/s11920-022-01406-4
Gordon-Smith, K., Perry, A., Di Florio, A., Forty, L., Fraser, C., Casanova Dias, M., Warne, N., MacDonald, T., Craddock, N., Jones, L., & Jones, I. (2020). Symptom profile of postpartum and non-postpartum manic episodes in bipolar I disorder: a within-subjects study. Psychiatry research, 284, 112748. https://doi.org/10.1016/j.psychres.2020.112748
Grover, S., Sahoo, S., Chakrabarti, S., Basu, D., Singh, S. M., & Avasthi, A. (2018). ECT in the Postpartum Period: A Retrospective Case Series from a Tertiary Health Care Center in India. Indian journal of psychological medicine, 40(6), 562–567. https://doi.org/10.4103/IJPSYM.IJPSYM_105_18
Jairaj, C., Seneviratne, G., Bergink, V., Sommer, I. E., & Dazzan, P. (2023). Postpartum psychosis: A proposed treatment algorithm. Journal of Psychopharmacology (Oxford, England), 37(10), 960–970. doi:10.1177/02698811231181573
Kleiman, K. R. (2022). Therapy and the postpartum woman: notes on healing postpartum depression for clinicians and the... women who seek their help. ROUTLEDGE. https://doi.org/10.4324/9781003248477
Madora, M. J., Knopf, H. S., Prakash, M., Kim, J., Medavaram, M. R. & Vaughn, R. L. (2023). Postpartum psychosis or something else? The Primary Care Companion for CNS Disorders, 25(1). https://doi.org/10.4088/PCC.22nr03269
Nall, R. (2018). Depressive psychosis: Causes, symptoms, and diagnosis. Healthline.https://www.healthline.com/health/depression/major-depression-with-psychotic-features
Postpartum Support International. (n.d.). Postpartum psychosis. https://www.postpartum.net/learn-more/postpartum-psychosis/
Sobczak, A., Taylor, L., Solomon, S., Ho, J., Kemper, S., Phillips, B., Jacobson, K., Castellano, C., Ring, A., Castellano, B., & Jacobs, R. J. (2023). The Effect of Doulas on Maternal and Birth Outcomes: A Scoping Review. Cureus, 15(5), e39451. https://doi.org/10.7759/cureus.39451
Rommel, A. S., Molenaar, N. M., Gilden, J., Kushner, S. A., Westerbeek, N. J., Kamperman, A. M. & Bergink, V. (2021). Long-term outcome of postpartum psychosis: A prospective clinical cohort study in 106 women. International Journal of Bipolar Disorders, 9(31), 1-10. https://doi.org/10.1186/s40345-021-00236-2
Royal College of Psychiatrists. (2018). Postpartum psychosis. https://www.rcpsych.ac.uk/mental-health/mental-illnesses-and-mental-health-problems/postpartum-psychosis#:~:text=Postpartum%20psychosis%20(or%20puerperal%20psychosis,1%2D2
Spinelli, M. (2021). Postpartum psychosis: A diagnosis for the DSMV. Archives of Women’s Mental Health, 24(5), 817–822. https://doi.org/10.1007/s00737-021-01175-8
Steven L. D., Biswarup M. G., Jordan C. S., & Victoria C. Psychotic Depression: Diagnosis, Differential Diagnosis, and Treatment. Psychother Psychosom 13 April 2021; 90 (3): 160–177. https://doi.org/10.1159/000511348
Timms, P. (Ed.). (2018, November). Postpartum psychosis for carers: Royal College of Psychiatrists. www.rcpsych.ac.uk. https://www.rcpsych.ac.uk/mental-health/mental-illnesses-and-mental-health-problems/postpartum-psychosis-in-carers
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