Stolen motherhood-case study of postpartum depression

Open access

Abstract

Aim: The objective was to analyze the case of postpartum depression complicated with extended suicide attempt.

Method: The analysis of clinical case and medical history.

Results: In 25-year-old patient, two weeks after childbirth, postpartum depression episode occurred. In the further course of illness psychotic symptoms (delusions, mood disorders), suicidal and infanticide thoughts emerged. Four weeks after childbirth, the patient killed her baby and took an unsuccessful suicidal attempt. Based on medical records, several risk factors of postpartum depression were identified: 1. obstetric and child-related risk factors: Caesarean section, premature birth, obstetric complications during pregnancy, infant’s difficult temper, difficulties related to breastfeeding; 2. psychological risk factors: baby blues, high anxiety level during pregnancy, high level of stress related to child care.

Conclusions: Psychoeducation of women during pregnancy, including their families, is an extremely crucial element of postpartum depression prevention. It is also necessary to raise awareness among healthcare professionals who have frequent contact with mothers after childbirth: midwives, gynaecologists and paediatricians.

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  • 1. Gavin N. I. Gaynes B. N. Lohr K. N. Meltzer-Brody S. Gartlehner G. Swinson T. Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol.2005; 106(51):1071-1083.

  • 2. Norhayati M. N. Hazlina N. N. Asrenee A. R. Emilin W.W. Magnitude and risk factors for postpartum depression. A literature review. J Affect Disord. 2015;1(175): 34-52.

  • 3. Pużyński S. Wciórka J. Klasyfikacja zaburzeń psychicznych i zaburzeń zachowania ICD-10. Opisy kliniczne i wskazówki diagnostyczne. Uniwersyteckie Wydawnictwo Medyczne Vesalius. Instytut Psychiatrii i Neurologii .Kraków-Warszawa:2000.

  • 4. Wciórka J. Kryteria diagnostyczne według DSM-IV-TR. Elsevier Urban and Partner. Wrocław:2008.

  • 5. Rybakowski J. Dudek J. Jaracz D. Choroby afektywne w: Standardy leczenia farmakologicznego niektórych zaburzeń psychicznych. red. Jarema M. Via Medica. Gadańsk:86-87:2015.

  • 6. Munk-Olsen T. Laursen T. M. Pedersen C. B. Mors O. Mortensen P. B. New parents and mental disorders: a population-based register study. JAMA. 2006;296(21):2582-2589.

  • 7. Wisner K. . Sit D. K. McShea M. C. Rizzo D. M. Zoretich R. A. Hughes C. L. Onset timing thoughts of self-harm and diagnoses in postpartum women with screen-positive depression findings. JAMA Psychiatry.2013;70(5):490-498.

  • 8. Sharma V. Mazmanian D. The DSM-5 peripartum specifier: prospects and pitfalls. Arch Womens Ment Health. 2014; 17(2):171-173.

  • 9. .Reck C. Stehle E. Reinig K. Mundt C. Maternity blues as a predictor of DSM-IV depression and anxiety disorders in the first three months postpartum. J Affect Disord.2009; 113(1):77-87.

  • 10. Bothan P. Postpartum mood disorders-a practitioner’s guide to diagnosis and treatment. South African Journal of Psychiatry.2015; 9(1) 6-8

  • 11. Spinelli M. G. Postpartum psychosis: detection of risk and management. Am J Psychiatry.2009;166(4):405-408.

  • 12. Akiskal H. S. Walker P. Puzantian V. R. King D. Rosenthal T. L. Dranon M. Bipolar outcome in the course of depressive illness: phenomenologic familial and pharmacologic predictors. J Affect Disord.1983; 5(2): 115-128.

  • 13. Sharma V. Khan M. (2010). Identification of bipolar disorder in women with postpartum depression. Bipolar Disord. 2010;12(3):335-340.

  • 14. Freeman M. P. Smith K. W. Freeman S. A. McElroy S. L. Kmetz G. E. Wright R. Keck Jr. P. E.. The impact of reproductive events on the course of bipolar disorder in women. J Clin Psychiatry 2002;63(4) 284-287.

  • 15. Viguera A. C. Tondo L. Koukopoulos A. E. Reginaldi D. Lepri B. & Baldessarini R. J. (2011). Episodes of mood disorders in 2252 pregnancies and postpartum periods. Am J Psychiatry. 2011;168(11):1179-85

  • 16. Rybakowski J. Suwalska K. A. Lojko D. Rymaszewska J. Kiejna A.. Types of depression more frequent in bipolar than in unipolar affective illness: results of the Polish DEP-BI study. Psychopathology 2007;40(3): 153-158.

  • 17. Azorin J. M. Angst J. Gamma A. Bowden C. L. Perugi G. Vieta E. Young A. Identifying features of bipolarity in patients with first-episode postpartum depression: findings from the international BRIDGE study. J Affect Disord.2012; 136(3): 710-715.

  • 18. Vliegen N. Casalin S. Luyten P. (2014). The course of postpartum depression: a review of longitudinal studies. Harv Rev Psychiatry.2014;22(1):1-22.

  • 19. Kammerer M. Marks M. N. Pinard C. Taylor A. von Castelberg B. Künzli H. Glover V. Symptoms associated with the DSM IV diagnosis of depression in pregnancy and post partum. Arch Womens Ment Health. 2009;12(3):135-141.

  • 20. Pitt B. “Atypical” depression following childbirth. Br. J. Psychiatry 1968;114(516):1325-1335

  • 21. Hendrick V. Altshuler L. Strouse T. Grosser S. Postpartum and nonpostpartum depression: differences in presentation and response to pharmacologic treatment. Depress Anxiety. 2000;11(2):66-72.

  • 22. Bernstein I. H. Rush A. J. Yonkers K. Carmody T. J. Woo A. McConnell K. Trivedi M. H.. Symptom features of postpartum depression: are they distinct?. Depress Anxiety.2008; 25(1):20-26.

  • 23. Beck C. T. Indman P. The many faces of postpartum depression. J Obstet Gynecol Neonatal Nurs.2005;34(5):569-576.

  • 24. Dalton K.. Depression after delivery . Oxford UK: Oxford University Press 1996

  • 25. Lindahl V. Pearson J. L. Colpe L. Prevalence of suicidality during pregnancy and the postpartum. Arch Womens Ment Health. 2005;8(2):77-87.

  • 26. Howard L. M. Flach C. Mehay A. Sharp D. Tylee A.. The prevalence of suicidal ideation identified by the Edinburgh Postnatal Depression Scale in postpartum women in primary care: findings from the RESPOND trial. BMC Pregnancy Childbirth 2011; 3(11):57.

  • 27. Johannsen B. M. W. Larsen J. T. Laursen T. M. Bergink V. Meltzer-Brody S. Munk-Olsen T. (2016). All-cause mortality in women with severe postpartum psychiatric disorders. Am J Psychiatry.2016 ;3 (in press).

  • 28. Wisner K. L. Peindl K. S. Hanusa B. H. Obsessions and compulsions in women with postpartum depression. J Clin Psychiatry 1999;60(3):176-80

  • 29. Wisner K. L. Peindl K. S. Hanusa B. H. Psychiatric episodes in women with young children. J Affect Disord.1995;34(1):1-11.

  • 30. Barr J. A. & Beck C. T. Infanticide secrets Qualitative study on postpartum depression. Can Fam Physician 2008;54(12):1716-1717.

  • 31. Beck C. T. Records K. Rice M. Further Development of the Post-partum Depression Predictors Inventory-Revised. J Obstet Gynecol Neonatal Nurs 2006;35(6) 735-745.

  • 32. Webster J. Pritchard M. A. Creedy D. East C. A simplified predictive index for the detection of women at risk for postnatal depression. Birth 2003;30(2):101-108.

  • 33. Krzyżanowska-Zbucka J. Problemy emocjonalne kobiet w okresie okołoporodowym. Fundacja Rodzić po Ludzku Warszawa 2008

  • 34. Kettunen P. Koistinen E. Hintikka J. Is postpartum depression a homogenous disorder: time of onset severity symptoms and hopelessness in relation to the course of depression. BMC Pregnancy and Childbirth 2014;10(14):402

  • 35. Austin M. P. Tully L. Parker G. Examining the relationship between antenatal anxiety and postnatal depression. J. Affect Disord.2007;101(1):169-174.

  • 36. Lee A. M. Lam S. K. Lau S. M. S. M. Chong C. S. Y. Chui H. W. Fong D. Y. T. Prevalence course and risk factors for antenatal anxiety and depression. Obstet Gynecol. 2007;110(5):1102-1112.

  • 37. Huizink A. C. Mulder E. J. de Medina P. G. R. Visser G. H. Buitelaar J. K. Is pregnancy anxiety a distinctive syndrome?. Early Human Dev.2004; 79(2):81-91.

  • 38. Smith-Nielsen J. Steele H. Mehlhase H. Cordes K. Steele M. Harder S. Væver M. S. Links Among High EPDS Scores State of Mind Regarding Attachment and Symptoms of Personality Disorder. J Pers Disord 2015;29(6):771-793.

  • 39. Apter G. Devouche E. Gratier M. Valente M. Le Nestour A. (2012). What lies behind postnatal depression: is it only a mood disorder?. J Pers Disord.2012;26(3) 357.

  • 40. Fonseca A. Gorayeb R. Canavarro M. Women C.׳ help-seeking behaviours for depressive symptoms during the perinatal period: Socio-demographic and clinical correlates and perceived barriers to seeking professional help. Midwifery 2015;31(12):1177-1185.

  • 41. Dennis C. L. Chung Lee L. Postpartum depression help-seeking barriers and maternal treatment preferences: A qualitative systematic review. Birth 2006;33(4):323-331.

  • 42. Goodman J. H. Women’s attitudes preferences and perceived barriers to treatment for perinatal depression. Birth 2009;36(1):60-69.

  • 43. Bilszta J. Ericksen J. Buist A. Milgrom J. Women’s experience of postnatal depression-beliefs and attitudes as barriers to care. Austalian Journal of Advanced Nursing. 2010;27(3):44-

  • 44. Horowitz A. Cousins A. Postpartum depression treatment rates for at-risk women. Nurs Res. 2006:55(2):23-27.

  • 45. Hendrick V. Altshuler L. Strouse T. & Grosser S.. Postpartum and nonpostpartum depression: differences in presentation and response to pharmacologic treatment. Depress Anxiety 2000;11(2):66-72.

  • 46. De Crescenzo F. Perelli F. Armando M. Vicari S. Selective serotonin reuptake inhibitors (SSRIs) for post-partum depression (PPD): a systematic review of randomized clinical trials. J Affect Disord.2014;152 39-44.

  • 47. Molyneaux E. Howard L. M. McGeown H. R. Karia A. M. Trevillion K. Antidepressant treatment for postnatal depression. Advances in Psychiatric Treatment 2014; 20(6):368-368.

  • 48. Sharma V. Sommerdyk C. Are antidepressants effective in the treatment of postpartum depression? A systematic review. Prim. Care Companion CNS Disord. 2013;15 (6) PCC-13r01529.

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