UAMS Physicians See Dramatic Increase In Postpartum Psychosis Cases during COVID-19 Pandemic
| LITTLE ROCK — Postpartum psychosis is a serious, albeit rare illness, compared to the number of postpartum depression cases seen in the United States.
The Women’s Mental Health Program at the University of Arkansas for Medical Sciences (UAMS) on average treats two cases of the illness a year.
That’s why Jessica Coker, M.D., the medical director of the Psychiatric Research Institute’s women’s inpatient unit, became alarmed when she saw a growing number of cases during the COVID-19 pandemic. Between March 2020 and February 2021, Coker and her team saw a total of nine cases of postpartum psychosis, which can develop within four weeks of giving birth and can include feelings of paranoia or irritability, hallucinations and hyperactivity.
UAMS delivers between 2,500 and 3,000 newborns every year, according to Coker. Nationally, approximately 150 out of 1,000 will experience postpartum depression; postpartum psychosis affects 1 out of 1,000 mothers, on average.
“It is very recognizable when present. The patients are typically very, very ill,” said Coker. “Family members see it first usually. They’re not sleeping, paranoid and can be very irritable.”
When Coker and Erin Bider, M.D., a fourth-year resident in the UAMS College of Medicine’s Department of Psychiatry, recognized the dramatic increase in postpartum psychosis statistics, they began to review five years of patient records in an effort to determine if such a spike in cases was out of the ordinary.
Of the nine patients seen by the Women’s Mental Health Program, eight required inpatient psychiatric hospitalization due to the severity of their symptoms, with another seen on an outpatient basis. Three of these cases tested positive for COVID-19 prior to the onset of psychosis, but all were asymptomatic for the respiratory illness.
“We can safely say that the pandemic was associated with a higher risk for postpartum psychosis,” said Bider, who, along with Coker, authored a paper that was published in the Archives of Women’s Mental Health medical journal earlier this month about a possible correlation between the increase in postpartum psychosis cases and the pandemic. “We think that the stress of the pandemic, combined with being isolated from their families and friends, contributed to their psychosis.”
One of Coker’s patients, well-educated and with no history of psychotic behavior, began exhibiting postpartum psychosis symptoms shortly after giving birth.
“She wasn’t sleeping, saying bizarre things to her family,” said Coker. “She was paranoid about anyone caring for her baby but herself.”
After being seen in the UAMS Emergency Department, the patient was admitted to the Psychiatric Research Institute’s women’s inpatient unit. “She was very disorganized and aggressive, which is typical of postpartum psychosis,” said Coker, who saw her symptoms improve greatly after two weeks in the hospital. “We convinced her to take medication to help her sleep, which made a big difference.”
Coker said that stress related to childbirth, even in a normal, non-pandemic setting, is something that should be taken seriously. “It’s always something that you should be aware of, stress causes bad things to happen.”
“We think this is a wake-up call for women and their families about how much support new mothers need,” said Bider. “We should always be asking these questions regardless of whether we’re having a pandemic or not. We need to recognize a problem before it becomes full-blown psychosis.”
UAMS is the state’s only health sciences university, with colleges of Medicine, Nursing, Pharmacy, Health Professions and Public Health; a graduate school; a hospital; a main campus in Little Rock; a Northwest Arkansas regional campus in Fayetteville; a statewide network of regional campuses; and eight institutes: the Winthrop P. Rockefeller Cancer Institute, Jackson T. Stephens Spine & Neurosciences Institute, Harvey & Bernice Jones Eye Institute, Psychiatric Research Institute, Donald W. Reynolds Institute on Aging, Translational Research Institute, Institute for Digital Health & Innovation and the Institute for Community Health Innovation. UAMS includes UAMS Health, a statewide health system that encompasses all of UAMS’ clinical enterprise. UAMS is the only adult Level 1 trauma center in the state. UAMS has 3,275 students, 890 medical residents and fellows, and five dental residents. It is the state’s largest public employer with more than 12,000 employees, including 1,200 physicians who provide care to patients at UAMS, its regional campuses, Arkansas Children’s, the VA Medical Center and Baptist Health. Visit www.uams.edu or uamshealth.com. Find us on Facebook, X (formerly Twitter), YouTube or Instagram.###