Neurobiology of maternal mental illness

Maguire, Jamie; McCormack, Clare; Mitchell, Anika; Monk, Catherine

doi:10.1016/b978-0-444-64239-4.00005-9

Cited by 17 publications

(15 citation statements)

References 225 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The rapid onset of postpartum psychosis following parturition suggests that hormonal factors are potentially involved in the aetiology of this disorder. This hypothesis is plausible given that the abrupt withdrawal of progesterone and oestrogen that occurs postbirth [60] coincides with the peak timing of onset of postpartum psychosis. In line with this theory, associations have been reported between mood episodes triggered by childbirth, the premenstrual phase of the menstrual cycle and/or the menopause in women with bipolar disorder [57][58][59][60][61].…”

Section: Hormonal Factorsmentioning

confidence: 99%

Phenomenology, Epidemiology and Aetiology of Postpartum Psychosis: A Review

et al. 2021

View full text Add to dashboard Cite

Postpartum psychoses are a severe form of postnatal mood disorders, affecting 1–2 in every 1000 deliveries. These episodes typically present as acute mania or depression with psychosis within the first few weeks of childbirth, which, as life-threatening psychiatric emergencies, can have a significant adverse impact on the mother, baby and wider family. The nosological status of postpartum psychosis remains contentious; however, evidence indicates most episodes to be manifestations of bipolar disorder and a vulnerability to a puerperal trigger. While childbirth appears to be a potent trigger of severe mood disorders, the precise mechanisms by which postpartum psychosis occurs are poorly understood. This review examines the current evidence with respect to potential aetiology and childbirth-related triggers of postpartum psychosis. Findings to date have implicated neurobiological factors, such as hormones, immunological dysregulation, circadian rhythm disruption and genetics, to be important in the pathogenesis of this disorder. Prediction models, informed by prospective cohort studies of high-risk women, are required to identify those at greatest risk of postpartum psychosis.

show abstract

Section: Hormonal Factorsmentioning

confidence: 99%

Phenomenology, Epidemiology and Aetiology of Postpartum Psychosis: A Review

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Immune cells, including natural killer (NK) cells, dendritic cells and macrophages, infiltrate the decidua and surround the invading trophoblasts. However, rather than rejecting the blastocyst, these immune cells instead play a supportive role, repairing and restructuring uterine tissue ( Mor et al., 2011 , 2017 ; Maguire et al., 2020 ; Leff-Gelman et al., 2016 ; Sherer et al., 2018 ). The first and early second trimester of pregnancy are, therefore, characterised by a T helper (Th) 1-type proinflammatory response, necessary to repair damaged tissue and remove cell debris ( Mor et al., 2011 , 2017 ; Maguire et al., 2020 ; Dutta and Sengupta, 2017 ).…”

Section: The Immune System and The Perinatal Periodmentioning

confidence: 99%

“…However, rather than rejecting the blastocyst, these immune cells instead play a supportive role, repairing and restructuring uterine tissue ( Mor et al., 2011 , 2017 ; Maguire et al., 2020 ; Leff-Gelman et al., 2016 ; Sherer et al., 2018 ). The first and early second trimester of pregnancy are, therefore, characterised by a T helper (Th) 1-type proinflammatory response, necessary to repair damaged tissue and remove cell debris ( Mor et al., 2011 , 2017 ; Maguire et al., 2020 ; Dutta and Sengupta, 2017 ). Following successful implantation and placentation, there is a period of rapid foetal growth and development, which lasts from pregnancy weeks 13–27 ( Mor et al., 2011 , 2017 ).…”

Section: The Immune System and The Perinatal Periodmentioning

confidence: 99%

“…In addition to promoting immune tolerance towards the foetus, anti-inflammatory responses in this stage also promote uterine growth and foetal development ( Mor et al., 2017 ; Sherer et al., 2018 ; Dutta and Sengupta, 2017 ). Thus, the second immunological stage provides a supportive immune environment in which symbiosis is established between maternal and foetal physiology ( Mor et al., 2011 , 2017 ; Maguire et al., 2020 ; Dutta and Sengupta, 2017 ). Once foetal development is complete, the final immunological stage of pregnancy occurs in preparation for the delivery.…”

Section: The Immune System and The Perinatal Periodmentioning

confidence: 99%

“…Following the onset of labour, immune cells migrate into the myometrium resulting in a shift back to a proinflammatory state. This proinflammatory milieu promotes uterine contractions and the subsequent expulsion of the baby and placenta ( Mor et al., 2011 , 2017 ; Maguire et al., 2020 ). Finally, pre-pregnancy immune function is not thought to return for up to several months post-delivery ( Groer et al., 2015 ).…”

Section: The Immune System and The Perinatal Periodmentioning

confidence: 99%

See 2 more Smart Citations

The role of the immune system in postpartum psychosis

Hazelgrove

2021

Brain, Behavior, & Immunity - Health

View full text Add to dashboard Cite

Postpartum psychosis is the most severe psychiatric disorder associated with childbirth. The risk is particularly high for women with a history of bipolar disorder or schizoaffective disorder, or those who have suffered a previous episode of postpartum psychosis. However, the aetiology of the illness remains unclear. Pregnancy and the early postpartum are times of significant immunological change. Furthermore, alterations to the immune system have been implicated in the onset and course of various psychopathologies, both related and unrelated to childbirth. Emerging evidence, from studies on immune related disorders, immune cells and inflammatory markers, suggests that the immune system might also be involved in the pathophysiology of postpartum psychosis. Furthermore, recent research has also begun to explore the potential mechanisms underlying immune dysfunction in postpartum psychosis (e.g., disturbances in the Treg–CCN3 protein–(re)myelination axis). Nevertheless, more research is required to understand whether immune dysfunction is a cause or consequence of postpartum psychosis and to clarify the exact mechanisms involved. The aim of this short review is to present the current findings on immune system dysregulation in postpartum psychosis, discuss possible mechanisms underlying the association, highlight potential challenges and confounders and provide suggestions for future research.

show abstract