Materiały źródłowe

• #1 Postpartum Psychosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK544304/

  With an estimated global prevalence of 0.089 to 2.6 per 1000 births, postpartum psychosis classifies as an illness with a low incidence rate. However, it carries the potential for serious medical and social consequences, including the risk of suicide and filicide, if not promptly detected and treated. […] While first-time pregnancies in women with a history of affective mood disorders, specifically bipolar one disorder are considered the single most important risk factor, almost fifty percent of cases reported in first-time mothers are without any previous psychiatric hospitalization history. Moreover, observation shows that the latter group of patients had nearly ten times higher incidence rate during the first couple of months postpartum. […] Other factors like advanced maternal age and low birth weight of the baby (less than one hundred fifty grams) are also considered possible contributing factors while maternal diabetes and high birth weight of the baby (more than four thousand five hundred grams) appear to be protective against puerperal psychosis in first-time mothers during the first ninety days. Negative pregnancy and birthing outcomes like congenital malformations, preterm birth (less than thirty-two weeks), and fetal/infant death also increase the risk of psychoses and major depressive disorders in not just first-time mothers but in all mothers.

• #2

  https://link.springer.com/article/10.1007/s11920-022-01406-4

  Postpartum psychosis is a psychiatric emergency that can affect the health and life of mothers, infants, and families. […] We therefore sought to review the latest research findings about PPP with the intention of updating readers about the latest evidence base. […] Risk assessment and treatment should include consideration of the woman patient but also the mother-infant dyad and the larger family. […] It is our hope that this review of research updates in postpartum psychosis may inform clinical practice and promote specialized, evidence-based diagnosis, risk assessment, and treatment. […] This systematic review synthesized qualitative research regarding mothers and families experiences of PPP, finding themes and sub-themes across studies of 103 mothers and 42 family members.

• #3 Postpartum psychosis: Epidemiology, clinical features, and diagnosis – UpToDate

  https://www.uptodate.com/contents/postpartum-psychosis-epidemiology-pathogenesis-clinical-manifestations-course-assessment-and-diagnosis

  Postpartum psychosis (or puerperal psychosis) is most often seen in patients that have been or will be diagnosed with bipolar disorder but can also occur in women with a major depression with psychosis, schizophrenia, or schizoaffective disorder. […] The epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis of postpartum psychosis are reviewed here. […] The clinical picture of postpartum psychosis includes rapid onset of psychotic symptoms including hallucinations and delusions, bizarre behavior, confusion, and disorganization that may appear to be delirium.

• #4 Tragic or Treated: Why We Cannot Miss Postpartum Psychosis

  https://www.psychiatrictimes.com/view/tragic-or-treated-why-we-cannot-miss-postpartum-psychosis

  It is critical not to miss the diagnosis of postpartum psychosis. […] Postpartum psychosis, across cultures, occurs in about 1 to 2 per thousand new mothers. […] Symptoms of postpartum psychosis often present in the first couple weeks postpartum, though they can also appear later in the postpartum year—such as when hormonal changes occur with cessation of breastfeeding. […] The risk of infanticide and of suicide without treatment is quite high—estimated at up to 1 in 20 untreated mothers. […] Mothers experiencing postpartum psychosis need identification and urgent treatment, due to these elevated risks. […] Most require psychiatric hospitalization for a period of stabilization. […] Postpartum psychosis is listed in the ICD (as puerperal psychosis F53.1), but is not specified in the DSM.

• #5 Perinatal depression and psychosis: an update | BJPsych Advances | Cambridge Core

  https://www.cambridge.org/core/journals/bjpsych-advances/article/perinatal-depression-and-psychosis-an-update/A6B207CDBC64D3D7A295D9E44B5F1C5A

  Around 50% of women who experience postpartum psychosis start to develop symptoms on days 1-3, with 22% of those showing symptoms as early as day 1. […] Munk-Olsen’s group also found that the risk of admission was increased in the first 3 months and was highest for first-time mothers 10-19 days postpartum. […] The prognosis of an acute episode is generally good, with most women making a good recovery and returning to premorbid levels of functioning. […] The Scottish Intercollegiate Guidelines Network (2012) recommends that all pregnant women be asked about personal history of postpartum psychosis, other psychotic disorders (especially bipolar affective disorder and schizophrenia) and severe depressive disorder. […] Women at high risk of perinatal mental illness should have a detailed plan for their late pregnancy and early postnatal psychiatric management. […] It is important to be vigilant for symptoms of mental illness during both pregnancy and the postpartum period: about half of episodes of so-called postnatal depression start during pregnancy, and some seemingly postpartum psychotic episodes start before delivery.

• #6 The global prevalence of postpartum psychosis: a systematic review | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1427-7

  Mental health is a significant contributor to global burden of disease and the consequences of perinatal psychiatric morbidity can be substantial. We aimed to obtain global estimates of puerperal psychosis prevalence based on population-based samples and to understand how postpartum psychosis is assessed and captured among included studies. […] Five studies reported incidence of puerperal psychosis (ranging from 0.89 to 2.6 in 1000 women) and one reported prevalence of psychosis (5 in 1000). […] This review confirms the relatively low rate of puerperal psychosis; yet given the potential for serious consequences, this morbidity is significant from a global public health perspective. […] The most frequently cited prevalence of puerperal psychosis is 12 per 1000 childbirths. […] The reported incidence of perinatal psychosis among our included studies ranged from 0.89 to 2.6 in 1000 women, aligning with the commonly reported prevalence rate of 12 per 1000.

• #7 The global prevalence of postpartum psychosis: a systematic review | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1427-7

  Our review found that post-partum psychosis incidence ranged between 0.89 and 2.6 in 1000 births across several countries, and one study reported prevalence to be 5 in 1000 births. […] However, due to the wide variation in definitions and assessments used to capture cases of postpartum psychosis, it was not possible to pool data and make a summary estimate. […] Although this systematic review confirms the relatively low rate of puerperal psychosis, given the potential for serious consequences associated with puerperal psychosis, even a low rate becomes a significant public health issue from a global perspective.

• #8 Tragic or Treated: Why We Cannot Miss Postpartum Psychosis

  https://www.psychiatrictimes.com/view/tragic-or-treated-why-we-cannot-miss-postpartum-psychosis

  Postpartum psychosis affects 1-2 per thousand new mothers, with symptoms often appearing within weeks postpartum. […] The condition is not included in the DSM, leading to underdiagnosis and inadequate treatment. […] Proper identification and urgent treatment, including hospitalization and medication, are crucial to prevent serious outcomes. […] Awareness and education among psychiatrists are essential to improve diagnosis and treatment, preventing tragedies. […] Postpartum psychosis occurs in about 1 to 2 per thousand new mothers. […] Maternal mental health issues are the most common complication of childbirth, and postpartum psychosis—the most severe among them—has been recognized as a possible complication of childbirth for millennia. […] Postpartum psychosis is linked to the most serious of mental health outcomes, both suicide and infanticide when untreated.

• #9 Tragic or Treated: Why We Cannot Miss Postpartum Psychosis

  https://www.psychiatrictimes.com/view/tragic-or-treated-why-we-cannot-miss-postpartum-psychosis

  It is critical not to miss the diagnosis of postpartum psychosis. […] Postpartum psychosis, across cultures, occurs in about 1 to 2 per thousand new mothers. […] Symptoms of postpartum psychosis often present in the first couple weeks postpartum, though they can also appear later in the postpartum year—such as when hormonal changes occur with cessation of breastfeeding. […] The risk of infanticide and of suicide without treatment is quite high—estimated at up to 1 in 20 untreated mothers. […] Mothers experiencing postpartum psychosis need identification and urgent treatment, due to these elevated risks. […] Most require psychiatric hospitalization for a period of stabilization. […] Postpartum psychosis is listed in the ICD (as puerperal psychosis F53.1), but is not specified in the DSM.

• #10 An update on the presentation, nosology, and causes of postpartum psychosis

  https://www.contemporaryobgyn.net/view/an-update-on-the-presentation-nosology-and-causes-of-postpartum-psychosis

  Postpartum psychosis is experienced by 1 to 2 women every 1000 deliveries. […] Postpartum psychosis (PP) is an umbrella term for the impairing and isolating psychotic-mood symptoms experienced by a small proportion of women (1 to 2 women every 1000 deliveries) shortly after childbirth. […] The condition is regarded as a psychiatric emergency and is associated with an increased risk of maternal suicide and infanticide. […] Besides a previous episode of PP, by far the largest risk factor for the condition is an existing diagnosis of bipolar disorder particularly bipolar I disorder. Between 20% and 40% of individuals with bipolar I disorder who give birth will experience PP. […] Current diagnostic classification systems do not recognize PP as an entity in its own right, but rather as a variant or subform of other mood-psychotic conditions.

• #11 Phenomenology, Epidemiology and Aetiology of Postpartum Psychosis: A Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7824357/

  Postpartum psychoses are a severe form of postnatal mood disorders, affecting 12 in every 1000 deliveries. […] While childbirth appears to be a potent trigger of severe mood disorders, the precise mechanisms by which postpartum psychosis occurs are poorly understood. […] In a seminal study conducted in a UK population sample, the risk of psychiatric admission for a psychotic or mood illness was 22 times greater in the first month following delivery compared to before pregnancy. […] Evidence robustly indicates a strong and specific relationship with bipolar disorder, suggesting that in most cases, postpartum psychosis may be a manifestation of bipolar disorder in women vulnerable to the puerperal trigger. […] A recent meta-analysis estimated that as many as one in five women with bipolar disorder are affected postnatally by a psychotic or manic episode, a rate considerable higher than that observed in the general population (12 in every 1000 deliveries) and other psychiatric disorders.

• #12 Postpartum Psychosis | Article | GLOWM

  https://www.glowm.com/article/heading/vol-7–maternal-mental-health-in-pregnancy–postpartum-psychosis/id/411363

  Postpartum psychosis is a severe episode of mental illness, with an acute onset occurring in women in the postpartum period. It constitutes some of the most severe forms of pregnancy related psychiatric illness and has a clear onset, days or weeks after childbirth. The prevalence of postpartum psychosis is in the region of 12 : 1000 births. Episodes of postpartum psychosis can be the first presentation of psychiatric illness and recur only following subsequent pregnancies or they can happen in the context of serious mental illness such as bipolar disorder with episodes also occurring unrelated to childbirth. Women with history of bipolar disorder have a 20% risk of experiencing postpartum psychosis. The risk of recurrence of postpartum psychosis in future pregnancies is also high. A meta-analysis estimated recurrence of postpartum psychosis to be 29% for women with a diagnosis of postpartum psychosis (outside the context of bipolar) and 17% for those with a diagnosis of bipolar disorder. Although postpartum psychosis prevalence is 12 : 1000 births, there are groups at higher risk.

• #13 Phenomenology, epidemiology and aetiology of postpartum psychosis: a review -ORCA

  https://orca.cardiff.ac.uk/id/eprint/140347/

  Postpartum psychoses are a severe form of postnatal mood disorders, affecting 12 in every 1000 deliveries. […] While childbirth appears to be a potent trigger of severe mood disorders, the precise mechanisms by which postpartum psychosis occurs are poorly understood. […] Prediction models, informed by prospective cohort studies of high-risk women, are required to identify those at greatest risk of postpartum psychosis.

• #14 Postpartum psychosis – Wikipedia

  https://en.wikipedia.org/wiki/Postpartum_psychosis

  PPP is rare, reported to occur in about 1 to 2 of every 1000 childbirths (0.9 to 2.6 per 1,000). […] Reported cases are thought to underestimate the actual occurrence of PPP due to the probability of some individuals avoiding hospitalized care to avoid separation from their child (particularly in locations with no mother-baby units) or fear of stigma, as well as the likelihood of misdiagnosis with other postpartum disorders. […] The first month following childbirth is associated with a higher relative risk for hospital admission due to psychosis when compared to other times in an individual’s life. […] While no specific genetic factors have been linked to PPP, a family history or personal history of bipolar disorder has been strongly associated with higher risk for PPP episodes.

• #15 Phenomenology, Epidemiology and Aetiology of Postpartum Psychosis: A Review

  https://www.mdpi.com/2076-3425/11/1/47

  Postpartum psychoses are a severe form of postnatal mood disorders, affecting 1–2 in every 1000 deliveries. […] In a seminal study conducted in a UK population sample, the risk of psychiatric admission for a psychotic or mood illness was 22 times greater in the first month following delivery compared to before pregnancy. […] While more than 40% of women affected by postpartum psychosis have no history of severe psychiatric illness, the remainder present with a recurrence of a pre-existing psychiatric illness, predominantly of a psychotic or mood disorder. […] Evidence robustly indicates a strong and specific relationship with bipolar disorder, suggesting that in most cases, postpartum psychosis may be a manifestation of bipolar disorder in women vulnerable to the puerperal trigger. […] A recent meta-analysis estimated that as many as one in five women with bipolar disorder are affected postnatally by a psychotic or manic episode, a rate considerably higher than that observed in the general population (1–2 in every 1000 deliveries) and other psychiatric disorders.

• #16 Perinatal depression and psychosis: an update | BJPsych Advances | Cambridge Core

  https://www.cambridge.org/core/journals/bjpsych-advances/article/perinatal-depression-and-psychosis-an-update/A6B207CDBC64D3D7A295D9E44B5F1C5A

  About 85% of women experience some type of postpartum mood disturbance. […] However, 10-15% of women have clinically significant symptoms of depression or anxiety. […] During the postpartum period, about 85% of women experience some type of mood disturbance. […] A quarter of a century ago, Kendell and colleagues demonstrated that women experience a dramatic increase in their risk of developing severe mental illness in the first 3 months after delivery. […] Kendell demonstrated that, in the 3 months following childbirth, women are more than 20 times more likely to be admitted to hospital with a diagnosis of a psychotic disorder than at any other time in their lives. […] Postpartum psychosis is the most severe form of perinatal psychiatric illness. It is a rare event that occurs in approximately 1-2 women per 1000 after childbirth.

• #17 Perinatal depression and psychosis: an update | BJPsych Advances | Cambridge Core

  https://www.cambridge.org/core/journals/bjpsych-advances/article/perinatal-depression-and-psychosis-an-update/A6B207CDBC64D3D7A295D9E44B5F1C5A

  Around 50% of women who experience postpartum psychosis start to develop symptoms on days 1-3, with 22% of those showing symptoms as early as day 1. […] Munk-Olsen’s group also found that the risk of admission was increased in the first 3 months and was highest for first-time mothers 10-19 days postpartum. […] The prognosis of an acute episode is generally good, with most women making a good recovery and returning to premorbid levels of functioning. […] The Scottish Intercollegiate Guidelines Network (2012) recommends that all pregnant women be asked about personal history of postpartum psychosis, other psychotic disorders (especially bipolar affective disorder and schizophrenia) and severe depressive disorder. […] Women at high risk of perinatal mental illness should have a detailed plan for their late pregnancy and early postnatal psychiatric management. […] It is important to be vigilant for symptoms of mental illness during both pregnancy and the postpartum period: about half of episodes of so-called postnatal depression start during pregnancy, and some seemingly postpartum psychotic episodes start before delivery.

• #18 Postpartum Psychosis – PsychDB

  https://www.psychdb.com/psychosis/z-postpartum

  The single strongest risk factor for PPP is a personal history of bipolar disorder. Around 20-30% of parous women with diagnosed bipolar disorder experience PPP. […] Interestingly, however, only 1/3 of women who present with PPP will have a prior psychiatric history. Regardless, the association of PPP with bipolar disorder is so strong that it should be considered a bipolar diagnosis until proven otherwise. […] Other studies have found a higher risk for PPP in primiparous (first pregnancy) women. […] The onset of PPP is typically sudden, and usually occurs within the first 2 weeks postpartum. […] PPP is considered a psychiatric emergency, and requires immediate hospitalization and treatment.

• #19 What Is Postpartum Psychosis? Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/postpartum-psychosis/guide/

  Postpartum psychosis is a rare but severe mental health condition that some people experience soon after giving birth. […] Postpartum psychosis is not recognized as a stand-alone diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). As a result, many cases may go unreported or underdiagnosed, and researchers are currently working on changing this. […] Postpartum psychosis is a rare condition, affecting 1 or 2 of every 1,000 new mothers after giving birth. […] Having bipolar disorder raises the risk of postpartum psychosis quite significantly. According to some estimates, 1 in 5 women with bipolar disorder have postpartum psychosis or mania. […] Women with a family history of related conditions are at a higher risk. Specifically, 40 to 50 percent of women who had postpartum psychosis have a first- or second-degree relative with a mood disorder.

• #20 Phenomenology, Epidemiology and Aetiology of Postpartum Psychosis: A Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7824357/

  In contrast, the risk of psychiatric admission for a recurrence of bipolar disorder in the postpartum period is especially high, being 37 times more likely than in women who had never given birth. […] This finding has since been replicated in a more recent study, showing psychiatric admissions within the first 6 weeks of childbirth to most commonly be for a severe recurrence of bipolar disorder (14.4%), while other psychiatric disorders accounted for a considerably lower proportion of all admissions (ranging from 1.4 to 7.2%).

• #21 Phenomenology, Epidemiology and Aetiology of Postpartum Psychosis: A Review

  https://www.mdpi.com/2076-3425/11/1/47

  In contrast, the risk of psychiatric admission for a recurrence of bipolar disorder in the postpartum period is especially high, being 37 times more likely than in women who had never given birth. […] This finding has since been replicated in a more recent study, showing psychiatric admissions within the first 6 weeks of childbirth to most commonly be for a severe recurrence of bipolar disorder (14.4%), while other psychiatric disorders accounted for a considerably lower proportion of all admissions (ranging from 1.4 to 7.2%).

• #22 Postpartum Psychosis | Article | GLOWM

  https://www.glowm.com/article/heading/vol-7–maternal-mental-health-in-pregnancy–postpartum-psychosis/id/411363

  The strongest clinical risk factors are a history of bipolar disorder or previous postpartum psychosis. The risk is higher for bipolar disorder type I than type II. A number of obstetric factors have been linked to postpartum psychosis: primiparity, cesarean section and preterm birth; and prolonged labor due to the failure to descend/progress. […] Identifying those at high risk is a key consideration in the management of postpartum psychosis. Women with bipolar disorder and of childbearing age should be made aware of the risks of relapse associated with pregnancy. This should be discussed with them by their treating psychiatrist at standard psychiatric reviews as the majority of pregnancies are unplanned. Women with previous history of postpartum psychosis need to be aware of the higher risks and plan accordingly.

• #23 Psychiatric Conditions Surrounding Pregnancy | InfantRisk Center

  https://www.infantrisk.com/content/psychiatric-conditions-surrounding-pregnancy

  Postpartum psychosis is the most serious of the postpartum disorders which occurs in 1-2 per 1000 delivers and may develop within 30 days postpartum. Symptoms often include severe agitation, restlessness, disorientation and confusion. Delusions about the baby and fantasies about harming ones self or the baby may also be present. […] Postpartum psychosis is relatively rare, particularly in comparison to postpartum blues and postpartum depression. Hospitalization for psychosis is increased during the first month postpartum as compared to any other time in a woman’s life. Approximately half of these episodes were a first psychotic episode, while the others had a prior history for psychosis. The risk factors for postpartum psychosis include history of puerperal psychosis, history of bipolar disorder, family history of puerperal psychosis, first pregnancy, and recent discontinuation of lithium or other mood stabilizers. Postpartum psychosis can be dangerous because of the risk of suicide and/or infanticide. Psychiatric hospitalization is nearly always required, as is treatment with antipsychotic or other psychopharmacologic medications.

• #24 Postpartum Psychosis | Doctor

  https://patient.info/doctor/postpartum-psychosis-pro

  Postpartum psychosis occurs following 1-2 per 1,000 deliveries. Women have a higher risk of psychosis in the few weeks following childbirth than at any other time in their lives. Incidence is significantly increased in women with a history of hospitalisation for psychiatric illness, especially where the past history was related to pregnancy. Women with a family history of postpartum psychosis have been found to have a six-fold increased risk themselves. This is even higher if they have a first-degree relative with bipolar disorder. […] Suicide and psychiatric conditions are known to be significant leading causes of late maternal death in the UK, and awareness of mental health problems in pregnancy and the postnatal period is vital.

• #25 Postpartum Psychosis – A Comprehensive Review

  https://psychscenehub.com/psychinsights/postpartum-psychosis-review/

  PPP typically presents in the first two weeks (1-14 days) after childbirth as either acute mania or depression, with psychosis. [Kendell et al., 1987] […] PPP should be distinguished from postnatal depression (PND), which is more common (10-15%). While both can be equally serious, differentiating the two is essential due to treatment implications. Postpartum depression refers to a nonpsychotic depressive episode, while postpartum psychosis refers to a manic or affective psychotic episode linked temporally with childbirth. […] PPP usually occurs in around 1–2 of every 1000 deliveries. […] The risk of requiring psychiatric admission for postnatal psychosis increases to around 22 times more likely in the first month postnatally. […] The risk for primiparous mothers (those who have given birth to their first baby) was 35 times higher than in the general population. [Kendell et al.,1987]

• #26 Can We Identify Women at High Risk for Postpartum Psychosis? – MGH Center for Women’s Mental Health

  https://womensmentalhealth.org/posts/can-we-identify-women-at-high-risk-for-postpartum-psychosis/

  Postpartum psychosis is rare, occurring in about 1 to 2 per 1000 women after delivery. […] A recent study, using data from the Swedish Medical Birth Registry, has examined possible risk factors that may be used to identify women at risk for postpartum psychosis. […] The authors found that 892 of these women (1.2 per 1,000 births) had been admitted to a psychiatric hospital with a diagnosis of psychosis within the first 90 days postpartum, a rate which is consistent with previous epidemiologic studies. […] This study is the largest to date to examine the risk factors for postpartum psychosis. […] It was estimated that women without any previous psychiatric hospitalizations before delivery had a ten-fold higher risk of psychiatric hospitalization during the first month postpartum compared to after 90 days postpartum.

• #27 An update on the presentation, nosology, and causes of postpartum psychosis

  https://www.contemporaryobgyn.net/view/an-update-on-the-presentation-nosology-and-causes-of-postpartum-psychosis

  In terms of demographics, postpartum psychiatric symptom risk may be greater in younger mothers and in primiparous individuals (ie, those having their first child); however, this latter finding may be confounded by mitigating measures being put in place after a first PP episode. […] There is strong reason to believe that PP risk is, in part, determined by biological factors: The prevalence and manifestations of the condition are similar across countries and cultures, and the condition is tightly linked to childbirth and its associated biological changes. […] Identifying and characterizing the biological features that underlie PP risk through increased collaborative endeavors and novel experimental approaches is important for 3 main reasons: It will clarify the extent to which PP overlaps with, or is distinct from, other psychiatric and medical conditions.

• #28 An Update on the Presentation, Nosology, and Causes of Postpartum Psychosis

  https://www.contemporarypediatrics.com/view/update-on-presentation-nosology-causes-postpartum-psychosis

  In terms of demographics, postpartum psychiatric symptom risk may be greater in younger mothers and in primiparous individuals (ie, those having their first child). […] There is strong reason to believe that PP risk is, in part, determined by biological factors: The prevalence and manifestations of the condition are similar across countries and cultures, and the condition is tightly linked to childbirth and its associated biological changes. […] Identifying and characterizing the biological features that underlie PP risk through increased collaborative endeavors and novel experimental approaches is important for 3 main reasons: It will clarify the extent to which PP overlaps with, or is distinct from, other psychiatric and medical conditions. […] Maternal physiology changes significantly throughout pregnancy and into the postpartum period, notably with respect to immune function and circulating sex hormones.

• #29

  https://link.springer.com/article/10.1007/s00737-023-01347-8

  Postpartum psychosis is a psychiatric emergency that is currently not represented in diagnostic systems, to the detriment of people with lived experience. […] There is a paucity of reports on stakeholders engagement in psychiatry. […] Postpartum psychosis is a severe postnatal mental illness, reported to affect around 12 for every 1000 childbirths worldwide (Perry et al. 2021), yet it is currently unrecognised by diagnostic systems. […] The lack of an official recognition and standardised diagnosis has hindered research, in turn preventing improvements in early intervention and standards of care for women and their families (Di Florio et al. 2016). […] Limited evidence suggests that service user-led research provides rich data in areas rarely researched in such detail. […] Research into postpartum psychosis, particularly within LMICs, has been impeded by an absence of appropriate assessment tools, consistent diagnostic guidelines and reproducible results.

• #30 Tragic or Treated: Why We Cannot Miss Postpartum Psychosis

  https://www.psychiatrictimes.com/view/tragic-or-treated-why-we-cannot-miss-postpartum-psychosis

  Not having a name in the DSM means limitations on study and research about the disorder. […] Its absence there also means postpartum psychosis is often not in curricula. […] In turn, psychiatrists and trainees struggling to learn the major mental disorders often do not prioritize understanding the illness—despite its significant risks. […] Regardless of whether postpartum psychosis is in the DSM or not, psychiatrists need to be aware of the condition and able to recognize and diagnose it. […] A large percentage of general psychiatry patients are women of reproductive age, and as noted above, postpartum psychosis can strike those who have no mental health history—and rapidly evolve. […] With knowledge, psychiatrists can recognize this highly treatable illness, and prevent tragedies by acting quickly.

• #31 An Update on the Presentation, Nosology, and Causes of Postpartum Psychosis

  https://www.contemporarypediatrics.com/view/update-on-presentation-nosology-causes-postpartum-psychosis

  Postpartum psychosis is experienced by 1 to 2 women every 1000 deliveries. […] Postpartum psychosis (PP) is an umbrella term for the impairing and isolating psychotic-mood symptoms experienced by a small proportion of women (1 to 2 women every 1000 deliveries) shortly after childbirth. […] The condition is regarded as a psychiatric emergency and is associated with an increased risk of maternal suicide and infanticide. […] Besides a previous episode of PP, by far the largest risk factor for the condition is an existing diagnosis of bipolar disorder particularly bipolar I disorder. Between 20% and 40% of individuals with bipolar I disorder who give birth will experience PP. […] Current diagnostic classification systems do not recognize PP as an entity in its own right, but rather as a variant or subform of other mood-psychotic conditions.

• #32 An update on the presentation, nosology, and causes of postpartum psychosis

  https://www.contemporaryobgyn.net/view/an-update-on-the-presentation-nosology-and-causes-of-postpartum-psychosis

  Although immunological and neuroimaging markers associated with PP may be confounded by environmental exposures (eg, the patients comorbid medical conditions, demographics, or treatment), genetic factors associated with PP are stable; their impact upon disorder risk is not complicated by reverse causation issues. […] An insightful new study has used a genetics-based approach to provide evidence that first-onset PP may be biologically dissociable from bipolar disorder and therefore may represent a separate nosological entity within the bipolar disorder spectrum.

• #33 An Update on the Presentation, Nosology, and Causes of Postpartum Psychosis

  https://www.contemporarypediatrics.com/view/update-on-presentation-nosology-causes-postpartum-psychosis

  The results of multiple recent studies have suggested that in individuals with PP, this final inflammatory phase is exaggerated potentially, in part, as a consequence of altered activity, or number, of immunosuppressive regulatory T-cells (Tregs). […] The immediate postpartum period sees precipitous drops in circulating estrogen and progesterone levels in the new mother following expulsion of the placenta. […] Although immunological and neuroimaging markers associated with PP may be confounded by environmental exposures, genetic factors associated with PP are stable; their impact upon disorder risk is not complicated by reverse causation issues. […] An insightful new study has used a genetics-based approach to provide evidence that first-onset PP may be biologically dissociable from bipolar disorder and therefore may represent a separate nosological entity within the bipolar disorder spectrum.

• #34 Postpartum Psychosis: Updates and Clinical Issues

  https://www.psychiatrictimes.com/view/postpartum-psychosis-updates-and-clinical-issues

  The authors focus on the epidemiology of postpartum psychosis, its clinical presentation, etiology, treatment, and strategies to prevent its recurrence. […] The prevalence of postpartum psychosis in the general population is 0.1% to 0.2%, which is significantly lower than the prevalence of postpartum blues (50% to 75%) and postpartum depression (10% to 13%).1 Postpartum psychosis is one of the rarest psychiatric disorders, yet it is almost always considered a psychiatric emergency because of the rapid onset of severe maternal symptoms and the potential for a catastrophic outcome, such as infanticide or suicide. […] Once a woman has had an episode of postpartum psychosis, the risk of recurrence after a subsequent pregnancy can exceed 50%.5 […] Studies have suggested that postpartum psychosis may be a variant of bipolar disorder and that hormonal and other physiological changes in the perinatal period may play an important role in its development. […] Lithium has been effective in decreasing relapse rates after subsequent pregnancies, although it is not clear if lithium should be restarted during pregnancy or immediately postpartum.

• #35 Postpartum Psychosis – PsychDB

  https://www.psychdb.com/psychosis/z-postpartum

  Postpartum psychosis is a perinatal mental disorder that begins exclusively after childbirth. It is a disorder linked closely with postpartum depression. […] PPP affects affects 1-2 per 1,000 women. […] The prognosis for patients with PPP is somewhat poor. Follow up studies up to 10 years later have shown that up to 40% of the women had not retained full working capacity due to ongoing psychiatric symptoms. […] Recurrent episodes of psychosis are also common, both postpartum and non-puerperal psychosis (not pregnancy-related). Postpartum psychosis is associated with high rates of both suicide and infanticide. […] Once a woman has had a postpartum episode with psychotic features, the risk of recurrence with each subsequent delivery is between 30% and 50%. […] PPP has a clear biological trigger caused by childbirth.

• #36 Postpartum psychosis – NHS

  https://www.nhs.uk/mental-health/conditions/post-partum-psychosis/

  Postpartum psychosis is a serious mental health illness that can affect someone soon after having a baby. It affects around 1 in 1,000 mothers after giving birth. […] Postpartum psychosis is a serious mental illness that should be treated as a medical emergency. It can get worse rapidly and the illness can risk the safety of the mother and baby. […] If you’re at high risk of developing postpartum psychosis, you should have specialist care during or before pregnancy and be seen by a perinatal psychiatrist. […] An episode of postpartum psychosis is sometimes followed by a period of depression, anxiety and low confidence. It might take a while for you to come to terms with what happened. […] Many people who’ve had postpartum psychosis go on to have more children. Although there is about a 1 in 2 chance you will have another episode after a future pregnancy, you should be able to get help quickly with the right care and the risks can be reduced with appropriate interventions.

• #37

  https://link.springer.com/article/10.1007/s00737-023-01347-8

  To date, the literature on stakeholder perspectives of postpartum psychosis has been limited. […] Key outcomes included the knowledge that postpartum psychosis presents comparably across countries with similar symptoms and characteristics, despite differences in labelling, conceptualisation, service provision and approaches to mental health. […] Major differences in provision, access to services and approaches to care emerged not only between countries, but also within each country, making reproducible research particularly challenging. […] The need to include stakeholders in healthcare research has been highlighted consistently across all three countries.

• #38 Spotlight on perinatal mental health at RCM’s national conference – Royal College of Midwives

  https://rcm.org.uk/news/2025/05/rcm-conference-puts-the-spotlight-on-perinatal-mental-health-to-provide-support-when-its-needed-most/

  With more women needing mental health support during pregnancy and in the postnatal period, the Royal College of Midwives (RCM) is putting perinatal mental health in the spotlight at its 2025 Conference. […] The RCM has long raised the need for better perinatal mental health support, with investment not only in services, but also the midwives that provide them. […] Janet Fyle, who leads on perinatal health at the RCM, said: “Perinatal mental health issues affect one in five women, but services remain inconsistent across the UK. This isn’t about the baby blues: that downplays the very real struggles that women experience during pregnancy and in the postpartum period. […] With suicide one of the biggest causes of death among women during pregnancy or in the six-month postpartum, this should be a key priority for policymakers.”

• #39 Spotlight on perinatal mental health at RCM’s national conference – Royal College of Midwives

  https://rcm.org.uk/news/2025/05/rcm-conference-puts-the-spotlight-on-perinatal-mental-health-to-provide-support-when-its-needed-most/

  In one of the sessions, midwives and maternity support workers from across the UK will hear from Professor Heather O’Mahen, a clinical psychologist from the University of Exeter and National Clinical Advisor and postpartum psychosis awareness campaigner, Chris Wasley. The session aims to confront gaps in mental health care provision for women before and after birth.

• #40 Postpartum psychosis: beyond the baby blues and postpartum depression – Evidence-Based Nursing blog

  https://blogs.bmj.com/ebn/2021/05/23/postpartum-psychosis-beyond-the-baby-blues-and-postpartum-depression/

  In this latest blog in our spotlight on maternal mental health Dr Amy Perry, Research Psychologist from the Mood Disorders Research Group, University of Worcester, provides an overview of postpartum psychosis. […] Most women and healthcare professionals are familiar with the concepts of the ‘baby blues’ and postpartum depression, both are which are common in the postpartum period (affecting between 50-80% and 10-15% women respectively). However, comparatively less is known about postpartum psychosis. […] Recent research also shows that midwives and other related healthcare professionals frequently cite lack of knowledge and training in identifying cases of postpartum psychosis compared to other forms of perinatal mental illness. […] Postpartum psychosis occurs in 1-2 in every 1000 deliveries in the general population and it is estimated that for more than 40% of women affected, is the first episode of psychiatric illness experienced.

• #41 A Review of Postpartum Psychosis (2021)

  https://www.mghp3.org/post/a-review-of-postpartum-psychosis-2021

  Postpartum psychosis is a severe psychiatric illness requiring emergency medical attention, occurring in about one delivery out of every thousand. […] The postpartum period is a time of exceptionally high psychiatric risk, with one study finding the risk of psychiatric hospitalization twenty-two times higher in the first month postpartum versus during pregnancy. The relative risk for first-time mothers was even greater at thirty-five times over the risk during pregnancy. […] While postpartum psychosis is relatively rare in the general population as described, there is a very strong association between bipolar disorder and postpartum psychosis. Nearly 20% of women with pre-existing bipolar illness go on to develop symptoms of postpartum psychosis after delivery. […] Mothers who have experienced postpartum psychosis are at high risk of future illness, with roughly half experiencing perinatal affective illness in future pregnancies. The risk of developing severe mood or psychotic symptoms is particularly high in mothers with bipolar I disorder. […] The relative rarity of postpartum psychosis complicates efforts to clearly define its diagnostic features, describe its associated risk factors, and elucidate its underlying causes, as these require study of large numbers of patients.

• #42 Postpartum Psychosis: could chronic insomnia or short sleep be protective? | medRxiv

  https://www.medrxiv.org/content/10.1101/2024.12.13.24319005v1.full-text

  Postpartum Psychosis (PP) is a severe and understudied perinatal mental illness which disproportionately affects women with bipolar disorder (BD). […] A relationship between sleep disturbance and PP is often assumed, but is poorly understood. […] Higher PRS for insomnia and short sleep were protective against PP. […] Individuals in the lowest decile for insomnia PRS had approximately double the risk of PP than individuals in the highest decile. […] BD, schizophrenia, long sleep and sleep efficiency PRS were not associated with PP. […] Individuals with genetic vulnerability to insomnia or short sleep may develop a heightened tolerance to sleep disruption earlier in life, mitigating the impact of childbirth on mood. […] These findings suggest that genetic susceptibility to sleep disturbance may play a crucial role in the aetiology of PP, offering a new potential avenue for risk stratification and targeted prevention.

• #43 Postpartum Psychosis: could chronic insomnia or short sleep be protective? | medRxiv

  https://www.medrxiv.org/content/10.1101/2024.12.13.24319005v1.full-text

  Improved prediction of PP is essential to facilitate early intervention and mitigate its impact on maternal, child and public health. […] We demonstrate that individuals with BD who develop PP may have a lower genetic propensity for insomnia and short sleep. […] These findings suggest that genetic vulnerability to sleep disturbance plays a critical role in the aetiology of PP, highlighting the importance of assessing individual sleep history in perinatal psychiatric risk.

• #44 Genetic risk scores for major psychiatric disorders and the risk of postpartum psychiatric disorders | Translational Psychiatry

  https://www.nature.com/articles/s41398-019-0629-9

  Genetic risk score for MD significantly predicted postpartum psychiatric disorders as well as psychiatric disorders at any time point. […] A 10-decile increase in MD GRS was associated with an increased risk of postpartum psychiatric disorders (OR: 1.73, 95% CI: 1.46-2.05), in both women with no personal psychiatric history (OR: 1.88, 95% CI: 1.26-2.81) and women with personal psychiatric history (OR: 1.44, 95% CI: 1.19-1.74). […] We found no associations between GRS for BD and postpartum psychiatric disorders, either overall or stratified by psychiatric history. […] There was a slight association between GRS for SCZ and postpartum psychiatric disorders overall. […] In a large sample of women who had given birth, we found that genetic risk score for lifetime MD was associated with postpartum psychiatric episodes in both women with no psychiatric history and women with psychiatric history. […] Our findings demonstrate that although GRS is not yet appropriate as a clinical tool, genetic information about the risk of lifetime psychiatric illness can reasonably be applied to the postpartum period in the research setting.

• #45 Postpartum Depression: Overview, Risk Factors for Postpartum Mood Disorders, Screening for Postpartum Mood Disorders

  https://emedicine.medscape.com/article/271662-overview

  Postpartum psychosis is the most severe form of postpartum psychiatric illness. The condition is rare, occurring in approximately 1-2 per 1000 women after childbirth. At highest risk are women with a personal history of bipolar disorder or a previous episode of postpartum psychosis. […] Postpartum psychosis has a dramatic onset, emerging as early as the first 48-72 hours after delivery. In most women, symptoms develop within the first 2 postpartum weeks. The condition resembles a rapidly evolving manic or mixed episode, with symptoms such as restlessness and insomnia, irritability, rapidly shifting depressed or elated mood, and disorganized behavior. The mother may have delusional beliefs that relate to the infant (eg, the baby is defective or dying, the infant is Satan or God), or she may have auditory hallucinations that instruct her to harm herself or her infant. The risks for infanticide and suicide are high among women with untreated postpartum psychosis. Rates of infanticide in this population are as high as 4%.

• #46 Postpartum psychosis: Protecting mother and infant | MDedge

  https://blogs.the-hospitalist.org/content/postpartum-psychosis-protecting-mother-and-infant

  Mothers with postpartum psychosis (PPP) typically present fulminantly within days to weeks of giving birth. […] In the vast majority of cases, psychiatric hospitalization is required to protect both mother and baby; untreated, there is an elevated risk of both maternal suicide and infanticide. […] Postpartum psychosis is a rare disorder, with a prevalence of 1 to 2 cases per 1,000 childbirths. […] The risk of infanticide is also elevated in untreated PPP, with approximately 4% of these women committing infanticide. […] Hospitalization is required in almost all cases for diagnostic evaluation, assessment and management of safety, and initiation of treatment. […] Mood stabilizers and second-generation antipsychotics (SGAs) are often used for acute management of PPP. […] To prevent relapse in the postpartum period, consider initiating treatment with mood stabilizers and/or SGAs, particularly for women with bipolar disorder who do not take medication during pregnancy.

• #47 Azthena logo with the word Azthena

  https://www.news-medical.net/news/20200420/Study-4025-of-women-who-suffer-postpartum-psychosis-do-not-become-ill-again.aspx

  A new research result from iPSYCH shows that forty per cent of the women who suffer a psychosis after giving birth – known as postpartum psychosis – do not subsequently become ill again. […] Out of every thousand mothers, one or two will suffer a postpartum psychosis, but psychological vulnerability in connection with childbirth does not necessarily follow them through the rest of their lives. […] The new study is based on a systematic literature review and a meta-analysis of published articles within the field, and the results have just been published in the international journal, Journal of Clinical Psychiatry. […] The results are also particularly interesting for psychiatrists who are planning the treatment of women with postpartum psychosis, once the acute phase of the disorder is over. […] The study is a literature study and a meta-analysis based on previously published results from six studies with a total of 645 women.

• #48 Phenomenology, Epidemiology and Aetiology of Postpartum Psychosis: A Review – Worcester Research and Publications

  https://eprints.worc.ac.uk/10167/

  Postpartum psychoses are a severe form of postnatal mood disorders, affecting 12 in every 1000 deliveries. These episodes typically present as acute mania or depression with psychosis within the first few weeks of childbirth, which, as life-threatening psychiatric emergencies, can have a significant adverse impact on the mother, baby and wider family. […] Prediction models, informed by prospective cohort studies of high-risk women, are required to identify those at greatest risk of postpartum psychosis.

• #49 An Update on the Presentation, Nosology, and Causes of Postpartum Psychosis

  https://www.contemporarypediatrics.com/view/update-on-presentation-nosology-causes-postpartum-psychosis

  In the future, testing clinical samples that are larger and better defined should allow us to more robustly identify sleep-related, cognitive, neuroimaging, and peripheral biological measures that distinguish women who develop PP both from healthy controls and from at-risk women who do not develop PP.

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