Puerperal Mental Illness, Clinical Features and Classification: A Study of 142 Mother-and-Baby Admissions

Abstract

The case notes were studied of 142 mothers admitted to psychiatric hospitals in the south-east Thames region within 12 months of childbirth during the years 1979 and 1980. Only 6% of the sample were categorised as schizophrenics by RDC criteria, whereas affective disorders were found to predominate in 80%. Manic and schizo-affective illnesses almost always began within two weeks of parturition, as did psychotic depressions. A third of the patient sample had suffered relatively minor disorders, and given adequate resources, some might have been better managed in the community. A parallel investigation of diagnostic returns to the Department of Health revealed considerable uncertainty about how to classify puerperal mental illnesses in accordance with ICD-9. There is an urgent need to improve the system for categorising and registering mental illnesses related to childbirth. Until this is achieved, research into aetiology, outcome, and the provision of services will continue to be impeded.

Parapartum Mental Illness: A Long-Term Follow-Up Study

“…This finding was also in line with the study by Meltzer and Kumar [16]. It has already been reported in earlier prospective studies [21][22][23] and in a recent Swedish community-based study [Bågedahl-Strindlund and Monsen Börjesson, unpubl.…”

“…In agreement with Meltzer and Kumar's [16] study, presenting in-patients with puerperal mental illness in England, we found that women with schizophrenic symptoms remained the longest time in hospital at index admission.…”

“…British studies using RDC criteria indicate that approximately 75-80% of the patients hospitalised for postpartum mental illness meet the criteria for affective or schizo-affective disorders [16][17][18]. In our study, only 44% of the patients could possibly be regarded as affective at index admission (schizo-affective disorders and generalised anxiety disorder added).…”

Motherhood, Mental Illness and Recovery

“…The illnesses that can manifest with psychosis in the postpartum period include major depression with psychotic features, bipolar I, bipolar II, schizoaffective, unspecified functional psychosis, and brief psychotic disorder. Studies since the 1980s have linked the occurrence of postpartum psychosis to underlying bipolar disorder diagnosis in over 80 % of patients (Meltzer and Kumar 1985;Kendell et al 1987;Brockington et al 1981). Bipolar disorder is widely accepted as the illness underlying most cases of postpartum psychosis.…”

Wochenbettpsychosen – klinische, neurobiologische und psychosoziale Aspekte

“…zykloides Symptombild, während Frauen mit einem späteren Krankheitsbeginn häufiger paranoid sind [20]. Eine Betrachtung der "Postpartumpsychosen" unter dem Konzept der Kraepelinschen Dichotomie schizophrener vs. affektiver Psychosen spricht stark für eine überwiegend affektive Natur dieser Psychosen [21,11,12,[22][23][24][25]. Das syndromale Gepräge speziell der früh sich manifestierenden Postpartumpsychosen legt eine Verbindung zum Konzept der zykloiden Psychose nahe [26,27].…”