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Postpartum psychosis — DRCOG MCQ

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HardPostnatal CarePostpartum psychosisDRCOG

A 29-year-old woman is 10 days postpartum. Her partner says she has not slept for 3 nights, is speaking rapidly and believes the baby has a divine mission. She is irritable and refuses help with feeding. What is the most likely diagnosis?

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Correct answer: E — Postpartum psychosis

Grandiose beliefs, reduced need for sleep and marked behavioural change within 2 weeks postpartum suggest postpartum psychosis. Baby blues is transient and does not involve delusions. Postnatal depression can be severe, but psychotic or manic symptoms indicate a psychiatric emergency. The pearl is to ask about delusions, hallucinations and risk whenever postpartum behaviour changes abruptly.

Reference: NICE CG192; NICE CG185