A woman with postpartum psychosis may exhibit a range of clinical features. The diagnosis may be difficult if the psychotic features are masked or if early signs are misleading.
A woman with postpartum psychosis should manifest one or more of the following:
(1) hallucinations
(2) delusions
(3) paranoia
(4) catatonia
The psychotic features may be preceded or masked by other features:
(1) organic brain syndrome (see below)
(2) anxiety and/or depression (see below)
(3) violence (see below)
Organic brain syndrome - one or more of the following:
(1) delirium
(2) altered mental status (stupor, etc)
(3) disorientation, confusion
(4) disordered sleep
Affective disorder - one or more of the following:
(1) affective instability with irritability, agitation and anxiety
(2) depression, mania and/or bipolar disorder
Violence may take the form of:
(1) suicide or self-harm
(2) infanticide or filicide
The possibility of a psychotic disorder should always be considered if any of these findings are present.
