A comparison of puerperal psychosis and the schizophreniform variant of manic‐depression

Abstract

The authors review the evidence indicating that puerperal psychosis is a nosological entity. The psychosis most closely resembling puerperal psychosis is the schizophreniform variant of manic-depression, and the authors propose that if marked differences can be found between that state and puerperal psychosis, then the finding will tend to confirm the separateness of puerperal psychosis. They compare two such sets of patients, and conclude that the claim of puerperal psychosis to the status of a nosological entity is further supported.

Long-term outcome of severe puerperal psychiatric illness: a 23 year follow-up study

“…In addition to describing outcome, risk and predictors, follow-up studies, by considering nature of recurrences, can also answer questions as to nosology. Some authors have regarded severe puerperal illnesses as distinct nosological entities (Hamilton, 1962 ;Hays & Douglas, 1984 ;Hays, 1978), while others have considered them as episodes of affective or schizophrenic psychoses, occurring coincidentally in the puerperium or precipitated by it (Platz & Kendell, 1988).…”

The clinical features of postpartum psychoses

“…In addition to this attitude the repudiation of etiological diagnoses and an alleged lack of specific clinical features contributed to the removal of postpartum psychosis from modern classificatory systems. The opinion that postpartum psychosis lacks specific clinical features has been challenged by a number of authors (Hamilton, 1962;Hays and Douglas, 1984;Munoz, 1985;Klompenhouwer and Hulst, 1991). They especially point to the fact that confusional symptoms (disorientation, confusion and perplexity) and the changeability of the picture are not adequately described by the usual nosological categories (Hamilton, 1962;Klompenhouwer and Hulst, 1991;Melges, 1968).…”

A Matched-control Follow-up and Family Study of ‘Puerperal Psychoses’

“…It is also generally agreed that women with puerperal psychoses frequently have other episodes of illness unrelated to childbirth both before and after their puerperal illness, and that the psychiatric morbidity of their close relatives is increased as well. Even so, it is still possible to maintain, and indeed is maintained (Hamilton, 1982;Hays & Douglass, 1984), that puerperal psychoses differ in both their aetiology and their prognosis from other functional psychoses. Part of the reason the issue has not been resolved is that, although many investigators have studied the subsequent careers of women with puerperal psychoses, most have not had a control group of women with non-puerperal psychoses to compare them with.…”