Peripartum mood disturbances natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sunita Kumawat, M.B.B.S[2]
Overview
Postpartum blues are characterized by mild, temporary, and self-limiting mood disturbance. Postpartum blues puts a woman at risk of Postnatal depression. If left untreated, females with postpartum depression may progress to develop chronic depressive disorder, and are predisposed to major depression in future. This can also result in depression in father. Children of untreated females may have emotional, behavioural issues and language problems. Greater chances of having ADHD, excessive crying, eating and sleeping problems.[1] This condition can impact bonding between mother and child. Postpartum psychosis is a psychiatric emergency and patient needs immediate treatment. Majority of individuals with postpartum psychosis react well to therapy and have rapid recovery and remission. Suffering from postpartum psychosis increases its likelihood in future pregnancy. Common complications of postpartum psychosis, if left untreated include filicide, suicide, and many psychosocial implications.[2] [3]
Natural History, Complications, and Prognosis
Complications during the perinatal period may affect a woman's long term medical health. The sleep deprivation, hormonal fluctuations and care for the newborn may cause the mental illnesses and increases their psycho-biological vulnerability for future psychiatric illness. These not only affect the new mothers but also their newborns and the family. The natural history, complications and the prognosis of peripartum mood disturbances differs and are specific to the individual condition.
- Postpartum blues is a temporary condition characterised by sadness, weeping, impatience, anxiety, sleeplessness, fatigue, and reduced focus, as well as mood lability that can include elation.
- Symptoms usually appear two to three days after delivery, peak within a few days, and disappear within two weeks.
- Although postpartum blues is frequent and temporary, it is crucial to recognize it because women who have postpartum blues are more likely to develop severe postpartum depression, psychosis and postpartum anxiety disorders than those who do not.
- Untreated Postpartum depression can resolve on its own or with therapy, or it might progress to a chronic (long-term) depressive illness. In 30 to 50 percent of patients, postpartum serious depression lasts at least a year.[4]
- Recurrence is a concern for patients who have recovered from an episode of postpartum depression. It occurs in around 40 to 50 percent of women with postpartum depression.[5][6]
- Postpartum psychosis can affect maternal-infant attachment, which is further interrupted by the mother's inpatient hospitalization. Psychosis can be severe and last for a long time.[7]
Women who have had their first episode of postpartum psychosis have a significant chance of recurrence outside of the postpartum period.[8]
References
- ↑ "Postpartum Depression - StatPearls - NCBI Bookshelf".
- ↑ Burgerhout KM, Kamperman AM, Roza SJ, Lambregtse-Van den Berg MP, Koorengevel KM, Hoogendijk WJ, Kushner SA, Bergink V (January 2017). "Functional Recovery After Postpartum Psychosis: A Prospective Longitudinal Study". J Clin Psychiatry. 78 (1): 122–128. doi:10.4088/JCP.15m10204. PMID 27631144.
- ↑ Bergink V, Burgerhout KM, Koorengevel KM, Kamperman AM, Hoogendijk WJ, Lambregtse-van den Berg MP, Kushner SA (February 2015). "Treatment of psychosis and mania in the postpartum period". Am J Psychiatry. 172 (2): 115–23. doi:10.1176/appi.ajp.2014.13121652. PMID 25640930.
- ↑ "The Course of Postpartum Depression: A Review of Longitudina... : Harvard Review of Psychiatry".
- ↑ Josefsson A, Sydsjö G (2007). "A follow-up study of postpartum depressed women: recurrent maternal depressive symptoms and child behavior after four years". Arch Womens Ment Health. 10 (4): 141–5. doi:10.1007/s00737-007-0185-9. PMID 17533557.
- ↑ Rollè L, Giordano M, Santoniccolo F, Trombetta T (April 2020). "Prenatal Attachment and Perinatal Depression: A Systematic Review". Int J Environ Res Public Health. 17 (8). doi:10.3390/ijerph17082644. PMC 7216181 Check
|pmc=value (help). PMID 32290590 Check|pmid=value (help). - ↑ Gilden J, Kamperman AM, Munk-Olsen T, Hoogendijk W, Kushner SA, Bergink V (March 2020). "Long-Term Outcomes of Postpartum Psychosis: A Systematic Review and Meta-Analysis". J Clin Psychiatry. 81 (2). doi:10.4088/JCP.19r12906. PMID 32160423 Check
|pmid=value (help). Vancouver style error: initials (help) - ↑ Howard LM, Molyneaux E, Dennis CL, Rochat T, Stein A, Milgrom J (November 2014). "Non-psychotic mental disorders in the perinatal period". Lancet. 384 (9956): 1775–88. doi:10.1016/S0140-6736(14)61276-9. PMID 25455248.