Postpartum Psychoses in Patients With Manic Depressive Disease

From a consecutive series of 61 manic depressive patients a group of 20 bipolar manic depressive mothers and 29 female first degree relatives who had children and an episodic affective disorder were examined with respect to their postpartum state. The frequency of postpartum breakdowns was significantly greater than the frequency of nonpuerperal episodes during the period at risk of 15 to 80 years and during the childbearing years. Postpartum episodes followed 30 per cent of births of the patient group and 20 per cent of the births of the family group. Forty per cent of the patients with children and 41 per cent of the family members with children and affective disorder had a postpartum episode. These rates are much higher than population rates. After the first episode of manic depressive illness, the rates for postpartum illness were 50 per cent in the patient group and 25 per cent in the family group, suggesting that careful observation and early treatment is indicated. Eighty-three per cent of the postpartum episodes occurred during the 2 months following parturition and the symptoms during these episodes were similar to nonpuerperal manias and depressions.