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PubMed1994

Postnatal mental illness: a transcultural perspective.

The three main conditions that are associated with childbirth are the maternity blues, postnatal depression and post-partum psychosis. The prevalence of the blues, which are mild, transient and very common disturbances of postnatal mood, does not appear in a major way to be related to environmental, social or cultural factors. Postnatal depression, which has a predominantly psychosocial etiology, surprisingly does not appear to vary in incidence across different cultures in the few studies reported that permit direct comparisons. There is also no good evidence for or against the theory that postnatal depression is partly the consequence of the customs and rituals that traditionally mark the transition to parenthood being stripped away in developed Western societies. However, the lack of relevant research and limitations of method severely restrict any conclusions that can be drawn. There is much firmer evidence for a consistent incidence of post-partum psychosis across cultural and ethnic divides; this observation, together with clinical data and historical evidence of an unchanging incidence rate during the past 150 years, points to a primarily endogenous etiology for the psychoses, which may be triggered by the physiology of childbirth. The transcultural approach to postnatal psychiatric disorders provides a unique opportunity not only to test hypotheses about social and cultural contributions to the etiology of psychotic and non-psychotic reactions to childbirth, but also an opportunity to study the ways in which social factors can influence the evolution of psychopathology. It is also possible that in some cultures the family and social milieu may play a major part in buffering infants from the adverse effects of maternal postnatal illness, but the evidence is anecdotal. Systematic research across cultures will lead to better recognition of maternal illness as well as to better prevention and management.

Cross-Cultural Comparison↗
PubMed1994

Follow-up and family study of postpartum psychoses. Part II: Early versus late onset postpartum psychoses.

Patients suffering from a severe psychiatric postpartum disorder (n = 119) were classified according to early onset (EO) of symptoms, i.e. onset within 2 weeks postpartum, versus late onset (LO) in the 3-month period following delivery. The patients were admitted for the first time in their life to a psychiatric hospital. The EO cases more often had a manic syndrome, the symptomatology of cycloid psychoses, signs of confusion and an abrupt onset of illness. They were also younger at the index delivery and at the first episode of illness. No important difference in the distribution of diagnoses considering the long-term course was found in the two groups. The global psychopathological outcome was also similar. There is no definite evidence that different diseases are provoked in the early and later postpartum period.

Adult↗
PubMed1995

Bromocriptine and psychosis: a literature review.

Bromocriptine is an ergot-derived dopamine agonist. Its current uses include the treatment of Parkinson's disease, postpartum ablaction, prolactinomas, acromegaly, and amenorrhea and galactorrhea secondary to neuroleptic use. It is often reported to produce psychiatric side effects such as confusion, hallucinations, and delusions. The literature is reviewed and supports a strong anecdotal relationship between bromocriptine use and psychosis.

Amenorrhea↗
PubMed2004

Relational ethics: when mothers suffer from psychosis.

OBJECTIVE: The goal of this review is to aid clinicians with ethical issues arising in the treatment of women who suffer from psychosis. METHOD: This paper is a synthesis of the recent literature in adult and child psychiatry, ethics, law, and child welfare pertaining to the topic of maternal psychosis. Topics include: family planning, the care of pregnant women with schizophrenia, postpartum psychosis, child custody, involuntary treatment, confidentiality issues, and service fragmentation. CONCLUSION: Appreciation of the particularized circumstances of issues arising in the treatment of mothers who suffer from psychosis serve the clinician better than the dispassionate application of a principle-driven ethic.

Adult↗
PubMed1992

Postpartum paravaginal hematoma and lower-extremity infection.

We report a case of infection of the lower extremity after a normal vaginal delivery. The infection originated in an occult obturator internus muscle hematoma, and diagnosis was based on a clinical suspicion and characteristic findings on computerized tomography scan. These findings permitted prompt surgical drainage, debridement, and antibiotic therapy and resulted in a successful outcome.

Adult↗
PubMed1988

Reduced beta-casein levels in milk samples from patients with postpartum psychosis.

Defatted breast milk from women with postpartum psychosis and from healthy lactating women was analyzed by high-resolution gel permeation chromatography as well as by sodium dodecyl sulfate (SDS) and urea polyacrylamide gel electrophoresis. The gel permeation procedure allowed quantitative analysis of milk proteins (including beta-casein) with minute amounts of defatted milk (10-15 microliter). By electrophoresis, further characterization of the protein pattern, including the beta-casein fraction, was obtained. Milk samples from five control and seven psychotic subjects were analyzed. The concentration of the beta-casein-containing peak was significantly lower in milk samples from the psychotic group by both chromatography and electrophoresis. These lower levels of beta-casein may result from a higher rate of enzymatic degradation generating i.a. peptides with opioid activity, as shown earlier in plasma and CSF of women with postpartum psychosis.

Adult↗
PubMedDate not supplied

Postpartum psychiatric disorders: a review.

Postpartum emotional disorders generally fall into one of three categories: "blues," depressions, or psychoses. Such postpartum syndromes are described as to their presenting symptomatology, phenomenology, treatment, and prognosis. The role of the appropriate use of psychotropic medication in these conditions, after proper diagnosis, is also discussed. This overview is meant to be helpful to consultation-liaison psychiatrists and to other psychiatrists who work closely with obstetricians and primary care physicians.

Depressive Disorder↗
PubMedDate not supplied

A case of monthly unipolar psychotic depression with suicide attempt by self-burning: selective response to bupropion treatment.

A second case of monthly, unipolar, psychotic depression is presented, involving a 26-year-old woman whose illness had a postpartum onset, recurred premenstrually for 33 consecutive months, and involved a suicide attempt by self-burning. Whereas various antidepressant, antipsychotic, and hormonal treatments were ineffective, bupropion (together with low-dose trifluoperazine) induced an immediate and complete remission that was maintained at a 16-month evaluation.

Adult↗
PubMed1994

Postpartum ovarian veins thrombophlebitis.

Puerperal ovarian vein thrombophlebitis (POVT) is a rare postpartal complication. Its incidence is about 0.05%. POVT can follow a term pregnancy, a premature delivery, an abortion or an ectopic pregnancy. POVT usually presents as a syndrome consisting in lower abdominal pain and fever which does not respond to adequate antibiotics. We present a case report, in which the diagnosis was based upon computed tomography.

Adult↗