The clinical picture of the depressed form of puerperal psychosis.
The clinical features of 104 patients admitted to a mother and baby unit over a 5-year period with RDC diagnoses of depression or schizoaffective depression were studied by self-ratings, measurements of non-verbal behaviour from standardised videotaped interviews, and observer ratings based on multiple information sources. The hypothesis was tested that they included a large subset which represented the depressed form of a bipolar puerperal psychosis. It was deduced that these illnesses would start early in the puerperium, and would have some specific clinical features. A comparison of patients with onset of depression within 2 weeks of delivery with those with onset during pregnancy or much later in the postnatal period showed a number of significant differences. A discriminant function analysis using serial reclassification of atypical patients refined the early-onset group by the exclusion of about one third of the patients who had an atypical clinical picture; the patients who remained, who are considered to represent the depressed form of puerperal psychosis, showed less anger, less self-rated emotion and more animation than the other depressed patients.
Brockington
I F
IF
Birmingham University Department of Psychiatry, Queen Elizabeth Hospital, U.K.
Margison
F R
FR
Schofield
E
E
Knight
R J
RJ
D000786:Anger; D003866:Depressive Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D009043:Motor Activity; D011247:Pregnancy; D011618:Psychotic Disorders / Q000523:psychology; D011644:Puerperal Disorders / Q000523:psychology*; D013997:Time Factors