Understanding Postpartum Psychosis: Current Perspectives and Clinical Implications

Abstract

Postpartum psychosis (PPP) is a rare but severe psychiatric condition that typically emerges within the first two weeks after childbirth, requiring immediate clinical intervention due to risks of suicide and infanticide. Despite its severity, PPP remains under-recognized in major diagnostic classifications such as the DSM-5 and ICD-10, complicating diagnosis and legal considerations. This review synthesizes current knowledge on PPP, including its epidemiology, multifactorial etiology, clinical presentation, and management strategies. Risk factors span genetic vulnerability, hormonal and immune dysregulation, sleep disruption, and psychosocial stressors. Diagnosis is often delayed due to stigma and lack of specific screening tools. Treatment includes a stepwise pharmacological approach using benzodiazepines, antipsychotics, lithium, and electroconvulsive therapy (ECT) for refractory cases, alongside psychosocial interventions. Lithium maintenance therapy has demonstrated significant efficacy in relapse prevention, while medication safety during lactation remains a key clinical concern. The review underscores the urgent need for standardized diagnostic criteria, greater public and professional awareness, and further research into the biological mechanisms underlying PPP. Timely detection and coordinated care can significantly improve outcomes for both mother and child.