PUEPERAL PSYCHOSIS

 

PUEPERAL PSYCHOSIS

Puerperum- is the period after giving birth up to six weeks.

Puerperal psychosis - is the mental illness which occurs in a woman during the puerperum up to one year.

AETIOLOGY

 

Hereditary

Biochemical changes

Chronic depression

Stress

CLINICAL MANIFESTATIONS

-        Restlessness

-        Agitation

-        Irritability

-        Violence

-        Apathetic mood

-        Insomnia

-        Fearfulness

-        Hyperactivity

-        Neglect of basic needs

-        Auditory hallucinations

-        Delusional mood involving pt and the baby

-        Miserable mood

-        Pressure of speech

-        Flight of ideas

-        Mutism

 

MANAGEMENT

 

NURSING CARE

 

v  Greet patient to ensure effective communication

v  Sedate patient where need be.

v  Take history and probe for past psychiatric disturbance

v  Encourage patient to eat

v  Carry out thorough investigations to rule out secondary infections.

v  Feed patient with nutritious and well balanced food

v  Both the mother and baby be admitted in a facility they easily keep contact of each other.

v  Do vitals 4 hourly.

 CHEMOTHERAPY

 

Sedate the patient with diazepam 10-20mg IV/IM Stat or repeat after 20 – 30 minutes

Depending on the phase mostly manifested, the drug will administered accordingly.

Eg; if in manic phase, give Inj. Haloperidol 10 – 20 mg IV/IM 6 hourly for a number of hours or days.

Then resort to tablets when patient starts to stabilize.

 

Electro-convulsive therapy (ECT) is most preferred in Puerperal psychosis which is not responding very well to chemotherapy.

 

Prophylactic treatment can be given for up to 2 years.