Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2017

Open Access 01-12-2017 | Research article

The global prevalence of postpartum psychosis: a systematic review

Authors: Rachel VanderKruik, Maria Barreix, Doris Chou, Tomas Allen, Lale Say, Lee S. Cohen, on behalf of the Maternal Morbidity Working Group

Published in: BMC Psychiatry | Issue 1/2017

Login to get access

Abstract

Background

Mental health is a significant contributor to global burden of disease and the consequences of perinatal psychiatric morbidity can be substantial. We aimed to obtain global estimates of puerperal psychosis prevalence based on population-based samples and to understand how postpartum psychosis is assessed and captured among included studies.

Methods

In June 2014, we searched PubMed, CiNAHL, EMBASE, PsycINFO, Sociological Collections, and Global Index Medicus for publications since the year 1990. Criteria for inclusion in the systematic review were: use of primary data relevant to pre-defined mental health conditions, specified dates of data collection, limited to data from 1990 onwards, sample size >200 and a clear description of methodology. Data were extracted from published peer reviewed articles.

Results

The search yielded 24,273 publications, of which six studies met the criteria. Five studies reported incidence of puerperal psychosis (ranging from 0.89 to 2.6 in 1000 women) and one reported prevalence of psychosis (5 in 1000). Due to the heterogeneity of methodologies used across studies in definitions and assessments used to identify cases, data was not pooled to calculate a global estimate of risk.

Conclusions

This review confirms the relatively low rate of puerperal psychosis; yet given the potential for serious consequences, this morbidity is significant from a global public health perspective. Further attention to consistent detection of puerperal psychosis can help provide appropriate treatment to prevent harmful consequences for both mother and baby.
Appendix
Available only for authorised users
Literature
1.
World Health Organization. Trends in Maternal Mortality: 1990 to 2013. Estimates by WHO, UNICEF, UNFPA, The World Bank and the United Nations Population Division; 2014.
2.
United Nations Secretary-General. The Global Strategy for Women’s, Children’s and Adolescents’ Health (2016-2030). New York: United Nations; 2015.
3.
4.
Say L, Barreix M, Chou D, Tunçalp Ö, Cottler S, McCaw-Binns A, Gichuhi GN, Taulo F, Hindin M. Maternal morbidity measurement tool pilot: study protocol. Reprod Health. 2016;13(1):1–6.CrossRef
5.
Firoz T, Chou D, von Dadelszen P, Agrawal P, Vanderkruik R, Tuncalp O, Magee LA, van Den Broek N, Say L. Maternal morbidity working G: measuring maternal health: focus on maternal morbidity. Bull World Health Organ. 2013;91(10):794–6.CrossRefPubMedPubMedCentral
6.
7.
Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE, Charlson FJ, Norman RE, Flaxman AD, Johns N, et al. Global burden of disease attributable to mental and substance use disorders: findings from the global burden of disease study 2010. Lancet. 2013;382(9904):1575–86.CrossRefPubMed
8.
Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):593–602.CrossRefPubMed
9.
Fisher J. Cabral de Mello M, Patel V, Rahman a, Tran T, Holton S, Holmes W: prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review. Bull World Health Organ. 2012;90(2):139G–49G.CrossRefPubMed
10.
O'hara MW, Swain AM. Rates and risk of postpartum depression-a meta-analysis. Int Rev Psychiatry. 1996;8(1):37–54.CrossRef
11.
Hendrick V, Altshuler L, Cohen L, Stowe Z. Evaluation of mental health and depression during pregnancy: position paper. Psychopharmacol Bull. 1998;34(3):297–9.PubMed
12.
Field T. Prenatal depression effects on early development: a review. Infant Behav Dev. 2011;34(1):1–14.CrossRefPubMed
13.
Howard LM, Piot P, Stein A. No health without perinatal mental health. Lancet. 2014;384(9956):1723–4.CrossRefPubMed
14.
Souza J, Tuncalp O, Vogel J, Bohren M, Widmer M, Oladapo O. Obstetric transition: the pathway towards ending preventable maternal deaths. BJOG. 2014;121:1–4.CrossRefPubMed
15.
Monzon C, Lanza di Scalea T, Pearlstein T. Postpartum psychosis: updates and clinical issues. Psychiatric times; 2014.
16.
Sit D, Rothschild AJ, Wisner KL. A Review of Postpartum Psychosis. J Women's Health. 2006;15:352–68.CrossRef
17.
Jones I, Chandra PS, Dazzan P, Howard LM. Bipolar disorder, affective psychosis, and schizophrenia in pregnancy and the post-partum period. Lancet. 2014;384(9956):1789–99.CrossRefPubMed
18.
Munk-Olsen T, Laursen TM, Pedersen CB, Mors O, Mortensen PB. New Parents and Mental Disorders A Population-Based Register Study. JAMA Psychiatry. 2006;296(21):2582–9.
19.
Reich T, Winokur G. Postpartum psychoses in patients with manic depressive disease. J Nerv Ment Dis. 1970;151(1):60–8.CrossRefPubMed
20.
21.
Spinelli MG. Postpartum Psychosis: Detection of Risk and Management. Am J Psychiatry. 2009;166(4):405–8.CrossRefPubMed
22.
Ko JY, Farr SL, Dietz PM, Robbins CL. Depression and treatment among U.S. pregnant and nonpregnant women of reproductive age. J Womens Health (Larchmt) 2012. 2005-2009;21(8):830.CrossRef
23.
Marcus SM, Flynn HA, Blow FC, Barry KL. Depressive Symptoms among Pregnant Women Screened in Obstetrics Settings. J Women's Health. 2003;12(4):373–80.CrossRef
24.
O'Mahen HA, Flynn HA. Preferences and perceived barriers to treatment for depression during the perinatal period. J Women's Health (Larchmt). 2008;17(8):1301–9.CrossRef
25.
Kohn R, Saxena S, Levav I, Saraceno B. The treatment gap in mental health care. Bull World Health Organ. 2004;82:858–66.PubMedPubMedCentral
26.
Kendell RE, Chalmers JC, Platz C. Epidemiology of puerperal psychoses. Br J Psychiatry. 1987;150:662–73.CrossRefPubMed
27.
Gulmezoglu AM, Say L, Betran AP, Villar J, Piaggio G. WHO systematic review of maternal mortality and morbidity: methodological issues and challenges. BMC Med Res Methodol. 2004;4:16.CrossRefPubMedPubMedCentral
28.
Say L, Pattinson RC, Gulmezoglu AM. WHO systematic review of maternal morbidity and mortality: the prevalence of severe acute maternal morbidity (near miss). Reprod Health. 2004;1(1):3.CrossRefPubMedPubMedCentral
29.
Vanderkruik R, Tuncalp O, Chou D, Say L. Framing maternal morbidity: WHO scoping exercise. BMC Pregnancy Childbirth. 2013;13(213).
30.
Okano T, Kumar NR, Kaneko E, Tamaki I, Hanafusa I, Hayashi M, Matsuyama A. An epidemiological and clinical investigation of postpartum illness in Japanese mothers. J Affect Disord. 1998;48:233–40.CrossRefPubMed
31.
Adefuye PO, Fakoya TA, Odusoga OL, Adefuye BO, Ogunsemi SO, Akindele RA. Post-partum mental disorders in Sagamu. East Afr Med J. 2008;85(12):607–11.
32.
Vesga-López O, Blanco C, Keyes K, Olfson M, Grant BF, Hasin DS. Psychiatric Disorders in Pregnant and Postpartum Women in the United States. Arch Gen Psychiatry. 2008;65(7):805–15.
33.
Valdimarsdóttir U, Hultman CM, Harlow B, Cnattingius S, Sparén P. Psychotic illness in first-time mothers with no previous psychiatric hospitalizations: a population-based study. PLoS Med. 2009 Feb 10;6(2):e13.
34.
Bang RA, Bang AT, Reddy MH, Deshmukh MD, Baitule SB, Filippi V. Maternal morbidity during labour and the puerperium in rural homes and the need for medicalattention: A prospective observational study in Gadchiroli, India. BJOG. 2004;111(3):231–8.
35.
American Psychiatric Association A. Diagnostic and statistical manual of mental disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association; 2000.
36.
Protheroe C. Puerperal psychosis: A long-term study 1927–1961. Br J Psychiatry. 1969;111(9):9–30.CrossRef
37.
38.
Mitsuhiro SS, Chalem E, Moraes Barros MC, Guinsburg R, Laranjeira R. Brief report: prevalence of psychiatric disorders in pregnant teenagers. J Adolesc. 2009;32(3):747–52.CrossRefPubMed
39.
Di Florio A, Jones L, Forty L, Gordon-Smith K, Blackmore ER, Heron J, Craddock N, Jones I. Mood disorders and parity - a clue to the aetiology of the postpartum trigger. J Affect Disord. 2014;152-154:334–9.CrossRefPubMedPubMedCentral
40.
Mino Y, Aoyama H, Froom J. Depressive disorders in Japanese primary care patients. Fam Pract. 1994;11:363–7.CrossRefPubMed
41.
Oates M. Perinatal psychiatric disorders: a leading cause of maternal morbidity and mortality. Br Med Bull. 2003;67(1):219–29.CrossRefPubMed
42.
Miranda J, Patel V. Achieving the Millennium Development Goals: does mental health play a role? PLoS Med. 2005;2(e291):0962–5.
43.
Whiteford HA, Ferrari AJ, Degenhardt L, Feigin V, Vos T. The global burden of mental, neurological and substance use disorders: an analysis from the global burden of disease study 2010. PLoS One. 2015;10(2):e0116820.CrossRefPubMedPubMedCentral
44.
Nager A, Sundquist K, Ramírez-León V, Johansson LM. Obstetric complications and postpartum psychosis: a follow-up study of 1.1 million first-timemothers between 1975 and 2003 in Sweden. Acta Psychiatr Scand. 2008;117(1):12–9.
45.
Terp IM, Mortensen PB. Post-partum psychoses. Clinical diagnoses and relative risk of admission after parturition. Br J Psychiatry. 1998;172:521–6.
46.
Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6(6):e1000097. doi:10.​1371/​journal.​pmed1000097
Metadata
Title
The global prevalence of postpartum psychosis: a systematic review
Authors
Rachel VanderKruik
Maria Barreix
Doris Chou
Tomas Allen
Lale Say
Lee S. Cohen
on behalf of the Maternal Morbidity Working Group
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2017
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-017-1427-7

Other articles of this Issue 1/2017

BMC Psychiatry 1/2017 Go to the issue

Research article

Gray matter morphological anomalies in the cerebellar vermis in first-episode schizophrenia patients with cognitive deficits

Research article

Task shifting interpersonal counseling for depression: a pragmatic randomized controlled trial in primary care

Research article

Diaphragmatic breathing during virtual reality exposure therapy for aviophobia: functional coping strategy or avoidance behavior? a pilot study

Research article

Effect of unaffordable medical need on distress level of family member: analyses of 1997–2013 United States National Health Interview Surveys

Case report

Pharmacogenetic evaluation to assess breakthrough psychosis with aripiprazole long-acting injection: a case report

Study protocol

From the neurobiological basis of comorbid alcohol dependence and depression to psychological treatment strategies: study protocol of a randomized controlled trial