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Dopamine Supersensitivity and Hormonal Status in Puerperal Psychosis

Published online by Cambridge University Press:  02 January 2018

Christopher J. Meakin ,
Ian F. Brockington ,
Se Lynch  and
Stephen R. Jones
Christopher J. Meakin*
Affiliation:
Carlton Hayes Hospital, Narborough, Leicestershire
Ian F. Brockington
Affiliation:
Queen Elizabeth Psychiatric Hospital, Birmingham
Se Lynch
Affiliation:
Birmingham and Midland Hospital for Women, Sparkhill, Birmingham
Stephen R. Jones
Affiliation:
Queen Elizabeth Hospital, Birmingham
*
Dr C. J. Meakin, Carlton Hayes Hospital, Forest Road, Narborough, Leicestershire LE9 5ES
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Abstract

Background

We examine the dopamine receptor supersensitivity hypothesis of puerperal psychosis, and explore puerperal changes in the functional sensitivity of this receptor system.

Method

Dopamine receptor sensitivity was estimated using growth hormone (GH) response to apomorphine challenge following delivery in 37 control women, and 11 deliveries in 10 women at ‘high risk’ of puerperal psychosis (previous history of puerperal affective or nonpuerperal manic psychosis). Tests were on days 4 or 5, 11 or 12 and at six weeks postpartum.

Results

Three women developing puerperal psychosis had subsensitive GH responsiveness on day 4. GH response to 67 challenge tests (in control and ‘high risk’ women) increased between days 4 or 5 and six weeks postpartum (P < 0.05). GH response at six weeks correlated with free thyroxine levels (P < 0.01).

Conclusions

These three cases do not support the stated hypothesis. Hypothalamic dopamine receptor sensitivity increases during the puerperium; thyroxine might influence this.

Type
Papers
Information
The British Journal of Psychiatry , Volume 166 , Issue 1 , January 1995 , pp. 73 - 79
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

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