Postpartum Psychosis

■ Mothers have an inability to discern reality from that which is unreal (can have periods of lucidity).

■ Peak onset—10 to 14 days postpartum, but may occur months later

Thirty percent of adolescent women develop postpartum depression.

Criteria for major depression/post-partum depression:

Two-week period of depressed mood or anhedonia nearly every day plus one of the following:

1. Significant weight loss or weight gain without effort (or T or i in appetite)

2. Insomnia or hypersomnia

3. Psychomotor agitation/retardation

4. Fatigue or loss of energy

5. Feelings of worthlessness/excessive or inappropriate guilt

6. Decreased ability to concentrate/think

7. Recurrent thoughts of suicide/death

If these drugs are prescribed to nursing mothers, infant blood concentrations of the drug should be monitored.

Usually remits after 2 to 3 days.

Risk Factors

■ History of psychiatric illness

■ Family history of psych disorders

■ Primiparity

Course

Variable and depends on the type of underlying illness; often 6 months

Treatment

■ Psychiatric care

■ Pharmacologic therapy

■ Hospitalization (in most cases)

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