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Postpartum psychosis and management: a case study

02 February 2019
Clinical Practice
02 February 2019
Volume 27 · Issue 2

Abstract

Postpartum (or puerperal) psychosis is an acute mood disorder requiring close specialist care. It is a disorder that is rare and poorly understood, but has devastating consequences. This work retrospectively describes the case study of a young woman who suffered postpartum psychosis following the birth of her first child. A critical appraisal of the care received follows this, focusing specifically on the postnatal period when she was most affected. It was found that critical information was not unearthed at the initial booking appointment, nor were her presenting symptoms recognised in a timely manner; detailing a need for greater training among midwives and care givers regarding early recognition and referral for postpartum psychosis.

Postpartum (or puerperal) psychosis is a severe mood disorder characterised by acute onset manic or affective psychosis (Dias and Jones, 2016), usually within 2 weeks after childbirth (Norhayati et al, 2015). This may overlap with depression and often fluctuates before full recovery is achieved (Dias and Jones, 2016). Symptoms include agitation, insomnia, and thought processes that are eccentric, deviated and disorganised, with delusions and hallucinations, the content of which revolves around the neonate's safety (VanderKruik et al, 2017). Postpartum psychosis is considered a psychiatric emergency due to its high risk of suicide and infanticide (Nahar et al, 2017). It also increases the risk of later developing non-gestational psychosis (particularly bipolar disorder) and postpartum psychosis after a subsequent pregnancy (VanderKruik et al, 2017). It is the most severe mental illness of the perinatal period, defined as the period between pregnancy and 1 year after the birth (Dias and Jones, 2016).

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Postpartum psychosis
Puerperal psychosis
Perinatal mental health
Mental health nursing
Mood disorder