scholarly journals Postpartum Psychosis after Traumatic Cesarean Delivery

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 588
Author(s):  
Evangelia Antoniou ◽  
Eirini Orovou ◽  
Kassiani Politou ◽  
Alexandros Papatrechas ◽  
Ermioni Palaska ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Cesarean Delivery ◽  
Health Care Professionals ◽  
Psychotic Episode ◽  
Postpartum Psychosis ◽  
Childbirth Experience ◽  
Emergency Cesarean ◽  
History Of ◽  
Psychiatric Complications

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.

Postpartum Psychosis

2020 ◽  
pp. 39-50
Author(s):  
Nikole Benders-Hadi
Keyword(s):  
Bipolar Disorder ◽  
Family History ◽  
Elevated Risk ◽  
Psychotic Symptoms ◽  
Postpartum Psychosis ◽  
Poor Sleep ◽  
Activity Levels ◽  
History Of ◽  
Infant Hospitalization ◽  
Increased Activity

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.

scholarly journals A Survey on Causes of Cesarean Sections Performed on Women and Their Knowledge towards the Mode of Delivery

2020 ◽  
Vol 5 (1) ◽  
Keyword(s):  
Cesarean Delivery ◽  
Mode Of Delivery ◽  
Previous History ◽  
Breech Presentation ◽  
Cesarean Sections ◽  
College Hospital ◽  
Cross Sectional ◽  
Emergency Cesarean ◽  
Special Cases ◽  
History Of

Recently elective cesarean delivery rates have increased alongside with emergency cesarean delivery where less information has been conveyed to the women who have been subjected to C-sections. The main objective of C-section is reducing the incidence of maternal and neonatal mortality during childbirth in dangerous situations. It is recommended when there is a risk to mother or child during vaginal delivery. A descriptive type of cross-sectional study design was used. All the data were collected through structured format in questionnaires. The present study was carried out in the department of Obstetrics and Gynecology in the Chittagong Medical College Hospital. The data was collected from 29th September 2019 to 10th October 2019. Most of the patients who were subjected to c section were within the age range of 15-25 (57%). 41% of the cesarean sections were planned whereas 59% were on the basis of emergency and mostly the decision was doctor’s (66%). 58% of the population had enough information before undergoing C-sections and 42% wasn’t fully aware. Among pain medication intake, only 2% of the patients had taken a combination of three pain medications which include paracetamol, metronidazole and suppository. 80% of the patients consumed a combination of paracetamol and suppository whereas only 10% of population consumed paracetamol and metronidazole. 8% of the patients were managed only with paracetamol. 23% of the cesarean patients had a previous history of ceaser and among them some rare special cases had a previous history of 4 ceasers (2%). 43% of the patients suffered pregnancy induced hypertension and 8% suffered pregnancy induced diabetes. 20% of the c section were due to breech presentation and 80% were due to other reasons which included seventeen factors. Patients are not given enough information about C-section and mostly the decisions are taken by the doctors without the consent of the patients.

scholarly journals Microperforated Hymen Presenting Spontaneous Pregnancy with Cesarean Delivery and Hymenotomy Surgery: A Case Report

2018 ◽  
Vol 6 (3) ◽  
pp. 528-530
Author(s):  
Brikene Elshani ◽  
Heroid Arifi ◽  
Armond Daci
Keyword(s):  
Cesarean Delivery ◽  
Perioperative Complications ◽  
Female Genital Tract ◽  
Sexual Life ◽  
Imperforate Hymen ◽  
Vaginal Sex ◽  
History Of ◽  
Vaginal Anatomy ◽  
Female Genital

BACKGROUND: Female genital tract anomalies including imperforate hymen affect sexual life and fertility.CASE PRESENTATION: In the present case, we describe a pregnant woman diagnosed with imperforate hymen which never had penetrative vaginal sex. A 27–year-old married patient with 2 months of amenorrhea presented in a clinic without any other complications. Her history of difficult intercourse and prolonged menstrual flow were reported, and subsequent vaginal examination confirmed the diagnosis of imperforate hymen even though she claims to made pinhole surgery in hymen during puberty. Her urine pregnancy test was positive, and an ultrasound examination revealed 8.3 weeks pregnant. The pregnancy was followed up to 39.5 weeks when she entered in cesarean delivery in urgency. Due to perioperative complications in our study, a concomitant hymenotomy was successfully performed. The patient was discharged with the baby, and vaginal anatomy was restored.CONCLUSIONS: This case study suggests that even though as microperforated hymen surgery in puberty can permit pregnancy and intervention with cesarean section and hymenotomy is a good option to reduce the resulting perioperative complications which indirectly affect the increase of the fertilisation and improvement of later sexual life.

The effects of childhood trauma on psychotic symptoms in bipolar disorder

2011 ◽  
Vol 26 (S2) ◽  
pp. 240-240 ◽  
Author(s):  
M.M. Ozkose ◽  
O. Guclu ◽  
S. Guloksuz ◽  
O. Karaca ◽  
B. Yildirim ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Physical Abuse ◽  
Childhood Trauma ◽  
Rating Scale ◽  
Psychotic Symptoms ◽  
Psychotic Episode ◽  
History Of Childhood ◽  
History Of ◽  
Physical Neglect ◽  
Bipolar Patients

IntroductionAlthough history of childhood trauma is present in nearly 50% of bipolar patients, the effects of childhood trauma on the course of bipolar disorder are rarely investigated. Thus, we aimed to investigate the effects of childhood trauma on psychotic symptoms seen in patients with bipolar disorder.MethodsOne-hundred DSM-IV-TR diagnosed bipolar patients who were either manic or depressive were recruited from inpatient units of Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery. Patients were initially evaluated by Young Mania Rating Scale (YMRS), Montgomery-Asperg Depression Rating Scale (MADRS), Scales for Assessment of Positive Symptoms. Patients were also evaluated by Childhood Trauma Questionnaire (CTQ) and Dissociative Experiences Scale in euthymia which was defined by scores of < 7 in YMRS, < 4 in MADRASResultsThere were no differences between the patients with and without a history of psychotic episode in terms of age at onset, duration of illness and episode characteristics. Patients with a history of psychotic episode were hospitalized more. CTQ physical abuse scores were higher in male comparing to female. CTQ sexual abuse scores were higher in female comparing to male. CTQ emotional abuse, physical neglect, physical abuse and total scores were higher in patients who had at least one psychotic episode in lifetime than in patients without a history of psychotic episode.ConclusionThe history of childhood trauma should be investigated and therapeutic interventions for childhood trauma should be added to the standard treatment plan of bipolar patients.

scholarly journals Puerperal psychosis: identifying and caring for women at risk

2009 ◽  
Vol 15 (6) ◽  
pp. 411-418 ◽  
Author(s):  
Ian Jones ◽  
Sue Smith
Keyword(s):  
Bipolar Disorder ◽  
High Risk ◽  
Maternal Death ◽  
Severity Of Illness ◽  
Acute Onset ◽  
Psychotic Episode ◽  
Postpartum Psychosis ◽  
Clinical Services ◽  
Puerperal Psychosis ◽  
The Uk

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.

scholarly journals Religious or Spiritual Experiences and Bipolar Disorder: A Case Study from the Perspective of Dialogical Self Theory

Religions ◽  
2020 ◽  
Vol 11 (10) ◽  
pp. 527
Author(s):  
Eva Ouwehand ◽  
Hetty Zock ◽  
Hanneke Muthert
Keyword(s):  
Bipolar Disorder ◽  
Health Care Professionals ◽  
Explanatory Models ◽  
Spiritual Experiences ◽  
Religious Experiences ◽  
Dialogical Self ◽  
Psychological Dimension ◽  
Interpretation Process ◽  
Dialogical Self Theory

In this article, a case study will be presented of a person with bipolar I disorder, who struggles to interpret his religious experiences and how they are related to the disorder. The analysis builds on a larger study into religious experiences within the context of bipolar disorder (BD). In this previous study, medical and religious explanatory models for religious experiences related to BD often appeared to go hand in hand in patients who have had such experiences. In this case study, the various ‘voices’ in the interpretation process over time will be examined from the perspective of the dialogical self theory of Hubert Hermans, in order to explore the psychological dimension of this process. The case study demonstrates that a ‘both religious and pathological’ explanatory model for religious experiences consists of a rich and changing variety of I-positions that fluctuate depending on mood episode. Structured reflection from a spiritual and from a medical perspective over the course of several years helped this person to allow space for different dialoguing ‘voices’, which—in this case—led to a more balanced attitude towards such experiences and less pathological derailment. The systematic reflection on religious experiences by the person in the case study was mainly conducted without help of mental health care professionals and was not derived from a DST perspective. It could be argued, however, that DST could be used as a helpful instrument for the exploration of both medical and spiritual ‘voices’ in the interpretation of religious experiences in both clinical practice by hospital chaplains and by other professionals.

scholarly journals Postpartum psychosis in bipolar disorder: no evidence of association with personality traits, cognitive style or affective temperaments

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
A. Perry ◽  
K. Gordon-Smith ◽  
I. Webb ◽  
E. Fone ◽  
A. Di Florio ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Personality Traits ◽  
Cognitive Style ◽  
Cognitive Styles ◽  
Dysfunctional Attitudes ◽  
Postpartum Psychosis ◽  
Affective Temperaments ◽  
Increased Risk ◽  
Affective Temperament ◽  
History Of

Abstract Background Bipolar disorder has been associated with several personality traits, cognitive styles and affective temperaments. Women who have bipolar disorder are at increased risk of experiencing postpartum psychosis, however little research has investigated these traits and temperaments in relation to postpartum psychosis. The aim of this study is to establish whether aspects of personality, cognitive style and affective temperament that have been associated with bipolar disorder also confer vulnerability to postpartum psychosis over and above their known association with bipolar disorder. Methods Personality traits (neuroticism, extraversion, schizotypy and impulsivity), cognitive styles (low self-esteem and dysfunctional attitudes) and affective temperaments (including cyclothymic and depressive temperaments) were compared between two groups of parous women with DSM-IV bipolar I disorder: i) 284 with a lifetime history of postpartum psychosis within 6 weeks of delivery (PP group), ii) 268 without any history of mood episodes with onset during pregnancy or within 6 months of delivery (no perinatal mood episode, No PME group). Results After controlling for current mood state, and key demographic, clinical and pregnancy-related variables, there were no statistically significant differences between the PP and No PME groups on any of the personality, cognitive style or affective temperament measures. Conclusions Personality traits, cognitive styles and affective temperaments previously shown to be associated with bipolar disorder in general were not specifically associated with the occurrence of postpartum psychosis. These factors may not be relevant for predicting risk of postpartum psychosis in women with bipolar disorder.

First Clinical Signs of the Bipolar Prodrome

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
G. Juckel
Keyword(s):  
Bipolar Disorder ◽  
Family History ◽  
Positive Family History ◽  
Clinical Signs ◽  
Structured Interview ◽  
Psychotic Episode ◽  
Affective Temperament ◽  
History Of ◽  
Bipolar Patients

Temperament and mood swings are promising indicator for the characterization of mood-spectrum vulnerability. The aim of this study was to investigate the relationship between affective temperament and mood swings in bipolar disorder. We explored these clinical features retrospectively. Patients who met the criteria for Bipolar I disorder were enrolled in the study. Exclusion criteria were partial remittance and a full affective or psychotic episode. Data concerning illness and family history, mood swings (semi-structured interview) and depression (BDI) were obtained. We examined premorbid temperament with TEMPS-A, and with the validated German version TEMPS-M. Patients with and without mood swings were compared with respect to the dominant temperament. Out of 20 bipolar patients, 6 subjects reported mood swings prior to the onset of affective disorder. Subjects with mood swings significantly correlated with a positive family history of affective disorders. Concerning cyclothymic, irritable, and hyperthymic temperament, bipolar affective patients with mood swings had higher scores. No differences were found between males and females. Our findings support the assumption that mood swings, as represented by the cyclothymic temperament, could be prodromes of bipolar disorder. These traits may represent vulnerability markers and could presumably be used to identify individuals at high risk for developing bipolar disorder in order to prevent this illness or to modify its course. A further retrospective study with a larger sample size was started to deepen knowledge about putative prodromal symptoms of bipolar disorder.

Commentary

2013 ◽  
pp. 128-132
Author(s):  
W. Edward Craighead ◽  
Anjana Muralidharan
Keyword(s):  
Bipolar Disorder ◽  
Successful Treatment ◽  
Psychiatric Treatment ◽  
Clinical Information ◽  
Effective Intervention ◽  
Evidence Based ◽  
Critical Part ◽  
History Of

In the case study, “Psychiatric Treatment of Bipolar Disorder: The Case of Janice,” Rakofsky and Dunlop describe the successful treatment of a patient with a complicated history of bipolar disorder. They first provide an excellent descriptive, clinical information regarding the background and scientific findings relevant to treatment of this disorder. This information is important for several reasons. First, psychoeducation is a critical part of all evidence-based somatic and psychosocial treatments; thus, it is essential that the person providing treatment have command of this information in order to educate the patient. In addition to educating the patient about the disorder, effective intervention includes a coherent and compelling rationale for the treatment—a treatment that usually is long-term and requires adherence to a prescribed regimen of medications and psychosocial therapies....

Varenicline-Induced Mixed Mood and Psychotic Episode in a Patient with a Past History of Depression

CNS Spectrums ◽  
2008 ◽  
Vol 13 (6) ◽  
pp. 511-514 ◽  
Author(s):  
Andres J. Pumariega ◽  
Robert Nelson ◽  
Larry Rotenberg
Keyword(s):  
Bipolar Disorder ◽  
Adverse Effects ◽  
Preventive Measures ◽  
Past History ◽  
Psychotic Episode ◽  
Promising Agent ◽  
History Of ◽  
Effective Use ◽  
Psychiatric Adverse Effects ◽  
History Of Depression

ABSTRACTVarenicline is a promising agent with demonstrated efficacy in the promotion of smoking cessation. However, from the time of initial trials, it has been associated with significant psychiatric adverse effects. We describe a case where mixed mood and psychotic disturbance developed in an individual with a history of depression and a family history of bipolar disorder. Based on this case, we hypothesize a possible mechanism of action for these adverse effects and preventive measures that could be undertaken in its effective use.

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