Latest news with #postpartumpsychosis
BBC News
02-06-2025
- General
- BBC News
Maternal mental health: Calls for specialist unit in Northern Ireland
A new mother who was detained in a psychiatric hospital for five weeks says she "felt like a prisoner" because she was separated from her Browne, who had postpartum psychosis, was admitted under a mental health order after giving birth three years Great Britain mothers are cared for in specialist mother and baby units, but women in Northern Ireland are admitted to general psychiatric wards, separated from their business case for a mother and baby unit is months overdue, but the Department of Health (DoH) said it was well developed. However, it has also warned any future unit is dependent on funding being told BBC Spotlight she felt "lonely" and "pathetic" after being dropped off at the door of the Ulster Hospital psychiatric ward without her daughter, but said staff tried their best."I went in voluntarily and it was just the loneliest feeling in the world getting dropped off at a mental health ward with a bag and no baby," the 35-year-old year, about 100 women in Northern Ireland are admitted to adult psychiatric wards for similar care, without their babies. What is postpartum psychosis? A rare but serious mental health illness that can affect any motherSymptoms can include hallucinations, delusions, manic and low moods, loss of inhibitions, restlessness, out-of-character behaviour and confusionIf left untreated the condition can get rapidly worse and lead to mothers harming the baby, themselves or othersThe most severe symptoms usually last between two and 12 weeks but recovery can take several monthsSOURCE: NHS "I was a mother without her child and I felt like a prisoner," said Shelley."She wasn't with me, and I was in a mental facility. And it just broke me every morning."Seven health ministers have supported the idea of a mother and baby unit in Northern Ireland, but funding has never been found. Danielle Sands refused hospital treatment to stay with her first son, Joe, in she relied on specialist community teams."They had made it very clear that when I would go in there, I wouldn't have my Joe with me.""There was voices in my head 24/7, and they were negative," she said."Telling me everything I couldn't do, I wasn't good enough." Danielle and her partner, Nial, were supported by a community specialist perinatal mental health term perinatal covers the period of time from when a woman becomes pregnant, and up to a year after giving birth. Each of Northern Ireland's five health trusts receive more than 250 referrals for the community services each year, but because of staffing pressures they can only accept about 70 patients at a Julie Anderson, chair of the Royal College of Psychiatrists in Northern Ireland, estimates the number of women admitted to hospital could double or triple if a mother and baby unit was established."It's really, really frustrating knowing that there's much better care that our mums should be getting here in Northern Ireland," she said."And frankly, to be honest, somewhat embarrassing that we've been talking about this for almost 20 years and we're still not there yet." In 2018, Orlaith Quinn died at the Royal Jubilee Maternity Hospital in 33-year-old had given birth to her third child, a daughter, less than 48 hours Graham said her daughter began showing signs of postpartum psychosis shortly after giving birth."To go in and have a baby and come back out in a coffin, and you've three children left without their mother, it's just not a position you think you'll ever find yourself in a million years," she body was found in a part of the hospital that is unused at night. She had taken her own life. A 2022 inquest concluded Orlaith's death had been "foreseeable and preventable" and that there were a number of missed opportunities in her care and a statement, the Belfast Health Trust said it would like to extend a sincere and unreserved apology to Orlaith's added its maternity team would like the opportunity to meet Orlaith's family to offer an apology in trust said it was committed to learning from Orlaith's death and had put in place a training programme to help staff recognise the wider spectrum of perinatal mental health disorders, and the risk of maternal Maria Dougan tied the death to the absence of a mother and baby unit, finding that one should be established in Northern Ireland. Consultant perinatal psychiatrist, Dr Jo Black, who is originally from Cookstown, was instrumental in setting up a mother and baby unit in eight-bed unit, the layout and decor of Jasmine Lodge means it does not feel has areas for families to visit, and a team of said it was "extraordinary" there is not a similar unit on the island of Ireland."All of our evidence shows us that maternal suicide remains a major killer in the maternity period," she said."We can't shy away from that, and so these units save lives." 'Poor data collection' Between 2021 and 2023, 34% of late maternal deaths have been linked to mental health, according to a report by MBRRACE-UK, which includes Northern Ireland. A late maternal death is when a woman died between six weeks and one year after is currently thought more than 3,500 women develop perinatal mental illness in Northern Ireland each poor data collection could mean the need for perinatal mental health services is being underestimated, according to Dr Julie has confirmed the Department of Health has yet to implement a 2017 recommendation from the health regulator to improve data the time, the Regulation and Quality Improvement Authority (RQIA) said patient coding should be Department of Health said a review of coding practices for perinatal mental health conditions, and related hospital admissions, was planned. If you have been affected by any of the issues in this story you can find information and support on the BBC Actionline website.
Medscape
22-05-2025
- Health
- Medscape
Postpartum Psychosis Risk Linked to Sister's Medical History
LOS ANGELES — Risk for postpartum psychosis is significantly higher in women who have a sister who has experienced the condition and/or has bipolar disorder (BD), a new study showed. In a population-based cohort study of nearly 1.7 million women, those with a full sister who had had the disorder were 10 times more likely to have postpartum psychosis than those whose sister did not have it. Odds of developing the condition were doubled when a sister had BD and about 14-fold higher if a sister had both BD and postpartum psychosis. Although rare, postpartum psychosis is considered 'one of the most severe psychiatric conditions,' co-investigator Veerle Bergink, MD, PhD, professor in the Department of Psychiatry, Icahn School of Medicine at Mount Sinai, and director of Mount Sinai's Women's Mental Health Center, New York City, and colleagues noted. If not addressed and treated, the condition has been linked to increased risk for suicide and infanticide. But findings such as these can help clinicians identify those at potentially greater risk and make a plan, Bergink told Medscape Medical News. 'You don't have to start medication right away, but we do need to be aware' of the risk, she said. The findings were presented on May 19 at the American Psychiatric Association (APA) 2025 Annual Meeting and were simultaneously published online in the American Journal of Psychiatry. Relative Risks Postpartum psychosis typically occurs in the first 3 months after childbirth, with onset most likely in the first month. It can also occur in women who have no history of psychiatric illness and is the leading cause of maternal deaths, the researchers noted. If a woman shows symptoms of the condition — which include excessive energy, agitation, paranoia, confusion, and sleep problems — it should be addressed as a medical emergency, they added. Although previous research has shown that genetic factors can contribute to increased postpartum psychosis risk, the magnitude of that contribution has been unclear. In the current analysis, Bergink and colleagues examined data from Swedish national registers for 1,648,759 women who gave birth between January 1980 and September 2017. The primary outcome was a diagnosis of postpartum psychosis. Results showed that 2514 of the total participants — only 0.15% — had postpartum psychosis within the first 3 months of the birth of their first child. However, after adjusting for year and age at childbirth, the relative recurrence risk (RRR) was 10.69 for the condition in mothers with a full sister who had experienced the condition compared with mothers with a sister who had not experienced it (95% CI, 6.6-16.3; P < .001). Still, the absolute risk for those with an affected sister was estimated at just 1.6%. In the women diagnosed with postpartum psychosis, 49% had a history of BD, and 24% had a history of other mental health diagnoses. Prevalence of BD was 1.4% for the entire participant population. The odds ratio (OR) for postpartum psychosis when a sister had BD was 2.1 (95% CI, 1.0-4.0; P = .04). In addition, the combined OR was approximately 14.3 when a sister had experienced postpartum psychosis while also having BD. The RRR was also increased when a woman had a full woman cousin with postpartum psychosis, but it was not statistically significant when adjusted for birth year and age at childbirth or when adjusted for those factors plus history of BD. 'Our results provide guidance for clinicians working with pregnant women with personal or family histories of postpartum psychosis,' the investigators wrote. Diagnostic and Statistical Manual of Mental Disorders (DSM) Inclusion? Bergink noted that the condition is not currently listed as a stand-alone disorder in any version of the DSM. However, numerous research groups are collaborating to develop criteria for its inclusion in future iterations of the manual. They propose that criteria should include experiencing at least one of the following within 3 months of childbirth, with a duration of at least 1 week or of any duration if hospitalization is necessary: Mania/mixed state, delusions, hallucinations, disorganized speech or thoughts, and disorganized or confused behavior. Asked during a question-and-answer session if family history screenings are currently being done among women who are pregnant, Bergink answered, 'In general, no, but it should be.' 'Because of the potential negative impacts, sometimes severe, on mother and baby, this disorder needs to be identified and effectively treated,' Ned H. Kalin, MD, editor-in-chief of the American Journal of Psychiatry and professor and chair of the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, said in a press release. The current study is important because it highlighted the increased risk when the condition runs in families, he told Medscape Medical News . 'It also underscores the importance of understanding that risk and of working with your OB-GYN [obstetrician-gynecologist] doctor or psychiatrist to help reduce and mitigate the risk with treatment and close observation,' Kalin said. Bringing 'Stigma Out of the Darkness' Although postpartum psychosis is considered quite rare, tragic aftereffects in some undiagnosed and untreated women have been widely reported in the media. At the press briefing, Bergink shared that a medical colleague with the condition recently shot and killed herself and her baby girl. 'Unfortunately, not all cases are detected in time. At Sinai, we lost a colleague who had no psychiatric history and her baby,' she said. 'That happens. And it can occur in anyone.' Michael F. Myers, MD, chair of the APA meeting's Scientific Program Committee, shared that he was involved with two situations where patients had extreme forms of the condition, including one where a woman psychiatrist killed herself and her child. 'You hear about postpartum depression and postpartum blues. But then there's this subset that is not only dangerous to themselves but also to their baby,' Myers told Medscape Medical News. 'Talking about these situations is how we bring the stigma [about the condition] out of the darkness.' Psychiatric History Not Always a Factor 'There's a theme that having a psychiatric history is the main predictor for postpartum psychosis. But sometimes we miss it,' Misty C. Richards, MD, associate professor at the University of California, Los Angeles, and medical director of perinatal psychiatry for the university's Maternal Outpatient Mental Health Services Clinic, said at the briefing. She added that, as a clinician, 'you do the best that you can to try to catch this early because things can become wildly out of control in the postpartum period. Infanticide should just never happen.' She later told Medscape Medical News that the symptoms of postpartum psychosis differ from those of schizophrenia because they wax and wane and almost present as delirium. 'So you can be lucid one minute and the next be wildly delusional. It's usually in the setting of poor sleep and severe anxiety and becomes an emergency very quickly,' Richards said. She added that this is much more extreme than a normal response to the chaos that often occurs during the first week after delivery. 'People may think, 'Oh, she'll shake it off and be okay.' But no. If you miss it, that's when it can be catastrophic,' she concluded.
BBC News
17-05-2025
- Health
- BBC News
'I bin think say I don kill my baby' - di reality of postpartum psychosis
At first, Ellie say she bin dey veri happy. She born pikin for house without pain relief and she dey overjoyed to be new mama. Although she try sleep for few hours ova three days, she later decide say she no even need sleep at all. "Di best way I fit describe am na like waking from a nightmare wia you no fit tok weda na dream and reality. But [dat feeling] just continue dey go on," she tok. "Den I tink say I don kill my son for bed. I remember say I see my partner and I just dey reason say, dis dey real?" Ellie bin dey experience postpartum psychosis (PPP), one unbearable illness wey fit temporarily turn life upside down for new parents. Wetin be postpartum psychosis? Among di early warning signs for PPP na if new mothers no just dey feel like themselves or e be like say dem don lost touch wit reality. Although sleep-deprivation dey common wit new parents afta birth, one woman wey get PPP fit stop to dey sleep entirely. According to UK National Health Service, symptoms include: PPP na medical emergency, where in most cases, go need hospital admission for specialist care and treatment. But experts say di most important thing to remember na as severe as an episode of psychosis sound, wit treatment most women fit recover within months. Wetin dey cause postpartum psychosis? Despite years of research, e neva still dey clear wetin dey cause PPP. Doctors suggest say sudden change in hormones wey dey happun during childbirth fit get something to do wit am. Dis shift fit trigger extreme confusion and fear. But no reliable way dey to predict who go dey affected, for instance – blood test no dey. At least half of new mothers wey dey diagnosed wit PPP neva experience psychosis bifor, so for dem to begin hallucinate na sometin wey dey new and terrifying for dem. For Ellie, di beginning of PPP bin dey very fast. "I dey wonder now if e start as I dey active labour for hours overnight for house, for some reason, I bin decide not to wake my husband up until 6am," she tok. PPP dey affect one to two women wey give birth in every 1000. E no too common like post-natal depression wey dey affect around one in 10 new mums. Experts believe say more women dey affected pass bifor. For years, dem don dismiss severe post-natal depression as 'baby blues' but doctors warn dis attitude to mental health fit make am really hard for parents to access adequate support. Anecdotal research from UK charity Action on Postpartum Psychosis (APP) suggest say e still common for women to dey misdiagnosed, maybe by community midwife or doctor, who fit suggest sleeping tablets. Charities like APP, COPE: Centre of Perinatal Excellence and Perinatal Anxiety and Depression Aotearoa (PADA) dey work on campaigns wey dey raise awareness of PPP among di general public and frontline healthcare workers. For Ellie, wey dey work now for one charity wey dey support mothers' wit PPP, na few factors dey lead up to crisis point, wey include lack of sleep and di huge pressure to be perfect new mum. However, she also now know say she dey at much higher risk as she get bipolar disorder, type 1. Around 25% of women wey get dis disorder go get severe episode wey go make dem need hospital care afta dia first baby, according to Cardiff University research dem publish for The Lancet. For UK, Australia and New Zealand, dem dey encourage women for dis group to continue dia medication – Women for dis situation go need to see specialist perinatal psychiatrist for advice according to APP and multiple oda organisations. Research by Dr Ian Jones, one leading perinatal psychiatrist for Cardiff suggest say increased risk of postpartum psychosis no dey for pipo wit history of childhood trauma. E say dis add weight to im idea say biological element dey involved in PPP and surge in hormones be like one of di biggest driving factors. Wetin fit help? Risk dey say without treatment mothers wey get PPP fit try to harm themselves according to multiple pieces of research. For UK, Australia, and New Zealand clinical studies don establish say e dey beta to treat mums wit PPP by keeping dem wit dia babies in mother and baby psychiatric units under very close observation. "For me, e feel more like 'a switch' bin go off for my brain and e dey very obvious," Ellie tok. She get memory gaps but she remember say she stand for di top of di stairs for house dey listen to her husband phone di local maternity ward. "I dey very scared. I need help and bicos dem hear say I dey shout, di head midwife bin fight for me to go to MBU (mother and baby psychiatric unit)," Ellie tok. "Di most important thing e dey do na to keep you well, dat na di primary focus." Ariane Beeston, tok-tok pesin for di non-profit Centre of Perinatal Excellence for Australia wey don experience PPP, describe di need for these beds as crucial. For Ariane wey bin work for child protection, PPP come completely out of di blue. For her book I no be myself you see, she describe she hallucinate say she dey see dragons next to her baby son and government drones dey fly overhead. Afta dem finally admit her to a mother and baby psychiatric unit, she dey supported to get enough sleep, bond wit her new son and take part for 'parentcraft' lessons and recover. She say di experience don change her. One of di hardest moments for women wey dey transition out of these MBU na deciding wit dia care team, wen be di right time to return home. Weda or not to breastfeed na anoda major decision for women at higher risk, as you gatz understand how e go work with taking any ongoing medication, according to Dr Clare Dolman, one researcher for Kings College London. Accessing dis kain support fit dey extremely limited for oda kontris. Serious sociocultural differences dey for first time mums around di world. Some cultures still dey compulsory 40 days of confinement post-birth for new mums. For some parts of India, dem dey explain PPP as a religious fate — devva hididide, or being possessed by a ghost. Whereas for oda cultures, dem dey see postpartum mental health disorders as a personal deficit or failure as a mother. Researchers see say mothers for Hong Kong dey under pressure to play traditional maternal role and any failure to do dat go dey experienced as a shameful loss of face. So, wetin dey happun if you want anoda baby? For one in two mothers wey experience PPP, unfortunately dem dey go on to experience am again wit subsequent births according to Manchester and Cardiff University research. For mums wey get more children dem describe detailed pre-planning to ensure say dem get extra support in place - weda dis na additional family or friends on hand to help, prioritising sleep and essentially trying to "put yourself first, in order to be a good parent," Ellie tok.
