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UVA psychiatrist calls for reclassification of postpartum psychosis for better treatment options

UVA Medical Center/Courtesy City of Charlottesville


CHARLOTTESVILLE, VA (CVILLE RIGHT NOW) – An expert in reproductive psychiatry at the University of Virginia School of Medicine is among an international panel of leading women’s mental health experts calling for reclassification of postpartum psychosis as its own category of mental illness.

Dr. Jennifer Payne, a senior author of a new “consensus statement” urging the change wrote such a classification helps improve the care new mothers receive.

“Postpartum psychosis is a very rare and serious psychiatric illness which requires a specific treatment approach,” said Payne.

“Recognition of postpartum psychosis as a distinct clinical entity will promote evidence-based, safe and effective treatment.”

A UVA Health release said postpartum psychosis is a severe psychiatric illness that is estimated to strike up to 2.6 out of every 1,000 women after they give birth.

Symptoms can include mania, depression with psychotic features, impaired thinking, agitation and irritability.

Left untreated, the condition can cause women to commit suicide or kill their babies.

It is considered a psychiatric emergency and often requires hospitalization.

The condition is considered one of the most easily identified mental illnesses among women because of its rapid onset and distinctive symptoms, yet it is not recognized in two key resources used for medical treatment and billing: the Diagnostic and Statistical Manual, often called DSM-5, or the International Classification of Disease.

Changing that, Payne and her colleagues say, will improve treatment for postpartum psychosis and ultimately save lives of both mothers and infants.

The experts argue that postpartum psychosis does not fit into the existing categories of mental illness in the two billing and coding resources. The current descriptions only recognize “peripartum onset,” meaning the illness strikes during the period around childbirth.

This, the authors say, incorrectly describes how postpartum psychosis can set in weeks or months after delivery.

Recategorizing the illness and detailing its symptoms will speed diagnosis and help ensure women get the care they, and their babies, need, the experts say.

To facilitate diagnosis, they have proposed specific criteria, such as depression, delusions and hallucinations, to include in the treatment and coding resources.

“We hope that recognition of postpartum psychosis as a distinct clinical entity will improve identification and outcomes and lead to further research to identify the underlying pathophysiology,” Payne said.

“Postpartum psychosis is treatable, and potentially preventable if we identify the underlying biological basis for the illness.”

The experts have published their consensus statement in the scientific journal Biological Psychiatry.

The article is open access, meaning it is free to read, and includes a comprehensive review of the psychiatric literature on postpartum psychosis.

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