A 29-year-old woman develops confusion, restlessness, and disorganised behaviour on the fourth day after an uncomplicated delivery. She hears voices telling her that her newborn is possessed and must be harmed. She had an episode of elated mood with reduced sleep two years ago. What is the correct statement about this condition?
- A It is managed as an outpatient with weekly follow-up
- B It is strongly associated with bipolar disorder and carries a substantial risk of suicide and infanticide, mandating hospitalisation ✓
- C It is a normal variant of postpartum adjustment requiring only reassurance
- D It typically begins two to three months after delivery and resolves spontaneously
Correct answer: B. It is strongly associated with bipolar disorder and carries a substantial risk of suicide and infanticide, mandating hospitalisation
Explanation
Postpartum psychosis is a psychiatric emergency with onset classically within the first two weeks after delivery. It is strongly linked to bipolar spectrum illness (her prior hypomania is the clue) and carries significant risks of suicide and infanticide, so admission with the infant separated is indicated. It differs completely from postpartum blues, which peaks around day 3 to 5, involves tearfulness without psychosis, and resolves within two weeks without treatment.
Reference: Kaplan and Sadock's Synopsis of Psychiatry, 11th ed.
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Written and medically reviewed by the StethoPrep medical team.