Postnatal psychosis



It is the condition of many major mental disorder of organic or emotional origin characterized by a gross impairment  in reality testing , where by the individual incorrectly evaluate and makes incorrect references about external reality, even in the face of contrary evidence.
     The onset of puerperal psychosis is usually rapid , occurring with the first few days of delivery and rarely beyond the first 2-3 weeks.
Incidence
- Puerperal psychosis is of relatively low incidence 1:450.
- It is more common in primiparaus women.
- No defined cause has yet been isolated for postnatal psychosis.
Pre-disposing factor:
-         Stress.
-         Marital tension.
-         Baby’s sex.
-         Broken home.
-         Housing.
-         Hereditary.
Clinical manifestation:
-Actually become more profound with extreme mood swings during which feeling of guilt or anxiety may be expressed.
- Restless and inability to sleep.
- Suicidal impulses or desire to harm her baby.
 - Confused.
- Loss of memory.
- Loss of interest in maintaining personal hygiene,
- Loss of touch to reality.
Diagnostic Evaluation:
-History taking
-Family history
Treatment:
-Antipsychotics are used to control agitation and psychosis features.
-Support time psychotherapy.
-Anti depressants and ECT (electro-convulsive therapy) may be needed.
 Management:
-Maintain maternal infant contacts as soon as it is considered appropriate and safe to do which helps to.
-Re-establishment of the maternal-infant relationship.
-The opportunity to observe the interaction between mother and baby with the opportunity  for exploration  of feeling.
-To rebuild self-esteem by encouraging case of the baby within a safe environment.
-Consult with psychiatric doctor.
-Do not leave the baby alone with mother.
-Give emotional support as far as possible.
-Prevent from accident.
-Provide psychological support to the patient and family.



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