Postpartum Psychosis Risk Substantially Elevated, Swedish Study Finds
stockholm, Sweden – A new analysis of nearly 1.8 million pregnancies in Sweden reveals a significantly increased risk of psychosis in the first 20 weeks after childbirth – up to seven times higher than before pregnancy. The research, conducted by scientists at the Karolinska Institutet and spanning data from 2003 to 2019, also indicates a heightened risk of depression, peaking around 20% higher during weeks 5 to 15 postpartum.
While the risk of these conditions rises after delivery, the study simultaneously found a decrease in diagnoses of other psychiatric conditions, including anxiety, stress-related disorders, and substance abuse, compared to periods before pregnancy. Researchers attribute this decline to a combination of biological changes and lifestyle adjustments during and after pregnancy, such as cessation of alcohol and tobacco use and increased engagement with healthcare.
“There is a fairly hard zero tolerance for alcohol use and drug use during pregnancy, especially here in Sweden,” explained researcher Emma Bränn. “Our results indicate that many women have a strong driving force to actually end their addiction, not only for themselves but also for the child.”
The study’s methodology distinguishes it from previous research by comparing mental health diagnoses statistically to a woman’s baseline before pregnancy, offering greater confidence in the findings.
Researchers acknowledge uncertainty surrounding the precise causes of the elevated psychosis risk. “It’s a very fragile time,” stated researcher Donghao Lu. “After childbirth, a lot happens in the body: hormone levels drop, you have a large wound in the uterus after the placenta that will heal, you have to get to know your child and then there is a lot of sleep deprivation. Why the risk of psychosis is so high we do not know exactly.”
The implementation of national guidelines for screening depressive symptoms in 2010 appears to be having a positive impact, with diagnoses now occurring earlier – shifting from approximately 13 weeks postpartum to around 8 weeks. “We see that the top of depression diagnoses has been moved… I think screening is a good tool for detecting mental illness early and for reducing stigma,” Bränn added.
