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Limited research exists on mother-infant interaction in women at-risk-of postpartum psychosis (PP). This study aimed to investigate potential predictors of mother-infant interaction quality in women at-risk-of-PP during the first postnatal year. Potential predictors investigated were: maternal ability to recognize emotions, childhood maltreatment, parenting stress, and infant social-interactive behaviour at birth. 98 women (and their offspring) were included, 40 at-risk-of-PP because of a diagnosis of Bipolar Disorder, Schizoaffective Disorder or previous PP, and 58 with no current/previous mental illness or family history of PP. Mother-infant interaction was assessed using the CARE-Index at 8 weeks and 12 months postpartum. Maternal ability to recognize emotions was assessed with the VERT-K, maternal experience of childhood maltreatment with the CECA-Q, maternal parenting stress with the PSI-SF and infant social-interactive behaviour with the NBAS. Women at-risk-of-PP were less able to recognize fear than healthy controls and this predicted the quality of the mother-infant interaction at 8 weeks' and 12 months' post partum, over and above the effect of maternal Group (respectively, β = 0.33, p =.015; β = 0.40, p =.006). Infant social-interactive behaviour at birth was a significant predictor for mother-infant interaction at 12 months (β = 0.32, p =.031), although this did not differ significantly between the groups. A relatively small sample size precluded a more in-depth investigation of indirect pathways and other potential predictors. These results are important as they suggest that preventive interventions targeting emotion recognition may be implemented in women at-risk-of-PP, with the aim of improving mother-infant interaction and potentially also the infant long-term development. • We investigated multiple potential predictors of mother-infant interaction quality. • We included women at-risk-of postpartum psychosis (PP) and healthy controls. • Women at-risk-of-PP had more difficulty recognizing emotions than healthy controls. • Maternal ability to recognize fear predicted mother-infant interaction quality. • Infant social-interactive behaviour also contributed to mother-infant interaction. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: New parents who have previously experienced psychosis outside and/or following childbirth have an increased likelihood of experiencing an episode during the postpartum period.The decision to try to conceive can be agonising.Receiving care from a specialist perinatal community mental health team can improve outcomes. What does this paper add to existing knowledge?: This article offers a first‐person insight into the steps the author took to minimise the impact of an episode of postpartum psychosis and/or postnatal depression whilst navigating new motherhood. What are the implications for practice?: This lived experience narrative aligns with the evidence base that demonstrates specialist perinatal community mental health services improve outcomes.It highlights the importance of maternity care providers asking about mental health history to identify any previous episodes or family history and offering referral to a specialist perinatal mental health service if available. Introduction: Postpartum psychosis is a life‐changing but treatable condition that usually occurs in the first few days to weeks after childbirth affecting 1–2 in 1000 pregnancies. Those who have experienced psychosis before, either as a single episode, related or unrelated to childbirth or as part of a long‐term mental health condition have a higher likelihood of experiencing an episode in the postnatal period. Aim: In this lived experience narrative the author shares personal experience of planning and navigating pregnancy with a higher likelihood of experiencing postpartum psychosis and postnatal depression around this major life transition due to previous episodes. Methods: The author utilises a first‐person approach to share and reflect on her lived experience. Findings: The author shares her experience of receiving care and some of the steps she took to try to manage the impact of pregnancy and birth on her mental health during this major life transition. She describes how care from a specialist perinatal community mental health team and peer support contributed significantly to her family's well‐being. Discussion: Specialist perinatal community mental health services can improve outcomes for those with a higher likelihood of experiencing postpartum psychosis and postnatal depression by facilitating planning and mitigating some of the risks that could lead to relapse in the perinatal period. [ABSTRACT FROM AUTHOR]

Abstract Background Postpartum psychosis (PP) is a psychological emergency requiring rapid intervention, hospitalization and psychiatric management. However, PP has been neglected in the postpartum literature. Understanding the detrimental consequences of childhood trauma across mother’s life span is crucial to prevent this serious condition. The study’s objectives were to demonstrate the relationship between childhood trauma and postpartum psychotic experiences (PPEs) and to look over the mediating role of postnatal depression (PD) and anxiety (PA) in this relationship. Methods This cross-sectional study, which enrolled 438 postpartum females 4–6 weeks after delivery (mean age: 31.23 ± 5.24 years), was carried out from September 2022 to June 2023. The Arabic validated versions of the Postpartum Psychotic Experiences Scale, the Edinburgh Postnatal Depression Scale, the Perinatal Anxiety Screening Scale, and the Child Abuse Self Report Scale were used. Results Both PD and PA partially mediated the correlation between psychological abuse and PPEs, and fully mediated the association between neglect and PPEs. Higher psychological abuse and neglect were significantly associated with higher PD (Beta = 1.11) and PA (Beta = 3.94), higher PD (Beta = 0.84) and PA (Beta = 0.26) were significantly associated with higher PPEs in both models, whereas greater child psychological abuse (Beta = 1.37) (but not neglect) was directly and strongly correlated with higher PPEs in all models. Conclusion The significant mediating effect of PA and PD on the association between childhood adversities and PPEs among postpartum females may offer additional therapeutic avenues to help attenuate various postpartum mental health issues and their potential serious risks on both mother and child.

Background: Postpartum psychosis (PP) is a psychological emergency requiring rapid intervention, hospitalization and psychiatric management. However, PP has been neglected in the postpartum literature. Understanding the detrimental consequences of childhood trauma across mother's life span is crucial to prevent this serious condition. The study's objectives were to demonstrate the relationship between childhood trauma and postpartum psychotic experiences (PPEs) and to look over the mediating role of postnatal depression (PD) and anxiety (PA) in this relationship. Methods: This cross-sectional study, which enrolled 438 postpartum females 4–6 weeks after delivery (mean age: 31.23 ± 5.24 years), was carried out from September 2022 to June 2023. The Arabic validated versions of the Postpartum Psychotic Experiences Scale, the Edinburgh Postnatal Depression Scale, the Perinatal Anxiety Screening Scale, and the Child Abuse Self Report Scale were used. Results: Both PD and PA partially mediated the correlation between psychological abuse and PPEs, and fully mediated the association between neglect and PPEs. Higher psychological abuse and neglect were significantly associated with higher PD (Beta = 1.11) and PA (Beta = 3.94), higher PD (Beta = 0.84) and PA (Beta = 0.26) were significantly associated with higher PPEs in both models, whereas greater child psychological abuse (Beta = 1.37) (but not neglect) was directly and strongly correlated with higher PPEs in all models. Conclusion: The significant mediating effect of PA and PD on the association between childhood adversities and PPEs among postpartum females may offer additional therapeutic avenues to help attenuate various postpartum mental health issues and their potential serious risks on both mother and child. [ABSTRACT FROM AUTHOR]

Purpose: Postpartum psychosis (PP) is a severe psychiatric disorder affecting 1–2 per 1,000 deliveries. Prompt access to healthcare and timely initiation of treatment are crucial to minimizing harm and improving outcomes. This analysis seeks to fill gaps in knowledge surrounding barriers to care and treatment experiences among this population. Methods: Participants were individuals with histories of PP who enrolled in the Massachusetts General Hospital Postpartum Psychosis Project (MGHP3). The MGHP3 Healthcare Access Survey, a cross-sectional questionnaire, assesses barriers to care, treatment-seeking behaviors, and experiences with treatment. Descriptive statistics were utilized to describe sample characteristics. Results: 139 participants provided 146 episode-specific survey responses. Lack of available services was cited as the greatest barrier to care for PP. Among those who sought treatment, obstetric providers (34.5%) and emergency medical professionals (29.4%) were the most common initial points of contact. 82.2% of the respondents went to an emergency room or crisis center during their episode(s). Most (61.8%) reported being given insufficient information to manage their PP. Approximately half of participants were hospitalized (55.5%), the majority of whom had no access to their infant during hospitalization (70.4%). Of those breastfeeding or pumping at admission, 31.3% were not given access to a breast pump. 44.4% dealt with delivery-related medical issues during their hospitalization. Conclusion: This report is the first of its kind to assess key public health domains among individuals with PP. Findings point to several directions for future research and clinical practice to improve treatment timeliness and quality, potentially improving long-term outcomes related to this serious illness. [ABSTRACT FROM AUTHOR]

Introduction: Postpartum depression (PPD) is a growing mental health concern worldwide and has detrimental effects on the social and cognitive health of both mothers and infants. This review was performed to assess the risk of PPD in women with postpartum hemorrhage (PPH) and to identify potential moderators. Material and methods: The review protocol was registered in the PROSPERO database on June 17, 2023 (registration number: CRD42023432955). Two researchers independently performed a literature search of the PubMed, Embase, and Web of Science databases for articles published before May 25, 2023, with no filters and no language or location restrictions. Study quality was evaluated using the Newcastle–Ottawa Scale. The primary outcome was the odds ratio (OR) and 95% confidence interval (CI) of PPD in women with vs. without PPH. We performed sensitivity analyses and meta‐regression analyses to resolve heterogeneity. Meta‐regression analyses included the effects of age, maternal smoking, marital status, preterm labor, maternal education level, preeclampsia, anemia during pregnancy, and cesarean section. Results: In total, seven studies involving 540 558 participants met the eligibility criteria and were included in the meta‐analysis. Women with PPH were at increased risk of PPD compared with women without PPH (OR 1.10; 95% CI 1.03–1.16), and heterogeneity was low (I2 = 23%; τ2 = 0.0007; p = 0.25). Moreover, the results of the sensitivity analyses showed that the I2 value decreased from 23% to 0% after excluding one particular study, which may have been a source of heterogeneity. In the meta‐regression analyses, the OR of PPD was greatly affected by maternal smoking (OR −0.26; 95% CI −0.30 to −0.22; p < 0.001). However, we did not observe any effects for maternal age, marital status, preterm labor, maternal education level, preeclampsia, anemia during pregnancy, or cesarean section. Conclusions: Women with PPH must be closely monitored because they have a higher risk of PPD than women without PPH. Early recognition and management of these patients will improve treatment outcomes, maternal health, and newborn development. [ABSTRACT FROM AUTHOR]

In December 1973, the BBC aired Nemone Lethbridge’s auto-fictional play Baby Blues as one of their influential ‘Play for Today’ (PfT) series (1970–1984). This article explores the impact of Lethbridge’s controversial television play, which drew attention to taboo topics, such as infertility, caesarean section childbirth, infanticide, suicide, and, separately, motherhood ageism and dismissive medical professionals. It will illustrate how Lethbridge’s play Baby Blues was part of a broader change in discussing maternal mental illness and creating support for women experiencing postnatal depression and psychosis, instigated by the Women’s Liberation Movement (WLM). The article situates Baby Blues within the wider history of the PfT series, with its focus on socio-political issues, and highlights the challenges Lethbridge faced in bringing the play to production. It analyses the mixed responses to the play, many of which were critical, and how this led to Lethbridge’s launching of a grass-roots self-help group, Depressives Anonymous (DA), in 1974, which was—and still is—a long-lasting legacy of Baby Blues. The article builds on the history of maternal mental illness as explored in women’s narratives and its association with stigma, support and feminism, alongside the British Broadcasting Corporation’s television series PfT, in 1970s Britain. [ABSTRACT FROM AUTHOR]

Postpartum psychosis is a severe mental health illness following childbirth. Studies to date have developed from initial focus on experiences of women to address the role and experiences of partners, and recently to touch on the effect on their relationship. This study aimed to build on this work, by focussing directly on the impact of postpartum psychosis on the couple's relationship, from the perspectives of both the woman and her partner. A constructivist grounded theory approach was utilised to generate a theory that explained the impact of postpartum psychosis on the couple's relationship. In-depth semi-structured interviews were completed with a sample of eight women and six partners. Four stages and five general categories described the processes that the couple experienced, and the impact postpartum psychosis had on their relationship. The grounded theory adds to current evidence and helps increase understanding of factors that play a role in adjustment and outcomes. New insights were identified, including postpartum psychosis amplifying existing relational patterns; and the mediating role of the pre-existing relationship and couplehood. Clinical implications and areas for further research are considered. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate mother–infant interaction and infant development in women at-risk of postpartum psychosis (PP), with and without a postpartum relapse. Methods: 103 women (and their offspring) were included, 43 at-risk-of-PP because of a diagnosis of bipolar disorder, schizoaffective disorder or previous PP, and 60 with no current/previous mental illness or family history of PP. Of the at-risk women, 18 developed a psychiatric relapse within 4 weeks after delivery (AR-unwell), while 25 remained symptom-free (AR-well). Mother–infant interaction was assessed using the CARE-Index at 8 weeks' and 12 months' postpartum and infant development using the Bayley-III at 12 months' postpartum. Results: Women at-risk-of-PP as a group, regardless of whether they developed a psychiatric relapse within 4 weeks after delivery, had less synchronous mother–infant interactions and had infants with less optimal cognitive, language, motor and socio-emotional development than healthy controls. In particular, boys of at-risk women had the lowest scores in cognitive, language and motor development and in mother–infant interaction, while girls of the at-risk women had the lowest scores in socio-emotional development. The synchrony in the dyad predicted infant cognitive and language development. There was no evidence for a difference in mother–infant interaction nor in infant development between the AR-unwell and AR-well groups. Conclusions: These results suggest that, while there is a lack of evidence that an early postpartum relapse in women at-risk-of-PP could represent a risk for the infant per se , maternal risk for PP may be associated with less optimal mother–infant interaction and infant development. [ABSTRACT FROM AUTHOR]

Purpose: Postpartum psychosis (PPP) is a serious mental health illness affecting women post-parturition. Around 1 in 1000 women are affected by postpartum psychosis, and the symptoms usually appear within 2 weeks after birth. Postpartum mental disorders are classified into 3 main categories starting from the least to most severe types, including baby blues, postpartum depression, and postpartum psychosis. Materials and Methods: In this systematic review, genetic and epigenetic factors associated with postpartum psychosis are discussed. A PRISMA flow diagram was followed, and the following databases were used as main sources: PubMed, ScienceDirect, and Scopus. Additional information was retrieved from external sources and organizations. The time period for the articles extracted was 5 years. Results: Initially, a total of 2379 articled were found. After the stated criteria were applied, 58 articles were identified along with 20 articles from additional sources, which were then narrowed down to a final total of 29 articles. Conclusions: It can be concluded that there is an association between PPP and genetic and epigenetic risk factors. However, based on the data retrieved and examined, the association was found to be greater for genetic factors. Additionally, the presence of bipolar disorder and disruption of the circadian cycle played a crucial role in the development of PPP. [ABSTRACT FROM AUTHOR]

Women with bipolar disorder (BD) are at high risk of postpartum psychosis (PP). The factors that increase risk of PP among women with BD are not fully understood. Here, we examine whether sleep disruption in the perinatal period (poor sleep quality in late pregnancy and sleep deprivation related to childbirth) is associated with PP in a longitudinal study of pregnant women with BD. Participants were 76 pregnant women with lifetime DSM-5 bipolar I disorder or schizoaffective-BD, followed from week 12 of pregnancy to 12 weeks postpartum. Demographics and lifetime psychopathology were assessed at baseline via semi-structured interview (Schedules for Clinical Assessment in Neuropsychiatry). Psychopathology and sleep disruption within the current perinatal period were assessed in the third trimester and at 12 weeks postpartum. Data were supplemented by clinician questionnaires and case-note review. After controlling for prophylactic use of mood stabilising medication, the loss of at least one complete night of sleep across labour/delivery was associated with five times the odds of experiencing PP compared to no or less than one night of sleep loss across labour/delivery (OR 5.19, 95 % CI 1.45–18.54; p = 0.011). Sleep quality in late pregnancy was not associated with PP, and perinatal sleep disruption was not associated with postpartum depression. Lack of objective measures of sleep factors. In the context of other aetiological factors, severe sleep loss associated with childbirth/the immediate postpartum may act as a final trigger of PP. These findings could have important clinical implications for risk prediction and prevention of PP. • Perinatal sleep factors and postpartum psychiatric outcomes assessed longitudinally • Acute, childbirth related sleep loss associated with postpartum psychosis • No relationship between perinatal sleep factors and postpartum depression. • Implications for risk prediction of postpartum psychosis in bipolar disorder [ABSTRACT FROM AUTHOR]

Aims: This study aimed to systematically identify, appraise and synthesize qualitative evidence which explored fathers' experiences and perspectives of their partners' postpartum psychosis. Design: Qualitative evidence synthesis (QES). Data Sources: Seven databases (CINAHL, PsycINFO, Medline, Scopus, Google Scholar, ProQuest Dissertations and Open Grey) were systematically searched for qualitative studies from each database's inception to the 17th of February 2022. Review Methods: Studies that utilized a qualitative research design to explore fathers' experiences and perspectives of their partners' postpartum psychosis were included. Studies were appraised using the Critical Appraisal Skills Programme to determine their methodological quality. Qualitative data were extracted and synthesized using the process of thematic synthesis to form analytical themes. Results: Eleven reports (seven journal articles and four theses), representing six unique qualitative studies were included in the review. Two analytical themes and eight subthemes were identified. The analytical themes were 'a sense of loss across multiple domains of their lives', and 'informational and emotional support needs'. Conclusion: Postpartum psychosis is a severe mental health condition which also impacts the woman's partner. Fathers experienced an array of emotions which they attributed to a lack of knowledge and understanding of postpartum psychosis. The development of appropriate support structures is needed to better support fathers in supporting their partners. Reporting Method: This review adhered to Preferred Reporting Items for Systematic Reviews and Meta‐Analysis statement and ENTREQ reporting guidelines. Patient or Public Contribution: There was no patient or public contribution. Impact: What Problem did this Study Address?: Fathers play a pivotal role in supporting their partner who has postpartum psychosis, and a supportive father has a positive impact on the mental health of the mother.Several qualitative studies have explored fathers' experiences of their partners' psychosis. This QES integrated findings from these studies to gain a deeper understanding and knowledge of the father's experience. What are the Main Findings?: Fathers reported a significant sense of loss across multiple domains of their lives, from a perceived loss of their relationship with their partner to a loss of the future they had planned together.Fathers experienced an array of emotions, such as fear and shock which they attributed to their lack of knowledge and awareness of postpartum psychosis. Where and on Whom will this Research have an Impact?: This review provides a deeper insight and understanding into the father's experiences and perspectives of their partners' postpartum psychosis. This insight can inform healthcare professionals and policymakers in the development of appropriate support structures which meet the needs of this population. The provision of appropriate support structures could have a positive impact on the father's well‐being and ability to support their partner. [ABSTRACT FROM AUTHOR]

Sleep problems are extremely common during the postpartum period. The role of sleep in the development of postpartum psychosis (PP) is, however, still under-researched. This narrative review aims to (1) provide a summary of the existing evidence for the associations between sleep problems and PP, (2) discuss the relevant risk factors associated with sleep problems and PP, and (3) suggest future lines of research in this area. Some of the existing literature suggests an association between sleep problems, specifically insomnia, sleep loss and sleep disruption during pregnancy and postpartum, and PP, with the most relevant risk factors including history of bipolar disorder and time of delivery. However, it is still unclear whether the previously mentioned sleep problems are a symptom of, or a trigger for PP. Thus, further research is needed to identify the specific role of sleep problems in PP, using longitudinal designs and more objective measures of sleep. This will allow appropriate detection, intervention and support for women experiencing and/or at risk for PP. [ABSTRACT FROM AUTHOR]

Postpartum psychosis is a psychiatric emergency that is currently not represented in diagnostic systems, to the detriment of people with lived experience. Engaging with stakeholders offers an important avenue to improve clinical practice and make research more impactful, by providing perspectives based on first-hand, expert experience. There is a paucity of reports on stakeholders' engagement in psychiatry. Activities have thus far been limited to Western countries and there are few reports on postpartum psychosis. We report the results of public involvement activities (in the form of discussion groups) with key stakeholders in India, Malawi and the UK. These discussions centred around the clinical picture of postpartum psychosis and the terminologies used to describe these episodes. Seven major areas were highlighted: how postpartum psychosis is handled within services, common symptoms and characteristics, impact of episode, barriers to care, non-medical approaches, terminology and research areas of interest. According to the discussions, postpartum psychosis presents similarly across countries, although there are differences in access to services, approaches to mental health and terminologies used within and across countries. With this understanding comes the foundation for cross-cultural assessment, service improvement and a stakeholder-informed research agenda. [ABSTRACT FROM AUTHOR]

For most women, pregnancy and the postpartum period are times of great joy and expectation. However, for women with a diagnosis of bipolar affective disorder, there is an exceptionally high risk of deterioration in their mental health. There is the real possibility of developing postpartum psychosis, possibly requiring acute psychiatric admission and being separated from their baby. This can have devastating consequences for a woman, her baby, the family and society. Multiple services/disciplines across primary, secondary and tertiary care settings need to work together to enhance outcomes for these women. In Ireland, a relatively new collaborative way of working is emerging, as specialist perinatal mental health teams are developed. This case review aims to illustrate the complexities of and potential in collaborative team working to support a woman with a pre-existing a mental health disorder, and her family, during pregnancy. This was done through a specialist perinatal mental health teams collaboration co-ordinated by a clinical nurse specialist. [ABSTRACT FROM AUTHOR]

Purpose: To explore positive changes in women's beliefs, emotions, and behaviors following their struggles with postpartum psychosis. Study Design and Methods: This is a descriptive qualitative study of women who experienced posttraumatic growth after postpartum psychosis. We recruited participants from postings on three Facebook groups. Participants sent their stories of posttraumatic growth after postpartum psychosis via email attachment. We used the following five domains from Tedeschi and Calhoun's (2004) posttraumatic growth model to guide our deductive content analysis: Relating to Others, Personal Strength, Appreciation of Life, New Possibilities, and Spiritual and Existential Change. Results: Thirteen women participated. Relating to Others was the posttraumatic growth domain most often described by the participants followed in order of frequency by Personal Strength, Appreciation of Life, New Possibilities, and Spiritual and Existential Change. Partners and family members' support was instrumental in recovery from postpartum psychosis. Clinical Implications: When considering the total sample, participants experienced all five domains of posttraumatic growth after postpartum psychosis though not every individual experienced growth in all five domains. Interventions can be tailored to meet the needs of women depending on which phase of recovery from postpartum psychosis women are in, acute, early recovery, or advanced recovery. Advanced recovery is the most appropriate phase to discuss the possibility of posttraumatic growth with women. Such discussion should be done with caution and sensitivity as not all women experience positive growth, and it can be harmful to frame this in a way that indicates or encourages expectation. [ABSTRACT FROM AUTHOR]

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Background: Postpartum psychosis (PPP) is a psychiatric emergency that generally warrants acute inpatient care. PPP is marked by the sudden onset of affective and psychotic symptoms with a rapid deterioration in mental state. Evidence suggests that PPP is a discrete disorder on the bipolar disorder spectrum with a distinct treatment profile and prognosis. Methods: We conducted a PubMed database search for various terms involving PPP and its treatment and included peer-reviewed articles published in English. Objective: To provide a treatment algorithm for the management of PPP based on available evidence. Results: Pharmacological therapy is the mainstay of PPP management in the acute phase. Evidence points to a combination of antipsychotics and lithium in the acute treatment of PPP. Electroconvulsive therapy can offer a rapid treatment response where required. Lithium appears to have the best evidence for relapse prevention and prophylaxis in PPP. Psychoeducation is essential and psychosocial interventions used in bipolar disorder may be effective in PPP. Conclusion: Early detection and prompt treatment with antipsychotics and lithium, followed by maintenance treatment with lithium, is associated with a favourable prognosis in PPP. [ABSTRACT FROM AUTHOR]

Abstract Background The risks associated with postpartum psychosis (PP) are poorly recognized in Egyptian women. We aimed to study the role of sociodemographic, psychosocial, obstetric, and biological factors in the occurrence of PP within 4 weeks after delivery in a sample of Egyptian women. We included 60 women with PP and 30 postpartum women without psychosis. All participants underwent a full medical assessment and psychiatric assessment using the Holmes and Rahe Stress Scale, the Brief Psychiatric Rating Scale (BPRS), and hormonal assessment (including estrogen levels and thyroid function tests) were performed for each woman. Results The mean age of pregnancy of women with PP was significantly younger than that of controls (19.2 ± 2.04 years versus 24.37 ± 4.92 years). PP was significantly more common among primipara (73.3%), women who underwent cesarean sections (58.3%) and had thyroid dysfunction. The rates of low birth weight, and premature delivery were significantly higher among women with PP than among those without PP. The mean time-lapse from parturition to the onset of PP symptoms was 6.11 ± 1.62 days. Sleep disturbance, and irritability symptoms were the earliest symptoms of PP in our study. Plasma estrogen levels were significantly correlated with the total BPRS scores in patients with PP (P = 0.001). Conclusions Young age, primiparity, low birth weight, cesarean delivery, a rapid drop in the estrogen level and thyroid dysfunction all could contribute to the occurrence of PP.

We describe a young patient diagnosed with postpartum psychosis, and managed with antipsychotics. She presented with hyponatremia after an episode of gastroenteritis. Further probing revealed a history of amenorrhea after the delivery. Workup showed panhypopituitarism. This treatable cause can mimic postpartum psychosis.

The modern woman nowadays is subjected to more and more challenges. Whether it is due to her work, her appearance or her marital status, she must always show that she is coping in the most efficient way. This constant measurement and confrontation of the performance achieved in a certain field leads to the perception of otherwise normal, physiological actions as stressful. The mother who raises her child wants to face the multiple challenges, even when she is being subjected to pressures from the family, her own requirements, values and beliefs and at the same time from the micro group she belongs to or from society. That's why her slip into depression is extremely easy. The support she might receive from family, friends, professionals can save her from further complications such as deepening depression, job loss, long-term loss of self-esteem, child neglect and child abuse, the transition to a suicidal act in a moment of imbalance or the transition to alcohol misuse, sometimes witnessed by the child. Identifying factors involved in the onset and maintenance of postpartum depression can help prevent it and provide early intervention within vulnerable families with the aim of making women stronger and children healthier and happier. Postpartum depression is a fairly common phenomenon in the female population, the cumulative forms giving a percentage of 31%, of which minor forms occupy 19% and moderate and severe forms 12%. Among the factors that have an important influence we list: a weaker support of the mother by her support group, problems related to the mother's low self-esteem, the more difficult temperament of the child who can be more agitated and disrupts the mother's sleep-wake rhythm, but also the existence of other previous episodes of postpartum depression of the mother and the number of previous births. [ABSTRACT FROM AUTHOR]

Women with bipolar disorder have approximately 40 %–50 % chance of having a perinatal bipolar recurrence. Knowing the factors associated will be beneficial for the prediction and prevention of episodes. We aim to establish if borderline personality disorder traits, as measured by the BEST (Borderline Evaluation of Severity over Time) scale, are associated with perinatal psychiatric outcomes. We recruited women with bipolar disorder as part of the BDRN (Bipolar Disorder Research Network) study. Women were interviewed and we collected their demographic and clinical information. Participants subsequently completed the BEST questionnaire. We analysed the association of BEST scores with lifetime presence/absence of perinatal bipolar relapse and, employing multinomial logistic regression, with different subtypes of perinatal outcomes: postpartum psychosis; postpartum depression, and other episodes. In our sample of 807, although there was no significant association between the BEST total score and perinatal episodes as a whole (adjustedOR 1.01 CI95% [0.99, 1.03], p = 0.204), we found significant differing associations with different subtypes of episodes. Women scoring highly on BEST were less likely to experience a postpartum psychotic episode (RRR 0.96 CI95% [0.94, 0.99], p = 0.005) but more likely to experience a non-psychotic depressive episode (RRR 1.03 CI95% [1.01, 1.05], p = 0.007) than no relapse. This study is limited by its cross-sectional design and self-report nature of BEST. In women with bipolar disorder, borderline traits differentiate the risk of postpartum depression and postpartum psychosis, emphasise the importance of considering risk factors for these perinatal episodes separately, and may help individualise the risk for women in the perinatal period. • First study of borderline personality disorder traits in relation to perinatal episodes among women with bipolar disorder • Borderline traits differentiate the risk of postpartum depression and postpartum psychosis. • Women with more severe traits were less likely to experience a postpartum psychotic episode than no relapse. • And more likely to experience an episode of postpartum non-psychotic depression than no relapse [ABSTRACT FROM AUTHOR]

Background: The risks associated with postpartum psychosis (PP) are poorly recognized in Egyptian women. We aimed to study the role of sociodemographic, psychosocial, obstetric, and biological factors in the occurrence of PP within 4 weeks after delivery in a sample of Egyptian women. We included 60 women with PP and 30 postpartum women without psychosis. All participants underwent a full medical assessment and psychiatric assessment using the Holmes and Rahe Stress Scale, the Brief Psychiatric Rating Scale (BPRS), and hormonal assessment (including estrogen levels and thyroid function tests) were performed for each woman. Results: The mean age of pregnancy of women with PP was significantly younger than that of controls (19.2 ± 2.04 years versus 24.37 ± 4.92 years). PP was significantly more common among primipara (73.3%), women who underwent cesarean sections (58.3%) and had thyroid dysfunction. The rates of low birth weight, and premature delivery were significantly higher among women with PP than among those without PP. The mean time-lapse from parturition to the onset of PP symptoms was 6.11 ± 1.62 days. Sleep disturbance, and irritability symptoms were the earliest symptoms of PP in our study. Plasma estrogen levels were significantly correlated with the total BPRS scores in patients with PP (P = 0.001). Conclusions: Young age, primiparity, low birth weight, cesarean delivery, a rapid drop in the estrogen level and thyroid dysfunction all could contribute to the occurrence of PP. [ABSTRACT FROM AUTHOR]

This Note will examine the inconsistencies in the treatment of mothers diagnosed with postpartum psychosis who claim the insanity defense in cases of infanticide and/or child abuse. The defense of not guilty by reason of insanity is treated inconsistently throughout the U.S. court system, especially in cases involving a defendant suffering from postpartum psychosis. This Note proposes specific jury instructions for cases involving a defendant diagnosed with postpartum psychosis and introduces a new criminal charge of infanticide so that defendants do not have to rely on proving insanity alone. Key points for the family court community: As many as 50%–75% of new mothers experience a change in their emotions called the "baby blues" after delivery.Approximately two dozen countries have "infanticide laws" that are designed to allow for more lenient penalties in cases where a court determines the postpartum mother suffers from mental illness.Postpartum psychosis is much less common than other postpartum mood disorders—occurring in just 1 or 2 out of every 1000 births—about 3.8 million births were recorded in the United States in 2018.Medical researchers estimate that untreated postpartum psychosis leads to an estimated 4% risk of infanticide, and a 5% risk of suicide.Historically, states have used one of the following tests to determine whether a defendant was legally insane during the commission of a crime: the M'Naughten (Common Law) test, the "irresistible impulse" test, the Durham or "product" test, and the model penal code test. [ABSTRACT FROM AUTHOR]

Postpartum psychiatric disorders, from mild Postpartum Blues to severe Depression and Psychosis, represent an underrepresented crisis in Pakistan. Despite their impact on maternal and neonatal health, these conditions are often misdiagnosed and untreated. Contributing factors include weak familial support, sociocultural stigma, and lack of awareness, especially in underserved areas. The negligence towards new mothers highlights the gaps in maternal mental health care in Pakistan, where regulatory frameworks are still evolving. This editorial explores the crisis, critiques existing services, and provides recommendations to improve early identification and intervention, aiming to raise awareness and provide strong support for affected mothers. [ABSTRACT FROM AUTHOR]

Postpartum psychosis has been found to affect 0.89–2.6 per 1000 women. Onset is typically rapid and severe. Early recognition and appropriate treatment are crucial for a good prognosis. Our aim in this study was to understand women's experiences of mental health care and services for psychosis in the postnatal period. Semi-structured interviews were conducted with 12 women who reported being treated for postpartum psychosis. Findings were analysed thematically. Women reported that healthcare professionals across maternity and mental health services often lacked awareness and knowledge of postpartum psychosis and did not always keep them or their partners/families informed, supported, and involved. Women wanted better collaboration between and within services, and more efficient, appropriate, and timely care. They valued inpatient services that could meet their needs, favouring Mother and Baby Units over general psychiatric wards. Early Intervention in Psychosis services and specialist perinatal community mental health teams were also well liked. [ABSTRACT FROM AUTHOR]

Purpose of Review: Postpartum psychosis is a psychiatric emergency that can affect the health and life of mothers, infants, and families. Postpartum psychosis (PPP) is distinct from non-postpartum psychosis in many ways, and it is crucial to study and understand PPP to identify, treat, and possibly prevent this condition. We therefore sought to review the latest research findings about PPP with the intention of updating readers about the latest evidence base. Recent Findings: Multiple physiologic pathways have been implicated in the development of PPP, and further understanding these pathways may allow for early detection and treatment. Risk assessment and treatment should include consideration of the woman patient but also the mother-infant dyad and the larger family. Summary: It is our hope that this review of research updates in postpartum psychosis may inform clinical practice and promote specialized, evidence-based diagnosis, risk assessment, and treatment. [ABSTRACT FROM AUTHOR]

Postpartum psychosis is an acute mental disorder that occurs following childbirth, with a prevalence of 1–2/1,000 births. Its onset is usually sudden and it is a medical emergency, often requiring medication and inpatient care. In some cases, it marks the onset of chronic disease, mainly of the mood disorder spectrum. Studies have shown that postpartum psychosis has adverse effects on the emotional state and daily life of all the family members. The emotions experienced are modified during the course of the disease, changing from those at its appearance and the time the woman is hospitalized, to those during her recovery and in the long term. The main problem in the practical and emotional management of postpartum psychosis is insufficient information about the disease, and those who are affected feel isolated, and do not know how to deal with this difficult situation. [ABSTRACT FROM AUTHOR]