The postpartum (PP) period is a common time for the emergence or exacerbation of psychiatric disorders. Postpartum blues, PP depression, and PP psychosis are 3 of the most common psychiatric disorders experienced in the PP period. Although both genders are affected, PP is more common in women. Postpartum blues and PP depression affect up to 80% and 25% of women, respectively. Postpartum psychosis is less common but can be more serious. Unfortunately, perinatal mental illness is largely underdiagnosed and undertreated. Diagnosis is clinical, and management typically involves psychotherapy Psychotherapy Psychotherapy is interpersonal treatment based on the understanding of psychological principles and mechanisms of mental disease. The treatment approach is often individualized, depending on the psychiatric condition(s) or circumstance. Psychotherapy and antidepressants. Antipsychotics are used in the management of PP psychosis.
Last updated: Mar 29, 2023
The American Psychiatric Association (APA)’s Diagnostic and Statistical Manual 5th Edition (DSM-V) currently:
According to the DSM-V, to use the “with peripartum onset” modifier, the onset of symptoms must occur during pregnancy Pregnancy The status during which female mammals carry their developing young (embryos or fetuses) in utero before birth, beginning from fertilization to birth. Pregnancy: Diagnosis, Physiology, and Care or within 4 weeks PP (rather than within 1 year, which is commonly considered in clinical practice).
The exact mechanisms are unclear and often multifactorial.
There are a number of validated screening Screening Preoperative Care questionnaires that can help identify patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship with or at risk for PP psychiatric disorders. Some of the most common questionnaires include:
Postpartum depression is a clinical diagnosis. The following information may assist in establishing the diagnosis:
Symptoms are similar to those of non-obstetric psychosis. The presenting symptoms are often severe, interfere with daily activities, and require hospitalization Hospitalization The confinement of a patient in a hospital. Delirium.
According to the DSM-V, PP psychosis is not recognized as a distinct disorder. Instead, PP is classified as a primary psychiatric disorder and given the modifier “with peripartum onset” if symptoms begin within 4 weeks of delivery.
Postpartum psychosis is considered a psychiatric emergency.
|PP blues||PP depression||PP psychosis|
|Epidemiology||50%–80% of pregnancies||10%–25% of pregnancies||< 1% of pregnancies|
|Common symptoms||Guilt, crying, feeling of being overwhelmed||Inability to cope, disinterest in self, disinterest in infant||Visual or auditory hallucinations Hallucinations Subjectively experienced sensations in the absence of an appropriate stimulus, but which are regarded by the individual as real. They may be of organic origin or associated with mental disorders. Schizophrenia|
|Onset||Birth to 2 weeks PP||2 weeks to 1 year after delivery||Days to 1 year after delivery|
|Treatment||Resolves spontaneously||Psychotherapy Psychotherapy Psychotherapy is interpersonal treatment based on the understanding of psychological principles and mechanisms of mental disease. The treatment approach is often individualized, depending on the psychiatric condition(s) or circumstance. Psychotherapy, antidepressants||Antipsychotics|
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