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At least 145 records · Page 8Linked to original sources
PubMed1981

Puerperal Psychosis. Phenomena and diagnosis.

Fifty-eight psychoses beginning within two weeks of childbirth are compared with 52 episodes of nonpuerperal psychotic illness occurring in young women. A clinical approach based on the use of multiple information sources and integrated assessment was used. Statistically significant differences between the two groups of patients were found in 52 of 214 psychopathological variables. Postpartum patients had more manic symptoms and "confusion," while nonpuerperal patients had more schizophrenic symptoms. The Research Diagnostic Criteria (RDC) showed an excess of schizoaffective (manic) puerperal patients and schizoaffective (depressed) or schizophrenic nonpuerperal patients. Only five of 58 puerperal episodes met RDC for schizophrenia. The relative lack of schizophrenic symptoms in the puerperal group was confirmed by self-ratings. The results are interpreted as supporting a link between puerperal psychosis and manic-depressive disease.

Adult↗
PubMed1992

Infanticide: new medical considerations.

A relationship between disturbed hormonal and metabolic equilibrium during puerperium and ensuing mental and emotional imbalance has been postulated for a long time. In England and Wales this consideration has resulted in the crime of infanticide being reduced from murder to manslaughter. Recent data indicate that the therapeutic and even routine administration by physicians of powerful vasoactive agents during puerperium, and particularly that of ergot derivatives, is probably the most frequent factor leading to 'pure puerperal psychosis'. It is proposed, therefore, that this psychosis is in fact, in most instances, a form of ergotism and its signs and symptoms and consequences, including coincidental infanticide, themselves are actually manifestations of acute ergot poisoning. It is suggested that based on this information a thorough re-evaluation of the relevant legal concepts is necessary.

Ergotism↗
PubMedDate not supplied

Psychiatric side effects of indomethacin in parturients.

PURPOSE: To examine the central nervous system side effects of the non-steroidal anti-inflammatory drug (NSAID) indomethacin in a case-series of obstetric patients. METHODS: The hospital records of patients experiencing any postpartum complication between 1994 and 1999 were reviewed for adverse drug reactions (ADR) attributed to indomethacin. Additional cases of indomethacin-induced adverse effects were identified through reports to the nursing administration and the Saskatchewan ADR reporting program. The Naranjo ADR probability scale was applied to all cases. RESULTS: Thirty-two patients experienced a psychiatric reaction after receiving indomethacin for postpartum pain. The symptoms were often severe and included dizziness, anxiety, fear, agitation, affective lability, depersonalization, paranoia, and hallucinations. There was no past psychiatric history documented in any of the cases. CONCLUSION: This study identifies a possible ADR to indomethacin occurring in postpartum patients. Whether the vulnerability to these neuropsychiatric reactions is randomly distributed or if parturients are at increased risk is yet to be determined. Proposed mechanisms of these side effects include a postpartum dopamine supersensitivity exacerbated by prostaglandin inhibition as well as a structural similarity between serotonin and indomethacin. The severity of the reactions to indomethacin in parturients and the potential for these disturbing psychiatric side effects to compromise the safety of both mother and infant have led to the use of alternative analgesics including different classes of NSAIDs for this population at our institution.

Adult↗
PubMed2004

Outcome of postpartum disorders: a 10 year follow-up of hospital admissions.

OBJECTIVE: To determine readmission and recurrence rates of women admitted to psychiatric hospital with their babies, and index factors predicting subsequent course. METHOD: A total of 66 women were followed up after 10 years. Information was obtained from structured interviews or other personal contact, and from general practitioners and hospital notes. Psychiatric diagnoses were made according to Research Diagnostic Criteria (RDC). Outcome and predictive factors were investigated using survival analysis. RESULTS: A recurrence rate of 87.2%, and a readmission rate of 63.3% were found. Readmissions were more common after index schizophrenia than other diagnoses. The strongest predictor of readmission was previous psychiatric history. Among 27 subsequent pregnancies, puerperal recurrence was high among those with index psychoses (75-80%), but lower among those with index depression (27.3%). CONCLUSION: The recurrence rate is high, with a moderate readmission rate predicted by past psychiatric history. Continuing clinical vigilance over the long-term is required for these patients.

Adult↗
PubMed1990

[Bromocriptine-associated postpartum psychotic exacerbation].

2 cases are presented in which bromocriptine (Parlodel) was administered to suppress physiological lactation; parturition had precipitated deterioration in mental status and psychotic behavior. Discontinuation of bromocriptine and administration of antipsychotic medication resulted in gradual improvement in the psychotic symptoms, without complications of galactorrhea or breast engorgement. We recommend that changes in mental status be looked for when bromocriptine is given.

Adult↗
PubMed1997

Postpartum psychosis induced by bromocriptine and pseudoephedrine.

Bromocriptine is an ergot-derived dopamine agonist sometimes used for postpartum suppression of lactation. On rare occasions (a total of seven previous reports in the literature), use of the medication has been associated with psychotic symptomatology in postpartum patients. This case report describes a 19-year-old postpartum woman who developed severe psychotic symptoms while taking low doses of bromocriptine and pseudoephedrine. The use of bromocriptine for suppression of lactation is controversial. If prescribed for postpartum patients, bromocriptine alone or in combination with sympathomimetic drugs should be used only with caution.

Adult↗