ABSTRACT
Puerperal psychosis is the most severe and, fortunately, the most rare form of postnatal psychiatric disorder, occurring in approximately one in 500 newly delivered mothers. The onset is usually early, commonly within the first two weeks after delivery, and almost always during the first month postpartum. Opinion is divided about the classification of the illness, probably because sufferers are not a homogeneous group, and because research workers have imposed their own diagnostic 'set' on an illness which is characteristically mixed in symptomatology. Puerperal psychosis would seem to be an ideal condition for research in that vulnerable individuals can be identified, and the time of onset of the illness predicted with some accuracy, so that prospective studies of hormonal and biochemical change can be carried out. Treatment has to be symptomatic, and constantly has to weigh the benefits of medication against the risks to the baby of psychotropic drugs in breast milk.
