The global prevalence of postpartum psychosis: a systematic review

Abstract

BackgroundMental health is a significant contributor to global burden of disease and the consequences of perinatal psychiatric morbidity can be substantial. We aimed to obtain global estimates of puerperal psychosis prevalence based on population-based samples and to understand how postpartum psychosis is assessed and captured among included studies.MethodsIn June 2014, we searched PubMed, CiNAHL, EMBASE, PsycINFO, Sociological Collections, and Global Index Medicus for publications since the year 1990. Criteria for inclusion in the systematic review were: use of primary data relevant to pre-defined mental health conditions, specified dates of data collection, limited to data from 1990 onwards, sample size >200 and a clear description of methodology. Data were extracted from published peer reviewed articles.ResultsThe search yielded 24,273 publications, of which six studies met the criteria. Five studies reported incidence of puerperal psychosis (ranging from 0.89 to 2.6 in 1000 women) and one reported prevalence of psychosis (5 in 1000). Due to the heterogeneity of methodologies used across studies in definitions and assessments used to identify cases, data was not pooled to calculate a global estimate of risk.ConclusionsThis review confirms the relatively low rate of puerperal psychosis; yet given the potential for serious consequences, this morbidity is significant from a global public health perspective. Further attention to consistent detection of puerperal psychosis can help provide appropriate treatment to prevent harmful consequences for both mother and baby.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-017-1427-7) contains supplementary material, which is available to authorized users.

Maternal and infant characteristics associated with maternal opioid overdose in the year following delivery

“…We found that postpartum overdose is an uncommon event that occurs at a lower rate than overdose in the general population in Massachusetts (31 of 10000 in 2015) . While this rate was lower than reported national rates of other conditions affecting postpartum women in the United States, such as depression (impacting 9–20% of all deliveries) or obstetric complications requiring re‐admission (1–2% of all deliveries) , we found that the postpartum opioid‐related overdose rate was similar to that of postpartum psychosis (0.1–0.5% of deliveries) . Given that postpartum overdose can result in significant morbidity and mortality for women and the prevalence of OUD in pregnancy continues to rise , identifying women at risk of overdose is important to offer harm reduction services such as naloxone distribution and provide addiction treatment .…”

The psychometric properties of the 16-item version of the Prodromal Questionnaire (PQ-16) as a screening instrument for perinatal psychosis

“…Postpartum psychosis (PP) is a rare but devastating medical emergency affecting 0.1 to 0.2% of all pregnancies (Sit, Rothschild, & Wisner, 2006; VanderKruik et al, 2017). Each year there are more than 6,000 cases in the United States and 200,000 globally (Sit et al, 2006).…”

Postpartum psychosis and management: a case study

“…However, the rarity of PP (Vanderkrui et al, 2017), may render midwives lacking sufficient experience to confidently recognise its signs and symptoms (Noonan et al, 2017), hence consistent training (Cantwell, Gray and Knight, 2017) The CMW's lack of action did not fulfil the midwives' role in protecting women's dignity (NMC, 2015), as evidenced by Sarah's husband bringing her to A+E the next day in a state of pyrexia and confusion. In particular; shouting and baring her breasts while massaging them.…”

“…In particular; shouting and baring her breasts while massaging them. Effective timely referral to the SPMHM, leading to robust risk assessments could have avoided this (Cantwell, Gray and Knight, 2017 (Vanderkrui et al, 2017). The couple rented a room in a five bedroom house along with four other couples, whom two were recently postnatal.…”

“…Symptoms include agitation, insomnia, thought processes that are eccentric, deviated and disorganised, with delusions and hallucinations, the content of which revolves around the neonate's safety (Vanderkrui et al, 2017). PP is considered a psychiatric emergency due to its high risk of suicide and infanticide (Nahar et al, 2017), it also increases risk of later developing non-gestational psychosis (particularly bipolar disorder) and PP after a subsequent pregnancy (Vanderkrui et al, 2017). It is the most severe mental illness of the perinatal period, defined as between pregnancy and 1…”