Abstract
Postpartum psychosis (PPP) is a severe psychiatric condition requiring rapid restoration of health in view of significant risks to both mother and the infant. Electroconvulsive therapy (ECT) is often used for treatment of severe PPP. The aims of the study were to describe the indications for ECT among women admitted with PPP to a psychiatric hospital in India. It also aimed at assessing whether women with PPP who received ECT differed in their clinical history, diagnosis, severity of illness, psychopathology, drug dosage, and duration of hospital stay, compared to women who did not receive ECT. Infants of mothers who were breast-feeding their infants while receiving ECT were assessed for adverse effects. This was a naturalistic prospective study of 78 women admitted with PPP, 34 (43.6 %) of whom received ECT. Presence of catatonia, augmentation of medications, and suicidality were common indications for ECT. Catatonic symptoms were significantly higher among women who received ECT. There was no significant difference in duration of hospitalization or severity of psychopathology between women who did and did not receive ECT. Transient side effects to ECT were observed in few women, with no adverse effects noted in infants who were breast-fed. The current study supports the use of ECT as an effective and safe treatment for women with severe PPP.
Similar content being viewed by others
References
Agrawal P, Bhatia MS, Malik SC (1997) Postpartum psychosis: a clinical study. Int J Soc Psychiatry 43(3):217–222
Asberg M, Montgomery SA, Perris C, Schalling D, Sedvall G (1987) Comprehensive psychopathological rating scale. Acta Psychiatr Scand Suppl 271:5–27
Babu GN, Subbakrishna DK, Chandra PS (2008) Prevalence and correlates of suicidality among Indian women with post-partum psychosis in an inpatient setting. Aust N Z J Psychiatr 42:976–980
Brockington IF, Cernik KF, Schofield EM, Downing AR, Francis AF, Keelan C (1981) Puerperal psychosis. Phenomena and diagnosis. Arch Gen Psychiatry 38(7):829–833
Burt VK, Bernstein C, Rosenstein WS, Altshuler LL (2010) Bipolar disorder and pregnancy: maintaining psychiatric stability in the real world of obstetric and psychiatric complications. Am J Psychiatry 167(8):892–897
Bush G, Fink M, Petrides G, Dowling F, Francis A (1996) Catatonia I: rating scale and standardized examination. Acta Psychiatr Scand 93:129–136
Focht A, Kellner C (2012) Electroconvulsive therapy (ECT) in the treatment of postpartum psychosis. J ECT 28(1):31–33
Forray A, Ostroff RB (2007) The use of electroconvulsive therapy in postpartum affective disorders. J ECT 23(3):188–193
Gervasoni N, Aubry JM (2008) A catatonic syndrome in a postpartum major depressive episode with psychotic features. Schweiz Arch Neurol Psychiatr 159:394–396
Jones I, Craddock N (2001) Familiarity of the puerperal trigger in bipolar disorder: results of a family study. Am J Psychiatry 158(6):913–917
Kendell RE, Chalmers JC, Platz C (1987) Epidemiology of puerperal psychoses. Br J Psychiatry 150:662–673
Kohen D (2005) Psychotropic medication and breast-feeding. Adv Psychiatr Treat 11:371–379
Protheroe C (1961) Puerperal psychosis: a long term study 1927–1961. Br J Psychiatry 115:9–30
Reed P, Sermin N, Appleby L, Faragher B (1999) A comparison of clinical response to electroconvulsive therapy in puerperal and non-puerperal psychoses. J Affect Disord 54(3):255–260
Sit D, Rothschild AJ, Wisner KL (2006) A review of postpartum psychosis. J Womens Health (Larchmt) 15(4):352–368
Sneddon J, Kerry RJ (1984) Puerperal psychosis: a suggested treatment model. Am J Soc Psychiatry 4:30–34
Thirthalli J, Phutane VH, Muralidharan K, Kumar CN, Munishwar B, Baspure P, Gangadhar BN (2009) Does catatonic schizophrenia improve faster with electroconvulsive therapy than other subtypes of schizophrenia? World J Biol Psychiatry 1–6
Weiner RD et al (2001) The practice of ECT: recommendations for treatment, training and privileging, 2nd edn. American Psychiatric, Washington
WHO (1992) The ICD-10 classification of mental and behavioural disorders. WHO, Geneva
Yonkers KA, Wisner KL, Stowe Z, Leibenluft E, Cohen L, Miller L, Manber R, Viguera A, Suppes T, Altshuler L (2004) Management of bipolar disorder during pregnancy and the postpartum period. Am J Psychiatry 161(4):608–620
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Babu, G.N., Thippeswamy, H. & Chandra, P.S. Use of electroconvulsive therapy (ECT) in postpartum psychosis—a naturalistic prospective study. Arch Womens Ment Health 16, 247–251 (2013). https://doi.org/10.1007/s00737-013-0342-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00737-013-0342-2