partum psychosis

A previously healthy 36-year-old woman presented with visual hallucinations and acute psychosis manifested predominantly as hypersexuality. Laboratory testing demonstrated elevated free thyroxine levels, suppressed thyroid-stimulating hormone levels and presence of thyroid-stimulating immunoglobulin and thyroid peroxidase (TPO) antibodies consistent with Graves' disease. Despite achieving biochemical euthyroidism, she remained profoundly hypersexual. She did not respond to additional treatment with antipsychotics and corticosteroids, prompting further evaluation...

The perinatal period is associated with an increased risk of severe mental disorders. We summarise the evidence regarding the epidemiology, risk factors, and treatment of severe mental illness in relation to childbirth, focusing on bipolar disorder, affective psychosis, and schizophrenia. We discuss women with ongoing chronic conditions and those with the onset of new episodes of post-partum psychosis. Despite the importance of perinatal episodes, with suicide a leading cause of maternal death, few studies are available to guide the management of women with severe mental disorders in pregnancy and the post-partum period...

The transition to motherhood involves CNS changes that modify sociability and affective state. However, these changes also put females at risk for post-partum depression and psychosis, which impairs parenting abilities and adversely affects children. Thus, changes in expression and interactions in a core subset of genes may be critical for emergence of a healthy maternal phenotype, but inappropriate changes of the same genes could put women at risk for post-partum disorders. This study evaluated microarray gene expression changes in medial prefrontal cortex (mPFC), a region implicated in both maternal behavior and psychiatric disorders...

Post-partum depression (PPD) belongs to the depressive spectrum consecutive to a pregnancy. It is important to detect it as soon as possible to avoid non-negligible consequences for the mother, the new born and close relatives. It some cases, PPD may give way to post-partum psychosis, a psychiatric emergency. The present study splits 88 women in two groups, within days of delivery, as a function of their score at the Edinburgh postnatal Depression Scale (EPDS), an internationally validated scale which predicts future episodes of PPD...

BACKGROUND: Anaesthetists need to know the different causes of persistent headache or a change in level of consciousness following epidural analgesia for labour. Failure to recognise these neurological complications can lead to delayed diagnoses, with subsequent serious implications. METHODS: We present a patient who was re-admitted for postural headache resulting from an unrecognised dural puncture during an epidural for pain relief while in labour. During the interview, the patient confirmed drug use (cocaine), so she was evaluated by a psychiatrist with possible post-partum psychosis or drug withdrawal syndrome...

The post-partum period represents a time during which all maternal organisms undergo substantial plasticity in a wide variety of systems in order to ensure the well-being of the offspring. Although this time is generally associated with increased calmness and decreased stress responses, for a substantial subset of mothers, this period represents a time of particular risk for the onset of psychiatric disorders. Thus, post-partum anxiety, depression and, to a lesser extent, psychosis may develop, and not only affect the well-being of the mother but also place at risk the long-term health of the infant...

An incorrect, superficial suckling technique in breastfeeding frequently leads to milk congestion and sometimes mastitis. In the present study we have examined whether milk congestion may affect levels of the atypical opioid β-casomorphin-8 in milk and in plasma. We also investigated whether the rate of acute psychosis during the first half year after parturition has declined in Sweden over the years. Milk and plasma samples were collected for peptide analysis from 14 women with mastitis and 10 controls. We found that in a group of 14 late cases of mastitis (median 48 days post partum) the detected mean level of β-casomorphin-8 in milk was significantly higher and somewhat higher in plasma at the acute stage compared with 2-3 weeks later, after recovery when the symptoms had disappeared, as well as compared to the control subjects...

Gamma (γ) oscillations (30-120 Hz), an emergent property of neuronal networks, correlate with memory, cognition and encoding. In the hippocampal CA3 region, locally generated γ oscillations emerge through feedback between inhibitory parvalbumin-positive basket cells (PV+BCs) and the principal (pyramidal) cells. PV+BCs express δ-subunit-containing GABA(A)Rs (δ-GABA(A)Rs) and NMDA receptors (NMDA-Rs) that balance the frequency of γ oscillations. Neuroactive steroids (NS), such as the progesterone-derived (3α,5α)-3-hydroxy-pregnan-20-one (allopregnanolone; ALLO), modulate the expression of δ-GABA(A)Rs and the tonic conductance they mediate...

100 consecutive out patients with onset of Psychiatric illness within 40 days of child birth were studied by using Indian Psychiatric Interview Schedule and a specially designed Proforma. It was found that post partum psychiatric syndromes occurred most frequently in patients less than 25 years of age. Stress of Physical illness was present in a considerably high number of patients (74%). In 66% the Psychiatric illness was associated with first child birth and risk of Puerperal Psychosis in subsequent deliveries was found to be 32%...

INTRODUCTION: Hypertensive syndromes in pregnancy are one of the leading causes of obstetric admissions into intensive care units. They are related to changes in the central nervous system caused by a decrease in cerebral perfusion pressure, indicated by an increase in intracranial pressure. These changes in pressure usually result from acute injuries or a decrease in the mean arterial pressure due to iatrogenic action or shock. However, other vascular disorders may contribute to similar occurrences...

The study comprises of 34 cases, who developed psychiatric illness following childbirth. The diagnostic breakup reveals that 50% cases were of schizophrenia, 35.4% of affective disorder, 11.7% of organic confusional state and 2.9% of hysteria. Age of the patients ranged from 17 to 35 years, average being 24.2 years. 20.5% cases gave history of psychiatric illness in 1st degree relatives. All cases of organic psychosis, 41.6% of the affective disorder and 29.4% of the schizophrenia group had one or more of the physical complications during pregnancy, around delivery or during post-partum period...

A perinatal obsessive-compulsive disorder (OCD) is defined as an illness exhibiting first symptoms in the context of pregnancy and the postpartal period. There are no valid data up to date concerning the incidence of OCD, which might be of multifactorial origin, in this period in which females are highly vulnerable for psychiatric diseases. From a clinical point of view, obsessions and compulsions are mainly related to the well-being of the foetus or newborn baby. Differential diagnosis of perinatal OCD including pregnancy psychosis and post-partum depression is often difficult...

A case of recurrent pre and postpartum psychosis is described. Pre-partum psychosis was more severe in intensity when compared with postpartum psychosis and, if untreated, it may have continued as postpartum psychosis. Presence of bipolar affective illness in the family, ongoing stressor and unplanned pregnancy may be the risk factors for developing pregnancy- related psychosis. This case report also adds weight to the proposition that puerperal psychosis might occur in late pregnancy also.

The concept of nursing presence has been widely used in nursing and is a significant component of nursing practice. In order to increase our understanding of nursing presence, it needs to be studied in different contexts. In this study, a secondary analysis of interviews with 10 registered psychiatric nurses (RPN) in Sweden was conducted to explore nurses' descriptions of presence when caring for women with post-partum psychosis (PPP). Based on the research question: 'How do RPN describe nursing presence in the context of caring for women with PPP?' content analysis was used to analyze the data...

Recent data has highlighted the association of a bipolar disorder (BD) with an increased risk of post-partum psychosis and depression. It is suggested that genetic- and environmental-induced decrease in the levels of melatonin in BD contributes to post-partum disorders. Melatonin may also have some efficacy in the treatment of BD, especially in decreasing the side-effects associated with lithium and the neuroleptics. It is proposed that the optimization of melatonin levels, perhaps in conjunction with optimized vitamin D3 level, would decrease post-partum psychosis and depression associated with BD...

Olanzapine (OLNZ) and risperidone (RISP), two widely prescribed drugs for post-partum psychosis, transfer through milk to the neonates. Hence, neonates are susceptible to their adverse side effects. In the present study, the pituitary-testicular axis of lactationally exposed mice neonates (PND 28) was examined to evaluate the reproductive adverse effects. Testicular histopathology, immunocytochemistry and morphometric analysis of pituitary PRL (prolactin) and LH (luteinizing hormone) cells and plasma hormonal (PRL, LH and testosterone) levels were the various end points studied...

Whilst cerebral vascular disease and mental illness in the post-partum period are well recognised, their co-existence and the concept of organic psychoses in pregnancy, parturition and the puerperium remains poorly appreciated (Brockington 2006; Brockington Arch Women's Ment Health 10: 177-178, 2007a; Brockington Arch Women's Ment Health 10: 305-306, b). We report a woman who was referred to the Medical team on-call with a mixed presentation of euphoria, mutism and aggressive behaviour but ultimately demonstrated to have a transverse sinus thrombosis and recovered well with anti-coagulation...

There is general agreement that DSM-IV and ICD-10 require major improvements in format and content to make them more valid, evidence-based and clinically useful. DSM-IV-TR currently includes a series of clinical features that provide potentially useful information on cross-sectional and longitudinal courses of bipolar disorder. This conceptual and data-driven review proposes changes in the current classification by removing, modifying and adding bipolar episode and course specifiers in DSM-V. Specifiers to be maintained would be 'with catatonic features', 'with melancholic features', 'with atypical features' and 'with rapid cycling'...

Close similarities in the courses of multiple sclerosis and schizophrenia laid the theoretical ground for attempting to find a common infectious aetiology for the two diseases. Chlamydia pneumoniae, which belongs to the rickettsial family of microorganisms has been linked to both diseases. It is postulated that since rickettsial microorganisms are ubiquitous in human populations they and the human species normally live in peaceful coexistence. In rare cases, for unknown reasons, varieties of them may become aggressive and pathogenic...

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