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Searching for the causesof puerperal psychosis

Researchers are trying to find out why onewoman experiences puerperal psychosis and another one doesnt.

A team at the Institute of Psychiatry is recruitingpregnant women who are willing to give samplesof blood and saliva, which will allow researchersto test hormone levels before and after birth. Both reproductive and stress hormones are thought to somehow play a part in thedevelopment of puerperal psychosis, also known as postpartum psychosis.

After birth, the women will also have a brain scan so researchers can look for differences in the volume of various areas of the brain and study how different areas are connected to each other. They will also look at how the brain is activated when the women are asked to carry out a series of tasks while they are in the scanner.

Immediately after birth, the levels of oestrogendrop in all women, said Paola Dazzan, who isleading the research. There is also usually areduction in the stress hormone cortisol, which is normally high throughout pregnancy.

It may be that women who go on to developpuerperal psychosis have an underlying brainvulnerability that interacts with the drop inhormone levels following birth and that is what we are looking at.

Some of the women who are being recruited tothe study will be at risk of developing puerperalpsychosis because they have a history of bipolardisorder or schizoaffective disorder, because they have previous experience of puerperalpsychosis, or because a member of their family has experienced it. Other women will be recruited who have no risk.

We will end up with three groups of women one group who were at risk and go on todevelop puerperal psychosis, one group ofwomen who were at risk but do not developpuerperal psychosis and the group of womenwho were not at risk, said Paola. By comparingthe hormones and the brain images, we willunderstand more about why only some womenbecome unwell.

The researchers will also be looking for anydifferences in the womens brains that are similarto changes in the brains of people with psychosisthat have been documented in previous studies.So, for example, we will be looking in particularat white matter and connectivity between differentbrain areas, which has been shown to be alteredin people with psychosis, she said.

Researcher Astrid Pauls is undertaking theresearch for a PhD: the study is funded byNARSAD, an American charity that supportsresearch into the prevention and treatment ofmental illnesses such as schizophrenia andbipolar disorder. The results of the research are likely to be available early in 2013.

first uploaded onto site 21/4/10, this updated versionuploaded 4/4/12, to be updated March 2013.

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