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Determinants and pattern of postpartum psychological disorders in Hazara division of Pakistan.

BACKGROUND: The risk of psychological disorders in women increases during the postpartum period. The major forms of these disorders are post partum psychoses and post partal depression. This study was designed to evaluate the presentation and sociodemographic characteristics of postpartal psychological disorders at Hazara division of Pakistan. METHODS: This study was carried out over a period of three years at three major cities of Hazara, Pakistan. One psychiatry clinic in each of these cities was selected and record of all the psychiatric patients was kept. All the patients presenting with post partal disorders were included in the study. A proforma was used to collect information about a wide variety of sociodemographic variables and presentation of disease. Frequencies were calculated for different variables. RESULTS: 8.66% (1248) out of 14,400 patients of psychiatric disorders presented with post partal disorders. 60% out of these 1248 had post partal psychoses while the rest had post partal depression. The majority of our patients with post partal depression were young (20-31 years), illiterate (80%), having past history of psychoses/depression (70%), house wives (95%), from rural areas (65%), highly religious (60%), poor (90%), with husband away for job etc. (70%), primipara (80%) and with a live baby born (70%). A number of stressors were identified in 65% of subjects. CONCLUSIONS: There is a predictable set of risk factors for post partal psychological disorders in the population of Hazara. Proper identification of these risk factors during antenatal period with collaboration of obstetrician and psychiatrist can reduce the morbidity associated with this group of disorders.

Adult↗
PubMed1992

[The relationship between feeding and fertility in dairy cattle].

The possible relationship between nutrition and fertility in dairy cows are reviewed. Study of the literature shows that opinions on the effect of the various nutrients differ markedly. The conclusion which can be made is that in countries where standards of dairy farming are high, nutrition only plays a minor role in the problem of herd subfertility. In the course of time deficiencies in a large number of minerals, trace elements and vitamins have been stressed as a cause of inadequate fertility. However cows are at present generally fed with a lot of well balanced concentrates and therefore deficiencies are very unlikely to occur. During early lactation every high producing dairy cow has a negative energy balance. In a number of cows this results in anoestrus and in a long interval from parturition to first insemination. Overfeeding during late lactation and the dry period does not adversely affect subsequent reproduction but may cause puerperal disorders. The relation between protein nutrition and fertility is complex. Protein effects on fertility are minor. Problems can arise if there is a combination of a high percentage of crude protein (greater than 18%), a high rumen degradability of the protein and a low energy content of the diet. The value of metabolic profile tests is minimal because they do not differentiate between normal herds and herds with fertility problems.

Animal Feed↗
PubMed1992

Response to sleep deprivation in three women with postpartum psychosis.

BACKGROUND: Postpartum psychotic disorders are rare and poorly understood phenomena occurring after approximately 1 in 2000 births. Increasing attention has been given to the concept of postpartum psychosis as an affective spectrum disorder. We sought to characterize the responses to sleep deprivation of three women with postpartum psychotic and mood symptoms. METHOD: Three hospitalized postpartum women with no prior history of psychotic disorder were treated according to a partial sleep deprivation protocol. Each patient was awakened at 2:00 a.m. and kept awake until 9:00 p.m. the following night. A full and an abbreviated Hamilton Rating Scale for Depression (HAM-D) were completed for each patient before and after partial sleep deprivation. RESULTS: Two of the three patients became transiently manic and the third became hypomanic after sleep deprivation. HAM-D scores decreased drastically for each patient. After recovery sleep, each patient de-escalated but required further treatment with mood-stabilizing agents. CONCLUSION: These findings suggest that postpartum psychosis in our patients may represent a variant of bipolar affective disorder.

Adult↗
PubMed1992

[Effects of leukinferon on the phagocytic function of puerperal blood].

Leukinferon effects on the phagocytic activities of the monocytes and polymorphonuclear leukocytes of 12 pregnant women and puerperants with various chronic infectious diseases were studied in vitro. Blood samples of 5 female donors were examined for control. It was found possible to stimulate and correct phagocytic function by leukinferon, proceeding from the initial function of the blood cells and the presence of serum factors. The immunocorrecting properties of leukinferon were found particularly valuable in cases with immunodeficiencies, for infectious diseases and labor complications could thus be prevented in this high-risk group of puerperants.

Cytokines↗
PubMed2006

Postpartum hospitalization of psychotic parents with their infant: a case study.

BACKGROUND: Parents with mental illness are at risk for exacerbations during the postpartum period. The management of family members needing concurrent psychiatric hospitalization is unclear. This article describes the advantages and difficulties of a family hospitalization, focusing on the splitting processes in the staff and the use of "couple ego functions'. DATA: A couple, simultaneously psychotic after the sequential births of two children, were hospitalized separately after the birth of the first child, and simultaneously in the same room after the birth of the second child. RESULTS: The hospitalization of the couple with their infant led to a shorter, less stressful hospitalization, and strengthened the functioning of the family unit. CONCLUSIONS: Simultaneous hospitalization of family members is feasible and may lead to better clinical results.

Adult↗
PubMed1991

Life stress and post-partum psychosis: a preliminary report.

This is a preliminary report from a prospective study of the influence of psychosocial stressors on post-natal relapse in women at high risk of psychiatric disorder after childbirth. Forty-three index subjects with a previous history of psychosis or severe depression were compared with 45 pregnant control subjects without any previous psychiatric disorder. After delivery 51% of index subjects relapsed (RDC diagnoses): 28% were categorised as psychotic and 23% non-psychotic. All psychotic relapses were in women with a previous history of bipolar or schizoaffective disorder (46% of this subgroup). Only the non-psychotic post-partum relapses (mostly depressions) were associated with an increased likelihood of a severe life event in the 12 months preceding illness onset.

Bipolar Disorder↗
PubMed1991

The dialogical dimension in therapists' dreams about their patients.

The author develops a conception of the dialogical dimension in therapists' dreams about their patients by using elements of Martin Buber's dialogue philosophy, particularly "Inclusion." By way of illustration, the author discusses one of her cases, and a dream she had about her patient, "The Dream of the Meeting." The dream is interpreted along the lines of the classical countertransference interpretation, the projective identification and the uncovering of the dialogical dimension. The use of dreams as part of "Inclusion" therapy is then discussed.

Adult↗
PubMed1991

[Psychoses during the puerperium. Review of the literature].

More than half of the psychoses which develop a few weeks after delivery are manic depressive psychoses. A very limited fraction are schizoaffective psychoses. Up to one fourth are difficult to classify on account of dominating symptoms such as disturbances of consciousness and schizophrenic symptoms. No organic etiology has been found for these disturbances of consciousness. In British investigations, the hypothesis has been presented that these psychoses with atypical symptomatology represent a less serious variant of manic depressive psychoses. This question can only be solved by investigations concerning the etiology of manic depressive psychoses. In the present article, the hypothesis is presented that these psychoses may be reactive psychoses. Investigations concerning the etiology of reactive psychoses are necessary.

Female↗
PubMed1990

Outpatient medical management of postpartum psychiatric disorders.

Many psychiatric treatment modalities may be used in treating postpartum psychiatric disorders. A structured psychiatric interview specifically designed to elicit symptoms of postpartum depression and psychosis can be very useful in diagnosing the type and severity of the disorder. Once the diagnosis has been made, a combination of education, individual and group psychotherapy, and psychopharmacologic interventions can relieve the symptoms and help restore the new mother to her previous level of functioning.

Ambulatory Care↗