Download Psichosys postpartum: a general view

Psichosys postpartum: a general view
Authors: Marcos Lamas Sánchez, María Muñiz Pérez, María Leal Barquero, Cayetana
Malo Aso, Gloria Tendero Roldán, Lucía de los Ríos Gestoso, Daniel Lubián López
Affiliations: Obstetrics and Gynecology Service from University Hospital of Puerto Real,
Cádiz(Spain)
Background:
Psichosys postpartum it's a psychiatric disease which occurs in aproximately 1-2 per 1000
deliveries. The prognosis it's usually optimistic with an adecuate treatment, but the
symptomatology could be severe. Early detection it's important to prevent consecuences such
as suicide or infanticide.
Main Objetives:
To know the symptomatology and treatment of psychosis postpartum.
Methods:
Literature review of articles in Pubmed, Scielo, Cochrane Library and Scholar Google.
Preliminary Results:
Psichosys postpartum often appears in earlier postpartum period. Prophylaxis with lithium in
mothers with history of pcychosis postpartum or mania in previous gestations seems to be
highly effective.
The symptomatology goes from insomnia, mood fluctuation, obsessive concerns regarding the
newborn to more severe symptoms such as delusion, hallucinations, disorganized behavior.
Sometimes it's diagnosed as bipolar disease. It's important to make an initial clinical evaluation,
medical and psichiatric history and neurological examinations to get a differential diagnosis.
We need to discard infectious diseases, postmartum thyroiditis, encephalitis or the effect of
some drugs to exclude organic causes.
The treatment it's actually based on benzodiacepines, antipsichotics, mood stabilizers,
antidepressants and electroconvulsive therapy. The treatment algorithm is not well defined,
some authors propose a pharmacological treatment by spets. It's important to encourage the
safety of mother and child. Lithium treatment contraindicates breastfeeding.
Conclusions:
Differential diagnosis it's important. The treatment based on symptomatology it's well known,
but more studies to get an homogeneus algorithm are needed. The pronostic it's optimistic with
treatment and subsequence morbidity is sparse.
References:
1. Wesseloo R, Burgerhout KM, Koorengevel KM, Bergink V. Postpartum psychosis in clinical
practice: diagnostic considerations, treatment and prevention.Tijdschr Psychiatr.
2015;57(1):25-33.
2. Veerle Bergink, M.D., Ph.D. Karin M. Burgerhout, M.D. Kathelijne M. KoorengevelTreatment
of Psychosis and Mania in the Postpartum Period. Am J Psychiatry 172:2, February 2015
http://dx.doi.org/10.1176/appi.ajp.2014.13121652
3. SIT D, ROTHSCHILD AJ, WISNER KL. A Review of Postpartum Psychosis.Journal of
women’s health (2002). 2006;15(4):352-368. doi:10.1089/jwh.2006.15.352.
4. Webb RT, Howard L, Abel KM. Fármacos antipsicóticos para la psicosis no afectiva en el
embarazo y el postparto (Revisión Cochrane traducida). En: La Biblioteca Cochrane Plus, 2008
Número 4.
5. Gómez, M. S. (2013). Patología psiquiátrica en el puerperio. Psicosis puerperal. Revista de
Neuro-Psiquiatria, 65(1), 32-46.