postpartum Blues

1. Puerperal Mental
Disorders

3. Many factors are associated with
puerperal mental illness such as lack of
confiding relationship and support ,
marital tension, socio economic
problems and a previous psychiatric
history

9. POSTNATAL DEPRESSION
> Postnatal depression is the most
frequent neurotic disorder during
postnatal period.
> It occurs in 10% to 15% of women .
> Onset is usually with in the first
postpartum month, often on returning
home and usually between day 3 and day
14.
> Majority of women recover
spontaneously.

12. PUERPERAL PSYCHOSIS
 Puerperal psychosis affects
approximately 1-2 per 1000 birth.
 Unmarried status, primigravida, past
history of schizophrenia may predispose
to puerperal psychoses.
 Onset is very sudden, commonly
occuring within first postnatal week.

13. Main features are :
 Insomnia and early morning waking
 Lability of mood , sudden tearfulness or
inappropriate laughter
 Abnormal behaviour such as restlessness,
excitement or sudden withdrawal
 Suspiciousness and fear
 Unexpected rejection of the baby or a
conviction that baby is deformed or dead
 Suicidal or infanticide threats
 Excessive guilt, depression or anxiety

14. Management
 Puerperal psychosis is a psychiatric
emergency. Admission to hospital is
always required, due to the potential
danger to the baby and difficulty in
dealing with the mother’s behaviour at
the home.
 Electroconvulsive therapy
 Antipsychotics may cause over sedation
in baby
 Supportive psychotherapy