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Psychosis

What is the meaning of Psychosis, Psychotic Disorders and Postpartum Psychosis?

Sometimes words describing these mental health disorders are used interchangeably and can be confusing. 

Psychosis is a general term used to describe an aspect of several different mental health disorders where there is some loss of contact with reality in the way the woman thinks, behaves and what she believes.  It can occur in the more severe forms of schizophrenia, schizoaffective and bipolar disorders and sometimes with a major depressive disorder.

Psychotic Disorders are defined by the presence of psychotic symptoms as described above and often other symptoms too.  There are a range of psychotic disorders, diagnosed on the basis of the type and duration of symptoms.  Schizophrenia is described as a psychotic disorder.  Others, such as Schizoaffective Disorder and Brief Psychotic Disorder are also psychotic disorders.

Postpartum Psychosis is a rare mental health disorder that may occur within 72 hours of the birth but usually within two to four weeks after the birth.  One to two women per 1,000 births experience an episode of Postpartum Psychosis.  It can be a very frightening condition and needs immediate treatment.

Psychosis connected with any mental health disorder arising for the first time in pregnancy, is very uncommon and is generally more likely to occur in the immediate postpartum period than during pregnancy.

Women with a prior history of psychosis (e.g. Schizophrenia,or a Bipolar Disorder with psychotic features) may have a recurrence in the postpartum period.  Substance dependence can also bring on a psychotic episode. 

For some women, a Postpartum Psychosis may be the only psychotic episode they will experience. For others, a Postpartum Psychosis may be the first presentation of a psychiatric disorder.

What are the Risk Factors of Psychosis?

Women are at greater risk of having a psychotic experience during pregnancy or the postpartum period if they have a:

  • Previous history of Postpartum Psychosis (having a previous episode of Postpartum Psychosis increases your risk by 50% with a subsequent pregnancy).
  • Previous history of Bipolar Disorder or Schizophrenia.
  • Family history of Bipolar Disorder or Schizophrenia.
Treatment

Safety of the mother and the infant are the most important priorities. If available, a mother-baby unit or a designated bed on a maternity ward where the baby could be assigned to the nursery, supervised by neonatal nurses is recommended. Ideally, it is preferable not to separate the baby from the mother so that bonding can be promoted. However, this may not always be possible if the mother is too ill.

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