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Clinical Conundrum: A Complex Case of Postpartum Depression

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Complex Clinical Conundrums in Psychiatry

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Abstract

Pregnancy and postpartum are two of the most significant periods in a woman’s life. However, they are also periods in which women are vulnerable to both mental health problems and medical illness. Psychological disturbances can have negative effects on the mother, the fetus, and the growing infant. Postpartum depression is among the commonest mental health problems in the perinatal period with several psychosocial and medical factors adding to the risk. It is hence important that clinicians use a holistic approach to assessment and treatment of women with postpartum depression. We discuss Ms. V who presented to us in the postpartum period with low mood, suicidal ideas, and poor bonding with her infant on the background of several ongoing psychosocial stressors. In addition, she also had a comorbid chronic medical condition which added to the complexity of clinical presentation and management. The chapter discusses this clinically complex situation and reviews the relevant literature with regard to postpartum depression, trauma, mother-infant bonding, and medical conditions that add to the picture. The chapter also emphasizes the need for a multidisciplinary approach in the management of postpartum depression.

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References

  1. Beeghly M, Weinberg MK, Olson KL, Kernan H, Riley J, Tronick EZ. Stability and change in level of maternal depressive symptomatology during the first postpartum year. J Affect Disord. 2002;71:169–80.

    Article  PubMed  Google Scholar 

  2. Norhayati MN, Hazlina NHN, Asrenee AR, Emilin WMAW, Abbasi S, Chuang CH, et al. Magnitude and risk factors for postpartum symptoms: a literature review. J Affect Disord. 2015;175:34–52. https://doi.org/10.1016/j.jad.2014.12.041.

    Article  PubMed  CAS  Google Scholar 

  3. Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T. Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol. 2005;106:1071–83. https://doi.org/10.1097/01.AOG.0000183597.31630.db.

    Article  PubMed  Google Scholar 

  4. Vliegen N, Casalin S, Luyten P. The course of postpartum depression. Harv Rev Psychiatry. 2014;22:1–22. https://doi.org/10.1097/HRP.0000000000000013.

    Article  PubMed  Google Scholar 

  5. Fisher J, Cabral De Mello M, Patel V, Rahman A, Tran T, Holton S, et al. Prevalence and determinants of common perinatal mental disorders in women in low and lower-middle-income countries: a systematic review. Bull World Heal Organ. 2012;90:139–49. https://doi.org/10.2471/BLT.11.091850.

    Article  Google Scholar 

  6. Gelaye B, Rondon MB, Araya R, Williams MA. Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries. The Lancet Psychiatry. 2016;3:973–82. https://doi.org/10.1016/S2215-0366(16)30284-X.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Boyce P, Hickey A. Psychosocial risk factors to major depression after childbirth. Soc Psychiatry Psychiatr Epidemiol. 2005;40:605–12. https://doi.org/10.1007/s00127-005-0931-0.

    Article  PubMed  Google Scholar 

  8. Kozinszky Z, Dudas RB, Csatordai S, Devosa I, Tóth É, Szabó D, et al. Social dynamics of postpartum depression: a population-based screening in south-eastern Hungary. Soc Psychiatry Psychiatr Epidemiol. 2011;46:413–23. https://doi.org/10.1007/s00127-010-0206-2.

    Article  PubMed  Google Scholar 

  9. Quelopana AM, Champion JD, Reyes-Rubilar T. Factors associated with postpartum depression in Chilean women. Health Care Women Int. 2011;32:939–49. https://doi.org/10.1080/07399332.2011.603866.

    Article  PubMed  Google Scholar 

  10. Sword W, Kurtz Landy C, Thabane L, Watt S, Krueger P, Farine D, et al. Is mode of delivery associated with postpartum depression at 6 weeks: a prospective cohort study. BJOG An Int J Obstet Gynaecol. 2011;118:966–77. https://doi.org/10.1111/j.1471-0528.2011.02950.x.

    Article  CAS  Google Scholar 

  11. Glavin K, Smith L, Sørum R. Prevalence of postpartum depression in two municipalities in Norway. Scand J Caring Sci. 2009;23:705–10. https://doi.org/10.1111/j.1471-6712.2008.00667.x.

    Article  PubMed  Google Scholar 

  12. Goyal D, Gay C, Lee KA. How much does low socioeconomic status increase the risk of prenatal and postpartum depressive symptoms in first-time mothers? Women’s Heal Issues. 2010;20:96–104. https://doi.org/10.1016/j.whi.2009.11.003.

    Article  Google Scholar 

  13. Patel V, Rodrigues M, DeSouza N. Gender, poverty, and postnatal depression: a study of mothers in Goa, India. Am J Psychiatry. 2002;159:43–7. https://doi.org/10.1176/appi.ajp.159.1.43.

    Article  PubMed  Google Scholar 

  14. Lee DT, Yip AS, Leung TY, Chung TK. Identifying women at risk of postnatal depression: prospective longitudinal study. Hong Kong Med J = Xianggang Yi Xue Za Zhi. 2000;6:349–54.

    PubMed  CAS  Google Scholar 

  15. Seguin L, Potvin L, St-Denis M, Loiselle J. Depressive symptoms in the late postpartum among low socioeconomic status women. Birth. 1999;26:157–63. https://doi.org/10.1046/j.1523-536x.1999.00157.x.

    Article  PubMed  CAS  Google Scholar 

  16. Gaillard A, Le Strat Y, Mandelbrot L, Keïta H, Dubertret C, Adouard F, et al. Predictors of postpartum depression: prospective study of 264 women followed during pregnancy and postpartum. Psychiatry Res. 2014;215:341–6. https://doi.org/10.1016/j.psychres.2013.10.003.

    Article  PubMed  Google Scholar 

  17. Dennis C-L, Vigod S. The relationship between postpartum depression, domestic violence, childhood violence, and substance use: epidemiologic study of a large community sample. Violence Against Women. 2013;19:503–17. https://doi.org/10.1177/1077801213487057.

    Article  PubMed  Google Scholar 

  18. Patel V, Araya R, de Lima M, Ludermir A, Todd C. Women, poverty and common mental disorders in four restructuring societies. Soc Sci Med. 1999;49:1461–71.

    Article  CAS  PubMed  Google Scholar 

  19. Warner R, Appleby L, Whitton A, Faragher B. Demographic and obstetric risk factors for postnatal psychiatric morbidity. Br J Psychiatry. 1996;168:607–11.

    Article  CAS  PubMed  Google Scholar 

  20. O’hara MW, Swain AM. Rates and risk of postpartum depression—a meta-analysis. Int Rev Psychiatry. 1996;8:37–54. https://doi.org/10.3109/09540269609037816.

    Article  Google Scholar 

  21. Nielsen Forman D, Videbech P, Hedegaard M, Dalby Salvig J, Secher NJ. Postpartum depression: identification of women at risk. BJOG. 2000;107:1210–7.

    Article  CAS  PubMed  Google Scholar 

  22. Boyce PM, Todd AL. Increased risk of postnatal depression after emergency caesarean section. Med J Aust. 1992;157:172–4.

    PubMed  CAS  Google Scholar 

  23. Hannah P, Adams D, Lee A, Glover V, Sandler M. Links between early post-partum mood and post-natal depression. Br J Psychiatry. 1992;160:777–80.

    Article  CAS  PubMed  Google Scholar 

  24. Johnstone SJ, Boyce PM, Hickey AR, Morris-Yatees AD, Harris MG. Obstetric risk factors for postnatal depression in urban and rural community samples. Aust N Z J Psychiatry. 2001;35:69–74.

    Article  CAS  PubMed  Google Scholar 

  25. Räisänen S, Lehto SM, Nielsen HS, Gissler M, Kramer MR, Heinonen S. Fear of childbirth predicts postpartum depression: a population-based analysis of 511 422 singleton births in Finland. BMJ Open. 2013;3:e004047. https://doi.org/10.1136/bmjopen-2013-004047.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Nakku JEM, Nakasi G, Mirembe F. Postpartum major depression at six weeks in primary health care: prevalence and associated factors. Afr Health Sci. 2006;6:207–14. https://doi.org/10.5555/afhs.2006.6.4.207.

    Article  PubMed  PubMed Central  Google Scholar 

  27. East M. Postpartum anaemia. Are we vigilant enough? Pract Midwife. 2012;15:37–9.

    PubMed  Google Scholar 

  28. Murphy PK, Mueller M, Hulsey TC, Ebeling MD, Wagner CL. An exploratory study of postpartum depression and vitamin D. J Am Psychiatr Nurses Assoc. 2010;16:170–7. https://doi.org/10.1177/1078390310370476.

    Article  PubMed  Google Scholar 

  29. Sontrop J, Campbell MK. Omega-3 polyunsaturated fatty acids and depression: a review of the evidence and a methodological critique. Prev Med (Baltim). 2006;42:4–13. https://doi.org/10.1016/j.ypmed.2005.11.005.

    Article  CAS  Google Scholar 

  30. Beard JL, Hendricks MK, Perez EM, Murray-Kolb LE, Berg A, Vernon-Feagans L, et al. Maternal iron deficiency anemia affects postpartum emotions and cognition. J Nutr. 2005;135:267–72.

    Article  CAS  PubMed  Google Scholar 

  31. Wójcik J, Dudek D, Schlegel-Zawadzka M, Grabowska M, Marcinek A, Florek E, et al. Antepartum/postpartum depressive symptoms and serum zinc and magnesium levels. Pharmacol Rep. 2006;58:571–6.

    PubMed  Google Scholar 

  32. Dahale AB, Chandra PS, Sherine L, Thippeswamy H, Desai G, Reddy D. Postpartum psychosis in a woman with graves’ disease: a case report. Gen Hosp Psychiatry. 2014;36:761.e7–8. https://doi.org/10.1016/j.genhosppsych.2014.07.003.

    Article  Google Scholar 

  33. Kuijpens JL, Vader HL, Drexhage HA, Wiersinga WM, van Son MJ, Pop VJ. Thyroid peroxidase antibodies during gestation are a marker for subsequent depression postpartum. Eur J Endocrinol. 2001;145:579–84.

    Article  CAS  PubMed  Google Scholar 

  34. Salm Ward T, Kanu FA, Robb SW. Prevalence of stressful life events during pregnancy and its association with postpartum depressive symptoms. Arch Womens Ment Health. 2016;20:161–71. https://doi.org/10.1007/s00737-016-0689-2.

    Article  PubMed  Google Scholar 

  35. Kumar R, Robson KM. A prospective study of emotional disorders in childbearing women. Br J Psychiatry. 1984;144:35–47.

    Article  CAS  PubMed  Google Scholar 

  36. Manjunath NG, Venkatesh G, Rajanna. Postpartum blue is common in socially and economically insecure mothers. Indian J Community Med. 2011;36:231–3. https://doi.org/10.4103/0970-0218.86527.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Miller LJ, LaRusso EM. Preventing postpartum depression. Psychiatr Clin North Am. 2011;34:53–65. https://doi.org/10.1016/j.psc.2010.11.010.

    Article  PubMed  Google Scholar 

  38. Oates M. Suicide: the leading cause of maternal death. Br J Psychiatry. 2003;183:279–81.

    Article  PubMed  Google Scholar 

  39. Meena PS, Soni R, Jain M, Jilowa CS, Omprakash. Cognitive dysfunction and associated behaviour problems in postpartum women: a study from North India. East Asian Arch Psychiatry. 2016;26:104–8.

    Google Scholar 

  40. Massoudi P, Hwang CP, Wickberg B. Fathers depressive symptoms in the postnatal period: prevalence and correlates in a population-based Swedish study. Scand J Public Health. 2016. https://doi.org/10.1177/1403494816661652.

  41. Behrendt HF, Konrad K, Goecke TW, Fakhrabadi R, Herpertz-Dahlmann B, Firk C. Postnatal mother-to-infant attachment in subclinically depressed mothers: dyads at risk? Psychopathology. 2016;49:269–76. https://doi.org/10.1159/000447597.

    Article  PubMed  Google Scholar 

  42. Lindahl V, Pearson JL, Colpe L. Prevalence of suicidality during pregnancy and the postpartum. Arch Women’s Ment Heal. 2005;8:77–87. https://doi.org/10.1007/s00737-005-0080-1.

    Article  CAS  Google Scholar 

  43. Turkcapar AF, Kadıoğlu N, Aslan E, Tunc S, Zayıfoğlu M, Mollamahmutoğlu L. Sociodemographic and clinical features of postpartum depression among Turkish women: a prospective study. BMC Pregnancy Childbirth. 2015;15:108. https://doi.org/10.1186/s12884-015-0532-1.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Supraja TA, Thennarasu K, Satyanarayana VA, Seena TK, Desai G, Jangam KV, et al. Suicidality in early pregnancy among antepartum mothers in urban India. Arch Womens Ment Health. 2016;19:1101–8. https://doi.org/10.1007/s00737-016-0660-2.

    Article  PubMed  CAS  Google Scholar 

  45. Orsolini L, Valchera A, Vecchiotti R, Tomasetti C, Iasevoli F, Fornaro M, et al. Suicide during perinatal period: epidemiology, risk factors, and clinical correlates. Front Psych. 2016;7. https://doi.org/10.3389/fpsyt.2016.00138.

  46. Robertson E, Grace S, Wallington T, Stewart DE. Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry. 2004;26:289–95. https://doi.org/10.1016/j.genhosppsych.2004.02.006.

    Article  PubMed  Google Scholar 

  47. Milgrom J, Gemmill AW, Bilszta JL, Hayes B, Barnett B, Brooks J, et al. Antenatal risk factors for postnatal depression: a large prospective study. J Affect Disord. 2008;108:147–57. https://doi.org/10.1016/j.jad.2007.10.014.

    Article  PubMed  Google Scholar 

  48. Sutter-Dallay AL, Giaconne-Marcesche V, Glatigny-Dallay E, Verdoux H. Women with anxiety disorders during pregnancy are at increased risk of intense postnatal depressive symptoms: a prospective survey of the MATQUID cohort. Eur Psychiatry. 2004;19:459–63. https://doi.org/10.1016/j.eurpsy.2004.09.025.

    Article  PubMed  CAS  Google Scholar 

  49. Campbell SB, Cohn JF, Flanagan C, Popper S, Meyers T, Bates JE, et al. Course and correlates of postpartum depression during the transition to parenthood. Dev Psychopathol. 1992;4:29. https://doi.org/10.1017/S095457940000554X.

    Article  Google Scholar 

  50. Richman JA, Raskin VD, Gaines C. Gender roles, social support, and postpartum depressive symptomatology. The benefits of caring. J Nerv Ment Dis. 1991;179:139–47.

    Article  CAS  PubMed  Google Scholar 

  51. Barnett PA, Gotlib IH. Psychosocial functioning and depression: distinguishing among antecedents, concomitants, and consequences. Psychol Bull. 1988;104:97–126.

    Article  CAS  PubMed  Google Scholar 

  52. Pepper CM, Klein DN, Anderson RL, Riso LP, Ouimette PC, Lizardi H. DSM-III-R axis II comorbidity in dysthymia and major depression. Am J Psychiatry. 1995;152:239–47. https://doi.org/10.1176/ajp.152.2.239.

    Article  PubMed  CAS  Google Scholar 

  53. Apter-Danon G, Candilis-Huisman D. A challenge for perinatal psychiatry: Therapeutic management of maternal borderline personality disorder and their very young infants. Clin Neuropsychiatry. 2005;2:302–14.

    Google Scholar 

  54. Beydoun HA, Beydoun MA, Kaufman JS, Lo B, Zonderman AB. Intimate partner violence against adult women and its association with major depressive disorder, depressive symptoms and postpartum depression: a systematic review and meta-analysis. Soc Sci Med. 2012;75:959–75. https://doi.org/10.1016/j.socscimed.2012.04.025.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Kendall-Tackett KA. Depression in new mothers. Binghanton/New York: Haworth Press; 2005.

    Google Scholar 

  56. Buist A. Childhood abuse, postpartum depression and parenting difficulties: A literature review of associations. Aust N Z J Psychiatry. 1998;32:370–8. https://doi.org/10.3109/00048679809065529.

    Article  PubMed  CAS  Google Scholar 

  57. Kendall-Tackett KA. Violence against women and the perinatal period: the impact of lifetime violence and abuse on pregnancy, postpartum, and breastfeeding. Trauma, Violence, Abus. 2007;8:344–53. https://doi.org/10.1177/1524838007304406.

    Article  Google Scholar 

  58. Varma D, Chandra PS, Thomas T, Carey MP. Intimate partner violence and sexual coercion among pregnant women in India: relationship with depression and post-traumatic stress disorder. J Affect Disord. 2007;102:227–35. https://doi.org/10.1016/j.jad.2006.09.026.

    Article  PubMed  Google Scholar 

  59. Pearlstein T. Mood Disorders. In: Rosen-Montella K, editor. Med. Manag. Pregnant Patient. New York: Springer; 2015.

    Google Scholar 

  60. Olson AL, Kemper KJ, Kelleher KJ, Hammond CS, Zuckerman BS, Dietrich AJ. Primary care pediatricians’ roles and perceived responsibilities in the identification and management of maternal depression. Pediatrics. 2002;110:1169–76.

    Article  PubMed  Google Scholar 

  61. Committee on Psychosocial Aspects of Child and Family Health and Task Force on Mental Health. Policy statement—the future of pediatrics: mental health competencies for pediatric primary care. Pediatrics. 2009;124:410–21. https://doi.org/10.1542/peds.2009-1061.

    Article  Google Scholar 

  62. Bledsoe S, Grote N. Treating depression during pregnancy and the postpartum: a preliminary meta-analysis. Res Soc Work Pract. 2006;16:109–20.

    Article  Google Scholar 

  63. Stuart S, O’Hara MW. Treatment of postpartum depression with interpersonal psychotherapy. Arch Gen Psychiatry. 1995;52:75–6.

    Article  CAS  PubMed  Google Scholar 

  64. Sriraman NK, Melvin K, Meltzer-Brody S. ABM clinical protocol #18: use of antidepressants in breastfeeding mothers. Breastfeed Med. 2015;10:290–9. https://doi.org/10.1089/bfm.2015.29002.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Stevenson J, Meares R. An outcome study of psychotherapy for patients with borderline personality disorder. Am J Psychiatry. 1992;149:358–62. https://doi.org/10.1176/ajp.149.3.358.

    Article  PubMed  CAS  Google Scholar 

  66. Lieberman AF, Silverman R, Pawl JH. Infant-parent psychotherapy: Core concepts and current approaches. Handb infant Ment Heal. 2000;83:472–84.

    Google Scholar 

  67. Cohen NJ, Muir E, Lojkasek M, Muir R, Parker CJ, Barwick M, et al. Watch, wait, and wonder: testing the effectiveness of a new approach to mother-infant psychotherapy. Infant Ment Health J. 1999;20:429–51. https://doi.org/10.1002/(SICI)1097-0355(199924)20:4<429::AID-IMHJ5>3.0.CO;2-Q.

    Article  Google Scholar 

  68. Slade A. Parental reflective functioning: an introduction. Attach Hum Dev. 2005;7:269–81. https://doi.org/10.1080/14616730500245906.

    Article  PubMed  Google Scholar 

  69. Pearlstein TB, Zlotnick C, Battle CL, Stuart S, O’Hara MW, Price AB, et al. Patient choice of treatment for postpartum depression: a pilot study. Arch Womens Ment Health. 2006;9:303–8. https://doi.org/10.1007/s00737-006-0145-9.

    Article  PubMed  CAS  Google Scholar 

  70. Molyneaux E, Howard LM, McGeown HR, Karia AM, Trevillion K. Antidepressant treatment for postnatal depression, vol. 20. John Wiley & Sons, Ltd: Chichester, UK; 2014. https://doi.org/10.1002/14651858.CD002018.pub2.

    Book  Google Scholar 

  71. Kendall-Tackett K, Hale TW. Review: the use of antidepressants in pregnant and breastfeeding women: a review of recent studies. J Hum Lact. 2010;26:187–95. https://doi.org/10.1177/0890334409342071.

    Article  PubMed  Google Scholar 

  72. Oystein Berle J, Spigset O. Antidepressant use during breastfeeding. Curr Womens Health Rev. 2011;7:28–34. https://doi.org/10.2174/157340411794474784.

    Article  Google Scholar 

  73. Viguera AC, Newport DJ, Ritchie J, Stowe Z, Whitfield T, Mogielnicki J, et al. Lithium in breast milk and nursing infants: clinical implications. Am J Psychiatry. 2007;164:342–5. https://doi.org/10.1176/ajp.2007.164.2.342.

    Article  PubMed  Google Scholar 

  74. Sharma V, Smith A, Mazmanian D. Olanzapine in the prevention of postpartum psychosis and mood episodes in bipolar disorder. Bipolar Disord. 2006;8(4):400. https://doi.org/10.1111/j.1399-5618.2006.00335.x.

    Article  PubMed  CAS  Google Scholar 

  75. Misri S. Quetiapine treats postpartum bipolar disorder. 11th Can. Psychiatr. Assoc. Annu. Conf., Vancouver, British Columbia, Canada: n.d.

    Google Scholar 

  76. Gentile S. Infant safety with antipsychotic therapy in breast-feeding: a systematic review. J Clin Psychiatry. 2008;69:666–73.

    Article  CAS  PubMed  Google Scholar 

  77. Yoshida K, Smith B, Craggs M, Kumar R. Neuroleptic drugs in breast-milk: a study of pharmacokinetics and of possible adverse effects in breast-fed infants. Psychol Med. 2016;28:81–91.

    Article  Google Scholar 

  78. Lee A, Giesbrecht E, Dunn E, Ito S. Excretion of quetiapine in breast milk. Am J Psychiatry. 2004;161:1715–NaN-1716. https://doi.org/10.1176/appi.ajp.161.9.1715-a.

    Article  PubMed  Google Scholar 

  79. Gilad O, Merlob P, Stahl B, Klinger G. Outcome of infants exposed to olanzapine during breastfeeding. Breastfeed Med. 2011;6:55–8. https://doi.org/10.1089/bfm.2010.0027.

    Article  PubMed  Google Scholar 

  80. Soloff PH. Psychopharmacology of borderline personality disorder. Psychiatr Clin North Am. 2000;23:169–92. ix

    Article  CAS  PubMed  Google Scholar 

  81. Zanarini MC, Frankenburg FR. Olanzapine treatment of female borderline personality disorder patients: a double-blind, placebo-controlled pilot study. J Clin Psychiatry. 2001;62:849–54.

    Article  CAS  PubMed  Google Scholar 

  82. Perrella C, Carrus D, Costa E, Schifano F. Quetiapine for the treatment of borderline personality disorder; an open-label study. Prog Neuro-Psychopharmacology Biol Psychiatry. 2007;31:158–63. https://doi.org/10.1016/j.pnpbp.2006.08.012.

    Article  CAS  Google Scholar 

  83. Gressier F, Rotenberg S, Cazas O, Hardy P. Postpartum electroconvulsive therapy: a systematic review and case report. Gen Hosp Psychiatry. 2015;37(4):310. https://doi.org/10.1016/j.genhosppsych.2015.04.009.

    Article  PubMed  Google Scholar 

  84. Focht A, Kellner CH. Electroconvulsive therapy (ECT) in the treatment of postpartum psychosis. J ECT. 2012;28:31–3. https://doi.org/10.1097/YCT.0b013e3182315aa8.

    Article  PubMed  Google Scholar 

  85. Babu GN, Thippeswamy H, Chandra PS. Use of electroconvulsive therapy (ECT) in postpartum psychosis—a naturalistic prospective study. Arch Womens Ment Health. 2013;16:247–51. https://doi.org/10.1007/s00737-013-0342-2.

    Article  PubMed  Google Scholar 

  86. Lives S. Improving mothers’ care surveillance of maternal deaths in the UK 2011–13 and lessons learned to inform maternity care from the UK and Ireland confidential enquiries into maternal deaths and morbidity 2009–13. Oxford: University of Oxford; 2015.

    Google Scholar 

  87. Esscher A, Essén B, Innala E, Papadopoulos FC, Skalidou A, Sundström Poromaa I, et al. Suicides during pregnancy and 1 year postpartum in Sweden, 1980–2007. Br J Psychiatry. 2016;208(5):462–9.

    Article  PubMed  Google Scholar 

  88. Thornton C, Schmied V, Dennis CL, Barnett B, Dahlen HG. Maternal deaths in NSW (2000–2006) from nonmedical causes (suicide and trauma) in the first year following birth. Biomed Res Int. 2013;19:1–6.

    Article  Google Scholar 

  89. Johannsen BM, Larsen JT, Laursen TM, Bergink V, Meltzer-Brody S, Munk-Olsen T. All-cause mortality in women with severe postpartum psychiatric disorders. Am J Psychiatr. 2016;173(6):635–42.

    Article  PubMed  Google Scholar 

  90. Pinheiro RT, Da Silva RA, Magalhães PV, Horta BL, Pinheiro KA. Two studies on suicidality in the postpartum. Acta Psychiatr Scand. 2008;118(2):160–3.

    Article  CAS  PubMed  Google Scholar 

  91. Bodnar-Deren S, Klipstein K, Fersh M, Shemesh E, Howell EA. Suicidal ideation during the postpartum period. J Women's Health. 2016;25:1219–24.

    Article  Google Scholar 

  92. Newport DJ, Levey LC, Pennell PB, Ragan K, Stowe ZN. Suicidal ideation in pregnancy: assessment and clinical implications. Arch Womens Ment Health. 2007;10(5):181–7.

    Article  CAS  PubMed  Google Scholar 

  93. Khalifeh H, Hunt IM, Appleby L, Howard LM. Suicide in perinatal and non-perinatal women in contact with psychiatric services: 15 year findings from a UK national inquiry. The Lancet Psychiatry. 2016;3(3):233–42.

    Article  PubMed  Google Scholar 

  94. Celik C, Ozdemir B, Oznur T. Suicide risk among perinatal women who report thoughts of self-harm on depression screens. Obstet Gynecol. 2015;126(1):216–7.

    Article  PubMed  Google Scholar 

  95. Gavin AR, Tabb KM, Melville JL, Guo Y, Katon W. Prevalence and correlates of suicidal ideation during pregnancy. Arch Womens Ment Health. 2011;14(3):239–46.

    Article  PubMed  PubMed Central  Google Scholar 

  96. Comtois KA, Schiff MA, Grossman DC. Psychiatric risk factors associated with postpartum suicide attempt in Washington state, 1992-2001. Am J Obstet Gynecol. 2008;199(2):120–e1.

    Article  PubMed  Google Scholar 

  97. Alhusen JL, Frohman N, Purcell G. Intimate partner violence and suicidal ideation in pregnant women. Arch Womens Ment Health. 2015;18(4):573–8.

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India

    Prabha S. Chandra MD, FRCPsych, FAMS, Sundarnag Ganjekar & Soumya Parameshwaran

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  1. Prabha S. Chandra MD, FRCPsych, FAMS
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  2. Sundarnag Ganjekar
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Correspondence to Prabha S. Chandra MD, FRCPsych, FAMS .

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Editors and Affiliations

  1. Department of Psychiatry, Northern Ontario School of Medicine Psychiatry Department, Sudbury, Ontario, Canada

    Kuppuswami Shivakumar

  2. Woodstock General Hospital, Woodstock Ontario, University of Western Ontario, London, Ontario, Canada

    Shabbir Amanullah

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Chandra, P.S., Ganjekar, S., Parameshwaran, S. (2018). Clinical Conundrum: A Complex Case of Postpartum Depression. In: Shivakumar, K., Amanullah, S. (eds) Complex Clinical Conundrums in Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-319-70311-4_5

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  • DOI: https://doi.org/10.1007/978-3-319-70311-4_5

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