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Examination of a four-step treatment algorithm for postpartum psychosis
  1. Andrea Lawson,
  2. Ariel Dalfen
  1. Department of Psychiatry, Mount Sinai Hospital, University of Toronto, 600 University Ave, 9th Floor, Toronto, Ontario, Canada M5G 1X5
  1. Correspondence to Dr Andrea Lawson; alawson{at}mtsinai.on.ca

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ABSTRACT FROM: Bergink V, Burgerhout KM, Koorengevel KM, et al. Treatment of psychosis and mania in the postpartum period. Am J Psychiatry 2015;172:115–23.

What is already known on this topic

Postpartum psychosis (PPP) is a severe psychiatric illness that occurs in the first weeks following delivery and may have devastating consequences (eg, suicide, infanticide).1 Hospitalisation and medication are required to stabilise and protect the mother and ensure the baby’s safety. Current treatments include one or a combination of antipsychotics, mood stabilisers and electroconvulsive therapy (ECT);2 however, there is limited evidence for specific treatments of PPP.

Methods of the study

Bergink and colleagues designed a four-step algorithm and examined outcomes of 64 mothers (mean age: 31.9) diagnosed with PPP via the Structured Clinical Interview for DSM Disorders (SCID-I), Patient Edition. Participants were recruited between 2005 and 2011 from a psychiatric inpatient unit in the Netherlands specifically for postpartum patients with severe psychopathology. A psychiatrist (1 of 2 study authors) evaluated participants weekly during admission and 9 months post partum. Clinical remission was defined as the absence of psychotic, manic and depressive symptoms for …

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