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At least 73 records · Page 4Linked to original sources
PubMed1992

Puerperal psychoses: a clinical case study with follow-up.

Thirty cases of post-partum psychotic disorders occurred between 1973 and 1987 and hospitalized at the Psychiatric Ward of Florence University were studied and followed up. A structured diagnostic interview was used, which explored DSM Ill-R diagnosis both for mood disorders and for psychotic features. The psychotic symptoms had started within 8 weeks of parturition in all cases. Only 36.7% of the patients showed no subsequent pathology after the puerperal symptoms. The diagnoses, both at the index episode and at the follow-up, revealed a great predominance of mood disorders and the absence of schizophrenia. The follow-up survey showed a greater proportion of bipolar disorders than it appeared at the puerperal onset of the disease. A high frequency of puerperal psychotic relapses has also occurred after subsequent deliveries during the follow-up period.

Adult↗
PubMed1999

[Puerperal psychoses. Clinical diagnoses and relative risk of admission after parturition].

Previous studies have suggested that the risk of psychosis, especially affective psychosis, is greatly increased during the first 30 days following delivery. The aim of our study was to replicate these findings. Linking The Danish Medical Birth Register and The Danish Psychiatric Central Register from January Ist 1973 to December 31st 1993 has revealed 1253 admissions diagnosed as psychosis within 91 days after delivery. The admission rate following delivery was compared to the admission rate among non-puerperal women in the general, Danish female population. The relative risk of all admissions was only slightly increased, RR = 1.09 (CI, 1.03-1.16). The admission rate concerning first admissions was greatly increased, RR = 3.21 (CI, 2.96-3.49) whereas the admission rate concerning readmissions was reduced, RR = 0.66 (CI, 0.61-0.72. In conclusion, childbirth is a strong risk factor for first admission with psychosis, but the risk is less increased than previously assumed.

Denmark↗
PubMed1989

[Schizophrenic puerperal psychoses. A psychodynamic approach].

The author describes the psychodynamics of schizophrenic childbirth psychoses and criticizes attempts to explain these on a one-sided somatogenic basis. Referring to ethnographic material on childbirth customs, he develops therapeutic approaches are intended to bring about a better social integration of the woman as well as a deflection from her uncontrollable aggression against the child.

Adult↗
PubMed1991

Neuroendocrine challenge studies in puerperal psychoses. Dexamethasone suppression and TRH stimulation.

Subjects admitted to hospital with post-partum psychoses were compared with matched normal post-partum controls using two neuroendocrine challenge tests: dexamethasone suppression of cortisol and TRH stimulation of TSH. Post-dexamethasone cortisol levels were significantly elevated. There were less-clear hints of blunting of TSH response. In the small samples there was no obvious association of abnormalities with any particular diagnoses within the range of mania, psychotic depression and schizoaffective disorders.

Adult↗
PubMed2002

[Clinical aspects of puerperal psychoses. Review with 3 case examples].

Psychic disturbances in the post-partum period are divided into the postpartum blues, postpartum depression, and postpartum psychoses. The latter are severe endogenous psychoses which mostly fulfill the diagnostic criteria for cycloid psychoses according to Leonhard. Based on three case reports, characteristic symptoms, the phasic clinical course with remissions, and distinct etiological, therapeutic, and forensic aspects of cycloid psychoses in the post-partum period are discussed. The high relapse rate of approximately 50% in patients at risk requires intensive psychiatric care in the peripartal period. In particular, the possibility of a prophylactic treatment of patients at risk with lithium immediately after delivery is emphasized. However, this sophisticated therapeutic strategy requires close cooperation between gynecologists and psychiatrists.

Adult↗
PubMed1993

[Prognosis of puerperal psychoses: follow-up and outcome after an average of 26 years].

61 women, who became ill for the first time in their life within 6 weeks after childbirth were investigated after a mean of 25.6 years (minimum 12, maximum 41 years), using various standardised instruments of evaluation. A total of 39 Patient (63.9%) had had a recurrence of illness, the average number of further episodes being 4.8. 31 of the women had had additional pregnancies and deliveries, and 8 of these (25.8%) had suffered another postpartum psychosis. 23.5% of the patients who had reached or passed the climacteric became ill again in close connection with that time (first time after the postpartum psychosis or first time after a relapse-free interval of more than 12 years). 72.1% of the patients were symptom-free at the time of follow-up, only 17 (27.9%) showed persisting alterations (13.1% "adynamic-deficient syndrome", 9.8% "slight asthenic insufficiency syndrome", 4.9% "chronic subdepressive syndrome"). Considering also the findings according to the Global Assessment Scale (GAS) and Disability Assessment Schedule (WHO/DAS) the long-term outcome was found to be favourable in the majority of cases, with regard to the frequency and intensity of disability and persisting alterations.

Adolescent↗