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from Section 11 - Psychosocial Considerations
Published online by Cambridge University Press: 08 April 2025
Postpartum psychosis (PPP) is the least understood and most dangerous of the perinatal psychiatric disorders. Affecting 1–2 per 1,000 birthing persons, it is an obstetric and psychiatric emergency associated with increased risks of suicide and infanticide. Symptom onset is typically sudden, most often occurring within the first 2 weeks postpartum, and can be waxing and waning in presentation. Clinical features include delusional thoughts or bizarre beliefs, hallucinations, paranoia, rapid mood swings, irritability, hyperactivity, and decreased need for or difficulty sleeping. While the psychotic symptoms are often the most dramatic manifestation, women with PPP can also present with mood symptoms including mania and/or irritability, depression, or anxiety. This case discusses the diagnosis, initial evaluation and treatment, and long-term management of patients with postpartum psychosis.
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