{"id":591,"date":"2021-02-16T11:47:55","date_gmt":"2021-02-16T11:47:55","guid":{"rendered":"http:\/\/134.122.102.56\/SAND\/uk\/?post_type=professionals&p=591"},"modified":"2021-10-22T11:06:09","modified_gmt":"2021-10-22T10:06:09","slug":"severe-mental-illness","status":"publish","type":"professionals","link":"https:\/\/path-perinatal.eu\/uk\/professionals\/severe-mental-illness\/","title":{"rendered":"Severe mental illness"},"content":{"rendered":"\n
\n

Women with a history of severe mental illness, such as bipolar disorder<\/span><\/a>, schizophrenia<\/span><\/a>, schizoaffective disorder or severe depression will need specialist care, preferably by a specialist perinatal psychiatrist during their pregnancy and postnatal period.<\/p><\/div><\/div>\n\n\n\n

\n\n\n\n

Women with Bipolar Affective Disorder<\/span><\/a> (1-2% of the population) have a risk of developing postpartum psychosis of around one in four which increases to one in two, if they have had a previous episode of postpartum psychosis.<\/p><\/div><\/div>\n\n\n\n

\n\n\n\n

Joint working between midwifery and obstetric teams, perinatal psychiatrist and GP is recommended in order to make a plan for the woman\u2019s postnatal care, when she is at highest risk of relapse.<\/p><\/div><\/div>\n<\/div><\/section>\n\n\n\n

\n

Postpartum psychosis<\/span><\/a> is a psychiatric emergency and a woman should be assessed and treated by a psychiatrist, preferably a specialist perinatal psychiatrist, within 4 hours.<\/p><\/div><\/div>\n<\/div><\/section>\n\n\n\n

\n

Recognition<\/strong><\/strong><\/h3><\/div><\/div>\n\n\n\n
\n\n\n\n

At a woman\u2019s first contact with services in pregnancy and the postnatal period, ask about:<\/p><\/div><\/div>\n\n\n\n

  • <\/i><\/span>

    any past or present severe mental illness<\/p><\/span><\/span><\/span><\/li>

  • <\/i><\/span>

    past or present treatment by a specialist mental health service, including inpatient care<\/p><\/span><\/span><\/span><\/li>

  • <\/i><\/span>

    any severe perinatal mental illness in a first-degree relative (mother, sister or daughter).<\/p><\/span><\/span><\/span><\/li><\/ul><\/div>\n\n\n\n

    If a woman has any past or present severe mental illness or there is a family history of severe perinatal mental illness in a first-degree relative, she may present as high risk of developing postpartum psychosis in the initial weeks after childbirth.<\/p><\/div><\/div>\n<\/div><\/section>\n\n\n\n

    \n

    Referral<\/strong><\/strong><\/h3><\/div><\/div>\n\n\n\n
    \n\n\n\n
    \n\n\n\n

    Refer to a secondary mental health service (preferably a specialist perinatal mental health service) for assessment and treatment, all women who:<\/p><\/div><\/div>\n\n\n\n

    • <\/i><\/span>

      have or are suspected to have severe mental illness<\/p><\/span><\/span><\/span><\/li>

    • <\/i><\/span>

      have any history of severe mental illness (during a pregnancy or the postnatal period or at any other time).<\/p><\/span><\/span><\/span><\/li><\/ul><\/div>\n\n\n\n

      Ensure that the woman\u2019s GP is aware of the referral.<\/p><\/div><\/div>\n<\/div><\/section>\n\n\n\n

      \n

      References<\/strong><\/strong><\/h3><\/div><\/div>\n\n\n\n
      \n\n\n\n

      Jones et al Lancet series on Perinatal Mental Illness (2014) Bipolar disorder, affective psychosis, and schizophrenia in pregnancy and the post-partum period.<\/p><\/div><\/div>\n\n\n\n

      \n\n\n\n

      NICE Guidance CG192 Antenatal and postnatal mental health: clinical management and service guidance<\/p><\/div><\/div>\n<\/div><\/section>\n","protected":false},"excerpt":{"rendered":"","protected":false},"featured_media":0,"parent":0,"template":"","class_list":["post-591","professionals","type-professionals","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/path-perinatal.eu\/uk\/wp-json\/wp\/v2\/professionals\/591","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/path-perinatal.eu\/uk\/wp-json\/wp\/v2\/professionals"}],"about":[{"href":"https:\/\/path-perinatal.eu\/uk\/wp-json\/wp\/v2\/types\/professionals"}],"wp:attachment":[{"href":"https:\/\/path-perinatal.eu\/uk\/wp-json\/wp\/v2\/media?parent=591"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}