A 27-year-old primigravida delivers at term. On the fourth postpartum day her husband finds her sleepless, agitated, and expressing bizarre beliefs that her baby is possessed. She has auditory hallucinations commanding her to harm herself. She has no prior psychiatric history. Which statement about her condition is most accurate?

• A It usually resolves with reassurance and sleep hygiene alone
• B Antipsychotics are contraindicated during lactation
• C It is indistinguishable from postpartum blues in course
• D It carries a substantial future risk of bipolar disorder ✓

Explanation

Postpartum psychosis is a psychiatric emergency typically emerging within the first two weeks after delivery, characterized by delusions, hallucinations, and insomnia. Although it presents as an acute psychotic episode, it is most often the first manifestation of bipolar disorder, and a large proportion of affected women develop recurrent episodes consistent with bipolar illness over follow-up. It differs fundamentally from self-limited postpartum blues, and hospitalization with antipsychotic or mood stabilizer treatment is required.

Reference: Kaplan and Sadock's Synopsis of Psychiatry, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.