THE INVISIBILITY OF PUERPERAL PSYCHOSIS: MORTALITY IN BRAZIL AND THE GAP IN SCIENTIFIC EVIDENCE

Abstract

This article aimed to analyze available scientific evidence regarding the morbidity, mortality, and key clinical outcomes of women with a history of postpartum psychosis. This is an integrative literature review based on the framework proposed by Mendes, Silveira, and Galvão (2008), conducted in six stages. The search was performed in August 2026 in the MEDLINE/PubMed database, using DeCS/MeSH descriptors and free-text terms related to postpartum psychosis and puerperal disorders, combined with the Boolean operators AND and OR. Original studies published between 2021 and 2026 in Portuguese, English, or Spanish—available in full text and via open access—were included. Selection was carried out by two independent reviewers using Rayyan QCRI software and criteria based on PRISMA guidelines. The studies showed that postpartum psychosis has a rapid onset and can be associated with severe outcomes, including suicide, infanticide, hospitalization, readmission, and recurrence. Associations were identified with a history of psychiatric disorders, bipolar disorder, and family history, as well as barriers related to diagnosis, access to services, stigma, and cultural factors. Early identification, timely treatment, and continuous follow-up are essential for reducing complications and improving the quality of care, highlighting the importance of a multidisciplinary approach and care centered on the woman and her family.