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PubMed1988

Postpartum thyroid dysfunction in Mid Glamorgan.

A high prevalence of postpartum thyroid dysfunction has been reported in several countries, but there have been no systematic studies of its prevalence in Britain. Among a group of 901 consecutive, unselected pregnant women thyroid autoantibodies were detected in 117 (13%) at booking. The clinical course of postpartum thyroid dysfunction, factors associated with its development, and its likely prevalence were defined in 100 of these women with thyroid antibodies and 120 women with no such antibodies who were matched for age. None of the women had a history of autoimmune thyroid disease. Normal reference ranges for thyroid function during pregnancy and post partum were established in the 120 women negative for thyroid antibodies. On the basis of these observations postpartum thyroid dysfunction was observed in 49 (22%) of the 220 women studied, and the prevalence in the total group of 901 women was estimated to be 16.7%. Thyroid dysfunction, mainly occurring in the first six months post partum, was usually transient and included both destruction induced hyperthyroidism and hypothyroidism. The development of the syndrome was significantly related to smoking more than 20 cigarettes a day and the presence of thyroid microsomal autoantibodies at booking. Of the 16 women with a family history of thyroid disease in whom thyroid microsomal autoantibody activity was detectable at booking, 11 developed thyroid dysfunction. Age, parity, presence of goitre at presentation, duration of breast feeding, and the sex and birth weight of the infant were not associated with the development of postpartum thyroid dysfunction. The mood changes experienced by women post partum may in part be associated with altered thyroid function during this time.

Adult↗
PubMed1991

Suicide during pregnancy and in the first postnatal year.

OBJECTIVES: To calculate age adjusted mortality ratios for suicide by women in the first year after childbirth and during pregnancy, and to identify characteristics of postnatal suicide in childbearing women. DESIGN: Retrospective study based on population data for England and Wales from 1973 to 1984. SUBJECTS: Women aged 15-44 who committed suicide in the year after childbirth or during pregnancy. MAIN OUTCOME MEASURES: Observed to expected mortality ratios for the total postnatal sample, for five year age groups, for unmarried mothers, and for suicide after stillbirth; observed to expected mortality ratios for all suicides during pregnancy and for five year age groups; the timing of suicides in relation to delivery; and the frequency of the various methods of suicide. RESULTS: The standardised mortality ratio for postnatal suicide was calculated to be 0.17--that is, the actual total was only one sixth of that expected. The low ratio was not found after stillbirth, which was associated with a rate six times that in all women after childbirth. The low ratio was less pronounced, but still present, in teenage mothers and in unmarried mothers. Women who committed suicide after childbirth most often did so in the first month, and there was a tendency to use violent methods. The standardised mortality ratio for suicide during pregnancy was calculated to be 0.05 of all pregnant women. Teenagers were at substantially increased risk. CONCLUSIONS: Women in the first year after childbirth and during pregnancy have a low risk of suicide despite their high rate of psychiatric morbidity. Underreporting of maternal suicides is unlikely to explain the findings, though it may affect their magnitude. Motherhood seems to protect against suicide. Concern for dependants may be an important focus for suicide prevention in clinical practice.

Abortion, Spontaneous↗
PubMed1989

Visual contrast sensitivity in drug-induced Parkinsonism.

The influence of stimulus orientation on contrast sensitivity function was studied in 10 patients with drug-induced Parkinsonism. Nine of the 10 patients had at least one eye with contrast sensitivity deficit for vertical and/or horizontal stimuli. Only generalised contrast sensitivity loss, observed in two eyes, was stimulus orientation independent. All spatial frequency-selective contrast deficits in 15 eyes were orientation dependent. The striking similarity between the pattern of contrast sensitivity loss in drug-induced Parkinsonism and that in idiopathic Parkinson's disease, suggests that generalised dopaminergic deficiency, from whatever cause, affects visual function in an analogous way.

Adolescent↗
PubMed1986

Behavioral disturbances associated with endocrine disorders.

Patients with major endocrine disorders frequently experience significant changes in mood and mentation. Similarly, many individuals presenting as psychiatric patients have pathologic alterations in neuroendocrine function. Although pathognomic behavioral changes are rare, increased recognition of characteristic symptom complexes may lead to earlier diagnosis and improved treatment planning.

Addison Disease↗
PubMedDate not supplied

Recurring short delirium with postpartum onset in two sisters.

We report on a 30-year-old woman who twice developed a short postpartum psychosis with organic signs, but without obvious organic cause. Extensive investigations only yielded a state of moderate hypercoagulability. Her sister had developed similar signs and symptoms during her second puerperium and died 5 days after her delivery. We discuss the combination of various precipitating factors for postpartum psychosis, the possible impact of the findings on its cause and its classification.

Adult↗
PubMed2006

Shared obsessive-compulsive disorder.

BACKGROUND: Shared psychotic disorder (folie à deux) is an uncommon entity reported mainly in the context of delusions. Obsessions and compulsions occur very rarely as shared psychopathology. MATERIAL AND METHODS: We present two sisters who manifested shared obsessive-compulsive disorder. RESULTS: Both sisters were managed in keeping with their shared obsessive-compulsive disorder leading onto a similar pattern of response. CONCLUSIONS: Shared obsessions could represent the continuum concept of obsessions and delusions, and their relationship needs to be evaluated in greater detail.

Adult↗
PubMed1985

On the nosology of post-partum psychoses.

The author discusses whether post-partum psychoses are to be considered as a clinical entity per se. The studies conducted in Lausanne seem to demonstrate that the authors of DSM III were correct in excluding this possibility - of all the patients with a post partum episode, 65% had one or several relapses without connection with the puerperium.

Female↗
PubMed1993

Pseudopregnancy and postpartum psychosis: a case study.

We report on an uncommon case of a woman who presents with pseudopregnancy. In the past she suffered from postpartum psychosis and an episode characterized by pseudohallucinations. No such association was reported in the literature survey we have made. We discuss the distinction between the overvalued idea as presented in pseudopregnancy and delusion as presented in the postpartum psychosis and suggest that the two phenomena can be viewed as a continuum rather than dichotomized, especially in cases like the one reported here.

Adult↗
PubMed1993

Postpartum psychoses: onset and long-term course.

86 cases of narrowly defined postpartum psychosis were investigated with regard to onset and course of symptomatology. The most frequent initial symptoms were restlessness, paranoid symptoms, catatonic excitement, anxiety, sleep disturbances and depressed mood. 16 patients had died at the time of follow-up. Concerning the further course of the disease 64% of the 61 women who were followed up (average 26 years from onset), had recurrences of illness. The most frequent longitudinal diagnosis, in 49% of the 61 cases, was 'schizoaffective disorder'; only 28% of patients were diagnosed as having schizophrenic disorders at follow-up.

Adolescent↗