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First-time Mothers and Mental Illness

A study of risk factors associated with psychotic illness after childbirth shows that first-time mothers are at the greatest risk of developing psychosis in the month following the birth of their child.

Surprisingly, the risk exists even if they have never been treated in hospital for mental illness in the past.

According to the report in the open-source journal Public Library of Science, it can be common for mothers to experience mental illness in the postpartum period (the months following childbirth).

Most frequently these might involve short-lived cases of the “baby blues” in the days after birth, and mild to moderate postnatal depression in the weeks and months that follow.

Psychotic illness (a mental condition involving episodes where the individual is unable to distinguish between reality and their imagination) in the postpartum period is relatively rare.

Only around one in every 1,000 women develops psychosis after delivery, but it is dangerous for mother and child, with greater risk of self-harm and suicide. The causes of postpartum psychosis are not well understood.

Unnur Valdimarsdottir, of the Karolinska Institutet in Stockholm, and colleagues investigated the rates of psychosis in first-time mothers up to 90 days after the birth of their child, and a number of possible risk factors for psychosis, in Sweden between 1983 and 2000.

Sweden has excellent conditions for this research because it has population-based registers covering almost all births and inpatient records. The researchers therefore had a representative sample — they were able to identify nearly three quarters of a million first-time mothers in Sweden in this period and found that 892 had been admitted to hospital for psychosis within 90 days of giving birth (a rate of 1.2 cases for every thousand births).

About half of these women had no previous record of being hospitalized for any psychiatric illness.

Amongst the women who developed psychosis, the incidence rate was highest during the first month following birth and it dropped to a tenth of that initial rate at 90 days after birth. Furthermore, the research established that the risk of developing psychosis increased with maternal age: women older than 35 were at two times greater risk than women aged 19 or less.

Factors associated with less risk of psychosis in the population of women studied were higher infant birth weight and maternal diabetes; other factors, including smoking and not living with the infant’s father, had no or limited impact on the risk of psychosis during the postpartum period.

The study therefore suggests that there is a specific risk of first-time mothers developing psychosis in the early period after childbirth. This finding highlights the importance of carefully monitoring women in the first month after delivery.

However, the authors recognize that their findings cannot determine exactly why the risk of psychosis is greatest a month after delivery. They suggest several explanations, including the idea that women are at greater biological vulnerability in this period due to the profound hormonal fluctuations they experience.

In an expert commentary on the new study, Phillipa Hay (University of Western Sydney), uninvolved with the research, says: “it is unlikely that there will be any single explanation, and that biological factors will be independent of others.”

Hay argues that other interdependent risk factors, including biological, social and psychological factors, may contribute to postpartum psychosis in first-time mothers, and that by elucidating these risk factors we may “reduce the impact and burden” of this devastating illness.

Source: Public Library of Science

First-time Mothers and Mental Illness

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2015). First-time Mothers and Mental Illness. Psych Central. Retrieved on June 19, 2018, from https://psychcentral.com/news/2009/02/10/first-time-mothers-and-mental-illness/4013.html

 

Scientifically Reviewed
Last updated: 6 Oct 2015
Last reviewed: By John M. Grohol, Psy.D. on 6 Oct 2015
Published on PsychCentral.com. All rights reserved.