SYNOPSIS The Camberwell Psychiatric Register was searched for contacts by the 2257 women resident in the register catchment area who were known to have had a child in 1970. Of these, 99 women (and 39 of their husbands) were found to have had a 'new episode' of psychiatric illness in the two years before or the two years after the birth of their child. The distribution of these 'new episodes'relative to the time of childbirth was then studied. In the women, both functional psychoses and depressive illnesses showed a sharp rise in the new episode rate in the three months immediately after delivery. There was also a suggestion of a secondary rise, less dramatic but more sustained, from the 10th to the 24th month after delivery. There was no comparable rise in the husbands. Women whose children were illegitimate had high new episode rates throughout the four-year study period, but not particularly so in the puerperium itself.At one time puerperal psychosis was believed to be a distinct condition with a symptomatology, psychopathology and prognosis different from those of other psychoses. The failure to find any sexual differences between women with puerperal psychoses and other psychotic women (Anderson, 1933) and the demonstration that both the clinical features and the prognosis of puerperal illnesses were much the same as those of other functional psychoses (Strecker & Ebaugh, 1926;Vislie, 1956;Foundeur et al, 1957) discredited this belief. As a result, interest in the concept waned, and contemporary glossaries discourage use of the term (American Psychiatric Association, 1968;General Register Office, 1968). Nonetheless, there is good evidence that childbirth is followed by a sharp rise in the incidence of functional psychoses. Pugh et al. (1963), for example, studied admissions of women of childbearing age to public mental hospitals in Massachusetts, and found that, although the admission rate was below expectation throughout pregnancy, it rose to several times the expected rate in the first three months after delivery. As this rise was too large to be
SynopsisAll patients with anorexia nervosa were extracted from three psychiatric case registers— North-East Scotland, Camberwell, and Monroe County. The average incidence varied from 0·37 per 100,000 population per year in Monroe County to 1·6 per 100,000 in North-East Scotland, in all three areas the number of cases reported per year was increasing, and in Camberwell, but not in Monroe County or North-East Scotland, there was a significant excess of patients from middle-class backgrounds.
SYNOPSISA cohort of patients from Camberwell, who had been in psychiatric hospital for one year or more on 31 December 1964, is described. The attrition rate for this group, and the accumulation of ‘new’ long-stay patients from the area since that date, are analysed, and compared with published data from other studies. In the light of the resulting overall decrease in the long-stay population with time, possible trends in the future can be considered.
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