DOCSLIB.ORG

Scientific Understandings of Postpartum Illness: Improving Health Law and Policy?

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Scientific Understandings of Postpartum Illness: Improving Health Law and Policy? Scholarly Commons @ UNLV Boyd Law Scholarly Works Faculty Scholarship 2010 Scientific Understandings of ostparP tum Illness: Improving Health Law and Policy? Stacey A. Tovino University of Nevada, Las Vegas -- William S. Boyd School of Law Follow this and additional works at: https://scholars.law.unlv.edu/facpub Part of the Health Law and Policy Commons, Law and Gender Commons, Law and Psychology Commons, and the Science and Technology Law Commons Recommended Citation Tovino, Stacey A., "Scientific Understandings of ostparP tum Illness: Improving Health Law and Policy?" (2010). Scholarly Works. 10. https://scholars.law.unlv.edu/facpub/10 This Article is brought to you by the Scholarly Commons @ UNLV Boyd Law, an institutional repository administered by the Wiener-Rogers Law Library at the William S. Boyd School of Law. For more information, please contact [email protected]. \\server05\productn\H\HLG\33-1\HLG108.txt unknown Seq: 1 27-JAN-10 12:46 SCIENTIFIC UNDERSTANDINGS OF POSTPARTUM ILLNESS: IMPROVING HEALTH LAW AND POLICY? STACEY A. TOVINO* TABLE OF CONTENTS I. Scientific Understandings of Postpartum Illness ............ 103 R A. Early Medical Observations .......................... 103 R B. Psychoanalytic Theories.............................. 106 R C. Hormone-Based Theories............................. 107 R D. The Role of Neurotransmitters ........................ 110 R E. Neuroimaging Findings .............................. 111 R F. Genetic Bases ....................................... 114 R G. Evolutionary Theories................................ 116 R H. Psychosocial and Sociocultural Models ............... 118 R I. Current Understandings.............................. 121 R II. Legal Understandings of Postpartum Illness ............... 122 R A. Criminal Infanticide Legislation ...................... 123 R B. Judicial Interpretation of Health Insurance Policies .... 133 R C. Postpartum Awareness Legislation .................... 137 R D. A Contemporary Legal Understanding of Postpartum Illness .............................................. 140 R III. Legal Implications of Advances in the Scientific Understanding of Postpartum Illness ...................... 146 R A. Implications for Mental Health Parity Law ............ 147 R B. Implications for Disability Discrimination Law ........ 155 R C. A Limited, Legal Merger of Physical and Mental Illness .............................................. 161 R D. Conclusion .......................................... 171 R * J.D., Ph.D. Associate Professor of Law and Director, Health Law and Policy Center, Drake University Law School, Des Moines, Iowa. I thank John Edwards, Sara Lowe, Sherry VonBehren, and Karen Wallace at the Drake University Opperman Law Library for their generous assistance in locating many of the medical and scientific sources referenced in this Article. I also thank Martha Farah and the University of Penn- sylvania Center for Neuroscience & Society for the invitation to attend the 2009 Neuros- cience Summer Institute, which helped shape this Article, as well as the participants of the 32nd Annual Health Law Professors Conference sponsored by the American Society of Law, Medicine & Ethics at Case Western Reserve University School of Law for their helpful comments and suggestions. \\server05\productn\H\HLG\33-1\HLG108.txt unknown Seq: 2 27-JAN-10 12:46 100 Harvard Journal of Law & Gender [Vol. 33 In its broadest sense, this Article examines the relationship between science and the law in the context of postpartum illness.1 From classical antiquity to the present day, physicians and scientists have investigated the causes, correlates, and consequences of the depressions and psychoses that develop in some women following their transition to motherhood.2 The sci- entific investigation of postpartum illness has been characterized by an open-ended search for knowledge with the recognition that scientific find- ings published one day are subject to revision the next.3 Legislators and judges also have sought to understand postpartum illness as necessary to make laws that affect and adjudicate disputes involving new mothers,4 al- though legal inquiries regarding postpartum illness have yielded factual find- ings that are fixed in time.5 When the results of scientific research and legal research are compared in the context of postpartum illness, several differ- ences emerge,6 perhaps because science and law share neither a common process nor common goals.7 This Article resolves these differences and de- velops a new organizing principle for understanding illness; that is, a unified health law framework that limits distinctions between physical and mental illness. This Article has three Parts. Part I examines the scientific understand- ing of postpartum illness from 400 B.C. to the present day. From classical antiquity to the late nineteenth century, scientific understandings of postpar- tum illness were based primarily on observed temporal relationships be- tween childbirth or lactation and the symptoms of mental illness.8 At the turn of the twentieth century, psychoanalytic theories of postpartum illness, including theories that explained causality in terms of female intra-psychic 1 As discussed in more detail at text accompanying note 27, infra, postpartum depres- R sion is characterized by sadness, crying, self-blame, loss of control, irritability, anxiety, tension, and sleep difficulties that may develop in new mothers between two weeks and six months postpartum and that may last as long as six to twelve months. Postpartum psychosis is characterized by extreme emotional liability, mania, disorganization, and/or the experience of hallucinations and delusions with an onset of three to fourteen days postpartum. See infra text accompanying note 28. R 2 See infra Part I. 3 See infra Part I; see also Daubert v. Merrell Dow Pharmaceuticals, Inc., 509 U.S. 579, 590 (1993) (“Science is not an encyclopedic body of knowledge about the universe. Instead, it represents a process for proposing and refining theoretical explanations about the world that are subject to further testing and refinement.”) (emphasis in original) (in- ternal references and citations omitted); NAT’L RESEARCH COUNCIL, A CONVERGENCE OF SCIENCE AND LAW: A SUMMARY REPORT OF THE FIRST MEETING OF THE SCIENCE, TECHNOL- OGY, AND LAW PANEL 1 (2001) [hereinafter NRC] (discussing the process of fact finding in science). 4 See infra Part II. 5 See infra Part II; see also Vern R. Walker, Epistemic and Non-epistemic Aspects of the Factfinding Process in Law, 5 J. PHIL., SCI. & L., 1–2 (2005), http://www.psljournal. com/archives/all/walkerpaper.cfm (examining the process of fact finding in law). 6 See infra Part II. 7 See, e.g., David Goodstein, How Science Works, in REFERENCE MANUAL ON SCIEN- TIFIC EVIDENCE 67, 80–81 (2nd ed. 2000). 8 See infra Part I(A). \\server05\productn\H\HLG\33-1\HLG108.txt unknown Seq: 3 27-JAN-10 12:46 2010] Scientific Understandings of Postpartum Illness 101 conflict surrounding gender and interpersonal relationships and roles, gained popularity.9 In the second half of the twentieth century, unicausal hormone- based theories10 were followed by theories explaining causality in terms of a reduction in neurotransmitters11 and the influence of psychosocial and soci- ocultural factors.12 In the first decade of the twenty-first century, a number of neuroanatomical and neurofunctional findings13 as well as genetic find- ings14 and evolutionary theories15 contributed to the scientific understanding of postpartum illness. Part I concludes by summarizing postpartum illness’s current (and still incomplete) scientific understanding and outlining a con- temporary multifactorial model for postpartum illness that gives weight to hormonal, neurochemical, neuroanatomical, genetic, evolutionary, psychosocial, sociocultural, and other biological and environmental factors.16 Because Part I provides scientific support for the legal arguments presented in Parts II and III, Part I is necessarily technical. Part II examines the legal understanding, incorporation, and utilization of postpartum illness. Part II finds that a range of past, current, and pro- posed legal authorities, including criminal infanticide laws, judicial opinions interpreting health insurance policy provisions, and postpartum awareness laws expressly reference postpartum illness, its probable causes, and its ob- served effects.17 Part II discovers that the science lawmakers use to support and interpret postpartum law and policy is not always accurate,18 and sug- gests that lawmakers who rely on outdated scientific findings risk develop- ing inappropriate postpartum laws and policies, encouraging the introduction of expert testimony that will not meet evidentiary standards for use in litiga- tion, establishing conflicts between different health laws and policies, and supporting the public misunderstanding of postpartum illness.19 Part II con- cludes by arguing that lawmakers, judges, and other stakeholders need to recognize the complexity of illness etiology, including the etiology of post- partum illness.20 To assist with these efforts, Part II proposes a contempo- rary legal explanation of postpartum illness that emphasizes the illness’s incomplete understanding and likely multifactorial etiology.21 Part II also proposes the repeal or reformulation of outdated common law tests designed to distinguish physical and mental illness. 9 See infra Part I(B). 10 See infra Part I(C). 11 See infra Part I(D). 12 See infra Part I(H). 13 See infra Part
Load more

Recommended publications
  • Puerperal Psychosis’, 2013-2017
    Review Article Annals of Women's Health Published: 07 Dec, 2018 Publications on ‘Puerperal Psychosis’, 2013-2017 Ian Brockington* University of Birmingham, UK Abstract This is a review of 142 works that have appeared in the five years 2013-2017. The relative neglect of this group of psychoses since 1950 has continued, with few case descriptions, investigations or hypotheses about the triggers of bipolar/cycloid episodes with onset soon after childbirth. One new incidental organic psychosis has been reported-herpes simplex encephalitis. There is much to support Marcé's idea that early and late non-organic postpartum episodes are distinct, and his views on the role of menstruation. There are only four active research groups-in Britain, Canada, India and the Netherlands-and there is a need to establish more research programs in populous nations with high birth rates. Introduction In 2014, I reviewed 2,452 works on puerperal psychosis [1], and will now extend this by five years. Since What is worth knowing about ‘Puerperal Psychosis’ went to press, there have been published, to my knowledge, 139 articles, two books and one thesis; the reference list below [2-142] is arranged by year and, within each year, alphabetical order. It is sure to be incomplete, because there will be other theses and articles in unlisted journals. All but seven were in the English language- four in French [29,60,79,89], two in Dutch [72,76] and one in Turkish* [15]. Comparison with Other Medical Literature Figure 1 compares the number of publications on puerperal psychosis with all medical publications (as represented by Medline citations), and with those on the favoured topic of 'schizophrenia'.
    [Show full text]
  • Subsequent Pregnancy in Women with a History of Postpartum Psychosis
    Jefferson Journal of Psychiatry Volume 9 Issue 1 Article 8 January 1991 Subsequent Pregnancy in Women with a History of Postpartum Psychosis Richard G. Hersh, M.D. Northwestern University, Chicago, Illinois Follow this and additional works at: https://jdc.jefferson.edu/jeffjpsychiatry Part of the Psychiatry Commons Let us know how access to this document benefits ouy Recommended Citation Hersh, M.D., Richard G. (1991) "Subsequent Pregnancy in Women with a History of Postpartum Psychosis," Jefferson Journal of Psychiatry: Vol. 9 : Iss. 1 , Article 8. DOI: https://doi.org/10.29046/JJP.009.1.006 Available at: https://jdc.jefferson.edu/jeffjpsychiatry/vol9/iss1/8 This Article is brought to you for free and open access by the Jefferson Digital Commons. The Jefferson Digital Commons is a service of Thomas Jefferson University's Center for Teaching and Learning (CTL). The Commons is a showcase for Jefferson books and journals, peer-reviewed scholarly publications, unique historical collections from the University archives, and teaching tools. The Jefferson Digital Commons allows researchers and interested readers anywhere in the world to learn about and keep up to date with Jefferson scholarship. This article has been accepted for inclusion in Jefferson Journal of Psychiatry by an authorized administrator of the Jefferson Digital Commons. For more information, please contact: [email protected]. Subsequent Pregnancy in Women with a History of Postpartum Psychosis Richard G. Hersh, M.D. INTROD UCTI ON Postp artu m psychosis stands ou t a mo ng t he psychiatric synd romes associated wit h child bir th, not abl e for the variabi lity of its symptom profile and th e po te ntial severity of its course, if unrecogni zed.
    [Show full text]
  • Phenomenology, Epidemiology and Aetiology of Postpartum Psychosis: a Review
    brain sciences Review Phenomenology, Epidemiology and Aetiology of Postpartum Psychosis: A Review Amy Perry 1,*, Katherine Gordon-Smith 1, Lisa Jones 1 and Ian Jones 2 1 Psychological Medicine, University of Worcester, Worcester WR2 6AJ, UK; [email protected] (K.G.-S.); [email protected] (L.J.) 2 National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff CF24 4HQ, UK; [email protected] * Correspondence: [email protected] Abstract: Postpartum psychoses are a severe form of postnatal mood disorders, affecting 1–2 in every 1000 deliveries. These episodes typically present as acute mania or depression with psychosis within the first few weeks of childbirth, which, as life-threatening psychiatric emergencies, can have a significant adverse impact on the mother, baby and wider family. The nosological status of postpartum psychosis remains contentious; however, evidence indicates most episodes to be manifestations of bipolar disorder and a vulnerability to a puerperal trigger. While childbirth appears to be a potent trigger of severe mood disorders, the precise mechanisms by which postpartum psychosis occurs are poorly understood. This review examines the current evidence with respect to potential aetiology and childbirth-related triggers of postpartum psychosis. Findings to date have implicated neurobiological factors, such as hormones, immunological dysregulation, circadian rhythm disruption and genetics, to be important in the pathogenesis of this disorder. Prediction models, informed by prospective cohort studies of high-risk women, are required to identify those at greatest risk of postpartum psychosis. Keywords: postpartum psychosis; aetiology; triggers Citation: Perry, A.; Gordon-Smith, K.; Jones, L.; Jones, I.
    [Show full text]
  • Psychiatric Disorders in the Postpartum Period
    BCMJ /#47Vol2.wrap3 2/18/05 3:52 PM Page 100 Deirdre Ryan, MB, BCh, BAO, FRCPC, Xanthoula Kostaras, BSc Psychiatric disorders in the postpartum period Postpartum mood disorders and psychoses must be identified to prevent negative long-term consequences for both mothers and infants. ABSTRACT: Pregnant women and he three psychiatric disor- proportion of women with postpartum their families expect the postpartum ders most common after the blues may develop postpartum de- period to be a happy time, charac- birth of a baby are postpar- pression.3 terized by the joyful arrival of a new Ttum blues, postpartum de- baby. Unfortunately, women in the pression, and postpartum psychosis. Postpartum depression postpartum period can be vulnera- Depression and psychosis present The Diagnostic and Statistical Man- ble to psychiatric disorders such as risks to both the mother and her infant, ual of Mental Disorders, Fourth postpartum blues, depression, and making early diagnosis and treatment Edition, Text Revision (DSM-IV-TR) psychosis. Because untreated post- important. (A full description of phar- defines postpartum depression (PPD) partum psychiatric disorders can macological and nonpharmacological as depression that occurs within have long-term and serious conse- therapies for these disorders will 4 weeks of childbirth.4 However, most quences for both the mother and appear in Part 2 of this theme issue in reports on PPD suggest that it can her infant, screening for these dis- April 2005.) develop at any point during the first orders must be considered part of year postpartum, with a peak of inci- standard postpartum care. Postpartum blues dence within the first 4 months post- Postpartum blues refers to a transient partum.1 The prevalence of depression condition characterized by irritability, during the postpartum period has been anxiety, decreased concentration, in- systematically assessed; controlled somnia, tearfulness, and mild, often studies show that between 10% and rapid, mood swings from elation to 28% of women experience a major sadness.
    [Show full text]
  • Perinatal Mood Disorders
    PERINATAL MOOD DISORDERS SIGNS & SYMPTOMS Baby Blues Postpartum Depression Postpartum Anxiety “Baby Blues” is a term used to describe the With postpartum depression, feelings of sadness and anxiety can be Approximately 6% of pregnant women and 10% of feelings of worry, unhappiness, and fatigue extreme and might interfere with a woman’s ability to care for herself or postpartum women develop anxiety. Sometimes that many women experience after having a her family. The condition occurs in nearly 15% of births. anxiety is experienced alone and sometimes in addition baby. Babies require a lot of care, so it’s to depression. normal for mothers to be worried about, or Symptoms: tired from, providing care. Baby blues, which - Insomnia Symptoms: affects up to 80% of mothers, includes feelings - Difficulty thinking, concentrating or making decisions - Constant worry that are somewhat mild, last a week or two, - Feeling worthless, guilt or shame - Feeling that something bad is going to happen and go away on their own. - Changes in appetite or weight - Racing thoughts - Overwhelming fatigue - Disturbances of sleep and appetite Symptoms: - Intense anger and irritability - Inability to sit still - Bouts of crying with no specific - Severe mood swings - Physical symptoms like dizziness, hot flashes, reason - Difficulty bonding with baby and nausea - Impatience, irritability, restlessness, - Lack of joy in life and anxiety - Withdrawal from family or friends Risk factors: - Occurs during the immediate first - Loss of interest in sex - Personal or family history of anxiety three days after birth, temporary - Thoughts of harming self or baby - Previous perinatal depression or anxiety experience of mild depression - Recurrent thoughts of death or suicidal ideation, plans or - Thyroid imbalance attempts Symptoms usually disappear, but some Postpartum Panic Disorder women who experience the baby blues are at Symptoms intensify gradually and can occur anytime up to a year after This is a form of anxiety with which the sufferer feels risk for developing postpartum depression.
    [Show full text]
  • Postpartum Psychosis After Traumatic Cesarean Delivery
    healthcare Case Report Postpartum Psychosis after Traumatic Cesarean Delivery Evangelia Antoniou 1,2,* , Eirini Orovou 1, Kassiani Politou 2, Alexandros Papatrechas 2, Ermioni Palaska 1, Angeliki Sarella 1 and Maria Dagla 1,2 1 Department of Midwifery, University of West Attica, 12243 Athens, Greece; [email protected] (E.O.); [email protected] (E.P.); [email protected] (A.S.); [email protected] (M.D.) 2 Non-Profit/Non Governmental Organization (NGO) “Fainareti”, 12243 Athens, Greece; [email protected] (K.P.); [email protected] (A.P.) * Correspondence: [email protected]; Tel.: +30-6977796004 Abstract: An emergency cesarean delivery can be a traumatic childbirth experience for a woman and a risk factor for postpartum psychosis, especially in a patient with a history of bipolar disorder. This article describes the case of a pregnant woman with an unknown history of bipolar disorder who developed an acute psychotic reaction during the procedure of an emergency caesarian section and switched to mania. The purpose of this case study is for perinatal health care professionals to identify suspicious symptoms and promptly refer to psychiatric services so as to ensure the mother’s and the newborn’s safety. This case study highlights the importance of assessing women with bipolar disorder or a previous psychotic episode for the risk of psychiatric complications in pregnancy and after childbirth. Midwifery education on perinatal mental health is crucial for the detection of suspicious symptoms and early referral to a specialist. Keywords: postpartum psychosis case report; bipolar disorder; emergency cesarean section; trau- matic childbirth; acute delirium episode after delivery Citation: Antoniou, E.; Orovou, E.; Politou, K.; Papatrechas, A.; Palaska, E.; Sarella, A.; Dagla, M.
    [Show full text]
  • Texas Clinician's Postpartum Depression Toolkit
    The Texas Clinician’s Postpartum Depression Toolkit Volume 2 A resource for screening, diagnosis and treatment of postpartum depression Table of Contents 1. Introduction ............................................................................................. 3 Definition and Prevalence ............................................................................. 3 Scope ........................................................................................................ 4 Risk factors ................................................................................................ 4 2. Screening and Diagnosis of Postpartum Depression ................................. 6 Screening tools ........................................................................................... 6 Screening for suicide risk ............................................................................. 8 Diagnosis ................................................................................................... 8 Laboratory testing ..................................................................................... 10 3. Treatment of Postpartum Depression ..................................................... 11 Nonpharmacologic treatment ...................................................................... 11 Pharmacologic treatment ........................................................................... 11 Breastfeeding ........................................................................................... 13 Contraception ..........................................................................................
    [Show full text]
  • Postpartum Psychosis
    REVIEW ARTICLE East J Med 23(1): 60-63, 2018 DOI: 10.5505/ejm.2018.62207 Postpartum psychosis Mesut Işık Van Education and Research Hospital, Department of Psychiatry, Van ABSTRACT: The postpartum period is a risky period for the emergence or exacerbation of psychiatric disorders. Postpartum psychosis is the most severe psychiatric disorder in the postpartum period that requires immediate intervention. In most of the cases, the onset is immediate and it is usually in the first two weeks of postpartum period. Sleep disturbances, mood swings, delusions, hallucinations, disorganized behavior, psychomotor agitation, food rejection may be seen. Due to risk of suicide and infanticide, patients should be admitted to the hospital. The most important treatment option in addition to antipsychotic drug therapy is electroconvulsive therapy. Bipolar disorder or postpartum psychosis history, sleep deprivation, primiparity, postpartum hormone changes are important risk factors. The etiology has not been clearly identified yet, although here are many ongoing studies. Key Words: Postpartum, postpartum psychosis, pregnancy Definition of Postpartum Psychosis grandiose delusions that are incompatible with mood. Delusions often have a bizarre character. Postpartum period is a risky period for psychiatric "Schneiderian first-line symptoms" are relatively diseases (1). Women experience 22 times more rare (9). Tactile and visual hallucinations that psychotic or mania episodes in postpartum period point to the organic syndrome can be seen. Severe than in any other periods of their lives (2). mood symptoms such as depression, mania or Postpartum Psychosis (PP) is a rare and severe mixed episodes are frequently observed. Affective disease. (3). The prevalence of postpartum phenomenology seems to be a feature of the psychosis has been reported to be 0.1-0.2% (4).
    [Show full text]
  • Sarah Hightower, LPC
    Maternal Mental Health: The Basics and Beyond Sarah Hightower, LPC © 2014 Postpartum Support International www.postpartum.net Postpartum Support International Universal Message You are not alone You are not to blame With Help, you will be well. © 2014 Postpartum Support International www.postpartum.net Keep up with us: www.facebook.com/PSIGACHAPTER/ and www.psiga.org 3 You are not alone If you are depressed or anxious when you are expecting or have a new baby, you need to remember… You are not alone. You are not to blame. With help, you will feel better. © 2014 Postpartum Support International www.postpartum.net Did You Know? ● About 80% of new mothers experience the baby blues in the first few weeks after the baby arrives. ● At least 1 in 8 mothers experience serious depression or anxiety during pregnancy or postpartum. ● 1-2 mothers out of 1,000 might have a serious condition called postpartum psychosis. ● 1 in 10 fathers experience depression before or after the birth of their child © 2014 Postpartum Support International www.postpartum.net PSI Principle of Social Support Every mother is entitled to a social support network in her community. It is time for every community around the world to value, honor and support mothers, not only in words, but in action. © 2014 Postpartum Support International www.postpartum.net Spectrum of Perinatal Mood & Anxiety Disorders (PMAD’s) ● Prenatal Depression or Anxiety ● Postpartum Depression ● Postpartum Anxiety or Panic Disorder ● Post-Traumatic Stress Disorder ● Postpartum Obsessive-Compulsive Disorder
    [Show full text]
  • Perinatal Mood and Anxiety Disorders
    Postpartum Support International Perinatal Mood and Anxiety Disorders FACT SHEET Among women, the leading cause of disease-related disability is depression (World Health Organization, 2013). Perinatal Mood and Anxiety Disorders have been identified in women of every culture, age, income level and ethnicity. We use the term “Perinatal” for the period of pregnancy and the first year after a baby is born. Research shows that Perinatal Mood and Anxiety Disorders can appear during pregnancy or days or even months after childbirth, and does not usually resolve without treatment (Woolhouse H. et al. BJOG 2014). Although the term “Postpartum Depression” is often used, there is actually a spectrum of disorders that can affect mothers during pregnancy and postpartum. These include: Depression/Anxiety in Pregnancy: It is estimated that 15-21% of pregnant women experience moderate to severe symptoms of depression or anxiety (Wisner KL, Sit DKY, McShea MC, et al. JAMA Psychiatry 2013). Postpartum Depression: Approximately 21% of women experience major or minor depression following childbirth. (Wisner KL, Sit DKY, McShea MC, et al. JAMA Psychiatry 2013) Low income women and teens have rates up to 60% (Earls, M. Pediatrics 2010). Symptoms differ for everyone, and may include: feelings of anger, fear and/or guilt, lack of interest in the baby, appetite and sleep disturbance, difficulty concentrating/ making decisions, and possible thoughts of harming the baby or oneself. Perinatal Panic Disorder: This is a form of anxiety that occurs in up to 11% of new mothers. Symptoms include: feeling very nervous, recurring panic attacks (shortness of breath, chest pain, heart palpitations), many worries or fears (Wenzel A.
    [Show full text]
  • First-Onset Postpartum Psychosis First-Onset Postpartum Psychosis Voor Het Bijwonen Van De Openbare Verdediging Van Mijn Proefschrift
    Uitnodiging First-onset Postpartum Psychosis Psychosis Postpartum First-onset First-onset Postpartum Psychosis voor het bijwonen van de openbare verdediging van mijn proefschrift First-onset Postpartum Psychosis door Veerle Bergink Woensdag 31 oktober 2012 Om 15.30 Prof. Andries Queridozaal Eg-370 Onderwijscentrum, Erasmus MC Dr. Molewaterplein 50 Rotterdam Na afloop van de promotie is er een receptie ter plaatse Parkeren is mogelijk in de Museumparkgarage Veerle Bergink Veerle Veerle Bergink [email protected] Paranimfen Veerle Bergink Elles Berger en Harm de Wit [email protected] Bergink_Omslag.indd 1 29-08-12 10:31 First-onset Postpartum Psychosis Onderzoeksprogramma Postpartum Psychose Erasmus MC Rotterdam OPPER Studie Veerle Bergink The studies described in this thesis were performed at the Department of Psychiatry and Department of Immunology, Erasmus Medical Center, Rotterdam, The Netherlands This research project was supported by the European Commission EU-FP7- HEALTH-F2-2008-222963 “MOODINFLAME”, and the Jan Dekker and Dr. Ludgardine Bouwman stichting. ISBN: 978-90-5335-582-4 Cover: Studio 100% Naarden, The Netherlands Lay-out: Simone Vinke, Ridderprint BV, Ridderkerk, the Netherlands Printing: Ridderprint BV, Ridderkerk, The Netherlands © Veerle Bergink, Rotterdam, The Netherlands. No part of this thesis may be reproduced without permission of the author. First-onset Postpartum Psychosis PROEFSCHRIFT Ter verkrijging van de graad van doctor aan de Erasmus Universiteit Rotterdam op gezag van de rector magnificus Prof.dr. H.G. Schmidt en volgens besluit van het College voor Promoties. De openbare verdediging zal plaatsvinden op woensdag 31 oktober 2012 om 15.30 uur door Veerle Bergink Geboren te Oak Ridge PROMOTIECOMMISSIE Promotor: Prof.
    [Show full text]
  • What the Media Should Know: Myths & Mis-Characterizations About Postpartum Depression and Related Illnesses
    What the Media Should Know: Myths & Mis-characterizations About Postpartum Depression and Related Illnesses In order to ensure that the media does not stigmatize women with perinatal mood and anxiety disorders, it is important when reporting on these illnesses to be careful about how they are characterized. The following information is to help correct some of the consistent errors we see in the media. When the subject of “postpartum depression” (PPD) comes up in the news, it is often accompanied by misinformation and erroneously linked to mothers who commit infanticide, abuse or neglect their children. There is NO direct correlation between infanticide, abuse or neglect and perinatal mood and anxiety disorders. There are several different types of mental illness related to childbirth, with different symptoms and risks. It can be confusing because "postpartum depression" is often used as an umbrella term to cover many different conditions that can occur during pregnancy or postpartum. It is possible for women to have symptoms such as panic and anxiety, obsessive intrusive thoughts, anger, and mania, without primary depression. If a mom has a major Postpartum Depression with no psychotic features, she does not have delusional thinking, although she might have distorted negative views of herself or her life due to her depression. Rather than being at risk of hurting others, a severely depressed or anxious mom without proper support and information can be at risk of suicide because she does not realize that she will recover. She is likely to fear that she is not a good mother, and myths and mistaken descriptions of postpartum depression add to her fear and resulting risk.
    [Show full text]