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

Published online by Cambridge University Press:  29 January 2018

E. S. Meitzer  and
R. Kumar
E. S. Meitzer
Affiliation:
Warley Hospital, Brentwood, Essex (formerly Senior Registrar, Bethlem Royal and Maudsley Hospitals)
R. Kumar*
Affiliation:
Institute of Psychiatry, De Crespigny Park, London SE5 8AF, and Honorary Consultant Psychiatrist, Bethlem Royal and Maudsley Hospitals
*
∗Correspondence
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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.

Type
Papers
Information
The British Journal of Psychiatry , Volume 147 , Issue 6 , December 1985 , pp. 647 - 654
Copyright
Copyright © 1985 The Royal College of Psychiatrists 

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References

Brockington, I. F., Cernik, K. F., Schofield, E. M., Downing, A. R., Francis, A. F. & Keelan, C. (1981) Puerperal psychosis. Archives of General Psychiatry, 38, 829–833.Google Scholar
Brockington, I. F., Winokur, G. & Dean, C. (1982) Puerperal psychosis. In Motherhood and Mental Illness (eds. Brockington, I. F. & Kumar, R.). London: Academic Press.Google Scholar
Cox, J. L., Connor, Y. & Kendell, R. E. (1982) Prospective study of the psychiatric disorders of childbirth. British Journal of Psychiatry, 140, 111–117.CrossRefGoogle ScholarPubMed
Da Silva, L. & Johnstone, E. C. (1981) A follow-up study of severe puerperal psychiatric illness. British Journal of Psychiatry, 139, 346–354.Google Scholar
Dean, C. & Kendell, R. E. (1981) The symptomatology of puerperal illnesses. British Journal of Psychiatry, 139, 128–133.CrossRefGoogle ScholarPubMed
Granville-Grossman, K. (1971) Psychiatric aspects of pregnancy and the Puerperium. In Recent Advances in Clinical Psychiatry (ed. Granville-Grossman, K.). London: Churchill.Google Scholar
Grundy, P. F. & Roberts, C. J. (1975) Observation on the epidemiology of post partum mental illness. Psychological Medicine, 5, 286–290.Google Scholar
Hamilton, J. A. (1962) Postpartum Psychiatric Problems. St Louis: Mosby.Google Scholar
Hamilton, J. A. (1982) The identity of postpartum psychosis. In Motherhood and Mental Illness (eds. Brockington, I. F. & Kumar, R.). London: Academic Press.Google Scholar
Hays, P. & Douglass, A. (1984) A comparison of puerperal psychosis and the schizophreniform variant of manic depression. Acta Psychiatrica Scandinavica, 69, 177–181.Google Scholar
Kadrmas, A., Wlnokur, G. & Crowe, R. (1980) Postpartum mania. British Journal of Psychiatry, 135, 551–554.Google Scholar
Katona, C. L. E. (1982) Puerperal mental illness: comparisons with non-puerperal controls. British Journal of Psychiatry, 141, 447–452.CrossRefGoogle ScholarPubMed
Kendell, R. E., Wainwright, S., Hailey, A. & Shannon, B. (1976) The influence of childbirth on psychiatric morbidity. Psychological Medicine, 6, 297–302.Google Scholar
Kendell, R. E., Rennie, D., Clarke, J. A. & Dean, C. (1981a) The social and obstetric correlates of psychiatric admission in the Puerperium. Psychological Medicine, 11, 341–350.Google Scholar
Kendell, R. E., Mcguire, R. J., Connor, Y. & Cox, J. L. (1981b) Mood changes in the first three weeks after childbirth. Journal of Affective Disorders, 3, 317–326.CrossRefGoogle ScholarPubMed
Kumar, R. (1982) Neurotic disorders in childbearing women. In Motherhood and Mental Illness (eds. Brockington, I. F. & Kumar, R.). London: Academic Press.Google Scholar
Kumar, R. & Robson, K. M. (1984) A prospective study of emotional disorders in childbearing women. British Journal of Psychiatry, 144, 35–47.Google Scholar
Kumar, R., Meltzer, E. S., Hepplewhite, R. & Stevensen, A. D. (1985) ‘Mother and Baby’ admissions to psychiatric hospitals in the South East Thames Region: a survey of facilities. (Submitted for publication).Google Scholar
Margison, F. & Brockington, I. F. (1982) Psychiatric mother and baby units. In Motherhood and Mental Illness (eds. Brockington, I. F. & Kumar, R.). London: Academic Press.Google Scholar
Paffenbarger, R. S. JR. (1964) Epidemiological aspects of postpartum mental illness. British Journal of Preventive and Social Medicine, 18, 189–195.Google Scholar
Paykel, E. S., Emms, E. M., Fletcher, J. & Rassaby, E. S. (1980) Life events and social support in puerperal depression. British Journal of Psychiatry, 136, 339–346.CrossRefGoogle ScholarPubMed
Pitt, B. (1968) Atypical depression following childbirth. British Journal of Psychiatry, 114, 1325–1335.Google Scholar
Protheroe, C. (1969) Puerperal psychoses: a long term study 1927–1961. British Journal of Psychiatry, 115, 9–30.Google Scholar
Pugh, T. F., Jerath, B. K., Schmidt, W. M. & Reed, R. B. (1963) Rates of mental disease related to childbearing. New England Journal of Medicine, 268, 1224–1228.Google Scholar
Seager, C. P. (1960) A controlled study of post-partum illness. Journal of Mental Science, 106, 214–230.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry, 35, 773–782.Google Scholar
Stein, G. (1982) The maternity blues. In Motherhood and Mental Illness (eds. Brockington, I. F. & Kumar, R.). London: Academic Press.Google Scholar
Thuwe, I. (1974) Genetic factors in puerperal psychosis. British Journal of Psychiatry, 125, 378–385.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. London: Cambridge University Press.Google Scholar
World Health Organisation (1978) Mental disorders: glossary and guide to their classification in accordance with the Ninth Revision of the International Classification of Diseases. Geneva: World Health Organisation.Google Scholar
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