MATERNAL MENTAL HEALTH CHALLENGES: A REVIEW ON POSTPARTUM PSYCHOSIS

Abstract

The puerperium is a period marked by hormonal, emotional, and social changes that may increase vulnerability to mental disorders, including puerperal psychosis, a rare yet severe condition characterized by the abrupt onset of psychotic symptoms and significant risk to both mother and infant. The objective of the present study was to conduct a literature review on puerperal psychosis, its clinical characteristics, risk factors, and therapeutic strategies. This is a narrative and qualitative literature review carried out using the MedLine/PubMed and LILACS databases, employing the descriptors “Puerperal Disorders,” “Postpartum,” and “Psychosis,” combined with the Boolean operators AND and OR. Articles published within the last five years, available in full text, in Portuguese or English, were included. Studies that did not directly address puerperal psychosis or did not meet the defined methodological criteria were excluded. Puerperal psychosis generally emerges in the first weeks postpartum and involves delusions, hallucinations, mood disturbances, as well as the possibility of suicide and infanticide. This disorder negatively affects mother–infant bonding, breastfeeding, and family dynamics, and may progress to persistent psychiatric disorders when not adequately treated. Management requires hospitalization in a large proportion of cases, often involving the combined use of antipsychotics, mood stabilizers (particularly lithium), benzodiazepines, and, in specific situations, electroconvulsive therapy. Multiprofessional support, psychotherapy, and family involvement in treatment are essential to improve care and reduce adverse outcomes. It is concluded that puerperal psychosis represents a significant public health challenge and requires early diagnosis, immediate intervention, continuous follow-up, and strengthening of support networks, promoting safe recovery, prevention of recurrences, and reduction of impacts on maternal, infant, and family health.