Marneros (Reference Marneros2006) addresses an important issue in his editorial on the concept of acute and transient psychosis, which is a challenge to the Kraepelinian dichotomy. He argues that acute and transient psychoses are separate from schizophrenia, schizoaffective disorder or affective disorder, based on the clinical manifestations, but he did not mention puerperal or post-partum psychosis, which also lacks a consensus of definition (Reference KohlKohl, 2004). Post-partum psychosis has been described as functional psychosis with good prognosis and clinical presentation similar to acute and transient psychosis (Reference Kendell, Chalmers and PlatzKendell et al, 1987). Despite a varying symptomatology, women with schizophrenia rarely experience arousal of their symptoms after childbirth (Reference Meltzer and KumarMeltzer & Kumar, 1985). Puerperal psychosis appears to occupy a clinical position which is different from schizophrenia and affective disorder.

It is of interest that acute and transient psychosis mainly affects females (Reference MarnerosMarneros, 2006), and suggests a link between puerperal psychosis and acute and transient psychosis. I therefore suggest that the concept of puerperal psychosis should be included in discussions of the concept of acute and transient psychosis.