Informing psychological intervention development for postpartum psychosis: A systematic review and delphi study

Palmer, Bethany Jade (2026) Informing psychological intervention development for postpartum psychosis: A systematic review and delphi study. Doctoral thesis, University of East Anglia.

Preview

PDF Download (3MB) | Preview

Abstract

Background: Postpartum Psychosis is a severe mental health disorder featuring delusions, hallucinations and other cognitive symptoms (Friedman et al, 2023). Qualitative research suggests that difficulties continue after the resolution of acute psychotic symptoms, however there are currently no evidence-based psychological interventions specifically targeting recovery after postpartum psychosis. There are interventions for both psychosis and other mental health disorders in the perinatal context. Although these may be helpful, they were not all designed for the perinatal context. Therefore, adaption of existing interventions to the context of recovery after postpartum psychosis should be considered further.

Aims: This thesis portfolio aims to start the process of complex intervention development following the ADAPT framework (Moore et al., 2021). Firstly, the systematic review will identify difficulties that individuals have after an episode of postpartum psychosis. Then, evidence-based intervention components will be considered in relation to these difficulties, understanding which components should be included in an intervention to improve recovery after postpartum psychosis.

Methods: A summative content analysis of the literature base determined the psychological difficulties endured after an episode of postpartum psychosis. These difficulties were then used to research psychological treatment components. Expert professionals and experts by experience were asked to rate these components for importance using a two round delphi survey to determine consensus.

Results: The systematic review revealed 46 psychological difficulties occurring after an episode of postpartum psychosis, termed psychological treatment targets. A patient and public involvement group (PPI) identified 15 treatment targets deemed most important to consider within psychological intervention of these difficulties. These include anxiety, relationship with baby and harm to self. These difficulties/targets were researched and broken down into treatment components and presented during the delphi survey. This found there was consensus on psychological treatment components important to consider within an intervention after postpartum psychosis. Mutually agreed upon items can be considered to fit within seven broad categories including psychoeducation, coping strategies and understanding thoughts and worries.

Conclusions: In relation to complex intervention development, the current portfolio has determined there is a rationale for psychological intervention after postpartum psychosis and that existing interventions could be adapted to this context. Possible psychological treatment components have also been identified. Future research should consider further steps of the ADAPT framework to begin adapting existing interventions to fit the context of postpartum psychosis.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Chris White
Date Deposited:	09 Nov 2026 14:05
Last Modified:	09 Nov 2026 14:05
URI:	https://ueaeprints.uea.ac.uk/id/eprint/105025
DOI:

Downloads

Actions (login required)

View Item