Post-Partum Psychosis
Doctors see some kind of mental disturbance in up to 80% of mothers in the post-partum period, or the few days or weeks after childbirth. Depression is the most common problem, but for about one in 1,000 women the issue is post-partum psychosis. Psychosis is defined as a mental illness characterized by a loss of contact with reality and requires immediate medical attention. Valdimarsdottir et al. decided to determine what characteristics increased the chance of post-partum psychosis by searching through a very large number of first time mothers in Sweden and identifying and studying those women diagnosed this mental illness within 90 days of giving birth (2009). They focused their study on patients where the post-partum psychosis was the first example of being hospitalized with a mental illness, in an attempt to focus on those psychoses that were related to the childbirth rather than other pre-existing factors (Valdimarsdottir et al., 2009).
This study found that the time with a highest chance of psychosis was the first month after birth. Characteristics of the mother that increased the chances for psychosis was increased age, but other factors, such as smoking or not living with the baby’s father did not increase the chances. Having material diabetes and high birth weight decreased the chances of the illness. The timing of the illness suggests that either the experience of giving birth or hormonal changes that happen after the birth may be involved. The protective effect of diabetes may help provide clues as to the cause. The most important result of this study for nurses is the need to provide at least one month of careful monitoring for psychosis in order to identify any woman with this serious mental illness so she will received appropriate care (Valdimarsdottir et al., 2009).
References
Valdimarsdottir, U., Hultman, C. M., Harlow, B., Cnattingius, S., & Sparen, P. (2009). Psychotic illness in first-time mothers with no previous psychiatric hospitalizations: A population-based study. PLoS Medicine, 6(2). http://dx.doi.org/10.1371/journal.pmed.1000013
