Postpartum Mood
Disorders
Description
1. The Diagnostic and Statistical Manual of Mental Disorders contains official
guidelines for the assessment and diagnosis of psychiatric illness. The
disorders recognized during the postpartum period are:
▪ Postpartum blues
▪ Postpartum depression without psychotic features
▪ Postpartum depression with psychotic features (postpartum
psychosis)
2. Between 50% and 80% of all new mothers report some form of
postpartum blues.
3. The incidence of moderate or major postpartum depression or
postpartum bipolar disorder ranges from 30 to 200 per every 1,000 live
births; the incidence of brief psychotic disorders with postpartum onset
is about 1 in every 1,00 live births.
Aetiology
1. Predisposing factors include a history of puerperal psychosis, bipolar
(for merely manic-depressive) disorder, delirium and hallucinations,
rapid mood changes, agitation or confusion, and the potential for
suicide or infanticide.
2. Postpartum depression with and without psychosis is being studied
from three perspectives.
▪ Biologic theories include alteration in hypothalamic function,
possibly related to altered hormonal influence.
▪ Psychological theories include poor support systems, psychologic
stress, or poor relationship with partner.
, ▪ Socio-cultural theories include low levels of social gratification,
support, and control both at work and in the parenting role.
Comparison of Postpartum Blues, Depression and Psychosis
POSTPARTAL POSTPARTAL POSTPARTAL
BLUES DEPRESSION PSYHOSIS
Within first to third
1-10 days after 1-2 months after month after giving
ONSET giving birth giving birth birth
Delusions or
hallucinations of
Anxiety, feelings harming infant or
SYMPTOMS Sadness, tears of loss, sadness self
1% to 2% of all
INCIDENCE 70% of all births 10% of all births births
History of Possible activation
previous of previous mental
Probably caused depression, illness, hormonal
by hormonal hormonal changes, family
changes, stress of response, lack of history of bipolar
ETIOLOGY life changes social support disorder
Counselling, drug Psychotherapy,
THERAPY Support, empathy therapy drug therapy
Referring to
counselling,
safeguarding
Offering mother from injury
compassion and Referring to to self or to new-
NURSING NOTE understanding counselling borns.
Comparison Table Source: Pellitory, A. (2007). Maternal and Child Health Nursing: Care of the Childbearing and
Childbearing Family. 5th Edition
Assessment Findings
▪ Serious postpartum depression or psychosis usually does not occur
until 3 to 5 days after delivery, at which time the client is usually
discharged from the hospital or birthing centre. Clinical manifestations
depend on the type of mood disorder.
Disorders
Description
1. The Diagnostic and Statistical Manual of Mental Disorders contains official
guidelines for the assessment and diagnosis of psychiatric illness. The
disorders recognized during the postpartum period are:
▪ Postpartum blues
▪ Postpartum depression without psychotic features
▪ Postpartum depression with psychotic features (postpartum
psychosis)
2. Between 50% and 80% of all new mothers report some form of
postpartum blues.
3. The incidence of moderate or major postpartum depression or
postpartum bipolar disorder ranges from 30 to 200 per every 1,000 live
births; the incidence of brief psychotic disorders with postpartum onset
is about 1 in every 1,00 live births.
Aetiology
1. Predisposing factors include a history of puerperal psychosis, bipolar
(for merely manic-depressive) disorder, delirium and hallucinations,
rapid mood changes, agitation or confusion, and the potential for
suicide or infanticide.
2. Postpartum depression with and without psychosis is being studied
from three perspectives.
▪ Biologic theories include alteration in hypothalamic function,
possibly related to altered hormonal influence.
▪ Psychological theories include poor support systems, psychologic
stress, or poor relationship with partner.
, ▪ Socio-cultural theories include low levels of social gratification,
support, and control both at work and in the parenting role.
Comparison of Postpartum Blues, Depression and Psychosis
POSTPARTAL POSTPARTAL POSTPARTAL
BLUES DEPRESSION PSYHOSIS
Within first to third
1-10 days after 1-2 months after month after giving
ONSET giving birth giving birth birth
Delusions or
hallucinations of
Anxiety, feelings harming infant or
SYMPTOMS Sadness, tears of loss, sadness self
1% to 2% of all
INCIDENCE 70% of all births 10% of all births births
History of Possible activation
previous of previous mental
Probably caused depression, illness, hormonal
by hormonal hormonal changes, family
changes, stress of response, lack of history of bipolar
ETIOLOGY life changes social support disorder
Counselling, drug Psychotherapy,
THERAPY Support, empathy therapy drug therapy
Referring to
counselling,
safeguarding
Offering mother from injury
compassion and Referring to to self or to new-
NURSING NOTE understanding counselling borns.
Comparison Table Source: Pellitory, A. (2007). Maternal and Child Health Nursing: Care of the Childbearing and
Childbearing Family. 5th Edition
Assessment Findings
▪ Serious postpartum depression or psychosis usually does not occur
until 3 to 5 days after delivery, at which time the client is usually
discharged from the hospital or birthing centre. Clinical manifestations
depend on the type of mood disorder.
