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Jefferson Journal of Psychiatry

Abstract

Postpartum psychosis stands out among the psychiatric syndromes associated with child birth, not able for the variability of its symptom profile and the potential severity of its course, if unrecognized. Significant questions regarding nosology, etiology, prevention and treatment remain only partially answered (1). While controversy surrounds many of the critical issues regarding postpartum psychosis, including its definition, current epidemiologic data indicates severe, frequently psychotic episodes occur following 1-2 per 1,000 of all births (2). As diagnosis and treatment of puerperal conditions have evolved, clinicians now are frequently involved in assisting women with a history of postpartum psychosis with decision making about subsequent pregnancies. The purpose of this paper is to review the fundamental issues related to postpartum psychosis, examine the risk of subsequent episodes of psychiatric illness in postpartum and non-postpartum periods, and review three cases of women hospitalized with postpartum psychosis who went on to deliver a second child without incident, focusing on issues of prediction, prophylax is and intervention.

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