Original Paper

Psychiatric Quarterly

, Volume 85, Issue 1, pp 91-96

First online:

Confounding Psychosis in the Postpartum Period

  • Jack CastroAffiliated withMetropolitan Hospital CenterNew York Medical College Email author 
  • , Stephen BillickAffiliated withNew York Medical College
  • , Anne KleimanAffiliated withMetropolitan Hospital CenterNew York Medical College
  • , Maria ChiechiAffiliated withMetropolitan Hospital CenterNew York Medical College
  • , Mohamed Al-RashdanAffiliated withMetropolitan Hospital CenterNew York Medical College

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Abstract

This case report alerts the psychiatric clinician to consider nonpsychiatric etiologies of psychosis appearing during the postpartum period besides postpartum psychosis. The case includes a description of the patient’s psychiatric presentation, admission to the inpatient psychiatric unit with subsequent transfer to the medicine department including neuroimaging and neurological consultation. The patient had a remission of psychosis after only two and half days of antipsychotic medication administration. Positive findings on the MRI suggested a demyelinating disease and a 4-month follow up MRI continued to be positive. The etiology was presumed to be a demyelinating disease. In conclusion, psychiatrists need to be alert to include nonpsychiatric pathologies in the differential diagnosis when a patient presents with psychosis in the postpartum period.

Keywords

Psychosomatic medicine Psychiatric misdiagnosis Postpartum psychosis Multiple sclerosis Demyelinating diseases Psychosis