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[Psychic disturbances in the postpartum period: an increasing problem?]
Birgit Kemp1, Kerstin Bongartz, Werner Rath
1Frauenklinik für Gynäkologie und Geburtshilfe, Universitätsklinikum der RWTH Aachen. Dr.Kemp@t-online.de
Zeitschrift Fur Geburtshilfe Und Neonatologie
|November 6, 2003
Summary
Postpartum mood disorders include blues, depression, and psychosis. Early identification and appropriate treatment, ranging from psychotherapy to medication, are crucial for maternal and infant well-being.
Area of Science:
- Psychiatry and Perinatal Mental Health
- Obstetrics and Gynecology
- Clinical Psychology
Context:
- Postpartum psychic disorders affect a significant percentage of new mothers.
- These conditions range from transient 'postpartum blues' to severe postpartum psychosis.
- Accurate diagnosis is essential to differentiate between these conditions and ensure timely intervention.
Purpose:
- To categorize postpartum psychic disorders into blues, depression, and psychosis.
- To outline the prevalence, typical onset, and key symptoms of each disorder.
- To recommend diagnostic approaches and treatment strategies for various postpartum mood disturbances.
Summary:
- Postpartum blues affect 50-70% of deliveries, usually resolving within a week.
- Postpartum depression (10-15% of deliveries) presents with persistent depressive symptoms, anxiety, and potential suicidal ideation, requiring evaluation, especially if blues last over two weeks.
- Postpartum psychoses (0.1-0.2%) are severe, often linked to bipolar or schizoaffective disorders, necessitating hospitalization due to risks of harm to self or infant.
Impact:
- Highlights the need for thorough postpartum mood assessments, utilizing tools like the Edinburgh scale.
- Emphasizes proactive screening for high-risk individuals and collaborative psychiatric care.
- Guides treatment decisions, from psychotherapy and sociotherapy for milder depression to pharmacotherapy (SSRIs, tricyclic drugs) and hospitalization for severe cases and psychoses.