Postpartum Psychosis: Risk factors and Management

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Ousman Bajinka

Following childbirth, with a psychosis and associated mood disturbance, Postpartum Psychosis (PPP) is studied to be a severe mental health condition. PPP affects 1 to 2 per 1000 women among the psychiatric emergency. To curb this severe disorder, acute clinical intervention is warranted. Maternal mental health problems with a focus on depression as the condition with the biggest public health impact should be the way forward. This review is set to look into the risk factors, prevention and management of PPP. Both the acute onset and recurrence of psychiatric illness are common during the perinatal period as women are more vulnerable during this period. Timely detection and effective management of perinatal psychiatric disorders are critical for managing PPP. Part of the management strategies for women who experience PPP is to seek guidance on further pregnancies and risk of illness. Since PPP is a disturbing complication of childbirth that carries high risks for both mother and child, if one is at high risk of developing puerperal psychosis, there is the need for a specialist care during pregnancy and be seen by a psychiatrist.

Author(s):  
Vandita Shanbhag ◽  
Madhura Bojappa ◽  
Prabha S. Chandra

Migration affects women and men differently. A discrepancy between gender roles and expectations influence the challenges and coping in immigrants. In this chapter, the importance of understanding migration in a gender-sensitive manner is discussed. Women are likely to have higher rates of psychiatric disorders due to risk factors such as unfavourable socio-economic status, stigma, role burden, and adversities faced during migration. The chapter highlights the protective and risk factors for developing mental health problems in women migrants. Mental health problems in various migrants, such as international, internal, asylum seekers, and vulnerable groups of women such as women in the perinatal period, adolescents and young girls, and elderly women, are discussed. The need to initiate preventive measures before the process of migration and in addition to early detection and intervention for mental health problems by sensitive healthcare providers is emphasized.


2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
M. Patabendige ◽  
S. R. Athulathmudali ◽  
S. K. Chandrasinghe

Background. Mental illness related to pregnancy can have long-lasting consequences. Healthcare providers are often the most frequent medical contact with the potential for early detection of these. Objectives were to study the awareness regarding mental health problems during pregnancy and the postpartum period among healthcare providers. Methods. A cross-sectional study was carried out with healthcare providers including the nursing staff, midwifery staff, and medical officers working at obstetric wards in three tertiary care hospitals in Sri Lanka. A self-administered questionnaire assessed staff experience with mothers having mental problems, knowledge on mental health problems related to pregnancy, and knowledge about risk factors, common symptoms, and possible consequences on a five-point Likert scale from “Strongly Agree” to “Strongly Disagree.” Results. A total of 300 staff were approached and invited to participate. Only 152 responded to the questionnaire (response rate of 50.1%). Mean (SD) age was 35.8 (9.7) years and mean (SD) years of experience was 10.1 (9.1) years. Age more than 35 years of healthcare providers is associated with statistically significant (p=0.02) average knowledge scores on the consequences of maternal mental health problems. The symptom of “excessively worrying about baby’s health” had the lowest score across all three categories with an average of 34.2%. Only 42.8% have ever heard of EPDS. Overall awareness and knowledge about risk factors, symptoms, and consequences regarding pregnancy-related maternal mental health problems are generally good among the healthcare providers studied. However, some of the few aspects are not satisfactory. Health education of pregnant women, promoting regular in-service training sessions, improvement of infrastructure, and involvement of family members from the antenatal period were discussed by the majority. Conclusion. Despite good overall awareness and knowledge, application into practice with the utilization of validated assessments is poor. This may probably explain why Sri Lanka has a high prevalence of postpartum depression suggesting urgent attention.


2013 ◽  
Vol 44 (16) ◽  
pp. 3421-3433 ◽  
Author(s):  
M. A. Landolt ◽  
E. Ystrom ◽  
K. Stene-Larsen ◽  
H. Holmstrøm ◽  
M. E. Vollrath

Background.A congenital heart defect (CHD) can increase the risk of mental health problems in affected children and their parents. The extent to which risk factors for these problems are shared in families or are specific to the individual family member is unclear.Method.Prospective data from the Norwegian Mother and Child Cohort Study (MoBa; n = 93 009) were linked with a nationwide CHD registry, and 408 children with CHD were identified. Mothers' reports on child internalizing problems and their own distress were assessed by questionnaires at child ages 6, 18 and 36 months. A structural model was applied to distinguish between familial (shared) factors and individual-specific factors for mental health problems.Results.CHD was a substantial risk factor for problems in children and their mothers at all time points. CHD contributed on average 31% and 39% to the variance in children's and mothers' problems respectively. Both shared familial and individual-specific factors unique to CHD families contributed to risk for mental health problems. Whereas individual-specific risk factors contributed to the stability of problems in mothers, the effect of these factors lasted only a short time in children. Mutual influences over time were found between the mother's and the child's mental health at 18 and 36 months.Conclusions.The burden of CHD in a child is shared between family members but is also specific to the individual. This study points to a need for both an individual and a family-based approach to provide psychological support to children with CHD and their parents.


Author(s):  
Robert Stewart ◽  
Selena Gleadow Ware

This chapter describes the high burden of mental health problems affecting women in the perinatal period, their impact on both the mother and child, and approaches to prevention and management, with a particular focus on low and middle-income countries. It outlines the main clinical conditions, including postpartum psychosis and perinatal depression. It summarises key biological and psychosocial aetiological factors, including the link with gender-based inequality. It explains that suicide is a leading cause of indirect maternal death and presents the evidence that perinatal mental health problems can impact on foetal and infant growth and development. It argues the importance of taking a broad bio-psycho-social approach to prevention and treatment, and highlights evidence-based psychosocial interventions that can be delivered by community health workers in low-resource settings.


PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257973
Author(s):  
Batala Barsisa ◽  
Habtamu Derajew ◽  
Kibrom Haile ◽  
Gebremeskel Mesafint ◽  
Shegaye Shumet

Background Common mental disorders are the major public healthproblem that affects mothers with young children. Although there were a number of studies done on maternal mental health problems, they were largely focused on perinatal period. However, there is scarcity of information on the magnitude and correlates of these mental health problems beyond perinatal period and due concern is not given mainly in LMICs including our country. Objective To assess the prevalence and factors associated with common mental disorderamong mothers of under-five year children at Arbaminch town, South Ethiopia, 2019. Methods A community based cross-sectional study was conducted in May and June 2019 at Arbaminch town. A systematic random sampling technique was used to select 776 participants. The Self-Reporting Questionnaire (SRQ-20) was used to assess common mental disorder (CMD). Data was coded and entered in EPIDATA3.1 and analyzed using SPSS version 25. Bivariable and multivariable logistic regression were used to identify factors associated to common mental disorder. P-values less than 0.05 were considered statistically significant and strength of the association was presented by adjusted odds ratio with 95% confidence interval. Result The prevalence of common mental disorder among mothers with children aged below five years was 36.6% with (95% CI, 33.2, 39.9). Being single/divorced/widowed [AOR = 3.64, 95% CI:(1.47, 8.99), chronic medical illness [AOR = 3.25, 95% CI:(2.10, 5.04)], exposure to two/more stressful events [AOR = 1.62, 95% CI:(1.11, 2.36)], poor social support [AOR = 2.59, 95% CI:(1.62, 4.14)], mothers living with cigarette smoker husband [AOR = 2.03, 95% CI:(1.19, 3.47)], and mothers physically abused by their spouse [AOR = 2.36, 95% CI:(1.49, 3.74)] were factors associated with common mental disorder. Conclusion and recommendation The prevalence of common mental disorder was high among mothers with children aged below five years compared to the general population. Being single/divorced/widowed, chronic medicalillness, exposure to two/more stressful events, poor social support, mothers living with cigarette smoker husbandand physically abuse by their spouse were factors associated with common mental disorder. Early detection and management of these maternal mental health problems is vital for mothers’ wellbeing as well as growth and development of children.


2021 ◽  
Vol 2 (4) ◽  
pp. 94-99
Author(s):  
Nadia Khoirunnisa Pasaribu

ABSTRACT   Domestic violence during pregnancy is a neglected & underreported problem having grave consequences. The world health organization (WHO) defines domestic violence as “the range of sexually, psychologically and physically coercive acts used against adult and adolescent women by current or former male intimate partners”. Physical & verbal abuse during pregnancy is a frequent phenomenon encountered by women of both developed and underdeveloped country, belonging to all cultural communities. There is a strong evidence that domestic violence is related to maternal mental health disorders. The aim of this literature study is to find the best available research evidence on risk factors of domestic violence in pregnancy and its correlation to mental health disorders. To achieve the goal of this study, researcher searched for all studies published between January 2010 until August 2021 using the databases such as google scholar and PubMed. The inclusion criteria were studies that describe risk factors of domestic violence in pregnancy and its correlation with maternal mental health and written in English languange. Condition such as mental retardation, substance abuse and pre-existing mental health problems before were excluded from this study. After a long review of the titles and abstracts of 358 studies, 20 studies were identified for potential inclusion in the review. In the end, a total of 10 trials that fulfil researcher criteria were used in this literature review. The number of participants in each study varied, ranged from 300 to 1000 and the characteristics of the sample are similar. Domestic violence against women and mental disorders amongst pregnant women are extremely prevalent in under-resourced, urban areas and ultimately, have detrimental effects on birth outcomes. Mental health disorders are significantly associated with having experienced domestic violence in pregnancy. High risk population needs to be identified so that preventive strategies can be planned & implemented to stop the violence and improve mental health during pregnancy.


2013 ◽  
Author(s):  
Ernie Gonzalez ◽  
Jorge G. Varela ◽  
Erika J. Canales ◽  
Alexandra Tellez ◽  
Amy B. Percosky

2019 ◽  
Vol 14 (10) ◽  
pp. 1-8 ◽  
Author(s):  
Jackson Alun ◽  
Barbara Murphy

Loneliness and social isolation are increasingly being acknowledged as risk factors for both physical and mental health problems. Recent statistics demonstrate that loneliness and isolation are on the rise internationally, to the point of being classed as an epidemic. In this paper, the authors outline some of the recent research linking loneliness and isolation to significant chronic diseases such as cardiovascular disease and type II diabetes; mental health disorders such as anxiety and depression; cognitive disorders and dementia. Isolation has also been shown to compromise recovery after acute cardiac events, being associated with increased hospital readmission and premature death. Indeed, isolation has now been identified as a risk factor equivalent in effect to traditional risk factors such as smoking, hypertension and obesity. While distinguishing between objective and subjective indicators of isolation, the authors highlight the complexity of this phenomenon, both in terms of definition and measurement, as well as the interplay between subjective and objective indicators. Important clinical implications for health professionals working with cardiac patients are also proposed, in terms of screening for isolation, and possible interventions to support patients at risk of isolation. The aim of the current article is to emphasise the importance of acknowledging loneliness and isolation as key risk factors requiring urgent attention, both in research and in clinical practice.


2015 ◽  
Vol 45 (9) ◽  
pp. 1999-2012 ◽  
Author(s):  
J. van der Waerden ◽  
C. Galéra ◽  
M.-J. Saurel-Cubizolles ◽  
A.-L. Sutter-Dallay ◽  
M. Melchior ◽  
...  

BackgroundMaternal depression in the pre- and postpartum period may set women on a course of chronic depressive symptoms. Little is known about predictors of persistently elevated depressive symptoms in mothers from pregnancy onwards. The aims of this study are to determine maternal depression trajectories from pregnancy to the child's fifth birthday and identify associated risk factors.MethodMothers (N = 1807) from the EDEN mother–child birth cohort study based in France (2003–2011) were followed from 24–28 weeks of pregnancy to their child's fifth birthday. Maternal depression trajectories were determined with a semi-parametric group-based modelling strategy. Sociodemographic, psychosocial and psychiatric predictors were explored for their association with trajectory class membership.ResultsFive trajectories of maternal symptoms of depression from pregnancy onwards were identified: no symptoms (60.2%); persistent intermediate-level depressive symptoms (25.2%); persistent high depressive symptoms (5.0%); high symptoms in pregnancy only (4.7%); high symptoms in the child's preschool period only (4.9%).Socio-demographic predictorsassociated with persistent depression were non-French origin;psychosocial predictorswere childhood adversities, life events during pregnancy and work overinvestment;psychiatric predictorswere previous mental health problems, psychological help, and high anxiety during pregnancy.ConclusionsPersistent depression in mothers of young children is associated to several risk factors present prior to or during pregnancy, notably anxiety. These characteristics precede depression trajectories and offer a possible entry point to enhance mother's mental health and reduce its burden on children.


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