What are Postpartum Mental and Behavioral Disorders Associated with the Postpartum Period?
The specificity of the postpartum period is that women often in the last weeks of pregnancy, in modern culture, are in conditions of relative deprivation. If pregnancy is complicated, this period is prolonged and sometimes leads to family problems that affect the pregnant psychogenically. Then follows the actual period of childbirth with its anxiety, pain, stress of expectation. Next is the first contact with the child, his feeding, which can be interrupted due to both anesthesia in the pregnant woman and the illness of the child.
Causes of Mental and Behavioral Disorders Associated with the Postpartum Period
It was psychologically assessed, for example, by forced deprivation in pregnant women who are being preserved, by the pain of childbirth itself and by separation for several days from a child who is not delivered to the mother due to his illnesses, death of the child during childbirth. The combination of all these factors leads to psychosis.
Symptoms of Mental and Behavioral Disorders Associated with the Postpartum Period
After giving birth for no more than 2 months, a period of bad mood develops, the mother complains that she does not feel feelings for the baby, and even doubts whether it is her baby. Sleep is disturbed and appetite is reduced, this can lead to a decrease in the amount of milk and again to a decrease in mood. Possible suicidal thoughts, guilt and self-incriminating ideas, as well as confusion and fussiness, anxiety and impaired attention.
Psychosis begins after childbirth, more often combines amentia, delirium, other exogenous syndromes (paroxysmal conditions, stupor, coma), later on there may be a transition to hallucinatory-paranoid and affective-paranoid pictures, that is, endogenous pictures, asthenia or subdepression. The duration of psychosis is not more than 2 months. High temperature correlates with a frequent pulse.
Diagnosis of Mental and Behavioral Disorders Associated with the Postpartum Period
They begin within 6 weeks after birth and do not meet the criteria for disorders from other sections.
Differential diagnosis
The most complicated differential diagnosis with febrile catatonia and malignant antipsychotic syndrome in the postpartum period. The emergence of catatonic elements is also possible upon exiting the period of exogenous syndromes of postpartum psychosis. With febrile catatonia and malignant antipsychotic syndrome, a transition from endogenous circle syndromes to exogenous syndromes more often occurs. The manifestation of schizophrenia or schizoaffective disorder in the postpartum period is difficult to distinguish from the actual postpartum psychosis. Therefore, a patient who has undergone acute postpartum psychosis should be carefully monitored for at least a year. In the strict diagnostic sense, it is difficult to distinguish between acute schizophrenia-like disorders, acute transient psychotic disorders, and postpartum psychoses.
Treatment of Mental and Behavioral Disorders Associated with the Postpartum Period
If the baby is breastfed, detoxification therapy and, in extreme cases, benzodiazepines should be preferred, but with artificial feeding, antipsychotics, antidepressants, and carbamazepine can be used.