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    Case Analysis 2

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    Hassan Maqsood
    Ursula Norman, a 32-year-old nurse, was brought to the emergency department 6 days after giving birth because her husband was concerned about her strange behavior. She had become convinced that she had smothered and killed her baby. She had a history of depression and mania. Her examination showed signs of mania such as distractibility, overtalkativeness, flight of ideas, and labile mood. She was diagnosed with bipolar disorder.

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    Case Analysis 2

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    Hassan Maqsood
    27 views1 page
    Ursula Norman, a 32-year-old nurse, was brought to the emergency department 6 days after giving birth because her husband was concerned about her strange behavior. She had become convinced that she had smothered and killed her baby. She had a history of depression and mania. Her examination showed signs of mania such as distractibility, overtalkativeness, flight of ideas, and labile mood. She was diagnosed with bipolar disorder.

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    Ursula Norman, a 32-year-old nurse, was brought to the emergency department 6 days after giving birth because her husband was concerned about her strange behavior. She had become convinced that she had smothered and killed her baby. She had a history of depression and mania. Her examination showed signs of mania such as distractibility, overtalkativeness, flight of ideas, and labile mood. She was diagnosed with bipolar disorder.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    27 views1 page

    Case Analysis 2

    Uploaded by

    Hassan Maqsood
    Ursula Norman, a 32-year-old nurse, was brought to the emergency department 6 days after giving birth because her husband was concerned about her strange behavior. She had become convinced that she had smothered and killed her baby. She had a history of depression and mania. Her examination showed signs of mania such as distractibility, overtalkativeness, flight of ideas, and labile mood. She was diagnosed with bipolar disorder.

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    © All Rights Reserved
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    of 1

    Case 3.8 A Postpartum Change Ian Jones, M.R.C.Psych., Ph.

    Ursula Norman, a 32-year-old nurse, was brought to an emergency department 6 days after giving birth.
    Her husband indicated that she had been behaving very strangely and that she had become convinced
    that she had smothered and killed her baby.

    Her husband reported that after a normal pregnancy and uncomplicated delivery, Ms. Norman had
    happily gone home with their first child. On the third day after delivery, however, her mood and affect
    began to shift rapidly between elation and weepiness. She became irritable and anxious. She slept only
    an hour a night, even where her baby was asleep. Her behavior became irritable and anxious. She slept
    only an hour a night, even when her baby was asleep. Her behavior became increasingly bizarre, with
    overactivity and agitation. Her speech was rapid and digressive. Although not previously a religious
    person, she became convinced that God was speaking through her and that she had special powers that
    could solve the problems of the world. She told her husband that she could identify evil people by
    looking into their eyes and had begun to worry that she was surrounded by evil people, including her
    own mother. Most disturbing for her, whenever she was out of sight of her son, she became totally
    convinced that she had smothered him, and no one could convince her otherwise.

    Ms. Norman had a history of three episodes of major depression in her teens and early 20s. these
    episodes resolved with psychotherapy and antidepressant medication. She also had a psychiatric
    admission for mania three years prior to the delivery of her child, after a flight from Asia to Europe.
    Following treatment with antipsychotic medication, she became depressed for several months.
    Although a diagnosis of bipolar disorder was discussed at this time, she was reluctant to accept this
    label, attributing the episode to stress and jet lag. She had discontinued the psychiatric medication in
    anticipation of getting pregnant.

    Ms. Norman’s own mother had been admitted to a psychiatric hospital shortly after the birth of her first
    child. This episode was not talked about in the family, and there were few other details. She had no
    other family history of note.

    Until just before delivery of her child, Ms. Norman had been a highly functional nurse in a renal unit. Her
    husband was the head of a sales team, and they lived in comfortable social circumstances. She had no
    history of illicit drug use, and, prior to pregnancy, drank only 2 or 3 classes of alcohol a week.

    On mental status examination, Ms. Norman wandered around the room, seemingly unable to sit for
    more than a few moments. She was distractible and overtalkative, and demonstrated flight of ideas,
    flitting from one subject to another. Her mood was labile. At times she appeared happily euphoric. At
    other times she was tearful, and she could become quickly irritable when she felt she was not being
    understood. It was clear that she had a number of delusional beliefs but was unwilling to discuss most of
    them with the examiner. She did insist that she had already killed her own child, which led to several
    minutes of tears, but she returned to an edgy euphoria within a few minutes. She denied intent to harm
    herself or anyone else. She appeared inattentive, with poor concentration, but would not participate in
    formal cognitive testing.

    Physical examination and laboratory testing results were all within normal limits.

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