Peripartum mood disturbances differential diagnosis
Template:Atherosclerosis Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sunita Kumawat, M.B.B.S[2]
Overview
Depression in the postpartum period without psychotic features is called postpartum depression and if psychotic features are present then it cahracterises postpartum psychosis. Psychosocial variables are linked to an increase in incidence of postpartum depression. In the case of postpartum psychosis, however, this is not the case. In contrast to postpartum depression, which can be sudden in start but generally has a more progressive onset over the weeks to months after labor, the clinical presentation of postpartum psychosis is severe, abrupt, and nearly immediately follows childbirth.
Differentiating Postpartum depression from other Diseases
| Postpartum anxiety | Postpartum blues | Hyperthyroidism or Hypothyroidism | Postpartum psychosis | Perinatal Obsessive Compulsive symptoms |
|---|---|---|---|---|
| The onset is anywhere between child birth to one year. | They usually occur within a few days after child birth and improve within a week or two. | Differentiated by evaluating free T4 and TSH levels. | This presents within days or weeks post delivery. | Occurs in approximately 3 – 5 percent of childbearing women. Because of changes in the level of estrogen and progesterone affecting transmission of dopamine and serotonin.
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| Presents with feelings of dread, worry, lack of concentration, sleeping and eating problems, nausea, palpitations, dizziness. | The new mother has low mood, frequent crying, change in appetite and sleep, feeling of inadequacy. | Mood diorders along with other physiologic symptoms | The mother experiences agitation, delusions, hallucinations, sleep deprivation for several nights and change in behaviour. | Intense distress, and senseless and intrusive thoughts.
Obsession is having thoughts or mental pictures of hurting or murdering one's own child. The compulsion is bathing the baby or changing the child's clothes.
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| The condition does not subside on its own. The patient has to seek medical advice.[1] | Does not impact day to day functioning or the capacity to look after the baby. | This is acute in onset and an emergency situation with the risks of suicide and harm to the baby. | Mothers know these are bizarre and unrealistic. Medical and psychotherapy are used for the treatment. |