Puerperal Psychosis: A brief review and unusual case report

Abstract

This is a brief review of puerperal (post-partum) psychosis and contains a case report of Donkin Psychosis, an unusual form which is associated with pre-eclampsia, from Queen Elizabeth Central Hospital in Blantyre, Malawi. It includes considerations for treatment of Donkin Psychosis, in particular. It is the first reported case of Donkin Psychosis from Africa, to our knowledge.

A Case Report on Seumumbo Ritual-Induced Postpartum Psychosis

“…Additionally, PP seems to be more prevalent in woman who have a personal history of major depressive disorder. Confusion, disorientation, agitation, auditory and visual hallucinations, delusions, and, probably most concerningly, indifference to or violent attacks on the baby are common symptoms of postpartum psychosis [4].…”

An Overview of Postpartum Psychosis

“…Although extensive efforts, definitive pathophysiology for postpartum psychiatric disorders has remained elusive. 1 Postpartum psychosis (PP) is a serious mental health problem in the postpartum period, affecting 0.89 to 2.6 per 1000 women. PP is characterized by a sudden onset, and rapid deterioration, with symptoms including delusions, hallucinations, disorganized behavior, and depression.…”

“…Family members are important in this process and should be involved in care and treatment planning. 1,2 With appropriate treatment, the symptoms resolve within 2 to 12 weeks. However, women remain at increased risk of the following postpartum and nonpostpartum episodes, including depression and anxiety.…”

“…etiology. It can be triggered by pre-existing bipolar affective disorder, previous postpartum psychosis, possibly major depressive disorder, and a family history with a psychiatric disorder 1. Guidelines and clinical description of psychiatric disorder, Fourth Edition of Diagnostic and Statistical Manual of Mental (DSM-IV-TR) and ICD-10 classification of mental and behavioral disorders, classify postpartum mental and behavioral disorders differently.…”

“…Depending to the American Psychiatric Association Practice Guidelines for the Assessment and Treatment of Patients with Suicidal Behaviors, a suicide risk assessment requires that the provider ask directly about 1) the patient's desire to live or die, 2) the specific thoughts about taking their life, 3) any plans they have to carry out the act, 4) access to means and, finally 5) the lethality of their intended means/plan. For patients who endorse thoughts of suicide or death, the clinician must ask about the frequency, intensity, and life stressors associated with the thoughts 1. Women with psychiatric illness can and do make excellent mothers -but those with acute postpartum psychosis may be in danger of harming their children either deliberately or through neglect in the throes of illness.…”