Postpartum psychosis: Epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis
- Jennifer Payne, MD
Jennifer Payne, MD
- Associate Professor of Psychiatry
- Johns Hopkins School of Medicine
During the postpartum time period, women are at an increased risk of the onset or recurrence of psychiatric illness, including mood, anxiety, and psychotic disorders. 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. A subset of women experience isolated postpartum psychosis that does not progress to mood or psychotic episodes outside the postpartum time period .
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. Postpartum psychosis constitutes a medical emergency and generally requires rapid intervention and hospitalization, as well as a comprehensive medical evaluation and psychiatric management.
The epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis of postpartum psychosis are reviewed here. The treatment of postpartum psychosis is discussed separately, as are individual psychotic disorders. The epidemiology, clinical manifestations, assessment, and diagnosis of other serious mental disorders with psychosis are also described separately.
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- Associated mental disorders
- Risk factors
- CLINICAL MANIFESTATIONS
- Risk of suicide and infanticide
- Psychiatric evaluation
- Medical evaluation
- Differential diagnosis
- - Bipolar disorder
- - Schizoaffective disorder
- - Schizophrenia
- - Major depression with psychotic features
- - Substance use disorders
- - Psychosis due to general medical conditions