A woman 5 days after delivery is agitated, confused, has delusions about her baby and has not slept for two nights. What is the likely diagnosis and action?
Answer and explanation
Correct answer: D. Puerperal psychosis, a psychiatric emergency needing urgent admission, ideally to a mother and baby unit
- Step 1: Acute psychotic symptoms in the first weeks after birth indicate puerperal psychosis.
- Step 2: It carries a risk of suicide and infanticide and needs urgent specialist care.
Answer
Puerperal psychosis, a psychiatric emergency needing urgent admission, ideally to a mother and baby unit.
Why not the others: Baby blues: Baby blues do not include delusions. Normal sleep deprivation, managed with earplugs and help from relatives: Sleep deprivation alone does not cause psychosis requiring treatment. Mild postnatal depression, needing self-help and a review in six weeks: Depression does not explain delusions of this severity.
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