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The postpartum period is a time of risk for mood disturbance in women. Postpartum blues occurs commonly, but is self-limited. Postpartum depression occurs in 13% of postpartum women. However, it is estimated that nearly one-half of all cases go undetected. Postpartum psychosis is rare, affecting 1-2 per 1000 women. Postpartum mood disorders can have far-reaching consequences and have been shown to affect the social and psychological development of children. It is critical that healthcare providers understand these disorders and their risk factors to increase detection and to educate women about the risks and treatments of postpartum mood disorders. This review is intended to provide healthcare providers with a better understanding of the descriptive epidemiology, risk factors, and treatments of postpartum mood disorders. The utility of specific screening instruments is also discussed.
Key words: postpartum depression, postpartum blues, postpartum psychosis, review article, risk factors
INTRODUCTION
The postpartum period is a time of risk for mood disturbance, including postpartum blues, depression and psychosis. Recent reports of infanticide by women with postpartum psychiatric illnesses have highlighted the importance of diagnosing and treating such disorders1. Postpartum blues are mild mood changes that commonly occur during the early postpartum period. In contrast, postpartum depression and psychosis are serious clinical disorders. Approximately 13% of women experience postpartum depression annually2,3, but nearly half of all postpartum depression goes undetected4. Early detection of postpartum mood disorders is difficult because women frequently do not seek care and are often not screened for postpartum depression5-7. The longer the delay to treatment, the longer the postpartum mood disorder can adversely affect the relationship between the new mother and infant, as well as the marital partnership. Research on postpartum mood disorders has increased substantially over the last three decades, which has improved our knowledge about hormonal, psychiatric and psychosocial risk factors, as well as potentially effective treatment strategies.
Postpartum mood disorders are generally divided into three categories from least to most severe: postpartum blues, postpartum depression and puerperal psychosis8. Symptoms may overlap between these disorders, but they have unique risk factors and the severity of each differs substantially. The purpose of this review is to describe the risk factors, screening instruments, and treatments for postpartum mood disorders so that healthcare providers can increase detection and...