Infanticide by a mother with untreated schizophrenia

A systematic review of postpartum psychosis resulting in infanticide: missed opportunities in screening, diagnosis, and treatment

PURPOSE

Impacting 1 in 1000 women, untreated postpartum psychosis is associated with a 4% infanticide rate. This systematic review aims to identify factors that are associated with infanticide resulting from psychosis in the puerperal period and pinpoint areas of missed opportunity for intervention.

METHODS

A systematic literature review was conducted in accordance with PRISMA guidelines to identify and synthesize cases of maternal infanticide among perinatal females with evidence of postpartum psychosis. Four independent reviewers screened 231 articles identified in searches of three databases (PsycInfo, PubMed, and Web of Science) for studies conducted from 2013 to 2023.

RESULTS

Twelve studies were included in the final review. Findings indicate that those experiencing puerperal psychosis have increased incidence of infanticide suggesting missed opportunities for intervention and treatment. Common factors in mothers who committed infanticide as a result of delusions and/or hallucinations associated with PMADs were identified, including lack of standardized screening tools, preference for traditional and/or cultural healing practices, and access to care.

CONCLUSION

The current body of evidence supports developing and evaluating clinical interventions aimed at improving maternal mental health outcomes and infant outcomes in perinatal women experiencing puerperal psychosis.

Centrality of Religiosity, Schizotypy, and Human Values: The Impact of Religious Affiliation

Previous research has established a reliable link between religiosity and schizotypy as well as schizophrenia. However, past research mainly measured religiosity as a one-dimensional construct. In the present research (N = 189), we aimed to get a better understanding of the religiosity–schizotypy link by measuring religiosity using Huber’s five-dimensional model of Centrality of Religiosity, while also testing for curvilinear relations and potential moderators. We found negative small-to-medium-sized correlations between all five dimensions of religiosity and the schizotypy dimension of impulsive nonconformity, but no reliable associations with the other three dimensions of schizotypy: unusual experiences, cognitive disorganization, and introverted anhedonia. Some of these associations were moderated by religious affiliation: Religiosity and schizotypy correlated positively among non-members, but negatively among members of religious communities, suggesting that affiliation has a positive impact on the well-being of religious people. In line with Huber’s predictions, we found a reversed U-shape association between the religious dimension of private religious practice and schizotypy. Unexpectedly, however, conformity and tradition values did not moderate the relations between religiosity and schizotypy. We discuss our findings in terms of person–environment fit, the prevention hypothesis of the schizotypy-religiosity link, and offer implications for mental health practitioners.

A case of suspected illegal abortion: how clinicians may assist the forensic pathologist

Abortion may be performed in a safe or unsafe manner, the latter being a frequent and dangerous event. It can also be performed in countries where abortion is legally recognised but, for various reasons, may be undertaken in an illegal environment. We present a case of a possible illegal abortion. A woman presented to the hospital with a dead fetus, saying that she was the victim of a car accident. Forensic and gynaecological examination of the woman were carried out, along with an autopsy of the fetus. It was discovered that the woman had performed a clandestine abortion. The differential diagnosis between illegal abortion and miscarriage represents a complicated issue and requires both clinical and forensic support. The gynaecologist may be of assistance to the forensic pathologist in confirming whether an illegal abortion has been performed.