Materiały źródłowe

• #1 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. […] Findings to date have implicated neurobiological factors, such as hormones, immunological dysregulation, circadian rhythm disruption and genetics, to be important in the pathogenesis of this 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. […] The close relationship between postpartum psychosis and bipolar disorder is further suggested by findings from longitudinal research.

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

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

  Postpartum psychosis is experienced by 1 to 2 women every 1000 deliveries. […] Despite being recognized for centuries, the condition has historically been understudied. […] Individuals affected by PP typically experience hallucinations, delusions (often infant-focused), mood swings, sleep problems, and cognitive disorganization/disorientation within 2 weeks of giving birth. […] However, with prompt medical intervention and enduring psychiatric and psychosocial support, the acute symptoms and long-term consequences associated with PP can generally be managed effectively. […] 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. […] A major challenge for the future will be deciphering the factors that distinguish women with bipolar disorder who develop PP from those who do not.

• #3 Postpartum Psychosis – StatPearls – NCBI Bookshelf

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

  Postpartum psychosis has a complex multifactorial origin. Risk factors include a history of bipolar disorder, history of postpartum psychosis in a previous pregnancy, family history of psychosis or bipolar disorder, history of schizoaffective disorder or schizophrenia, and discontinuation of psychiatric medications during pregnancy. The overall prevalence is higher in patients suffering from affective disorders like bipolar one, two, and first-time pregnancy with a previous family or personal history of bipolar one disorder is considered the single most important risk factor. […] Lack of sleep and hormonal fluctuations after birth, especially the rapidly falling levels of estrogen, may also pose a risk; previous postulations proposed that treatment with estradiol may be beneficial as an adjunctive treatment for women with psychosis in schizophrenia.

• #4 Postpartum psychosis – Wikipedia

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

  The largest known risks for the occurrence of PPP include a history of PPP in a previous pregnancy, or a personal or family history of bipolar disorder. […] A significant number of PPP cases, however, occur in individuals with no prior history of psychosis. […] Lifestyle and psychological factors, such as previous trauma or single parenthood, have likewise been inconclusive as factors contributing to PPP, though a number of patients have reported a perception that social and pregnancy-related challenges were the cause of their PPP episodes. […] Currently, the pathophysiology of PPP is not well understood and remains an open field of ongoing research. The leading theories under investigation involve areas of genetics, hormones, immunology, and sleep disturbance processes. […] Some findings suggest an association between PPP and variation in serotonin transporter genes and signaling or changes at specific chromosomes (e.g., 16p13 or METTL13).

• #5 Postpartum Psychosis: Causes, Symptoms, and Effective Treatments

  https://www.manipalhospitals.com/whitefield/blog/postpartum-psychosis-causes-symptoms-treatment-options/

  Postpartum psychosis is a critical mental health issue. […] There is no single cause behind postpartum psychosis. Research suggests that the interplay of several factors triggers it. This includes: […] Abrupt Hormonal Changes: After childbirth, rapid hormonal shifts can affect brain chemistry, potentially contributing to the onset of psychosis. […] History of Bipolar Disorder: Women with a history of bipolar disorder are at higher risk due to their existing vulnerability to mood disorders. […] Family History: A family history of postpartum psychosis or other psychiatric conditions may increase the likelihood of developing this condition. […] Sleep Deprivation and Stress: Lack of sleep and other stressors can also trigger or exacerbate symptoms. […] The primary factor contributing to postpartum psychosis (PPP) is often a previous diagnosis of bipolar disorder or a history of PPP.

• #6 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. […] Individuals affected by PP typically experience hallucinations, delusions (often infant-focused), mood swings, sleep problems, and cognitive disorganization/disorientation within 2 weeks of giving birth. […] 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. […] The relationship between bipolar disorder and PP risk appears remarkably strong and relatively specific, in that personal history for other mood-psychotic spectrum conditions (eg, schizophrenia, schizoaffective disorder) appears to raise an individuals PP risk only modestly (10% to 15% of individuals with schizophrenia-like disorders develop PP).

• #7 Postpartum psychosis

  https://www.rcpsych.ac.uk/mental-health/mental-illnesses-and-mental-health-problems/postpartum-psychosis

  Postpartum psychosis is not your fault, and is not caused by anything you or your partner have done. […] Several things seem to play a part in postpartum psychosis. Your family history and genetic factors are important, and you are more likely to have postpartum psychosis if a close relative has had it. No genetic differences in people who have postpartum psychosis have been discovered yet. […] Hormone levels and disturbed sleep patterns may also be involved. More research is needed on postpartum psychosis. […] You do have a higher risk if you have bipolar disorder type I or schizoaffective disorder, a previous postpartum psychosis yourself, or a history of postpartum psychosis in a close relative. […] If you have bipolar type II your risk is likely to be much lower than for bipolar type I. You may have an increased risk of postpartum psychosis if you have schizophrenia or another psychotic illness but this is not as high as for women with bipolar disorder.

• #8 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. […] Despite being recognized for centuries, the condition has historically been understudied. […] Individuals affected by PP typically experience hallucinations, delusions (often infant-focused), mood swings, sleep problems, and cognitive disorganization/disorientation within 2 weeks of giving birth. […] 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. […] The relationship between bipolar disorder and PP risk appears remarkably strong and relatively specific, in that personal history for other mood-psychotic spectrum conditions (eg, schizophrenia, schizoaffective disorder) appears to raise an individuals PP risk only modestly (10% to 15% of individuals with schizophrenia-like disorders develop PP).

• #9 What we already know

  https://rationalpsychiatry.substack.com/p/what-causes-postpartum-psychosis

  A lack of association between life events and postpartum psychosis suggests that other, more biological causes should be considered. […] During pregnancy, oestrogen and progesterone rise to high levels, then drop precipitously following birth. […] Could the fall in oestrogen trigger postpartum psychosis? […] Women with bipolar disorder who experience episodes triggered by sleep loss are twice as likely to have experienced an episode of postpartum psychosis compared with women without this trigger. […] Pregnancy and postpartum are associated with interesting changes in the mothers immune system, which has to tolerate the fetus while also providing protection from pathogens. […] The immune system is widely implicated in psychosis, with a particular focus in recent years on whether there is a subset of patients with autoimmune psychosis, caused by a persons own immune system targeting antigens in the brain. […] Postpartum psychosis, like most psychiatric disorders, clearly has a genetic component: a positive family history increases the risk 3-fold. […] The nature of this genetic liability is not well characterised but research is underway.

• #10 Causes of postpartum psychosis | Action on Postpartum Psychosis

  https://www.app-network.org/postpartum-psychosis/causes-of-postpartum-psychosis/

  We need more research to understand how biological, psychological and social factors interact. […] If you have had a diagnosis of bipolar disorder or schizoaffective disorder your chance of having postpartum psychosis is about 1 in 4 (a 25% likelihood). […] If you have had a diagnosis of one of these illnesses before, and your mother or sister had postpartum psychosis, your risk may be more like 1 in 2 (a 50% likelihood). […] If you have had a diagnosis or episodes of one of these illnesses in the past unrelated to childbirth, and you have also had postpartum psychosis before, the risk may be as high as 7 in 10 (a 70% chance). […] If your mother or sister has had postpartum psychosis but you have not had any previous mental health problems, your risk is about 3 in 100 (a 3% chance). This is higher than the general population but still relatively low risk. […] If you have had postpartum psychosis before, your risk of getting it again in another pregnancy is around 1 in 2 (a 50% chance).

• #11 Postpartum psychosis: What are the causes, symptoms, risk and treatments for this postnatal condition

  https://www.motherandbaby.com/mum/mental-health/postpartum-psychosis-what-you-need-to-know/

  Post-partum psychosis is a rare psychiatric emergency which is also known as puerperal psychosis, she says. […] According to Dr Joash, its difficult to predict who may be at risk of postnatal psychosis as it can occur in anybody: however, if a family member such as your mother has previously suffered from the disorder, you could be at increased risk. […] As for the cause, there is still lots more research needed, but there is a genetic link, as well as a possible link to hormones. […] Current thinking is that it stems from the disruption in hormones after the birth of your child, which is made worse by a lack of sleep or disrupted sleep patterns, says Lees. […] There are other risk factors that could increase the chances of developing it, for example, if youve previously suffered from bipolar disorder or manic depression, if you have previously suffered from postpartum psychosis, if you suffered from severe mental illness during your pregnancy, or if there is a family history of mental illness, Lees adds. […] If youve had previous postpartum psychosis, your risk of a recurrent episode is around 25%. […] Postpartum psychosis will not improve by ignoring it or hoping it will go away, he says.

• #12 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

  It is also noteworthy that, for around half of all cases of PP, the affected individual has no psychiatric history; the latest analysis indicates that in such women, psychotic experiences appear to be largely limited to the postpartum period, although around one-third of previously healthy women may subsequently exhibit recurrent symptoms consistent with a bipolar disorder spectrum condition. […] Numerous medical conditions may arise, or be exacerbated, in the perinatal period. […] Although exposure to adverse life events has traditionally been more strongly associated with postpartum depression risk than with PP risk, evidence is emerging to suggest that severe childhood maltreatment, exposure to more frequent stressful life events, and elevated levels of the stress-related molecules cortisol and C-reactive protein in late pregnancy may predict PP episodes in at-risk women.

• #13 Postpartum Psychosis: What to Know About Symptoms and Treatment – The New York Times

  https://www.nytimes.com/2024/10/09/well/postpartum-psychosis-pregnancy-what-symptoms-treatment.html

  Postpartum psychosis is thought to be triggered by a combination of the hormonal and immunological changes that accompany childbirth, as well as genetics and environmental factors like sleep deprivation. […] Research shows that women with a personal or family history of bipolar disorder are at much higher risk of developing postpartum psychosis. It can be the first presentation of bipolar disorder that endures beyond the postpartum period. […] But some research suggests about two-thirds of women with postpartum psychosis have no prior psychiatric history. That is why it’s important for family and friends to pay attention to the behaviors of new mothers, especially in the first weeks after giving birth, experts said.

• #14 Long-term outcome of postpartum psychosis: a prospective clinical cohort study in 106 women | International Journal of Bipolar Disorders | Full Text

  https://journalbipolardisorders.springeropen.com/articles/10.1186/s40345-021-00236-2

  Due to the high relative risk for suicide and infanticide, early recognition and adequate treatment of postpartum psychosis is crucial. With adequate treatment, nearly all women with postpartum psychosis achieve full remission, and a large proportion of patients achieve good functional recovery. For some women, postpartum psychosis is part of a severe, often life-long, psychiatric disorder. For other women, the vulnerability is limited to the postpartum period. […] Despite the widespread use of the term postpartum psychosis, this diagnosis is not recognized in current classification systems, including the International Classification of Diseases, Tenth Revision (ICD-10) and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Instead, the majority of women with postpartum psychosis receive a DSM-5 diagnosis of bipolar disorder, because they present with prominent manic or mixed affective episodes. Yet, according to our recent meta-analysis, 43.5% of women with postpartum psychosis have no manic or psychotic recurrence outside the postpartum period over a mean follow-up of 16 years, suggesting that a diagnosis of bipolar disorder might not always be warranted.

• #15 Postpartum Psychiatric Disorders – MGH Center for Women’s Mental Health

  https://womensmentalhealth.org/specialty-clinics/postpartum-psychiatric-disorders-2/

  The postpartum period is characterized by a rapid shift in the hormonal environment. Within the first 48 hours after delivery, estrogen and progesterone concentrations fall dramatically. As these gonadal steroids modulate neurotransmitter systems involved in the regulation of mood, many investigators have proposed a role for these hormonal shirts in the emergence of postpartum affective illness. While it appears that there is no consistent correlation between serum levels of estrogen, progesterone, cortisol, or thyroid hormones and the occurrence of postpartum mood disturbance, some investigators hypothesize that there is a subgroup of women who are particularly sensitive to the hormonal changes that take place after delivery. This population of women may be more vulnerable to PPD and to other hormonally driven mood disturbances, such as those occurring during the premenstrual phase of the menstrual cycle or during the perimenopause.

• #16 Postpartum Psychosis: Symptoms, Causes, Risks, Treatment, and Recovery

  https://www.webmd.com/parenting/baby/postpartum-psychosis-overview

  Postpartum psychosis is a condition you can get after giving birth. It affects your sense of reality. You might have hallucinations or delusions. In severe cases, you might try to harm yourself or your newborn. […] Doctors believe that the big hormonal changes before and after childbirth may help trigger postpartum psychosis. […] Caring for a newborn can leave you sleep-deprived. Researchers know that lack of sleep can kick off mania in people with bipolar disorder, and they suspect it could play a role in PPP. […] Psychosis can have physical causes, and you’re at higher risk of some of those conditions during pregnancy or right after giving birth. They include: autoimmune disorders, inflammatory diseases, electrolyte imbalances, thyroid conditions, vitamin deficiencies, and high blood pressure.

• #17 Postpartum Depression: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/9312-postpartum-depression

  Postpartum psychosis is an extremely severe form of postpartum depression and requires emergency medical attention. This condition is relatively rare, affecting only 1 in 1,000 women after delivery. The symptoms generally occur quickly after delivery and are severe, lasting for a few weeks to several months. Symptoms include severe agitation, confusion, feelings of hopelessness and shame, insomnia, paranoia, delusions or hallucinations, hyperactivity, rapid speech or mania. Postpartum psychosis requires immediate medical attention since there is an increased risk of suicide and risk of harm to the baby. Treatment will usually include hospitalization, psychotherapy and medication. […] What causes postpartum depression? More research is needed to determine the link between the rapid drop in hormones after delivery and depression. The levels of estrogen and progesterone increase tenfold during pregnancy but drop sharply after delivery. By three days postpartum, levels of these hormones drop back to pre-pregnancy levels. […] In addition to these chemical changes, the social and psychological changes associated with having a baby increase your risk of postpartum depression. Examples of these changes include physical changes to your body, lack of sleep, worries about parenting or changes to your relationships.

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

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

  The immediate postpartum period sees precipitous drops in circulating estrogen and progesterone levels in the new mother following expulsion of the placenta. […] It has been proposed that at-risk mothers are somehow especially biologically sensitive to estrogen and/or progesterone depletion. […] We have proposed that defective (re)myelination processes occurring in the perinatal period may underlie PP symptoms and be related to abnormal secretion of the cellular communication network factor 3 protein by Tregs. […] 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.

• #19 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

  It has been proposed that at-risk mothers are somehow especially biologically sensitive to estrogen and/or progesterone depletion. […] We have proposed that defective (re)myelination processes occurring in the perinatal period may underlie PP symptoms and be related to abnormal secretion of the cellular communication network factor 3 protein by Tregs. […] 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.

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

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

  The nosological status of postpartum psychosis remains a contentious issue. […] The challenges of classifying postpartum psychosis according to DSM and ICD criteria has contributed to confusion about how these episodes should best be conceptualised. […] The rapid onset of postpartum psychosis following parturition suggests that hormonal factors are potentially involved in the aetiology of this disorder. […] Despite plausibility of the hormone withdrawal hypothesis, evidence in support of this theory appears largely circumstantial. […] Evidence to indicate that risk of postpartum psychosis is increased with first pregnancy, combined with the fact that pregnancy itself is associated with considerable and highly modulated changes in immunological functioning suggests that postpartum psychosis may, in part, be explained by dysfunction or dysregulation of immunological systems. […] Strong evidence also implicates genetic factors in the pathophysiology of postpartum psychosis.

• #21 Postpartum depression – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/postpartum-depression/symptoms-causes/syc-20376617

  There is no single cause of postpartum depression, but genetics, physical changes and emotional issues may play a role. […] Studies show that having a family history of postpartum depression especially if it was major increases the risk of experiencing postpartum depression. […] After childbirth, a dramatic drop in the hormones estrogen and progesterone in your body may contribute to postpartum depression. Other hormones produced by your thyroid gland also may drop sharply which can leave you feeling tired, sluggish and depressed. […] When you’re sleep deprived and overwhelmed, you may have trouble handling even minor problems. You may be anxious about your ability to care for a newborn. You may feel less attractive, struggle with your sense of identity or feel that you’ve lost control over your life. Any of these issues can contribute to postpartum depression.

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

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

  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. […] Maternal physiology changes significantly throughout pregnancy and into the postpartum period, notably with respect to immune function and circulating sex hormones. […] 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). […] Heightened immunoreactivity may partially explain links between COVID-19 infection and apparent vulnerability to psychosis across the lifespan, including in the postpartum period.

• #23 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

  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. […] Maternal physiology changes significantly throughout pregnancy and into the postpartum period, notably with respect to immune function and circulating sex hormones. […] 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.

• #24 Postpartum psychosis – Wikipedia

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

  Despite significant hormone changes that occur around pregnancy and childbirth, there is little evidence supporting hormonal causes behind PPP. […] Due to above-average rates of PPP in individuals experiencing immunologic complications such as anti-N-methyl-D-aspartate (NMDA) receptor encephalitis and autoimmune thyroid disorders, as well as the known heightened immune response post-childbirth, some theories suggest a connection between PPP and the immune system. […] A link between sleep difficulty and PPP is not strongly supported by current evidence; however, some studies have demonstrated an increased risk for postpartum psychosis in women with bipolar disorder who have had manic episodes triggered by sleep disturbance.

• #25 Postpartum Psychosis – StatPearls – NCBI Bookshelf

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

  In one study conducted on parous women with bipolar disorder, sleep loss triggering episodes of mania was considered to be an essential marker to determine predisposition to developing postpartum psychosis. The conclusion was that women who reported sleep deprivation leading to manic episodes were twice as likely to have experienced an episode of postpartum psychosis at some point in their lives.

• #26 Postpartum Psychosis: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24152-postpartum-psychosis

  Postpartum psychosis (PPP) is a mental health emergency. […] Experts dont know why postpartum psychosis happens but suspect it involves a combination of factors, including: […] About one-third of people with PPP have a previously diagnosed mental health condition. […] PPP is more common in people who just gave birth to their first child. […] People with PPP often have family members with a history of PPP or related mental health conditions. […] Experts know that not getting enough sleep can trigger mania in people with bipolar disorder. […] Experts suspect certain hormones, especially estrogen and prolactin, might play a role. […] Psychosis can also happen for medical reasons, many of which are possible during or immediately after giving birth.

• #27 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. […] Findings to date have implicated neurobiological factors, such as hormones, immunological dysregulation, circadian rhythm disruption and genetics, to be important in the pathogenesis of this 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. […] The close relationship between postpartum psychosis and bipolar disorder is further suggested by findings from longitudinal research.

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

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

  The relationship between bipolar disorder and PP risk appears remarkably strong and relatively specific, in that personal history for other mood-psychotic spectrum conditions (eg, schizophrenia, schizoaffective disorder) appears to raise an individuals PP risk only modestly (10% to 15% of individuals with schizophrenia-like disorders develop PP). […] Additionally, in individuals with schizophrenia, PP manifests differently than it does in individuals with bipolar disorder. […] Numerous medical conditions may arise, or be exacerbated, in the perinatal period. […] Although exposure to adverse life events has traditionally been more strongly associated with postpartum depression risk than with PP risk, evidence is emerging to suggest that severe childhood maltreatment, exposure to more frequent stressful life events, and elevated levels of the stress-related molecules cortisol and C-reactive protein in late pregnancy may predict PP episodes in at-risk women.

• #29 What to Know About Postpartum Psychosis

  https://www.whattoexpect.com/first-year/postpartum-health-and-care/postpartum-psychosis

  Major life changes on top of giving birth. Women who lack support from family and friends, have troubled relationships, or experience sudden life changes (a death in the family, a move to a new state, illness, job loss, money woes) can also be more at risk for postpartum depression or psychosis. […] Complicated pregnancy, delivery, and other factors. Having a multiples birth, a baby born with health problems, or a lot of difficulty breastfeeding can also factor in, as can severe sleep deprivation, anxiety, restlessness, or feeling extremely overwhelmed by baby care.

• #30 Causes of postpartum psychosis | Action on Postpartum Psychosis

  https://www.app-network.org/postpartum-psychosis/causes-of-postpartum-psychosis/

  Postpartum psychosis is not your fault. It is not caused by anything you or your partner have thought or done. Relationship problems, stress or the baby being unwanted do not cause postpartum psychosis. […] There is still a lot to learn about the causes of postpartum psychosis. Lots of different things are likely to be involved. […] You are more likely to have postpartum psychosis if a close relative has had it. This means that it may be something to do with your genes. […] Changes in hormone levels and disrupted sleep patterns after having your baby are also likely to be involved but we don’t know exactly how. […] Postpartum psychosis might be more common if you have had pre-eclampsia or thyroid problems. […] There isnt yet enough evidence to suggest that there is a link between postpartum psychosis and the experience of a traumatic birth.

• #31

  https://therapytips.org/articles/the-terrifying-causes-and-effects-of-postpartum-psychosis

  According to a 2018 study from the Eastern Journal of Medicine, the postpartum period is an incredibly risky time for mothers, during which they are 22 times more likely to experience psychotic or manic breakdowns. The authors define postpartum psychosis as an exceptionally rare and severe postpartum psychiatric disorder, affecting between 0.10.2% of new mothers. […] Several aspects of pregnancy and the postpartum period are hypothesized to contribute to the onset of postpartum psychosis. These risk factors include: Primiparity. Being a first-time mother. Puerperal hormone changes. Significant hormonal fluctuations after childbirth. Sleep deprivation. Severe lack of sleep, which can exacerbate mental health issues. Pregnancy/postpartum complications. These include factors like environmental stress, complications during delivery (e.g. traumatic birth, miscarriage, stillbirth, etc.) or congenital malformations of the baby. Comorbidities with other psychiatric disorders. For example, the presence of bipolar disorder increases the likelihood of developing postpartum psychosis from 2550%. Similarly, the onset of postpartum psychosis has been linked to 4080% of mothers consequently developing bipolar disorder.

• #32 Postpartum psychosis: causes, signs, risks and treatment | GoodtoKnow

  https://www.goodto.com/family/pregnancy/postpartum-psychosis-283244

  We also know that it runs in families more than one might expect. […] Postpartum psychosis can happen to anyone. […] Having a family history of mental health problems, particularly a family history of postpartum psychosis […] Having a diagnosis of bipolar disorder or schizophrenia […] Experiencing a traumatic birth or pregnancy […] Previous experience of postpartum psychosis […] Possible pregnancy-related complications such as pre-eclampsia […] A lack of sleep after giving birth can also be a trigger.

• #33 Postpartum Psychosis – A Rare But Serious Mental Health Condition

  https://www.postpartumdepression.org/postpartum-psychosis/

  The factors increasing the risk of postpartum psychosis include: First pregnancy, History of postpartum psychosis in one or more previous pregnancies, History of bipolar disorder, History of schizophrenia and schizoaffective disorder, History of a traumatic pregnancy, Depression during pregnancy, Recent stressful or adverse life events, Inadequate social supports, Family history of bipolar disorder or postpartum psychosis, Discontinuation of psychiatric medications during pregnancy.

• #34 Long-term outcome of postpartum psychosis: a prospective clinical cohort study in 106 women | International Journal of Bipolar Disorders | Full Text

  https://journalbipolardisorders.springeropen.com/articles/10.1186/s40345-021-00236-2

  Postpartum psychosis is an umbrella term for postpartum mania, psychosis, psychotic depression and a mixed affective state, occurring shortly after childbirth. Postpartum psychosis is the most severe form of childbirth-related psychiatric disorders and has an incidence of~0.3 to 0.6 per 1000 births. Women with postpartum psychosis may initially present with mood fluctuations, insomnia and obsessive concerns about the baby, followed by severe mood symptoms, and sometimes disorganized behavior, delusions and hallucinations. The presence of severe mood symptoms differentiates postpartum psychosis from psychosis outside of the postpartum period. Postpartum psychosis is, therefore, a misnomer. Since psychotic symptoms in the postpartum period occur mostly within the setting of affective lability, the disorder is a bipolar-related mood disorder rather than a primary psychotic disorder.

• #35 Postpartum Psychiatric Disorders – MGH Center for Women’s Mental Health

  https://womensmentalhealth.org/specialty-clinics/postpartum-psychiatric-disorders-2/

  Postpartum psychosis is the most severe form of postpartum psychiatric illness. It is a rare event that occurs in approximately 1 to 2 per 1000 women after childbirth. Its presentation is often dramatic, with onset of symptoms as early as the first 48 to 72 hours after delivery. The majority of women with puerperal psychosis develop symptoms within the first two postpartum weeks. […] It appears that in most cases, postpartum psychosis represents an episode of bipolar illness; the symptoms of puerperal psychosis most closely resemble those of a rapidly evolving manic (or mixed) episode. The earliest signs are restlessness, irritability, and insomnia. Women with this disorder exhibit a rapidly shifting depressed or elated mood, disorientation or confusion, and erratic or disorganized behavior. Delusional beliefs are common and often center on the infant. Auditory hallucinations that instruct the mother to harm herself or her infant may also occur. Risk for infanticide, as well as suicide, is significant in this population.

• #36

• #37 New study aims to increase understanding of postpartum psychosis | Health Care Research Wales

  https://healthandcareresearchwales.org/withoutresearch/news/new-study-understanding-postpartum-psychosis

  A study funded by Health and Care Research Wales hopes to understand more about the causes of postpartum psychosis. […] The team previously conducted the largest study of postpartum psychosis in women with diagnosed mood disorder, finding a considerably higher risk of postpartum psychosis in women with bipolar type 1. […] Our research has highlighted many of the factors that make women more susceptible to this serious condition. Now, guidance recommends that if a woman has any past or present severe mental illness or bipolar disorder, or if there is close family history of severe perinatal mental illness, clinicians should be alert for possible symptoms of postpartum psychosis in the first two weeks after childbirth.

• #38 Differential Diagnosis of Postpartum Psychosis

  https://www.psychiatrictimes.com/view/differential-diagnosis-postpartum-psychosis

  The treatment for postpartum psychosis most often includes immediate hospitalization to ensure the safety of both mother and child. […] Because of the relationship between bipolar disorder and postpartum psychosis, an initial approach to medication management includes a mood stabilizer and an antipsychotic agent.

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