POSTPARTUM PSYCHOSIS AND POSTPARTUM THYROIDITIS1
Section snippets
INTRODUCTION
The uniqueness of postpartum psychiatric disorders has been recognized for centuries (Parry, 1995). Following pregnancy, women have almost a 4-fold increase in chance of being hospitalized with a psychotic disorder within 2 years after childbirth. The risk is highest in primiparas and in the first 3 months following pregnancy (Kendell et al., 1987). One of the earliest descriptions of postpartum psychosis was by Victor Marce’ who in 1858 observed these disorders (‘sympathie morbide’) to have
CASE REPORT
A 29-year-old, gravida 3, para 3, woman was hospitalized 3 months postpartum because of agitation, delusions, and hallucinations. About 2 weeks prior to admission, she started to experience severe insomnia, weight loss, fatigue and heat intolerance. At this point, she began to have visual and auditory hallucinations and appeared confused to her husband. She was not able to take care of herself or her infant. She developed extreme religiosity and believed that she was pregnant with the Christ
DISCUSSION
The patient exhibited typical symptoms for PPT and postpartum psychosis, although she did not meet DSM-IV criteria for postpartum onset (DSM-IV allows the specifier ‘with postpartum’ onset to be used in cases of mood disorders when the onset is within 4 weeks postpartum) (American Psychiatric Association, 1994, Gitlin and Pasnau, 1989, Inwood, 1985, Kendell et al., 1987, Parry, 1995, Pritchard and Harris, 1996). The physical examination (goiter, brisk reflexes, and tachycardia) and laboratory
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Cited by (35)
The role of the immune system in postpartum psychosis
2021, Brain, Behavior, and Immunity - HealthCitation Excerpt :Furthermore, the authors reported a faster and greater progression to clinical thyroid dysfunction in women with PP and AITD, when compared with the postpartum control group (Bergink et al., 2011a). These findings are consistent with an earlier case report, which documented the simultaneous onset of postpartum thyroiditis and PP in a 29-year-old woman with no past history of psychiatric or general medical disorders (Bokhari et al., 1998). Simiarly, a previous study of thyrotoxicosis and hypothyroidism in postpartum women found evidence of PP-like symptoms in the women with postpartum thyroid dysfunction.
Hormonal and immunological factors in postpartum psychosis
2019, Biomarkers of Postpartum Psychiatric DisordersExploring the aspect of psychosomatics in hypothyroidism: The WOMED model of body-mind interactions based on musculoskeletal changes, psychological stressors, and low levels of magnesium
2014, Woman - Psychosomatic Gynaecology and ObstetricsCitation Excerpt :Other authors have also analyzed the increased energy requirement involved in infant carrying both in humans as well as in animals (Wall-Scheffler et al., 2007; Altmann and Samuels, 1992). Combining this effect of energy need for child-carrying to the axial displacement associated with lateral tension rounds up a musculoskeletal component that will influence negatively the energy balance and lead partly to “psychosomatic” changes post-partum (Bokhari et al., 1998; Groer and Vaughan, 2013). Some studies done under experimental conditions can be taken as indirect evidence for our findings.
The role of midwives in facilitating recovery in postpartum psychosis
2010, Journal of Midwifery and Women's HealthCitation Excerpt :Although she did not express suicidal or homicidal ideation, she displayed aggression by becoming both physically and verbally combative. Women displaying symptoms of postpartum psychosis need to be assessed for underlying organic medical conditions that may also produce psychotic-like symptoms, including the following: stroke; uremic encephalopathy; hepatic failure; diabetic ketoacidosis; sepsis; preeclampsia; Graves disease; parathyroid abnormalities; deficiencies in vitamin B12, folate, and thiamine; adverse effects from medications, including steroids, opioids, sympathomimetics, antibiotics, and anticholinergics; substance abuse; meningitis; or HIV-related encephalitis.3,5,18–21 Postpartum psychosis also needs to be differentiated from postpartum depression (PPD) and obsessive compulsive disorder (OCD; Table 1).
Postpartum Biomedical Concerns: Breastfeeding
2008, Family Medicine ObstetricsAlterations in platelet serotonin transporter binding in women with postpartum onset major depression
2004, Journal of Psychiatric Research
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Presented at the 27th congress of International Society of Psychoneuroendocrinology (August 1996), Cascais, Portugal.