Article

Post-partum psychoses: Clinical diagnoses and relative risk of admission after parturition

KAS Glostrup, Psychiatric Department P, Denmark.
The British Journal of Psychiatry (Impact Factor: 7.34). 07/1998; 172:521-6.
Source: PubMed

ABSTRACT Previous studies have suggested that the risk for psychosis, especially affective psychosis, is highly increased during the first 30 days after delivery. The aim of our study was to replicate these findings.
Linking The Danish Medical Birth Register and The Danish Psychiatric Central Register from 1 January 1973 to 31 December 1993 revealed 1253 admissions diagnosed as psychosis within 91 days after delivery. The admission rate after delivery was compared with the admission rate among non-puerperal women in the general Danish female population.
The relative risk of all admissions was only slightly increased, RR = 1.09 (95% CI 1.03-1.16). The admission rate concerning first admissions was highly increased, RR = 3.21 (95% CI 2.96-3.49) whereas the admission rate concerning readmissions was reduced, RR = 0.66 (95% CI 0.61-0.72).
Childbirth is a strong risk factor for first admission with psychosis, but the risk may be less increased than previously assumed.

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    ABSTRACT: The aim of the study was to describe Swedish psychiatrists' experiences of involving the family in the treatment of women with postpartum psychosis. A qualitative design was used, and semistructured qualitative research interviews were conducted with nine psychiatrists from the south of Sweden. Data were analysed using qualitative content analysis. Four categories were found: the family as a resource, the family as coworkers, preparing the family for the future, and the family as a burden. The result showed that the psychiatrists considered the family to be a resource to which they devoted a great deal of care and effort. It was particularly important to involve the partner, informing about the course of the illness and the steps that need to be taken in the event of a relapse and reducing any guilt feelings. The psychiatrists instilled confidence and hope for a future of health and further child bearing. The family members' limited understanding of the treatment may impede the involvement of the family. Conclusion of the study was that the goal for family involvement was to facilitate the women's care and treatment. Further studies are needed to provide suggestions on how to develop family involvement in the care of women suffering from postpartum psychosis.
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    • "Although two epidemiological surveys ( Kendell et al . , 1987 ; Terp and Mortensen , 1999 ) reported the incidence of postpartum psychosis as somewhat less than 1 / 1000 deliveries , no study , to our knowledge , has reported specifically on the incidence of postpartum depression . A survey in Lundby , Sweden , ( Hagnell et al . "
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