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New Study on Psychosis After Childbirth

February 9, 2009

A study of Swedish women in PLoS Medicine looks at psychotic illness in first-time mothers. The researchers looked at nearly 750,000 women having a first birth from 1983-2000 and looked for for hospitalization for severe mental illness during the first 90 days postpartum (including postpartum psychosis, acute/reactive psychosis, schizophrenia, affective paranoia, and schizoaffective disorder). After the immediate postpartum period, the women were followed “annually until next pregnancy, death, emigration from Sweden, or towards the end of the observation period (31 December 2001).”

The authors report:

“Of 745,596 first-time mothers, 892 women (1.2 per 1,000 births) were hospitalized for psychoses during the first 90 d[ays] postpartum. In all, 436 women (49%; 0.6 per 1,000 births) had not previously been hospitalized for any psychiatric disorder, and the majority of them were diagnosed with reactive/acute psychoses or a postpartum psychosis.”

In other words, this was a completely new problem (of psychiatric illness) for half of the affected women. The authors also found that “Incidence rates peaked during the first month following childbirth,” with 32% happening within the first week after childbirth – the incidence of psychosis plunges a few months after delivery.

As the editors note:

“The timing of the peak of postpartum psychosis supports the idea that either giving birth or the hormonal changes that occur shortly after may trigger the development of psychosis, and the findings that maternal diabetes and high infant birth weight reduce the risk of postpartum psychosis whereas increasing maternal age increases the risk provide new clues about the causes of postpartum psychosis. Most importantly, however, these findings highlight the importance of carefully monitoring women for psychosis during the first month after delivery.

[Thanks to Becky for the tip]

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