Psychological interventions for managing postpartum psychosis: a qualitative analysis of women's and family members' experiences and preferences

BMC Psychiatry. 2019 Dec 19;19(1):411. doi: 10.1186/s12888-019-2378-y.

Abstract

Background: Postpartum psychosis is a rare, yet severe disorder, in which early identification and immediate intervention are crucial. Despite recommendations for psychological input, little is known about the types of psychological intervention reported to be helpful. The aim of this study was to explore the experiences, needs and preferences for psychological intervention from the perspective of women with postpartum psychosis and from the perspective of family members.

Methods: Thirteen women and eight family members, including partners were interviewed. The data from these semi-structured interviews were audio-recorded, transcribed and inductively analysed using thematic analysis.

Results: Twelve subthemes were identified and then organised around three main themes: 1) Seeking safety and containment, 2) Recognising and responding to the psychological impact and 3) Planning for the future. These themes highlight the temporal element of recovery from postpartum psychosis, because women's psychological needs and preferences changed over time. Emphasis was initially placed on ensuring safety, followed by a need to connect, process and adjust to their experiences. Additional needs were reported by women and family when planning for the future, including managing the fear of relapse and help to reach a decision about future pregnancies.

Conclusion: The results illustrate a range of areas in which psychological intervention could be delivered to facilitate and enhance recovery. Further research is needed to develop meaningful and effective psychological interventions and to investigate the most appropriate timing for this to be offered.

Keywords: Childbirth; Intervention; Perinatal mental health; Psychology; Psychosocial; Psychotic disorders.

MeSH terms

  • Adult
  • Family / psychology
  • Fear / psychology
  • Female
  • Humans
  • Postpartum Period / psychology
  • Pregnancy
  • Psychotic Disorders / psychology
  • Psychotic Disorders / therapy*
  • Puerperal Disorders / therapy*
  • Qualitative Research
  • Sexual Partners / psychology