Acute psychiatric disturbance in pregnancy and the puerperium

Psychiatric disturbance occurring during pregnancy or the puerperium can occur as a first presentation or as a recurrence or deterioration of a previously diagnosed psychiatric illness. Whatever the history or aetiology, the occurrence of psychiatric disturbance during this period can have profound, long-term implications not only for the mental health of the mother, but also for her relationship with her child and other family members, as well as for the child's development. The treatment of psychiatric disturbance at this time can present difficult dilemmas and should always involve a careful analysis of the risks and benefits of treatment. Liaison between obstetricians and psychiatrists is to be strongly encouraged in order to ensure the best possible outcome for both mother and baby. The antenatal period offers a unique opportunity to identify individuals at risk and target them in order to promote psychological well-being during pregnancy and the puerperium.