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pregnancy psychosis

Ian Brockington
A study of several hundred recurrent puerperal psychoses shows that about half of those with known onset recur in the same phase of reproduction, and half have onsets in different phases. Onsets in the same phase are especially a feature of prepartum psychosis and are the strongest indication of a specific trigger operating during pregnancy. Onsets in different phases provide a prima facie case for links between 'puerperal psychosis' and other reproductive onsets. They suggest that the 'picture puzzle' is not just about early onset puerperal psychosis, but a group of related reproductive triggers...
October 17, 2016: Archives of Women's Mental Health
Ian Brockington
This article describes periodic monthly psychoses that develop during the early months of pregnancy. It is probable that these are a variety of menstrual psychosis.
October 8, 2016: Archives of Women's Mental Health
Amy McKeever, SueEllen Alderman, Stephanie Luff, Brian DeJesus
Severe and persistent mental illness (SPMI) refers to complex mood disorders that include major depressive disorder with or without psychosis; severe anxiety disorders resistant to treatment; affective psychotic disorders including bipolar affective disorder, schizophrenia, and schizoaffective disorder; and other nonaffective subtypes of schizophrenia. SPMIs affect 1 in 17 people and are among the leading causes of disability and impaired health-related quality of life in the United States. Caring for childbearing women with preexisting SPMI can be challenging for maternal-child health clinicians...
October 2016: Nursing for Women's Health
Ian Brockington
Donkin psychoses are eclamptic psychoses without seizures. As symptomatic psychoses resulting from cerebral endothelial damage, they may explain the lucid intervals that sometimes occur between eclampsia and the eruption of psychosis. They have the same features as eclamptic psychoses, with onset during pregnancy or the early puerperium, especially in first-time mothers, a short duration and full recovery in most. The clinical picture is usually delirium, but mania is also seen, and some patients have retrograde amnesia or other cognitive defects...
October 8, 2016: Archives of Women's Mental Health
Ian Brockington
It has been known since the eighteenth century that postpartum psychoses can begin several weeks after childbirth, not during the first fortnight. There are almost 400 non-organic episodes in the literature, starting more than 3 weeks after the birth; some of them are recurrent. The distinction of this disorder from early onset puerperal psychosis is supported by the distribution of onsets (which shows a steep fall after 14-15 days), survey data and the association with later pregnancies, not the first. Marcé believed that these late onsets were related to the resumption of menstruation...
October 6, 2016: Archives of Women's Mental Health
Nina Rautio, Jouko Miettunen, Erika Jääskeläinen, Tanja Nordström, Matti Isohanni, Jussi Seppälä
BACKGROUND: We examined mortality in schizophrenia spectrum disorder (SSD) and non-schizophrenic psychosis (NSSD) compared to individuals without psychosis, and whether perinatal factors predict mortality. METHODS: Within Northern Finland Birth Cohort 1966 (n=10 933; 203 with SSD, 178 with NSSD), mortality was followed until end of 2011 by national register. Wantedness of pregnancy, mother's antenatal depression, smoking and age, parity, paternal socio-economic status (SES) and family type at birth were examined as predictors of mortality...
September 27, 2016: Schizophrenia Research
Emmi Keskinen, Riikka Marttila, Heli Koivumaa-Honkanen, Kristiina Moilanen, Sirkka Keinänen-Kiukaanniemi, Markku Timonen, Matti Isohanni, John McGrath, Jouko Miettunen, Erika Jääskeläinen
AIM: To find factors that are associated with not having psychotic illness in a prospective general population sample, with a special interest in individuals with parental psychosis. METHODS: Data from the Northern Finland Birth Cohort 1966 (n = 10 458) and several registers were used to detect individuals with and without parental psychosis. Altogether, 594 persons had parent(s) with psychosis and 48 of them also had psychosis subsequently. Variables related to pregnancy and birth, family and childhood, health and habits in adolescence, school performance and physical activity were studied to identify determinants of unaffected status among individuals with and without parental psychosis...
September 13, 2016: Early Intervention in Psychiatry
Veerle Bergink, Natalie Rasgon, Katherine L Wisner
OBJECTIVE: Psychosis or mania after childbirth is a psychiatric emergency with risk for suicide and infanticide. METHOD: The authors reviewed the epidemiologic and genetic research and physiological postpartum triggers (endocrine, immunological, circadian) of psychosis. They also summarized all systematic reviews and synthesized the sparse clinical studies to provide diagnostic recommendations, treatment options, and strategies for prevention. RESULTS: The incidence of first-lifetime onset postpartum psychosis/mania from population-based register studies of psychiatric admissions varies from 0...
September 9, 2016: American Journal of Psychiatry
Laura Orsolini, Alessandro Valchera, Roberta Vecchiotti, Carmine Tomasetti, Felice Iasevoli, Michele Fornaro, Domenico De Berardis, Giampaolo Perna, Maurizio Pompili, Cesario Bellantuono
Perinatal period may pose a great challenge for the clinical management and treatment of psychiatric disorders in women. In fact, several mental illnesses can arise during pregnancy and/or following childbirth. Suicide has been considered a relatively rare event during the perinatal period. However, in some mental disorders (i.e., postpartum depression, bipolar disorder, postpartum psychosis, etc.) have been reported a higher risk of suicidal ideation, suicide attempt, or suicide. Therefore, a complete screening of mothers' mental health should also take into account thoughts of suicide and thoughts about harming infants as well...
2016: Frontiers in Psychiatry
K P Singh, Manoj K Singh, Shrikant Gautam
For clinical management of different forms of psychosis, both classical and atypical anti-psychotic drugs (APDs) are available. These drugs are widely prescribed, even during pregnancy considering their minimal extra-pyramidal side effects and teratogenic potential compared to classical APDs. Among AAPDs, risperidone (RIS) is a first-line drug of choice by physicians. The molecular weight of RIS is 410.49 g/mol; hence, it can easily cross the placental barrier and enter the foetal bloodstream. It is not known whether or not AAPDs like RIS may affect the developing placenta and foetus adversely...
April 2016: International Journal of Experimental Pathology
Chittaranjan Andrade
Cannabis is popularly believed to be a relatively benign substance. Cannabis is also considered to have potential medical benefits, and medical marijuana has been legislated in many parts of the world. However, a recent meta-analysis found that cannabinoids were associated with only modest benefits for chemotherapy-related nausea and vomiting, small and inconsistent benefits for pain and spasticity, and inconclusive benefits for other indications such as improvement of appetite and weight, reduction in tic severity, and improvement of mood or sleep...
May 2016: Journal of Clinical Psychiatry
K P Singh, Manoj Kr Singh, Manish Singh
A tremendous increase has been documented in the recent past in prescribing second generation atypical antipsychotic drugs (AAPDs) to the pregnant women with psychosis, considering their reproductive and teratogenic safety. Among AAPDs, risperidone (RIS) ranked third after olanzapine (OLZ) and quetiapine (QUE) used during pregnancy, as OLZ is associated to substantial weight gain in adults and offspring. Although teratogenic safety of RIS has been established, its potential role in developmental neurotoxicity and related neurobehavioral impairments in adolescents has not been documented so far...
August 2016: International Journal of Developmental Neuroscience
Robert Langan, Andrew J Goodbred
Peripartum depression affects up to one in seven women and is associated with significant maternal and neonatal morbidity if untreated. A history of depression is the strongest risk factor for developing peripartum depression. The U.S. Preventive Services Task Force recommends screening pregnant and postpartum women for depression. Both two-step and one-step screening strategies are effective in identifying peripartum depression. Peripartum depression should be distinguished from the baby blues, which is characterized by short duration, mild symptoms, and minimal impact on functioning...
May 15, 2016: American Family Physician
Clare L Taylor, Leontien M van Ravesteyn, Mijke P Lambregtse van denBerg, Robert J Stewart, Louise M Howard
Women with severe mental illness are at increased risk of suicide in the perinatal period, and these suicides are often preceded by self-harm, but little is known about self-harm and its correlates in this population. This study aimed to investigate the prevalence of suicidal ideation and self-harm, and its correlates, in women with psychotic disorders and bipolar disorder during pregnancy. Historical cohort study using de-identified secondary mental healthcare records linked with national maternity data. Women pregnant from 2007 to 2011, with ICD-10 diagnoses of schizophrenia and related disorders, bipolar disorder or other affective psychoses were identified...
October 2016: Archives of Women's Mental Health
Catherine Winsper, Dieter Wolke, Alex Bryson, Andrew Thompson, Swaran P Singh
BACKGROUND: Recently, school mobility was identified as a risk factor for psychotic symptoms in early adolescence. The extent to which this risk continues into late adolescence and the trajectories via which this risk manifests remain unexplored. METHODS: Psychotic symptoms in 4,720 adolescents aged 18 were ascertained by trained psychologists using the Psychosis-Like Symptoms Interview. Mothers reported on sociodemographic factors (i.e., family adversity, ethnicity and urbanicity) from pregnancy to 4 years; child's involvement in bullying at age 6-7 years; residential mobility at 11 years and school mobility at 11-12 years...
August 2016: Journal of Child Psychology and Psychiatry, and Allied Disciplines
M Colombel, C Rebillard, C Nathou, S Dollfus
INTRODUCTION: Puerperal psychosis (PP) is a psychiatric disorder that occurs in 1 out of 1000 pregnancies. Well known since antiquity, its symptoms have often been described in mothers, but few studies have successfully investigated a related disorder in fathers. The characteristic of this pathology is more related to its appearance than to its semiological description which is why its nosographic place is always discussed. The objective here is to focus on the definition of PP and to suggest an entity for both genders...
August 2016: L'Encéphale
Irene Petersen, Rachel L McCrea, Cormac J Sammon, David P J Osborn, Stephen J Evans, Phillip J Cowen, Nick Freemantle, Irwin Nazareth
BACKGROUND: Although many women treated with psychotropic medication become pregnant, no psychotropic medication has been licensed for use in pregnancy. This leaves women and their health-care professionals in a treatment dilemma, as they need to balance the health of the woman with that of the unborn child. The aim of this project was to investigate the risks and benefits of psychotropic medication in women treated for psychosis who become pregnant. OBJECTIVE(S): (1) To provide a descriptive account of psychotropic medication prescribed before pregnancy, during pregnancy and up to 15 months after delivery in UK primary care from 1995 to 2012; (2) to identify risk factors predictive of discontinuation and restarting of lithium (multiple manufacturers), anticonvulsant mood stabilisers and antipsychotic medication; (3) to examine the extent to which pregnancy is a determinant for discontinuation of psychotropic medication; (4) to examine prevalence of records suggestive of adverse mental health, deterioration or relapse 18 months before and during pregnancy, and up to 15 months after delivery; and (5) to estimate absolute and relative risks of adverse maternal and child outcomes of psychotropic treatment in pregnancy...
March 2016: Health Technology Assessment: HTA
Sean J OʼHalloran, Antonia Wong, David A Joyce
BACKGROUND: Amisulpride is a second generation atypical antipsychotic drug. The management of psychosis exacerbation in late pregnancy or during lactation is often hampered by inadequate knowledge of risk to the baby from placental transfer or breast milk transfer of drugs. There is no specific information on adverse effects from amisulpride. To gather guiding information from one mother-baby pair, we conducted a drug concentration study on the fourth post-natal day and developed a novel liquid chromatography-tandem mass spectrometry method with application to the very small plasma volumes obtainable from a neonate, requiring 15 μL of plasma, and with application to human breast milk...
August 2016: Therapeutic Drug Monitoring
S Filatova, R Marttila, H Koivumaa-Honkanen, T Nordström, J Veijola, P Mäki, G M Khandaker, M Isohanni, E Jääskeläinen, K Moilanen, J Miettunen
AIMS: Few studies have compared time trends for the incidence of psychosis. To date, the results have been inconsistent, showing a decline, an increase or no significant change. As far as we know, no studies explored changes in prevalence of early risk factors. The aim of this study was to investigate differences in early risk factors and cumulative incidences of psychosis by type of psychosis in two comparable birth cohorts. METHODS: The Northern Finland Birth cohorts (NFBCs) 1966 (N = 12 058) and 1986 (N = 9432) are prospective general population-based cohorts with the children followed since mother's mid-pregnancy...
March 28, 2016: Epidemiology and Psychiatric Sciences
Nina Rautio, Juha Käkelä, Tanja Nordström, Jouko Miettunen, Sirkka Keinänen-Kiukaanniemi, Leena Ala-Mursula, Jaro Karppinen, Matti Penttilä, Erika Jääskeläinen
BACKGROUND: Little is known about whether factors during the first years of life predict later outcomes in schizophrenia spectrum disorder (SSD). As part of the Northern Finland Birth Cohort 1966, we examined if prospectively collected early parenthood-related and developmental factors predict employment and hospitalization in individuals with and without SSD. METHODS: Overall, 161 individuals with SSD and 10,116 without SSD were included in the study. Outcomes were analysed at age of 44-45years, defining "employment" as being employed for at least 25% of working days and "hospitalization" as having psychiatric hospitalization at least once during the last two years of follow-up...
May 2016: Schizophrenia Research
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