To highlight the familial influence in a patient presenting bipolar variant of postpartum psychosis (PP). Postpartum psychosis although less common than other postpartum psychiatric disorders is of immense significance in view of the course of the illness and impairment. Women with bipolar disorder or schizoaffective disorder have been reported to have >50% risk for another episode of PP. Postpartum psychosis affected 74% of mothers with bipolar disorder and a first-degree relative who had PP, compared with only 30% of bipolar women without any family history of PP. There is a strong familial component associated with the illness. Mrs. S, 24-year-old housewife, married for 5 years, 10th std, from Puducherry, brought by the mother to our OPD with complaints of sleep disturbance, irritability, anger outburst over trivial issues, and suspiciousness for past 15 days. Stressor patient gave birth to a child 15 days back following which she developed sleep disturbances, decreased self-care, neglecting the child, suspiciousness that people are talking ill about her, and that her husband had left her permanently, with a past history revealing similar illness in the past during the first childbirth 3 years ago, which resolved within 10 days of treatment. Familial aggregation of the illness will be presented in detail and treatment options will be discussed.
Kendell RE, Chalmers JC, Platz C. Epidemiology of puerperal psychoses. Br J Psychiatry 1987;150:662–673. DOI: 10.1192/bjp.150.5.662.
Sit D, Rothschild JA, Wisner KL. A Review of Postpartum Psychosis. J Womens Health 2006;15(4):352–368. DOI: 10.1089/jwh.2006. 15.352.
Davies W. Understanding the pathophysiology of postpartum psychosis: Challenges and new approaches. World J Psychiatry 2017;7(2):77–88. DOI: 10.5498/wjp.v7.i2.77.
Jones I, Craddock N. Familiality of the Puerperal Trigger in Bipolar Disorder: Results of a Family Study. Am J Psychiatry 2001;158(6): 913–917. DOI: 10.1176/appi.ajp.158.6.913.
Jones I, Chandra PS, Dazzan P, et al. Bipolar disorder, affective psychosis, and schizophrenia in pregnancy and the post-partum period. Lancet 2014;384(9956):1789–1799. DOI: 10.1016/S0140-6736(14)61278-2.
Bokhari R, Bhatara VS, Bandettini F, et al. Postpartum psychosis and postpartum thyroiditis. Psychoneuroendocrinology 1998;23(6): 643–650. DOI: 10.1016/S0306-4530(98)00034-1.
MacKinnon AL, Naguib M, Barr HJ, et al. Delusional ideation during the perinatal period in a community sample. Schizophr Res 2017;179: 17–22. DOI: 10.1016/j.schres.2016.09.027.
Jones I, Smith S. Puerperal psychosis: identifying and caring for women at risk. Adv Psychiatr Treat 2009;15(6):411–418. DOI: 10.1192/apt.bp.107.004333.
Chakrabarti S. Thyroid Functions and Bipolar Affective Disorder. J Thyroid Res 2011;2011:306367. DOI: 10.4061/2011/306367.
Doucet S, Jones I, Letourneau N, et al. Interventions for the prevention and treatment of postpartum psychosis: a systematic review. Arch Womens Ment Health 2011;14(2):89–98. DOI: 10.1007/s00737-010-0199-6.
Bergink V, Bouvy PF, Vervoort JS, et al. Prevention of postpartum psychosis and mania in women at high risk. Am J Psychiatry 2012;169(6):609–615. DOI: 10.1176/appi.ajp.2012.11071047.
Sharma V. Pharmacotherapy of postpartum psychosis. Expert Opin Pharmacother 2003;4(10):1651–1658. DOI: 10.1517/146565126.96.36.1991.
Chaudron LH, Pies RW. The relationship between postpartum psychosis and bipolar disorder: a review. J Clin Psychiatry 2003;64(11):1284–1292. DOI: 10.4088/JCP.v64n1102.