Which of the following is the single strongest risk factor for the development of postpartum psychosis?

• A Primiparity
• B Personal or family history of bipolar disorder ✓
• C Unplanned pregnancy
• D Absence of social support

Explanation

Postpartum psychosis is now regarded as almost always a manifestation of bipolar disorder, and a personal or family history of bipolar disorder confers by far the highest relative risk, with recurrence rates of roughly 30 to 50 percent in subsequent pregnancies after one episode. Primiparity, unplanned pregnancy, and poor social support are risk factors for postpartum depression and the blues, not for frank psychosis. This distinction drives management: these patients need mood stabilizer prophylaxis, not reassurance.

Reference: Kaplan and Sadock's Synopsis of Psychiatry, 12th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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