Depression Types
Puerperal psychosis (Puerperal Affective disorder)
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Puerperal psychosis is an acute mental illness, which has a sudden onset within the first few weeks (usually the first 10 days) following childbirth.
Affective illnesses and distress are common in women soon after they have given birth. Such disturbances are usually divided into maternity blues, postpartum (puerperal) psychosis and postnatal depressive illness. ' Maternity blues ' describe the brief episodes of emotional lability, irritability and tearfulness that occur in about 50% of women 2-3 days postpartum, which resolve spontaneously in a few days.
Postpartum psychosis occurs once in every 500-1000 births. Over 80% of cases are affective in type and the onset is usually within the first 2 weeks following delivery. In addition to the classical features of an affective psychosis, disorientation and confusion are often noted. Severely depressed patients may have delusional ideas that the child is deformed, evil or otherwise affected in some way, and such false ideas may lead to either attempts to kill the child or suicide. The response to speedy treatment is generally good. The recurrence rate for a psychosis in a subsequent puerperium is 20-30%.
Non-psychotic postnatal depressive disorders occur during the first postpartum year in 10% of mothers, especially in the first 3 months. Risk factors are first pregnancy, poor relationship with the partner, ambivalence about the pregnancy, and emotional personality traits. Depressive illness after childbirth is clinically similar to other depressive illnesses, but lack of emotional bonding with the baby is common.
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