Postpartum Psychiatric Disorders

Key points

• Baby blues: up to 50% of mothers; days 3–10; mild tearfulness/lability — self-limiting, reassurance only.
• Postnatal depression: ~10%; within a year of delivery; treat as depression (psychological therapy ± SSRI; sertraline preferred if breastfeeding).
• Puerperal psychosis: ~1 in 500; rapid onset within 2 weeks of delivery — psychotic symptoms, confusion, marked mood disturbance.
• Puerperal psychosis is a psychiatric EMERGENCY — admission (ideally mother-and-baby unit); risk of suicide AND infanticide.
• Previous puerperal psychosis → ~50% recurrence after next delivery.

Decision points in this pathway

• Onset days 3–10, mild lability?
• Psychotic features within 2 weeks of delivery?

The full step-by-step algorithm, including what to do at each branch, opens in the app for approved members.