scholarly journals Mania triggered by sleep loss and risk of postpartum psychosis in women with bipolar disorder

2018 ◽  
Vol 225 ◽  
pp. 624-629 ◽  
Author(s):  
Katie J.S. Lewis ◽  
Arianna Di Florio ◽  
Liz Forty ◽  
Katherine Gordon-Smith ◽  
Amy Perry ◽  
...  
Author(s):  
Nikole Benders-Hadi

This chapter on postpartum psychosis notes that the risk of postpartum psychosis in the general population is very rare at less than 1%. In a mother with a known history of schizophrenia, this risk increases to 25%. Psychotic symptoms appearing postpartum may also be evidence of a bipolar disorder. The presence of elevated mood, increased activity levels and energy, poor sleep, and a family history of manic episodes all increase the likelihood that a bipolar disorder is present. Women with a personal or family history of a bipolar disorder are at an elevated risk of developing a mania or depression with psychotic symptoms postpartum. Postpartum psychosis due to any cause is a psychiatric emergency and treatment should be initiated early and aggressively to ensure the safety of mother and infant. Hospitalization and/or separation of the baby and mother may be necessary. The use of medication to treat schizophrenia or bipolar disorder during pregnancy may decrease the risk of a postpartum psychosis. With appropriate postpartum medication and support, the majority of women experiencing postpartum psychosis recover well and the risk of recurrent psychotic symptoms can be greatly reduced.


2003 ◽  
Vol 64 (11) ◽  
pp. 1284-1292 ◽  
Author(s):  
Linda H. Chaudron ◽  
Ronald W. Pies

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Anna-Sophie Rommel ◽  
Nina Maren Molenaar ◽  
Janneke Gilden ◽  
Steven A. Kushner ◽  
Nicola J. Westerbeek ◽  
...  

Abstract Objective We aimed to investigate the outcome of postpartum psychosis over a four-year follow-up, and to identify potential clinical markers of mood/psychotic episodes outside of the postpartum period. Methods One hundred and six women with a diagnosis of first-onset mania or psychosis during the postpartum period were included in this prospective longitudinal study. Women were categorized into either (1) recurrence of non-postpartum mood/psychotic episodes or (2) mania/psychosis limited to the postpartum period. We summarize the longitudinal course of the illness per group. We used a logistic regression model to identify clinical predictors of recurrence of mood/psychotic episodes outside of the postpartum period. Results Over two thirds of the women included in this study did not have major psychiatric episodes outside of the postpartum period during follow-up. The overall recurrence rate of mood/psychotic episodes outside the postpartum period was ~ 32%. Of these women, most transitioned to a bipolar disorder diagnosis. None of the women fulfilled diagnostic criteria for schizophrenia or schizophreniform disorder. No clinical markers significantly predicted recurrence outside of the postpartum period. Conclusions For the majority of women with first-onset postpartum psychosis, the risk of illness was limited to the period after childbirth. For the remaining women, postpartum psychosis was part of a mood/psychotic disorder with severe non-postpartum recurrence, mainly in the bipolar spectrum. No clinical predictors for risk of severe episodes outside the postpartum period emerged. Our findings add to previous evidence suggesting a fundamental link between postpartum psychosis and bipolar disorder, which may represent two distinct diagnoses within the same spectrum.


2017 ◽  
Vol 211 (3) ◽  
pp. 169-174 ◽  
Author(s):  
Katie Swaden Lewis ◽  
Katherine Gordon-Smith ◽  
Liz Forty ◽  
Arianna Di Florio ◽  
Nick Craddock ◽  
...  

BackgroundSleep loss may trigger mood episodes in people with bipolar disorder but individual differences could influence vulnerability to this trigger.AimsTo determine whether bipolar subtype (bipolar disorder type I (BP-I) or II (BD-II)) and gender were associated with vulnerability to the sleep loss trigger.MethodDuring a semi-structured interview, 3140 individuals (68% women) with bipolar disorder (66% BD-I) reported whether sleep loss had triggered episodes of high or low mood. DSM-IV diagnosis of bipolar subtype was derived from case notes and interview data.ResultsSleep loss triggering episodes of high mood was associated with female gender (odds ratio (OR) = 143, 95% CI 1.17–1.75,P<0.001) and BD-I subtype (OR=2.81, 95% CI 2.26–3.50,P<0.001). Analyses on sleep loss triggering low mood were not significant following adjustment for confounders.ConclusionsGender and bipolar subtype may increase vulnerability to high mood following sleep deprivation. This should be considered in situations where patients encounter sleep disruption, such as shift work and international travel.


Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 588
Author(s):  
Evangelia Antoniou ◽  
Eirini Orovou ◽  
Kassiani Politou ◽  
Alexandros Papatrechas ◽  
Ermioni Palaska ◽  
...  

An emergency cesarean delivery can be a traumatic childbirth experience for a woman and a risk factor for postpartum psychosis, especially in a patient with a history of bipolar disorder. This article describes the case of a pregnant woman with an unknown history of bipolar disorder who developed an acute psychotic reaction during the procedure of an emergency caesarian section and switched to mania. The purpose of this case study is for perinatal health care professionals to identify suspicious symptoms and promptly refer to psychiatric services so as to ensure the mother’s and the newborn’s safety. This case study highlights the importance of assessing women with bipolar disorder or a previous psychotic episode for the risk of psychiatric complications in pregnancy and after childbirth. Midwifery education on perinatal mental health is crucial for the detection of suspicious symptoms and early referral to a specialist.


2003 ◽  
Vol 5 (2) ◽  
pp. 98-105 ◽  
Author(s):  
Verinder Sharma ◽  
Dwight Mazmanian

2016 ◽  
Vol 205 ◽  
pp. 69-72 ◽  
Author(s):  
A. Perry ◽  
K. Gordon-Smith ◽  
A. Di Florio ◽  
L. Forty ◽  
N. Craddock ◽  
...  

2017 ◽  
Vol 41 (S1) ◽  
pp. S112-S113
Author(s):  
M. Casanova Dias ◽  
I. Jones ◽  
A. Di Florio ◽  
L. Jones ◽  
N. Craddock

IntroductionFor women with bipolar disorder, childbirth is a high-risk period with 40–50% experiencing a recurrence and 20% developing a severe episode of postpartum psychosis. Bipolar episodes in the perinatal period affect women and their families.Managing bipolar disorder in pregnancy and postpartum is a challenge. There is lack of literature to inform that and an urgent need for more data.ObjectivesTo develop and validate a risk prediction model for individual prognosis of the risk of recurrence of bipolar disorder for women in the perinatal period.AimsTo provide evidence-based information to help women and the clinicians that look after them make decisions about their care, taking into account the most recent scientific knowledge and their individual characteristics.MethodsThe development of the model will be done in retrospective data from a large clinical cohort from the Bipolar Disorder Research Network (BDRN.org). The validation will be done in a prospectively recruited sample.Participants will be 2181 parous women with a lifetime diagnosis of bipolar disorder from BDRN and 300 prospectively recruited pregnant women with a history of postpartum psychosis or bipolar disorder.Predictors will be chosen based on clinical experience and literature, from data collected via semi-structured interview (in pregnancy and 3 months postpartum, medical and psychiatric notes) e.g. medication, smoking, parity, obstetric complications and sleep.ResultsN/A.ConclusionsWe will present the full prediction model (regression coefficients and model intercept) and report performance measures (with CIs).We will discuss its potential clinical use and implications for future research.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2009 ◽  
Vol 15 (6) ◽  
pp. 411-418 ◽  
Author(s):  
Ian Jones ◽  
Sue Smith

SummaryPuerperal (postpartum) psychosis – the acute onset of a manic or psychotic episode shortly after childbirth – most commonly occurs in women with a bipolar disorder diathesis who have a vulnerability to a specific childbirth-related trigger. Women with bipolar disorder are at particularly high risk of puerperal psychosis, with a severe affective episode following between 25 and 50% of deliveries. Suicide is a leading cause of maternal death in the UK and it is clear that we must do more to identify and better manage women at high risk of illness related to childbirth. The clinical picture of puerperal psychosis can vary dramatically from hour to hour and can escalate quickly to a true psychiatric emergency. It is vital that clinical services identify women who are unwell and can respond quickly to the severity of illness, delivering treatment in the most appropriate setting for the mother and her baby.


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