Hostname: page-component-76fb5796d-dfsvx Total loading time: 0 Render date: 2024-04-26T04:37:32.442Z Has data issue: false hasContentIssue false
  • English
  • Français

Emotional and Cognitive Changes in Pregnancy and Early Puerperium

Published online by Cambridge University Press:  29 January 2018

Ali Jarrahi-Zadeh ,
F. J. Kane Jr. ,
R. L. Van De Castlf ,
P. A. Lachenbruch  and
J. A. Ewing
Ali Jarrahi-Zadeh
Affiliation:
University of North Carolina School of Medicine, Chapel Hill, North Carolina 27514. John Umstead Hospital, North Carolina
F. J. Kane Jr.
Affiliation:
University of North Carolina School of Medicine, Chapel Hill, North Carolina, 27514
R. L. Van De Castlf
Affiliation:
Department of Psychiatry, University of Virginia
P. A. Lachenbruch
Affiliation:
School of Public Health, University of North Carolina, Chapel Hill, North Carolina 27514
J. A. Ewing
Affiliation:
Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, North Carolina 27514
Get access Rights & Permissions [Opens in a new window]

Extract

Emotional change during pregnancy and the postpartum period is very common (37, 42); mental illness of psychotic proportions occurs more frequently in the postpartum period than in the period of pregnancy (33). These psychotic illnesses occurring in the postpartum period have remained an area of controversy for several reasons. The clinical phenomenology of these psychotic reactions seems unusually rich in confusional and delirious features (19), even when reported by those who contend they are no different from the usual run of psychotic illness (41). The fact that 80 per cent. of these serious reactions occur in the first 30 days postpartum (33) has raised doubt in the minds of some that these reactions merely represent the stress of pregnancy falling on a predisposed personality. An alternative hypothesis might be that the interaction of psychological and endocrine factors at the end of pregnancy makes this a particularly stressful period. The delirious and confusional symptoms might also be better explained as being related to endocrine dysfunction of some kind.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 115 , Issue 524 , July 1969 , pp. 797 - 805
Copyright
Copyright © Royal College of Psychiatrists, 1969 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Anton-Tay, F., and Wurtman, R. (1968). “Norepinephrine turnover in rat brain after gonadectomy.” Science, 159, 1245.CrossRefGoogle ScholarPubMed
2. Barno, A. (1967). “Criminal abortion deaths, illegitimate pregnancy deaths and suicides in pregnancy.” Amer. J. Obstet. Gynec., 98, 356–367.CrossRefGoogle ScholarPubMed
3. Benedek, T., and Rubenstein, B. B. (1952). Psychosexual Functions in Women. New York.Google Scholar
4. Bergen, J. R., Krus, D., and Pincus, G. (1960). “Suppression of LSD-25 effects in rats by steroids.” Proc. Soc. exp. Biol. Med., 105, 254.CrossRefGoogle Scholar
5. Bibring, G. L. (1959). The Psychoanalytic Study of the Child. New York.Google Scholar
6. Bunney, W. E., and Davis, J. M. (1965). “Norepinephrine in depressive reactions.” Arch. gen. Psychiat., 13 (6), 483–494.CrossRefGoogle ScholarPubMed
7. Cha, , Keug-Sup, , Woo-Choo, , Lee, , Rudiyk, A., and Miller, J. W. (1965). “Comparison of the catecholamine concentrations of uteri from several species and the alterations which occur during pregnancy.” J. Pharma. and exper. Therapeutic, 148, 9–13.Google ScholarPubMed
8. Cohen, M., Steifel, M., et al. (1958). “The secretion and disposition of Cortisol during pregnancy.” J. clin. Endoc. and Metab., 18, 1076.CrossRefGoogle ScholarPubMed
9. Coppola, J. A., Leonardi, R. G., and Lippmann, W. (1966). “Ovulatory failure in rats after treatment with brain norepinephrine depletors.” Endocrinology, 78, 225–228.CrossRefGoogle ScholarPubMed
10. Dement, W. C. (1966). “Psychophysiology of sleep and dreams.” In American Handbook of Psychiatry. New York.Google Scholar
11. Deutsch, H. (1945). The Psychology of Women. New York.Google Scholar
12. Doe, R. P., Zinnemann, J. J., et al. (1960). “The significance of the concentration of the nonprotein bound plasma Cortisol concentration in normal subjects, Cushing's Syndrome, pregnancy and during estrogen therapy.” Forty-Second Meeting, Endocrine Society.Google Scholar
13. Erickson, M. T. (1967). “Method for frequent assessment of symptomatology during pregnancy.” Psychol. Reports, 20, 447.CrossRefGoogle Scholar
14. Freedman, Daniel X. (1968). “On the use and abuse of LSD.” Arch. of gen. Psychiat. (Chic.), 18, 330–347.CrossRefGoogle ScholarPubMed
15. Gjessing, L. (1967). “Effect of thyroxine, pyridoxine, orphenadrine, HCL, reserpine and disulfiram in periodic catatonia.” Acta psychiat. Scand., 43, 376–384.CrossRefGoogle ScholarPubMed
16. Goldstein, M., et al. (1964). “Inhibition of dopamine hydroxylase by disulfiram.” Life Sciences, 3, 764–768.CrossRefGoogle ScholarPubMed
17. Gorden, R. E., and Gorden, K. K. (1959). “Social factors in the prediction and treatment of emotional disorders of pregnancy.” Amer. J. Obstet., 77 (5), 1074–1083.CrossRefGoogle Scholar
18. Gibbs, F. A., and Reid, D. E. (1942). “The electroencephalogram in pregnancy.” Amer. J. Obstet. Gynec., 44, 672.CrossRefGoogle Scholar
19. Hamilton, J. A. (1962). Postpartum Psychiatric Problems. St. Louis.Google Scholar
20. Idestrom, C. (1966). “Reaction to norethisterone withdrawal.” Lancet, i, 718.CrossRefGoogle Scholar
21. Kane, F. J., Daly, R. J., Ewing, J., and Keeler, M. (1967). “Mood and behavioural changes with progestational agents.” Brit. J. Psychiat., 113, 265.CrossRefGoogle ScholarPubMed
22. Kane, F., Treadway, R., Ewing, J. (1968). Unpublished data.Google Scholar
23. Karaca, N. I., et al. (1967). “Sleep and dreaming during late pregnancy and postpartum.” Presented in APSS, Santa Monica, California.Google Scholar
24. Kear-Colwell, J. J. (1965). “Neuroticism in the early puerperium.” Brit. J. Psychiat., 111, 1189.CrossRefGoogle ScholarPubMed
25. Keeler, M., Daly, R., and Kane, F. (1964). “An acute schizophrenic episode following abrupt withdrawal of enovid in a patient with previous post-partum psychiatric disorder.” Amer. J. Psychiat., 120 (11), 1123–1124.CrossRefGoogle Scholar
26. Kety, S. (1967). Neurophysiology and Emotion. New York: Rockefeller U. Press and Russell Sage Foundation, p. 107.Google Scholar
27. Marcotte, D., Kane, F. J., and Lipton, M. Unpublished data.Google Scholar
28. Martensen-Larsen, O. (1953). “Five years' experience with disulfiram in the treatment of alcoholics.” Quart. J. Stud. Alcohol., 14, 406.CrossRefGoogle ScholarPubMed
29. McKinney, W. T., and Kane, F. J. (1967). “Depression with the use of alpha-methyldopa.” Amer. J. Psychiat., 124, 118–119.CrossRefGoogle ScholarPubMed
30. Morrell, F. (1959). “The role of estrogens in catamenial exacerbation of epilepsy.” Neurology, 9, 352.Google Scholar
31. Myerson, B. (1964). “Estrus behavior in spayed rats after estrogen or progesterone treatment in combination with reserpine or tetrabenazine.” Psychopharmacologia, 6, 210.CrossRefGoogle Scholar
32. Myerson, B. (1964). “The effect of neuropharmacological agents on hormone activated estrus behavior in ovariectomized rats.” Arch. Intern. Pharmacodyn., 150, 4.Google Scholar
33. Paffenbarger, R. S. Jr. (1961). “The picture puzzle of the postpartum psychosis.” J. chron. Dis., 13, 161.CrossRefGoogle Scholar
34. Plager, J. E., Schmidt, K. G., Staubitz, W. J. (1964). “Increased unbound Cortisol in the plasma of estrogen treated subjects.” J. clin. Invest., 43, 1066.CrossRefGoogle ScholarPubMed
35. Poulson, E., and Robson, J. M. (1964). “Effect of phenelzine and some related compounds on pregnancy and on sexual development.” J. Endoc., 30, 205.Google ScholarPubMed
36. Robin, A. A. (1962). “The psychological changes of normal parturition.” Psychiat. Quart., 36, 129.CrossRefGoogle ScholarPubMed
37. Ryle, A. (1961). “The psychological disturbances associated with 345 pregnancies in 137 women.” J. ment. Sci., 107, 279–286.CrossRefGoogle ScholarPubMed
38. Schildkraut, J. J., and Kety, S. S. (1967). “Biogenic amines and emotion.” Science, 156, 21.CrossRefGoogle ScholarPubMed
39. Selye, H. J. (1941). “Studies concerning the anesthetic action of steroid hormones.” J. Pharmacol. Exp. Therap., 73, 127.Google Scholar
40. Stefano, F. J. E., and Domoso, A. (1967). “Norepinephrine levels in the rat hypothalamus during the estrous cycle.” Endocrinology, 81, 1405–1406.CrossRefGoogle ScholarPubMed
41. Strecker, E. A., and Ebaugh, F. G. (1926). “Psychoses occurring during the puerperium.” Arch. Neurol. Psychiat., 15, 239–252.CrossRefGoogle Scholar
42. Tobin, S. M. (1957). “Emotional depression during pregnancy.” Obstet. and Gynec, 10, 677–681.CrossRefGoogle ScholarPubMed
43. Treadway, C. R., Kane, F. J., Jarrahi-zadeh, A., and Lipton, M. A. (1968). “A psychoendocrine study of pregnancy and puerperium.” Presented at the A.P.A. Meeting in Boston, Mass., in May, 1968.Google Scholar
44. Zinneman, H. H., Seals, U.S., and Doe, R. P. (1967). “Urinary amino acids in pregnancy, following progesterone and estrogen-progesterone.” J. clin. end. Metab., 27, 397–405.CrossRefGoogle ScholarPubMed
45. Van de Castle, L., and Hall, C. S. (1966). The Content Analysis of Dreams. New York.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.