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Postpartum (Puerperal) Psychosis: Risk Factors, Diagnosis, Management and Treatment

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Prevention in Mental Health

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Abstract

Postpartum psychosis is the most severe perinatal mental health problem and a psychiatric and obstetric emergency. It can result in considerable distress, and may have long-term consequences for women’s well-being, as well as that of their baby and their family, together with implications for wider society. Clinical characteristics of the illness include mood swings, confusion, disorganised behaviour, delusions and hallucinations. Postpartum psychosis is relatively rare, occurring in approximately 1–2 per 1000 live births, although the risk is significantly increased for women with a history of bipolar disorder or schizoaffective disorder, or those who have suffered a previous episode of postpartum psychosis. The clear temporal relationship between childbirth and postpartum psychosis suggests that biological factors are involved in the onset of the illness, with emerging evidence suggesting that altered stress and immune function might play a role in its aetiology. However, more research is needed to understand the exact biological, psychological and environmental factors associated with its occurrence, and to understand the potential long-term impact of postpartum psychosis on the mother-infant relationship and on child development. Due to its severity, postpartum psychosis requires rapid and intensive psychiatric treatment and hospitalisation for mother and baby safety, and for treatment to be initiated as soon as possible. However, with specialist support and treatment, women will typically return to their previous levels of functioning. This chapter aims to provide an overview of the main risk factors, clinical characteristics and possibilities for prevention and management of this rare but very severe psychosis.

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Acknowledgements

This work was partly supported by the UK Medical Research Foundation, by the UK Medical Research Council and the UK National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. CMP is a NIHR Senior Investigator.

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Authors and Affiliations

  1. Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK

    Paola Dazzan, Alessandra Biaggi, Katie Hazelgrove, Carmine M. Pariante & Chaitra Jairaj

  2. National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, London, UK

    Paola Dazzan & Carmine M. Pariante

  3. Channi Kumar Mother and Baby Unit, Bethlem Royal Hospital, South London and Maudsley NHS Foundation Trust, London, UK

    Gertrude Seneviratne

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  1. Paola Dazzan
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  2. Alessandra Biaggi
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Correspondence to Paola Dazzan .

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Editors and Affiliations

  1. Department of Medicine (DAME), University of Udine, Udine, Italy

    Marco Colizzi

  2. Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy

    Mirella Ruggeri

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Dazzan, P., Biaggi, A., Hazelgrove, K., Pariante, C.M., Jairaj, C., Seneviratne, G. (2022). Postpartum (Puerperal) Psychosis: Risk Factors, Diagnosis, Management and Treatment. In: Colizzi, M., Ruggeri, M. (eds) Prevention in Mental Health . Springer, Cham. https://doi.org/10.1007/978-3-030-97906-5_4

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