Puerperal psychosis: Vulnerability and aftermath

SUMMARY

The puerperium is a particularly vulnerable time for a depressive psychotic breakdown, with important consequences for both mother and child. While general psychiatric experience helps in the overall management, psychoanalytic insights help towards understanding the central psychopathology. Illustrative case-studies are presented.

Based on hospital admission rates, puerperal psychosis is regarded as a rare condition (one in 500 deliveries). In this paper, evidence is given to suggest that puerperal psychosis is a far commoner condition (three in 100 deliveries), and that many less-severe cases remain undetected and untreated in the community. It is argued that understanding interventions in these cases can be therapeutic for the mother, as well as having major implications for the baby's development.