A Prospective Observational Study on Risk Factors, Clinical Features, and Short-Term Outcomes in Postpartum Psychosis at a Tertiary Care Centre

Abstract

Background: Postpartum psychosis (PPP) is a rare but severe psychiatric emergency occurring in the early puerperal period. Despite its low prevalence, it poses significant risks to maternal and neonatal well-being. This study aimed to evaluate the clinical presentation, associated risk factors, and treatment outcomes in patients diagnosed with postpartum psychosis. Materials and Methods: This prospective observational study was conducted over 12 months at a tertiary care hospital. A total of 52 women who presented with new-onset psychotic symptoms within six weeks postpartum were enrolled after informed consent. Data collected included sociodemographic characteristics, psychiatric history, obstetric details, symptom profile, management strategies, and short-term outcomes. Patients were assessed using the Brief Psychiatric Rating Scale (BPRS) and followed for 12 weeks post-treatment. Statistical analysis included descriptive statistics, chi-square tests, and logistic regression to identify predictors of prolonged recovery. Results: The mean age of participants was 27.4 ± 4.6 years; 63.5% were primiparous. A previous history of mood disorders was reported in 32.7% of cases. The most common presenting symptoms were mood lability (76.9%), auditory hallucinations (55.8%), and delusions of persecution (44.2%). Antipsychotics were administered in all cases, while 17.3% required mood stabilizers. Electroconvulsive therapy was used in 11.5% of patients. Complete remission at 12 weeks was achieved in 84.6%. Delayed recovery was significantly associated with prior psychiatric illness (p=0.032) and lack of family support (p=0.014). Conclusion: Postpartum psychosis is strongly linked to prior psychiatric history and parity. Early diagnosis and structured intervention significantly improve short-term prognosis.