Postpartum (Puerperal) Psychosis

Severe mental illness which develops acutely in the early postnatal period, usually within the first month following delivery

Aetiology

  • About 1 in 1,000 births, presents between 2-4 weeks postpartum
  • Risk factors include: previous thyroid disorder, previous episode, family history, being unmarried, first pregnancy, c-section and perinatal death
  • Women with a history of mental illness are at increased risk, but 50% of patients do not have any previous history

Clinical presentation

  • Characterised by acute sudden onset of psychotic symptoms, manic symptoms/disinhibition, confusion

Management

  • It is a psychiatric emergency due to safeguarding risks - requires urgent assessment, referral, and usually admission, ideally to a specialist mother and baby unit
  • Medication usually involves an antipsychotic and/or mood stabiliser