Postpartum psychosis (PP) occurs in 1–2/1000 childbearing women within the first 2–4 weeks after delivery.
The onset of PP is rapid.
As early as 2–3 days after childbirth, the
patient develops paranoid, grandiose, or bizarre delusions, mood swings, confused thinking,and grossly disorganized behavior that represent a dramatic change from her previous
Among patients who develop PP immediately after childbirth, 72%–88% have bipolar illness or schizoaffective disorder, wheras only 12% have schizophrenia
The data suggest that postpartum psychosis is an overt presentation of bipolar disorder that is timed to coincide with tremendous hormonal shifts after delivery. The patient develops frank psychosis, cognitive impairment, and grossly disorganized behavior that represent a complete change from previous functioning
Once a woman has had a postpartum episode with psychotic features, the risk of recurrence with each subsequent delivery is between 30% and 50%. Postpartum episodes must be differentiated from delirium occurring in the postpartum period, which is distinguished by a fluctuating level of awareness or attention.
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