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Acute onset postpartum psychosis is much more severe, with women often looking “suddenly disorganized and confused like they’re in some sort of delirium,” Wisner said. Some sufferers have delusions such as a “dark or out-of-body force makes them want to harm their baby,” Wisner added. Another important finding from the review, Wisner said, was that physicians must distinguish between different treatments for the two groups of women who develop postpartum psychosis: Those who have postpartum-only episodes and those who have more chronic mood episodes throughout and after their pregnancy. “For women who only have postpartum episodes, I always recommend, ‘Baby comes out, lithium goes in,’ and you provide immediate medication to prevent an episode of psychosis,” Wisner said. Women with more chronic bipolar disorder usually require medication throughout their pregnancy to remain well, and their physician should monitor their dosing frequently to adjust for the body’s metabolic changes throughout pregnancy, Wisner said. Lastly, the review calls attention to the lack of mother-baby joint care offered at psychiatric hospitals in the United States. “In other countries, there are mother-baby joint admission units in which the mothers are admitted with the babies, and families can come as well, so they’re treated as a unit,” Wisner said. “In America, they’re admitted to a psychiatric hospital, which may not allow newborn visitation, making it impossible to breastfeed or care for their baby during their recovery.” Due to the small number of postpartum psychosis cases available to study, there are very few experts. The American Journal of Psychiatry requested this review to develop an updated and overarching view of the disorder.
For the original version including any supplementary images or video, visit http://www.eurekalert.org/pub_releases/2016-09/nu-ppb090916.php
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