Subject(s)
Depression, Postpartum/psychology , Menstruation/psychology , Mothers/psychology , Parturition/psychology , Psychotic Disorders/psychology , Bipolar Disorder/psychology , Depression, Postpartum/history , Female , History, 19th Century , History, 20th Century , Humans , Pregnancy , Psychotic Disorders/historySubject(s)
Pregnancy Complications/diagnosis , Psychotic Disorders/etiology , Puerperal Disorders/etiology , Adult , Alcohol Withdrawal Delirium/complications , Alcohol Withdrawal Delirium/diagnosis , Diagnosis, Differential , Epilepsy/complications , Epilepsy/diagnosis , Female , Humans , Hyperammonemia/complications , Hyperammonemia/diagnosis , Hypopituitarism/complications , Hypopituitarism/diagnosis , Necrosis , Pituitary Gland/pathology , Pregnancy , Psychotic Disorders/diagnosis , Puerperal Disorders/diagnosis , Water Intoxication/complications , Water Intoxication/diagnosisABSTRACT
129 mothers referred to specialist psychiatric services in Birmingham and Christchurch were interviewed with the Birmingham Interview. Anxiety disorders were more frequent than depression during pregnancy, and equally frequent after delivery. The focus of pre- and post-partum anxiety may be important for psychological treatment. At a severe level, the most common prepartum theme was fear of foetal death; this was associated with a history of reproductive losses or infertility. After delivery the commonest themes were the pathological fear of cot death and fear of the criticism of mothering skills (which was a clue to a disordered mother-infant relationship). Clinicians should be vigilant for obsessional disorders, querulant (complaining) disorders, post-traumatic stress disorder, conjugal jealousy and dysmorphophobic states, which are all quite common. Patients with "postpartum depression" usually had at least one other (co-morbid) disorder, and 27% had two or more. These findings emphasize the diversity of postpartum psychiatric illness.
Subject(s)
Anxiety/epidemiology , Obsessive-Compulsive Disorder/epidemiology , Postpartum Period/psychology , Adolescent , Adult , Depression, Postpartum , England/epidemiology , Female , Humans , Infant, Newborn , Interviews as Topic , New Zealand/epidemiology , PregnancyABSTRACT
We assessed the frequency of severe disorders of the mother-infant relationship in over 200 mothers referred to services in Birmingham and Christchurch, all of whom were interviewed using the Birmingham Interview for Maternal Mental Health. 10.6% had established rejection and 14.6% threatened rejection of their infants. 28.6% had various degrees of pathological anger, which was severe in 8.3%. Rejection was strongly associated with unwanted pregnancy and lack of interaction with the foetus.
Subject(s)
Mental Disorders/epidemiology , Mother-Child Relations , Acute Disease , Adult , England/epidemiology , Female , Humans , Infant , Infant, Newborn , Interviews as Topic , New Zealand/epidemiologyABSTRACT
This is a validation of a self-rating questionnaire designed to detect disorders of the mother-infant relationship. 125 subjects filled in the questionnaire, and were also interviewed using the 5(th) Edition of the Birmingham Interview for Maternal Mental Health. On the basis of these interviews and the case records, we made consensus diagnoses of various forms and degrees of mother infant relationship disorder, according to criteria published in this paper. We calculated specificity, sensitivity and positive predictive value of the four scale scores generated by the questionnaire. Scale 1 (a general factor) had a sensitivity of 0.82 for all mother-infant relationship disorders. Scale 2 (rejection and pathological anger) had a sensitivity of 0.88 for rejection of the infant, but only 0.67 for severe anger. The performance of scale 3 (infant-focused anxiety) was unsatisfactory. Scale 4 (incipient abuse) selected only a few mothers, but was of some value in identifying those at high risk of child abuse. Revision of the thresholds can improve sensitivity, especially of scale 2, where a cut-off point of 12 = normal, 13 = high better identifies mothers with threatened rejection. These new cut-off points would need validation in another sample.
Subject(s)
Mother-Child Relations , Object Attachment , Postpartum Period/psychology , Surveys and Questionnaires , Adolescent , Adult , England , Female , Humans , Infant , Infant, Newborn , Mother-Child Relations/ethnology , New ZealandSubject(s)
Abortion, Induced/history , Memory Disorders/history , Psychotic Disorders/history , Abortion, Induced/psychology , Adult , Female , History, 18th Century , History, 19th Century , Humans , Memory Disorders/etiology , Pregnancy , Psychotic Disorders/etiology , Self-Injurious Behavior/history , United Kingdom , Women's HealthABSTRACT
Compared with men, women have a greater lifetime risk of delusions of infestation, with the risk appearing to increase around the menopause, when the blood levels of reproductive hormones are decreasing. Women also have a greater lifetime risk of depression and an increased incidence of depressive symptoms post partum, when the blood levels of these hormones are decreasing as well. The first case of a delusion of infestation with post-partum onset is described, and possible associations with reproductive function in women are discussed.
Subject(s)
Delusions/psychology , Depression, Postpartum/psychology , Ectoparasitic Infestations/psychology , Helminthiasis/psychology , Puerperal Disorders/psychology , Adult , Defense Mechanisms , Delusions/diagnosis , Depression, Postpartum/diagnosis , Female , Humans , Infant, Newborn , Male , Psychoanalytic Interpretation , Puerperal Disorders/diagnosisABSTRACT
About half of newly delivered mothers suffer a transient phase of emotional lability or sadness a few days after parturition around the 2nd and 5th day after delivery. The transitory psychopathology of the postpartum blues is similar to premenstrual tension, whose main symptom is irritability. The essence of the postpartum blues is not depression, but a sudden, fleeting and unexpected mood change with anxiousness, low spirits, tearfulness, confusion, poor concentration and forgetfulness. The aetiology of this disorder is unknown. It is well known that oestrogens and progesterone modify catecholamine concentration and the density of adrenergic, noradrenergic und dopaminergic receptors in the limbic structures of the central nervous system. But most of the neurochemical studies have not distinguished between postpartum blues and other forms of depression found in women and occurring postpartum. Those research groups who defined a group with a dysphoric peak in the early puerperium could not find a significant correlation between sex hormone levels, neurobiochemical data, and postpartum mood changes.
Subject(s)
Depression, Postpartum/psychology , Depression, Postpartum/diagnosis , Depression, Postpartum/etiology , Depression, Postpartum/therapy , Diagnosis, Differential , Female , Humans , PregnancyABSTRACT
Cot death (sudden infant death syndrome) is one of the most common causes of death in the first year of life. Four cases with a pathological fear of cot death are presented. All the patients were depressed and in 2 cases the fear of cot death had an obsessional quality. In all cases there were complications during pregnancy (miscarriage, threatened abortion, recurrent vomiting in last trimester). In 1 case, the patient knew 3 mothers who had suffered cot deaths; in another, the infant was gravely ill in the neonatal period. Pathological fear of cot death can be recognised by the presence of two central features - overvigilance and excessive nocturnal checking of the baby's breathing. Therapeutic interventions are discussed.
Subject(s)
Fear , Sudden Infant Death , Adult , Depression, Postpartum/complications , Female , Humans , Infant, Newborn , Maternal Behavior , Mother-Child Relations , PregnancyABSTRACT
The possible occurrence of fetal abuse in expectant mothers has received little attention in either clinical practice or in research. Five cases with reported fetal abuse are presented. Each case suffered from depression and four of the five women had unplanned pregnancies and had considered a termination of pregnancy. Other possible factors associated with fetal abuse included: denial of the pregnancy, ambivalence towards the pregnancy, previous postpartum depression, and relationship difficulties. Enquiry of possible fetal abuse in pregnant women should be made, particularly if a depressive illness is demonstrated. The relationship between fetal abuse and subsequent child abuse remains unclear.
