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Is puerperal psychosis the same as bipolar manic-depressive disorder? A family study

Published online by Cambridge University Press:  09 July 2009

C. Dean ,
R. J. Williams  and
I. F. Brockington
C. Dean*
Affiliation:
Department of Psychiatry, University of Manchester
R. J. Williams
Affiliation:
Department of Psychiatry, University of Manchester
I. F. Brockington
Affiliation:
Department of Psychiatry, University of Manchester
*
1Address for correspondence: Dr C. Dean, Department of Psychiatry, Queen Elizabeth Hospital, Birmingham B15 2TH.
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Synopsis

The first degree relatives of three groups of women were interviewed; 51 women who had had an illness within two weeks of childbirth and no non-puerperal episodes (the puerperal group), 33 who had puerperal and non-puerperal episodes (the mixed group), and 19 women with bipolar manic-depressive disorder who had non-puerperal episodes only (the manic-depressive group).

Over 60% of the affected relatives in all three groups had affective illnesses; in the main these were not puerperal. There were significantly more first degree relatives who had had general practitioner or hospital treatment for psychiatric illness in the puerperal group and in the mixed group than in the manic-depressive group. The puerperal patients had a better prognosis in terms of their illness (number of relapses and time on medication), work functioning and social functioning than the manic-depressive group and the mixed group. The mixed group had an earlier age of onset than the manic-depressive group and the puerperal group. The hypothesis that puerperal psychosis is the same as bipolar manic-depressive disorder was not upheld. The mixed group and the puerperal group were similar with respect to the risk in first degree relatives but differed in terms of prognosis.

There were no significant differences between the groups with respect to puerperal episodes in first-degree relatives, although the rate of puerperal psychosis in the first-degree relatives of the puerperal patients was significantly greater than in the general population. The hypothesis that there is a specific genetically determined puerperal psychosis was not supported. Women who had had an illness with an onset within two weeks of childbirth (mixed and puerperal) subsequently had an illness following 36% of their childbirths. In women who had had puerperal and non-puerperal episodes (mixed) the risk was higher; over 50 % of deliveries in these women were followed by psychiatric illness.

Type
Original Articles
Information
Psychological Medicine , Volume 19 , Issue 3 , August 1989 , pp. 637 - 647
Copyright
Copyright © Cambridge University Press 1989

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