title: [Post-partum psychosis: an acute illness requiring resolute action].
abstract: A 34-year-old woman was seen in our hospital, where she had been brought after jumping from the window together with her 3-month-old son. She had survived the jump with severe foot fractures, but her son had died. In the weeks after giving birth she had suffered from sleep disturbances and fluctuating affective symptoms. After initial response to benzodiazepines, she developed psychotic symptoms that lead her to jump from the window. Psychotic symptoms had developed within just 3 days, and medical action came too late. Here we urge clinicians to be alert to psychotic symptoms in the first months of maternity, and to instantly refer young mothers with these symptoms to a closed ward for adequate treatment. Treatment starts with benzodiazepines to restore sleep, followed by an antipsychotic agent if symptoms fail to improve with this treatment; if psychosis and affective symptoms do not improve after 2 weeks this regimen should be followed by lithium augmentation.
authors.affiliation: Universitair Medisch Centrum Utrecht, afd. Psychiatrie, Utrecht.
authors.forename: Iris E
authors.initials: IE
authors.lastname: Sommer
authors.forename: Metten
authors.initials: M
authors.lastname: Somers
authors.forename: Marthe
authors.initials: M
authors.lastname: Bartel
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Vonk
authors.forename: Rob
authors.initials: R
authors.lastname: van Ojen
authors.forename: Marjan
authors.initials: M
authors.lastname: Kromkamp
mesh_terms: D000328:Adult; D000341:Affective Disorders, Psychotic / Q000188:drug therapy; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines / Q000009:adverse effects* / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008094:Lithium / Q000627:therapeutic use; D008297:Male; D009035:Mothers / Q000523:psychology; D049590:Postpartum Period; D011605:Psychoses, Substance-Induced / Q000175:diagnosis* / Q000517:prevention & control; D011644:Puerperal Disorders / Q000188:drug therapy
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D008094:Lithium