Effect of Pregnancy on Psychosis: Life Circumstances and Psychiatric Symptoms

Abstract

As part of an ongoing prospective study to correlate mother and infant outcome with social isolation during pregnancy, the Schedule for Affective Disorders, SADS-C, was administered to twenty-seven psychotic patients late in pregnancy. Extensive standardized evaluation of life stresses and social supports included a Prenatal Interview with sixty items relating to demographics, drug use, health and obstetrical history, family involvement and development expectations of the infant, and a thirty-item Difficult Life Circumstances questionnaire. In this sample the patients' previous life adjustments were stabilized by their pregnancy unless the pregnancy itself created personal stress for the patient. Higher scores on Difficult Life Circumstances were found to be associated with more psychiatric symptomatology. Symptoms of pregnancy confounded SADS-C items measuring vegetative signs of depression. One group of items on the SADS-C appeared to selectively identify a subset of women whose underlying affective symptomatology was potentiated by pregnancy. A second group of items identified women whose symptoms appeared to be reactive to current situational strains.

The Role of Estrogen in Schizophrenia: Implications for Schizophrenia Practice Guidelines for Women

“…Chang and Renshaw reported an amelioration of symptoms during pregnancy (17). Krener and others found that women with schizophrenia received and required less medication to control their thought disorder when they were pregnant (18). W Can J Psychiatry, Vol 47, No 5, June 2002…”

Psychopathology in Women and Men: Focus on Female Hormones

“…The hypothesis about the protective effects of estrogens is bolstered by the observation that in pregnancy, when estrogen levels are steadily rising, women who have had recurrent acute episodes of schizophrenia do not usually break down (59,60). However, they do suffer postpartum psychoses when estrogen levels have abruptly plummeted (61).…”

Risk of Recurrence of Bipolar Disorder in Pregnant and Nonpregnant Women After Discontinuing Lithium Maintenance

“…A traditional view is that pregnancy may protect against recurrence of major affective disorders or suicide. Recurrences of mania and bipolar depression are not uncommon during pregnancy (18)(19)(20)(21), and lithium has been used safely during pregnancy by many patients (22)(23)(24)(25). Recurrences of mania and bipolar depression are not uncommon during pregnancy (18)(19)(20)(21), and lithium has been used safely during pregnancy by many patients (22)(23)(24)(25).…”