puerperal psychosis

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Related to puerperal psychosis: war neurosis

post·par·tum psy·cho·sis

an acute mental disorder with depression in the mother following childbirth.
Synonym(s): puerperal psychosis
Farlex Partner Medical Dictionary © Farlex 2012


(si-ko'sis) plural.psychoses [ psycho- + -osis]
A mental disorder in which there is severe loss of contact with reality, evidenced by delusions, hallucinations, disorganized speech patterns, and bizarre or catatonic behavior. Psychotic disorders are common features of schizophrenia, bipolar disorders, and some affective disorders. They can also result from substance abuse (e.g., the use of hallucinogens), substance withdrawal (e.g., delirium tremens), or side effects of some prescription drugs.


In psychotic states patients may express unusual ideas (e.g., that they can read the minds of others, send radio messages directly to God or inanimate objects, travel to distant galaxies). These ideas are called delusions. Psychosis also is marked by patient reports of hearing voices (auditory hallucinations) or seeing objects or persons not visible to others (visual hallucinations). Auditory hallucinations are hallmarks of schizophrenic and manic states, while visual hallucinations are characteristic of drug intoxication or withdrawal. Disturbances in thought content and form, perception, affect, sense of self, volition, interpersonal relationships, and psychomotor behavior occur. Thorough physical and psychiatric examinations rule out organic causes of the patient symptoms and establish the diagnosis.


Treatment goals focus on meeting the patient’s physical and psychosocial needs, and usually combine drug therapies with behavioral therapies, long-term psychotherapy, psychosocial rehabilitation, and/or vocational counseling, requiring use of community resources. Patients with psychosis are treated effectively with neuroleptic drugs (which appear to work by blocking postsynaptic dopamine receptors), such as haloperidol, risperidone, or chlorpromazine. Side effects of some of these medications include dystonic reactions and tardive dyskinesia. The newer agents produce fewer of these extrapyramidal symptoms. Treatment drugs also have sedative, anticholinergic, and orthostatic hypotension effects, and about 1% of patients taking these agents experience neuroleptic malignant syndrome (life-threatening fever, muscle rigidity, and altered level of consciousness).

Patient care

The psychotic patient should be treated gently and with respect. A safe environment should be maintained, with suicide precautions instituted if needed. Trusting relationships are gradually developed, while avoiding promotion of dependence. Engaging the patient in reality-oriented activities that involve human contact and employing reality-orientation is helpful. Attempts to correct delusional thinking should be avoided because delusions are resistant to logical argument, and discussion about them may be misinterpreted. Because psychotic patients behave violently on occasion, careful practitioners eschew confrontation with them, and obtain immediate help to protect the safety of all involved.


1. Unfamiliar religious experiences and rituals may have all the hallmarks of psychosis when viewed by individuals from different cultures. What constitutes an especially meaningful experience in one society may be recognized as psychosis by another. 2. When assisting a psychotic patient, most clinicians sit close to a door, so that if they feel the need to leave the room quickly, they can do so unimpeded.

Clinicians need to be honest and dependable, and should never make promises that cannot be kept. The family needs to be involved in therapies, taught to recognize adverse drug effects and signs of relapse, as well as ways to manage patient symptoms. Patients are taught to manage their drug regimens, and advised to report any adverse reactions they experience, but not to discontinue a drug without specific direction from the primary care provider. If blood testing is required, the patient is taught when and where this monitoring will take place. If slow-release formulations are used, the patient needs to know when to return for the next dose.

alcoholic psychosis

Loss of contact with reality that results from acute or chronic alcohol use. Examples are pathological intoxication, delirium tremens, Korsakoff's psychosis, and acute hallucinosis.
See: acute alcoholism; acute alcoholic hallucinosis; delirium tremens; intoxication; Korsakoff's syndrome

depressive psychosis

Psychosis characterized by extreme depression, melancholia, and feelings of unworthiness.

drug psychosis

Psychosis caused by intoxication.

exhaustion psychosis

An acute state of confusion and delirium that occurs in relation to extreme fatigue, chronic illness, prolonged sleeplessness, or tension.

functional psychosis

A psychosis in which there is no apparent pathology of the central nervous system.

gestational psychosis

Psychosis that occurs during pregnancy.

involutional psychosis

Psychosis occurring during the period of bodily and intellectual decline.

manic depressive psychosis

Bipolar disorder.

organic psychosis

Psychosis induced by structural brain changes. Emotional instability, irritability, angry outbursts, and inattention are typical symptoms. At any time in the course of the disease, memory, comprehension, ideation, and orientation may become defective. Possible causes include alcohol, narcotics, trauma, syphilis, drugs, poisons, chronic infections, encephalitis, and brain tumors, among many others.

polyneuritic psychosis

Koraskoff's syndrome.

postinfectious psychosis

A psychosis following an infectious disease such as meningitis, pneumonia, or typhoid fever.

postpartum psychosis

A psychosis that develops during the 6 months following childbirth, the highest incidence being in the third to sixth day after delivery through the first month postpartum. The symptoms and signs include hallucinations, delusions, preoccupation with death, self-mutilation, infanticide, distorted reality, and interpersonal dependency. Therapies used to treat this condition include estrogens, electroconvulsive therapies, lithium, and neuroleptic drugs.
Synonym: puerperal psychosis See: depression, postpartum

puerperal psychosis

Postpartum psychosis.

senile psychosis

Psychosis in which onset occurs in an aged individual. This term is rarely used in the English-language health care literature but remains in use in non–English-speaking countries.

situational psychosis

Psychosis due to excessive stress in an unbearable environmental situation.

steroid-induced psychosis

, steroid p.
A psychosis that follows the administration of corticosteroids (e.g., prednisone or methylprednisolone) and cannot be clearly ascribed to another cause. The psychosis may remit after steroids are withheld or may respond to neuroleptic drugs or electroconvulsive therapy.

toxic psychosis

Psychosis brought on by intoxication.

traumatic psychosis

Psychosis or schizophrenia-like illnesses occurring in people who have suffered traumatic brain injury.
Medical Dictionary, © 2009 Farlex and Partners
References in periodicals archive ?
One of the articles cited by Skottowe as rejecting the concept of "puerperal psychosis" was published in the Canadian Medical Association Journal (Cruikshank 1940).
A family history of manic depression, for instance, means a woman has a 50 per cent chance of developing puerperal psychosis. Where there are no previous problems in the family, the risk is just 20 per cent.
Lorna was diagnosed with puerperal psychosis. She was so confused, she became convinced Katie hadn't died and had been taken from her by social workers.
Researcher Dr Ian Jones said: "If we can identify the genes involved it will help us work out the physiological and biological mechanisms that cause puerperal psychosis.
Rarely some new mothers may experience postpartum or puerperal psychosis - an extremely severe form of depression whose symptoms include extreme mood swings, delusions and hallucinations.
But a severe psychotic episode, such as puerperal psychosis, is much rarer, only affecting around one in 2000 women, and is viewed as very different to postnatal depression.
Now researchers are appealing for women who have suffered from the problem, puerperal psychosis, to contact them to help with the research.